Ukutyeba kakhulu

Umxholo

• Yintoni ukutyeba kakhulu?
• Ukwahlula njani ukutyeba?
• Yintoni ukutyeba kakhulu ebuntwaneni?
• Yintoni ebangela ukutyeba?
• Ngubani osemngciphekweni wokutyeba kakhulu?
• Imfuza
• Indalo esingqongileyo kunye noluntu
• Ingqondo kunye nezinye izinto
• Kufunyaniswa njani ukutyeba kakhulu?
• Zeziphi iingxaki zokutyeba kakhulu?
• Uphathwa njani ukutyeba kakhulu?
• Yeyiphi indlela yokuphila kunye notshintsho kwindlela yokuziphatha enokunceda ukunciphisa umzimba?
• Ngawaphi amayeza amiselweyo ukunciphisa umzimba?
• Zithini iindidi zotyando lokunciphisa umzimba?
• Abagqirha botyando
• Unokuthintela njani ukutyeba kakhulu?

Yintoni ukutyeba kakhulu?

Isalathiso sobunzima bomzimba (i-BMI) lubalo oluthatha ubunzima bomntu kunye nokuphakama kwakhe ekulinganiseni ubungakanani bomzimba.

Kubantu abadala, ukutyeba kakhulu kuchazwa njengokuba ne-BMI, ngokweZiko loLawulo lweNtsholongwane kunye noThintelo (CDC).

Ukutyeba kakhulu kunxulunyaniswa nomngcipheko ophezulu wezifo ezinzulu, ezinje ngohlobo lweswekile 2, isifo sentliziyo, kunye nomhlaza.

Ukutyeba kuqhelekile. I-CDC iqikelela ukuba abantu baseMelika abaneminyaka engama-20 ubudala nangaphezulu babetyebe kakhulu ngo-2017 ukuya ku-2018.

Kodwa i-BMI ayisiyiyo yonke into. Inemida ethile njengeetriki.

Ngokwe: “Izinto ezinje ngobudala, isini, ubuhlanga, kunye nobunzima bemisipha bunokuchaphazela ubudlelwane phakathi kwe-BMI kunye namafutha omzimba. Kwakhona, i-BMI ayenzi mahluko phakathi kwamafutha, izihlunu, okanye ubukhulu bamathambo, kwaye ayibonisi naluphi na ulwabiwo lwamafutha phakathi kwabantu. ”

Ngaphandle kwale miqobo, i-BMI iyaqhubeka nokusetyenziswa ngokubanzi njengendlela yokulinganisa ubungakanani bomzimba.

Ukwahlula njani ukutyeba?

Oku kulandelayo kusetyenziselwa abantu abadala abaneminyaka engama-20 ubuncinci:

Yintoni ukutyeba kakhulu ebuntwaneni?

Ukuba ugqirha axilonge umntwana ongaphezulu kweminyaka emi-2 ubudala okanye okwishumi elivisayo onokutyeba kakhulu, i-BMI yabo kufuneka ibe kubantu abakubudala obulinganayo kunye nesini sendalo:

Ukusuka kwi-2015 ukuya kwi-2016, (okanye malunga ne-13.7 yezigidi) ulutsha lwaseMelika phakathi kweminyaka emi-2 ukuya kweli-19 ubudala yathathelwa ingqalelo yokuba nokukhuluphala ngokwezonyango.

Yintoni ebangela ukutyeba?

Ukutya iikhalori ezingaphezulu kokutshisa kwimisebenzi yemihla ngemihla kunye nokuzilolonga- ixesha elide- kunokukhokelela ekutyebeni kakhulu. Ixesha elingaphezulu, ezi khalori zongezelelweyo zongeza kwaye zibangela ukutyeba.

Kodwa ayisoloko i malunga neekhalori ngaphakathi kunye neekhalori ngaphandle, okanye ukuhlala ngendlela ehleliyo. Ngelixa ezo zizinto ezibangela ukutyeba, ezinye izizathu awunakukwazi ukuzilawula.

Izizathu eziqhelekileyo zokutyeba zibandakanya:

• yemfuza, enokuthi ichaphazele indlela umzimba wakho oqhuba ngayo ukutya kumandla kunye nendlela agcinwa ngayo amanqatha
• ukukhula ngokudala, oku kunokukhokelela ekunciphiseni ubunzima besisipha kunye nesantya sokunciphisa umzimba, okwenza kube lula ukufumana ubunzima
• ukungalali ngokwaneleyo, nto leyo enokukhokelela kutshintsho lwehomoni ekwenza uzive ulambile kwaye unqwenele ukutya okuneekhalori eziphezulu
• ukukhulelwa, njengoko ubunzima obufunyenwe ngexesha lokukhulelwa kunokuba nzima ukuphulukana nabo kwaye ekugqibeleni kungakhokelela ekutyebeni kakhulu

Iimeko ezithile zempilo zinokukhokelela ekuzuzeni ubunzima, ezinokubangela ukutyeba kakhulu. Oku kubandakanya:

• i-polycystic ovary syndrome (i-PCOS), imeko ebangela ukungalingani kwamahomoni okuzala kwabasetyhini
• I-Prader-Willi syndrome, imeko enqabileyo ekhoyo ekuzalweni ebangela indlala egqithileyo
• I-Cushing syndrome, imeko ebangelwa kukufumana amanqanaba aphezulu e-cortisol (ihormon yoxinzelelo) kwinkqubo yakho
• i-hypothyroidism (i-thyroid engasebenzi), imeko apho i-thyroid gland ingavelisi ngokwaneleyo iihomoni ezithile ezibalulekileyo
• i-osteoarthritis (OA) kunye nezinye iimeko ezibangela iintlungu ezinokukhokelela kunciphiso lomsebenzi

Ngubani osemngciphekweni wokutyeba kakhulu?

Umxube odibeneyo wezinto unokunyusa umngcipheko womntu wokutyeba kakhulu.

Imfuza

Abanye abantu baneejini ezenza kube nzima kubo ukwehla emzimbeni.

Indalo esingqongileyo kunye noluntu

Imeko-bume yakho ekhaya, esikolweni, nasekuhlaleni ungasichaphazela njani nokuba utya ntoni, kwaye ukhuthele kangakanani.

Unokuba semngciphekweni omkhulu wokutyeba kakhulu ukuba:

• hlala kubumelwane obunokutya okunempilo okulinganiselweyo okanye ukutya okunekhalori eziphezulu, njengokutya okukhawulezayo
• khange ufunde ukupheka ukutya okusempilweni
• sukucinga ukuba unokukwazi ukuthenga ukutya okusempilweni
• indawo efanelekileyo yokudlala, ukuhamba, okanye ukwenza umthambo kwindawo ohlala kuyo

Ingqondo kunye nezinye izinto

Ukudakumba ngamanye amaxesha kungakhokelela ekuzuzeni ubunzima, njengoko abanye abantu besenokujika batye ukutya okuthuthuzela imvakalelo. Ezinye izidambisi zengqondo zinokunyusa umngcipheko wokufumana ubunzima.

Ukuyeka ukutshaya kuhlala kuyinto elungileyo, kodwa ukuyeka kunokukhokelela ekuzuzeni ubunzima. Kwabanye abantu, kunokukhokelela ekuzuzeni ubunzima. Ngenxa yeso sizathu, kubalulekile ukuba ugxile kukutya kunye nokuzilolonga ngelixa uyeka, ubuncinci emva kwexesha lokuqala lokurhoxa.

Amayeza, anje ngee-steroids okanye iipilisi zokulawula ukuzalwa, anokuphakamisa umngcipheko wokufumana ubunzima.

Kufunyaniswa njani ukutyeba kakhulu?

I-BMI bubalo oburhabaxa bobunzima bomntu ngokunxulumene nokuphakama kwabo.

Amanye amanyathelo achanekileyo okuhambisa amanqatha kunye nokusasazeka kwamafutha emzimbeni kubandakanya:

• Uvavanyo lokuqina kwesikhumba
• ukuthelekisa okhalweni ukuya esinqeni
• iimvavanyo zokuhlola, ezinje nge-ultrasound, iskena se-CT, kunye nokuvavanywa kweMRI

Ugqirha wakho unokuyalela iimvavanyo ezithile ukunceda ekuchongeni ingozi enxulumene nokutyeba. Oku kunokubandakanya:

• iimvavanyo zegazi zokuvavanya amanqanaba e-cholesterol kunye neglucose
• Uvavanyo lomsebenzi wesibindi
• ukuhlolwa kweswekile
• iimvavanyo zedlala lengqula
• iimvavanyo zentliziyo, ezinje nge-electrocardiogram (ECG okanye EKG)

Umlinganiso wamafutha ajikeleze esinqeni sakho ikwangumbono olungileyo womngcipheko wezifo ezinxulumene nokukhuluphala.

Zeziphi iingxaki zokutyeba kakhulu?

Ukutyeba kakhulu kunokukhokelela ekuzuzeni ubunzima obungaphezulu kokulula.

Ukuba nomlinganiselo ophezulu wamafutha omzimba kwimisipha kubeka uxinzelelo emathanjeni akho nakwizitho zakho zangaphakathi. Ikwonyusa nokudumba emzimbeni, ekucingelwa ukuba yeyona nto inobungozi kumhlaza. Ukutyeba kakhulu yeyona nto iphambili kuhlobo lwesifo seswekile.

Ukutyeba kakhulu kunxulunyaniswe nenani leengxaki zempilo, ezinye zazo ezinokuba sengozini yobomi ukuba azinyangwa:

• uhlobo lwe-2 yeswekile
• isifo sentliziyo
• igazi elonyukayo
• Umhlaza othile (ibele, ikholon, kunye ne-endometrium)
• ukubetha
• isifo senyongo
• isifo sesibindi esinamafutha
• cholesterol ephezulu
• ubuthongo bokulala kunye nezinye iingxaki zokuphefumla
• isifo samathambo
• ukungachumi

Uphathwa njani ukutyeba kakhulu?

Ukuba utyebe kakhulu kwaye awukwazanga ukunciphisa umzimba ngokwakho, uncedo lwezonyango luyafumaneka. Qala ngogqirha wakho wokunyamekela, onokukwazi ukukuthumela kwingcali yesisindo kwindawo yakho.

Ugqirha wakho unokufuna ukusebenza nawe njengenxalenye yeqela ekuncedeni ukunciphisa umzimba. Eli qela linokubandakanya i-dietitian, i-therapist, okanye abanye abasebenzi bezempilo.

Ugqirha wakho uya kusebenza nawe ekwenzeni utshintsho olufunekayo kwindlela yokuphila. Ngamanye amaxesha, banokucebisa amayeza okanye utyando lokulahleka kwesisindo ngokunjalo. Funda ngakumbi malunga nonyango lokutyeba kakhulu.

Yeyiphi indlela yokuphila kunye notshintsho kwindlela yokuziphatha enokunceda ukunciphisa umzimba?

Iqela lakho lokhathalelo lwempilo lingakufundisa ekukhetheni ukutya kwaye likuncede uphuhlise isicwangciso sokutya esifanelekileyo esikusebenzelayo.

Inkqubo yoqeqesho eyenziweyo kunye nokwanda kwemisebenzi yemihla ngemihla - ukuya kuthi ga kwimizuzu engama-300 ngeveki- kuya kunceda ukwakha amandla akho, unyamezelo, kunye nemetabolism.

Ukucebisa okanye amaqela enkxaso anokuchonga izinto ezingafunekiyo kwaye akuncede ujongane noxinzelelo, uxinzelelo, okanye imiba yokutya ngokweemvakalelo.

Indlela yokuphila kunye neenguqu zokuziphatha zezona ndlela zikhethiweyo zokunciphisa umzimba kubantwana, ngaphandle kokuba batyebe kakhulu.

Ngawaphi amayeza amiselweyo ukunciphisa umzimba?

Ugqirha wakho unokuyalela amayeza athile amayeza okunciphisa umzimba ukongeza kwisidlo nakwizicwangciso zokuzilolonga.

Amayeza ahlala emiselwe kuphela ukuba ezinye iindlela zokwehla kobunzima azisebenzi kwaye ukuba une-BMI engama-27.0 okanye nangaphezulu ukongeza kwimiba yezempilo enxulumene nokukhuluphala.

Amayeza amayeza okuphulukana nomzimba anokuthintela ukufunxwa kwamanqatha okanye ukucinezela ukutya. Oku kulandelayo kuvunyiwe ukuba kusetyenziswe ixesha elide (ubuncinci iiveki ezili-12) nguLawulo lokutya kunye noLawulo lweziyobisi (FDA):

• phentermine / topiramate (Qsymia)
• naltrexone / bupropion (Contra)
• iliraglutide (iSaxenda)
• orlistat (Alli, Xenical), ekuphela kwento evunyiweyo yi-FDA ukuba isetyenziswe kubantwana abaneminyaka eli-12 nangaphezulu

La machiza anokuba neziphumo ebezingalindelekanga ezingathandekiyo. Umzekelo, i-orlistat inokukhokelela ekuhambeni okunamafutha kunye nokuhamba rhoqo kwamathumbu, ukungxamiseka kwamathumbu kunye negesi.

Ugqirha wakho uya kukujonga ngokusondeleyo ngelixa uthatha la mayeza.

NgoFebruwari 2020, i-FDA yacela ukuba ilahleko yesisindo se-lorcaserin (Belviq) isuswe kwimarike yase-US. Oku kungenxa yenani elonyukayo lezehlo zomhlaza kubantu abathathe iBelviq ngokuthelekiswa ne-placebo.

Ukuba uthatha iBelviq, yeka ukuyithatha kwaye uthethe nomboneleli wakho wezempilo malunga nezinye iindlela zokulawula ubunzima.

Funda ngakumbi malunga nokurhoxa kwaye apha.

Zithini iindidi zotyando lokunciphisa umzimba?

Utyando lokulahleka kobunzima lubizwa ngokuba lunyango lwe-bariatric.

Olu hlobo loqhaqho lusebenza ngokunciphisa ukutya okunokutya ngokufanelekileyo okanye ngokuthintela umzimba wakho ekufuneni ukutya kunye neekhalori. Ngamanye amaxesha inokwenza zombini.

Utyando lokuphulukana nobunzima ayilungisi ngokukhawuleza. Utyando olukhulu kwaye lunokuba nobungozi obukhulu. Emva koko, abantu abaza kwenziwa utyando kuya kufuneka batshintshe indlela abatya ngayo kunye nokuba batya kangakanani, okanye basengozini yokugula.

Nangona kunjalo, ukhetho lwezonyango alusoloko lusebenza ekuncedeni abantu abanesisindo sokunciphisa umzimba kunye nokunciphisa umngcipheko we-comorbidities.

Iindidi zotyando lokulahleka kobunzima zibandakanya:

• Utyando olwenziwe ngendlela yesisu. Kule nkqubo, ugqirha wakho wotyando wenza isingxobo esincinci phezulu esiswini sakho esixhuma ngqo emathunjini akho amancinci. Ukutya kunye nolwelo kuhamba ngesikhwama ukuya emathunjini, kugqitha uninzi lwesisu. Kwakhona kwaziwa ngokuba yi-Roux-en-Y yokugaya isisu (RYGB).
• I-Laparoscopic ehlengahlengiswayo yokubopha isisu (LAGB). I-LAGB yahlulahlula isisu sakho sibe ziipakethi ezimbini usebenzisa ibhendi.
• Utyando lwemikhono esiswini. Le nkqubo isusa inxenye yesisu sakho.
• Ukuphambukiswa kwe-Biliopancreatic nge-duodenal switch. Le nkqubo isusa uninzi lwesisu sakho.

Abagqirha botyando

Kumashumi eminyaka, iingcali ziye zacebisa ukuba abantu abadala abavavanywa ukuthoba umzimba babe ne-BMI ubuncinci eyi-35.0 (iiklasi 2 kunye ne-3).

Nangona kunjalo, kwizikhokelo ze-2018, uMbutho waseMelika woNyango lweMetabolic kunye neBariatric (ASMBS) waxhasa utyando lokulahleka kwesisindo kubantu abadala abane-BMIs ezingama-30.0 ukuya kuthi ga kwi-35.0 (iklasi 1):

• ziye zadibana nokudibana, ngakumbi udidi lwesibini lweswekile
• khange babone ziphumo zizinzileyo kunyango lwezonyango, njengokutya kunye nokulungiswa kwendlela yokuphila

Kubantu abakudidi loku-1 lokutyeba kakhulu, utyando lusebenza kakhulu kwabo baphakathi kweminyaka eli-18 ukuya kwengama-65 ubudala.

Abantu baya kuhlala belahleka ngaphambi kokuba benziwe utyando. Ukongeza, baya kuthi badla ngokufumana iingcebiso ukuqinisekisa ukuba bobabini bakulungele ngokwasemoyeni ukwenza utyando kwaye bazimisele ukwenza utshintsho olufunekayo kwindlela yokuphila eya kuyidinga.

Ngamaziko ambalwa kuphela eUnited States enza ezi ntlobo zeenkqubo kubantwana abangaphantsi kweminyaka eli-18 ubudala.

Unokuthintela njani ukutyeba kakhulu?

Kubekho ukonyuka okumandla ekutyebeni kakhulu nakwizifo ezinxulumene nokutyeba kakhulu kule minyaka ingamashumi idlulileyo. Esi sizathu sokuba uluntu, ithi, kunye norhulumente wobumbano babeka ugxininiso kukhetho lokutya okunempilo kunye nemisebenzi yokunceda ukujika ithende ekutyebeni kakhulu.

Kwinqanaba lomntu, unokunceda ukuthintela ukuzuza komzimba kunye nokukhuluphala ngokwenza ukhetho olusempilweni lokuphila:

• Nenjongo yokuzivocavoca ngokulinganayo njengokuhamba, ukuqubha, okanye ukuhamba ngebhayisikili imizuzu engama-20 ukuya kwe-30 imihla ngemihla.
• Yitya kakuhle ngokukhetha ukutya okunesondlo, njengeziqhamo, imifuno, ukutya okuziinkozo, kunye neeproteni ezibuthathaka.
• Yitya ukutya okunamafutha aphezulu, ukutya okunekhalori ezininzi ngokumodareyitha.