Ukukhuluphala ngokweqile

-Delile

• Kuyini ukukhuluphala?
• Ukukhuluphala kuhlukaniswa kanjani?
• Kuyini ukukhuluphala kwengane?
• Yini ebangela ukukhuluphala?
• Ngubani osengozini yokukhuluphala ngokweqile?
• Izakhi zofuzo
• Imvelo nomphakathi
• Izici zengqondo nezinye izinto
• Kutholakala kanjani ukukhuluphala?
• Yiziphi izinkinga zokukhuluphala ngokweqile?
• Kuphathwa kanjani ukukhuluphala?
• Yiziphi izinguquko zokuphila nezokuziphatha ezingasiza ekwehliseni isisindo?
• Imiphi imishanguzo enqunyiwe yokwehlisa isisindo?
• Yiziphi izinhlobo zokuhlinzwa kwesisindo?
• Abaqokelwe ukuhlinzwa
• Ungakuvimbela kanjani ukukhuluphala?

Kuyini ukukhuluphala?

Inkomba yomzimba (BMI) ukubala okuthatha isisindo somuntu nokuphakama kwakhe ukukala usayizi womzimba.

Kubantu abadala, ukukhuluphala ngokweqile kuchazwa ngokuthi kune-BMI, ngokusho kwamaCenter for Disease Control and Prevention (CDC).

Ukukhuluphala kuhlotshaniswa nengozi ephezulu yezifo ezimbi, ezinjengesifo sikashukela sohlobo 2, isifo senhliziyo, nomdlavuza.

Ukukhuluphala kuvamile. I-CDC ilinganisela ukuthi abantu baseMelika abaneminyaka engama-20 ubudala nangaphezulu babekhuluphele ngo-2017 kuya ku-2018.

Kepha i-BMI akuyona yonke into. Inokulinganiselwa okuthile njengemethrikhi.

Ngokusho kwalokhu: “Izici ezinjengobudala, ubulili, ubuhlanga nobukhulu bemisipha zingabuthinta ubudlelwano phakathi kwe-BMI namafutha omzimba. Futhi, i-BMI ayihlukanisi phakathi kwamafutha amaningi, imisipha, noma isisindo samathambo, futhi ayihlinzeki nganoma iyiphi inkomba yokwabiwa kwamafutha phakathi kwabantu ngabanye. ”

Ngaphandle kwale mikhawulo, i-BMI iyaqhubeka nokusetshenziswa kabanzi njengendlela yokukala usayizi womzimba.

Ukukhuluphala kuhlukaniswa kanjani?

Okulandelayo kusetshenziselwa abantu abadala okungenani abaneminyaka engama-20 ubudala:

Kuyini ukukhuluphala kwengane?

Ukuze udokotela ahlolisise ingane eneminyaka engaphezu kwengu-2 ubudala noma osemusha okhuluphele ngokweqile, i-BMI yabo kufanele ibe kubantu abalingana nabo nobulili begazi:

Kusuka ku-2015 kuya ku-2016, (noma cishe izigidi eziyi-13.7) intsha yaseMelika eneminyaka ephakathi kwengu-2 nengu-19 ubudala yathathwa njengokukhuluphala emtholampilo.

Yini ebangela ukukhuluphala?

Ukudla ama-calories amaningi kunalawo owashisayo emsebenzini wansuku zonke nokuzivocavoca umzimba - esikhathini eside - kungaholela ekutheni ukhuluphale ngokweqile. Ngokuhamba kwesikhathi, lawa makhalori angeziwe ahlanganisa futhi abangele ukuzuza kwesisindo.

Kepha akuhlali kumayelana nama-calories angene ngaphakathi nama-calories aphelile, noma ukuba nokuhlala phansi. Yize lezo ziyizimbangela zokukhuluphala ngokweqile, ezinye izimbangela awukwazi ukuzilawula.

Izimbangela ezivamile zokukhuluphala zifaka:

• i-genetics, engathinta ukuthi umzimba wakho ukucubungula kanjani ukudla kube amandla nokuthi kugcinwa kanjani amafutha
• ukukhula, okungaholela ekunciphiseni kwesisindo somzimba kanye nesilinganiso sokunciphisa umzimba, okwenza kube lula ukukhuluphala
• ukungalali ngokwanele, okungaholela ekushintsheni kwama-hormone okwenza uzizwe ulambile futhi ufise ukudla okuthile okunama-kilojoule amaningi
• ukukhulelwa, njengoba isisindo esitholwe ngesikhathi sokukhulelwa kungaba nzima ukwehla futhi kungaholela ekukhuluphaleni

Izimo ezithile zempilo nazo zingaholela ekutholeni isisindo, okungaholela ekukhulupheleni. Lokhu kufaka phakathi:

• i-polycystic ovary syndrome (i-PCOS), isimo esidala ukungalingani kwamahomoni okuzala abesifazane
• I-Prader-Willi syndrome, isimo esingajwayelekile esikhona lapho kuzalwa esidala indlala eyeqile
• I-Cushing syndrome, isimo esidalwa ukuba namazinga aphezulu e-cortisol (i-hormone yokucindezeleka) kusistimu yakho
• i-hypothyroidism (i-thyroid engasebenzi), isimo lapho indlala yegilo ingakhiqizi ngokwanele amahomoni athile abalulekile
• i-osteoarthritis (OA) nezinye izimo ezidala izinhlungu ezingaholela ekwehliseni umsebenzi

Ngubani osengozini yokukhuluphala ngokweqile?

Ukuxubana okuyinkimbinkimbi kwezinto kungakhuphula ubungozi bomuntu bokukhuluphala.

Izakhi zofuzo

Abanye abantu banezakhi zofuzo ezenza kube nzima ngabo ukunciphisa umzimba.

Imvelo nomphakathi

Imvelo yakho ekhaya, esikoleni, nasemphakathini wakho konke kungathonya ukuthi udla ini nokuthi udlani, nokuthi ukhuthele kangakanani.

Ungaba sengozini enkulu yokukhuluphala uma:

• hlala endaweni enezinketho zokudla okunempilo ezinqunyelwe noma ngezinketho zokudla okunama-kilojoule amaningi, njengezindawo zokudlela ezidayisa ukudla okusheshayo
• bengakafundi ukupheka ukudla okunempilo
• ungacabangi ukuthi ungakwazi ukuthenga ukudla okunempilo
• indawo enhle yokudlala, ukuhamba, noma ukuzivocavoca endaweni yangakini

Izici zengqondo nezinye izinto

Ukudangala kwesinye isikhathi kungaholela ekuzuzeni isisindo, njengoba abanye abantu bengaphendukela ekudleni kokunethezeka ngokomzwelo. Amanye ama-anti-depressants nawo angandisa ingozi yokuthola isisindo.

Ukuyeka ukubhema njalo kuyinto enhle, kepha ukuyeka ukuhoxa kungaholela ekuzuzeni isisindo futhi. Kwabanye abantu, kungaholela ekutholeni isisindo. Ngaleso sizathu, kubalulekile ukugxila ekudleni nasekuzivocavoca umzimba ngenkathi uyeka, okungenani ngemuva kwesikhathi sokuqala sokuhoxa.

Imithi, efana ne-steroids noma amaphilisi okulawula ukubeletha, nayo ingakhuphula ubungozi bokuzuza isisindo.

Kutholakala kanjani ukukhuluphala?

I-BMI ukubalwa okunzima kwesisindo somuntu maqondana nokuphakama kwawo.

Ezinye izinyathelo ezinembe ngokwengeziwe zokusatshalaliswa kwamafutha omzimba nezomzimba zifaka:

• ukuhlolwa kobukhulu besikhumba
• ukuqhathanisa okhalweni kuya okhalweni
• ukuhlolwa kokuhlolwa, njengama-ultrasound, ama-CT scan, nama-MRI scan

Udokotela wakho futhi anga-oda izivivinyo ezithile ukusiza ukuxilonga izingozi zezempilo ezihlobene nokukhuluphala. Lokhu kungafaka:

• ukuhlolwa kwegazi ukuhlola amazinga e-cholesterol ne-glucose
• ukuhlolwa kwesibindi
• ukuhlolwa kwesifo sikashukela
• ukuhlolwa kwegilo
• ukuhlolwa kwenhliziyo, njenge-electrocardiogram (ECG noma i-EKG)

Ukulinganiswa kwamafutha okhalweni lwakho nakho kuyisibikezelo esihle sengozi yakho yezifo ezihlobene nokukhuluphala.

Yiziphi izinkinga zokukhuluphala ngokweqile?

Ukukhuluphala ngokweqile kungaholela kokungaphezulu kwesisindo esilula.

Ukuba nenani eliphakeme lamafutha omzimba nemisipha kubeka ubunzima emathanjeni akho kanye nasezithunzini zakho zangaphakathi. Futhi kwandisa ukuvuvukala emzimbeni, okucatshangwa ukuthi kuyingcuphe yomdlavuza. Ukukhuluphala nakho kuyimbangela enkulu yengozi yesifo sikashukela sohlobo 2.

Ukukhuluphala kuxhunyaniswe nezinkinga eziningi zezempilo, ezinye zazo ezingasongela impilo uma zingelashwa:

• thayipha 2 sikashukela
• Isifo senhliziyo
• umfutho wegazi ophakeme
• ezinye izinhlobo zomdlavuza (isifuba, ikholoni ne-endometrium)
• unhlangothi
• isifo se-gallbladder
• isifo sesibindi esinamafutha
• cholesterol ephezulu
• ukulala ubuthongo nezinye izinkinga zokuphefumula
• isifo samathambo
• ukungazali

Kuphathwa kanjani ukukhuluphala?

Uma ukhuluphele ngokweqile futhi ungakwazi ukwehlisa isisindo uwedwa, usizo lwezokwelapha luyatholakala. Qala ngodokotela wakho wokunakekelwa okuyisisekelo, ongase akwazi ukukudlulisela kuchwepheshe wesisindo endaweni yakho.

Udokotela wakho angafuna futhi ukusebenza nawe njengengxenye yeqembu elikusiza ulahlekelwe isisindo. Lelo thimba lingabandakanya isazi sokudla, udokotela, noma abanye abasebenzi bezempilo.

Udokotela wakho uzosebenzisana nawe ekwenzeni izinguquko ezidingekayo zokuphila. Kwesinye isikhathi, bangancoma nemithi noma ukuhlinzwa kwesisindo futhi. Funda kabanzi mayelana nokwelashwa kokukhuluphala.

Yiziphi izinguquko zokuphila nezokuziphatha ezingasiza ekwehliseni isisindo?

Ithimba lakho lokunakekelwa kwezempilo lingakufundisa ngokukhetha kokudla futhi lisize ukwakha uhlelo lokudla olunempilo olukusebenzelayo.

Uhlelo oluhlelekile lokuzivocavoca nokwanda komsebenzi wansuku zonke - kufika kumizuzu engama-300 ngeviki - kuzosiza ekwakheni amandla akho, ukukhuthazela, kanye ne-metabolism.

Ukwelulekwa noma amaqembu osizo angakhomba nezimbangela ezingenampilo futhi akusize ubhekane nanoma ikuphi ukukhathazeka, ukudangala, noma izingqinamba zokudla okungokomzwelo.

Izindlela zokuphila nezokuziphatha ziyizindlela ezincanyelwayo zokwehlisa isisindo ezinganeni, ngaphandle kwalapho zikhuluphele ngokweqile.

Imiphi imishanguzo enqunyiwe yokwehlisa isisindo?

Udokotela wakho angaphinde anikeze imishanguzo ethile yokuncipha kwesisindo ngokungeziwe ekudleni nasekusebenziseni izinhlelo.

Imithi ivame ukunikezwa kuphela uma ezinye izindlela zokwehlisa isisindo zingasebenzi futhi uma une-BMI engu-27.0 noma ngaphezulu ngokungeziwe ezindabeni zezempilo ezihlobene nokukhuluphala.

Imishanguzo yokuncipha kwesisindo ingavimbela ukumuncwa kwamafutha noma icindezele isifiso sokudla. Okulandelayo kuvunyelwe ukusetshenziswa kwesikhathi eside (okungenani amasonto ayi-12) yi-Food and Drug Administration (FDA):

• phentermine / topiramate (Qsymia)
• naltrexone / bupropion (Contrave)
• i-liraglutide (Saxenda)
• i-orlistat (i-Alli, i-Xenical), ukuphela kwayo evunyelwe yi-FDA ukuthi isetshenziswe ezinganeni ezineminyaka engu-12 nangaphezulu

Le mithi ingaba nemiphumela engemihle. Isibonelo, i-orlistat ingaholela ekunyukeni kwamathumbu anamafutha futhi kaningi, ukuphuthuma kwamathumbu, negesi.

Udokotela wakho uzokuqapha eduze ngenkathi uthatha le mithi.

NgoFebhuwari 2020, i-FDA yacela ukuthi i-lorcaserin (Belviq) yesisindo sokulahlekelwa isisindo isuswe emakethe yase-U.S. Lokhu kungenxa yokwanda kwamacala omdlavuza kubantu abathathe iBelviq ngokuqhathaniswa ne-placebo.

Uma uthatha uBelviq, yeka ukuyithatha bese ukhuluma nomhlinzeki wakho wezokunakekelwa kwempilo mayelana namanye amasu wokulawulwa kwesisindo.

Funda kabanzi ngokuhoxa nalapha.

Yiziphi izinhlobo zokuhlinzwa kwesisindo?

Ukuhlinzwa kwesisindo kuvame ukubizwa ngokuhlinzwa kwe-bariatric.

Lolu hlobo lokuhlinzwa lusebenza ngokukhawulela ukuthi kungakanani ukudla ongakudla kahle noma ngokuvimbela umzimba wakho ekutholeni ukudla nama-calories. Kwesinye isikhathi kungakwenza kokubili.

Ukuhlinzwa kwesisindo akuyona into esheshayo. Kuwukuhlinzwa okukhulu futhi kungaba nezingozi ezinkulu. Ngemuva kwalokho, abantu abazohlinzwa kuzodingeka bashintshe indlela abadla ngayo nokuthi badla kangakanani, noma babe sengozini yokugula.

Kodwa-ke, izinketho zokuhlinza azihlali zisebenza njalo ekusizeni abantu abanesisindo sokukhuluphala futhi banciphise ubungozi be-comorbidities.

Izinhlobo zokuhlinzwa kwesisindo zifaka:

• Ukuhlinzwa kokudlula esiswini. Kule nqubo, udokotela wakho ohlinzayo wakha isikhwama esincane phezulu kwesisu sakho esixhuma ngqo emathunjini akho amancane. Ukudla neziphuzo kudlula esikhwameni kuya emathunjini, kudlula iningi lesisu. Kuyaziwa nangokuthi ukuhlinzekwa kwe-Roux-en-Y gastric bypass (RYGB).
• I-Laparoscopic adjustable banding banding (i-LAGB). I-LAGB ihlukanisa isisu sakho sibe yizikhwama ezimbili usebenzisa ibhande.
• Ukuhlinzwa imikhono esiswini. Le nqubo isusa ingxenye yesisu sakho.
• Ukuphambukiswa kwe-Biliopancreatic nge switch duodenal. Le nqubo isusa isisu sakho esiningi.

Abaqokelwe ukuhlinzwa

Emashumini eminyaka, ochwepheshe bancoma ukuthi abantu abadala abazovivinyelwa ukwehlisa isisindo babe ne-BMI okungenani engama-35.0 (amakilasi 2 no-3).

Kodwa-ke, emihlahlandlela ka-2018, i-American Society for Metabolic and Bariatric Surgery (ASMBS) ivume ukuhlinzwa kwesisindo kubantu abadala abane-BMIs ka-30.0 kuze kufike ku-35.0 (isigaba 1) abathi:

• babe nama-comorbidities ahlobene, ikakhulukazi uhlobo lwesifo sikashukela sohlobo 2
• angibonanga imiphumela eqhubekayo evela ekwelashweni okungasetshenziswanga, njengokudla nokuguqulwa kwendlela yokuphila

Kubantu abanokukhuluphala kwesigaba 1, ukuhlinzwa kusebenza kakhulu kulabo abaphakathi kweminyaka eyi-18 nengama-65 ubudala.

Ngokuvamile abantu kuzodingeka banciphise isisindo ngaphambi kokuhlinzwa. Ngokwengeziwe, ngokujwayelekile bazokwelulekwa ukuze baqiniseke ukuthi bobabili bakulungele ngokomzwelo ukuhlinzwa futhi bazimisele ukwenza izinguquko ezidingekayo zokuphila ezizodingeka.

Izikhungo zokuhlinza ezimbalwa kuphela e-United States ezenza lezi zinhlobo zezinqubo ezinganeni ezingaphansi kweminyaka eyi-18 ubudala.

Ungakuvimbela kanjani ukukhuluphala?

Kube nokwanda okuphawulekayo kokukhuluphala nasezifweni ezihlobene nokukhuluphala emashumini eminyaka edlule. Lesi yisizathu esenza ukuthi imiphakathi, izifundazwe, kanye nohulumeni wobumbano bagcizelele ekukhetheni ukudla okunempilo kanye nemisebenzi ukusiza ukuguqula isimo sokukhuluphala.

Ezingeni lomuntu siqu, ungasiza ekuvimbeleni ukuzuza kwesisindo nokukhuluphala ngokwenza izinqumo zokuphila okunempilo:

• Lwela ukuvivinya umzimba ngokulingene njengokuhamba, ukubhukuda, noma ukuhamba ngebhayisikili imizuzu engama-20 kuye kwengama-30 nsuku zonke.
• Yidla kahle ngokukhetha ukudla okunomsoco, njengezithelo, imifino, okusanhlamvu okuphelele namaprotheni anciphile.
• Yidla ukudla okunamafutha amaningi, okunama-khalori amaningi ngokulinganisela.