The terms ‘obesity’ and ‘overweight’ denominate excessive growth of fat in the human body

Česká verzia

Authors: R. Krajčovičová; R. Hudeček
Published in the journal: Prakt Gyn 2008; 12(2): 109-116

Summary

It is a pandemic the incidence of which has increased dramatically over the recent years. 66 % of men and 54 % of women aged 20 to 65 are affected by overweight and obesity in the Czech Republic (data from the Centre for Diagnosis and Therapy of Obesity). Overweight and obesity increase cardiovascular morbidity and mortality, accident rate, the incidence of locomotive system degenerative diseases, of carcinoma of different organs, and contributes to the development of the syndrome of insulin resistance (Reaven’s X syndrome). Overweight and obesity are also associated with serious endocrine disorders. A typical example is increased androgen production and subsequent hirsutism. A frequent additional complication is the polycystic ovary syndrome. Acyclic elevation of LH and estradiol, FSH depression, irregular anovulatory cycles lead to fertility failure [1]. Obesity reduces the success rate of sterility therapy using methods of assisted reproduction [3]. Fat women need to take higher levels of gonadotropins for a longer time [22,23]. Obese women and women with overweight have a lower pregnancy rate on cycle [3]. They also have a lover fertilisation and implantation rate. Endometrial quality is altered as a consequence of metabolic and hormonal changes. These lead to more frequent failure of IVF therapy [3]. Weight reduction by only 5–10 % reduces dramatically all risks and increases the chance for pregnancy and delivery of a healthy child [3]. The therapy of obesity is a complex issue and requires interdisciplinary approach. Special diets, increased physical activity and an overall change of lifestyle with the help of behavioural psychotherapy are essential. Modern pharmacotherapy contributes to quicker and more effective weight reduction. On the other hand, the success achieved with it should encourage the patient to adhere, in the long run, to the diet and lifestyle guidelines as a whole.

Key words:
overweight and obesity – body mass index (BMI) – anovulatory cycles – polycystic ovary syndrome – insulin resistance – Sibutramine – STORM study

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