Posachedwapa panali lipoti loti kampani ya ku America ya Gl Dynamics yapanga njira yatsopano yochizira kunenepa kwambiri, yomwe ingakhale yotsika mtengo komanso yotetezeka kwa njira zopangira opaleshoni zomwe zilipo panopa. Wopangidwa ndi Gl Dynamics, chipangizo cha EndoBarrier ndi chubu chopanda kanthu chopangidwa ndi zotanuka polima, chomwe chimamangiriridwa ku maziko opangidwa ndi nitinol (aloyi ya titaniyamu ndi faifi tambala). Maziko a EndoBarrier amakhazikika m'mimba, ndipo "sleeve" yake ya polima pafupifupi 60 centimita yayitali imafalikira m'matumbo aang'ono, ndikuletsa kuyamwa kwa michere. Kuyesa kwa odzipereka opitilira 150 awonetsa kuti kuyika kwa EndoBarrier sikuli kothandiza kuposa kutsitsa kuchuluka kwa m'mimba popanga opaleshoni. Panthawi imodzimodziyo, chipangizocho chimayikidwa ndikuchotsedwa pakamwa, pogwiritsa ntchito njira ya endoscopic yosavuta komanso yotetezeka kwa wodwalayo, ngati kuli kofunikira, imachotsedwa, ndipo mtengo wake ndi wotsika kwambiri kuposa chithandizo cha opaleshoni. Kunenepa kwambiri ndi chikhalidwe chomwe minofu yambiri ya adipose m'thupi imakhala pachiwopsezo ku thanzi la munthu. Body mass index (BMI) imagwiritsidwa ntchito ngati muyeso wofuna kukhala wonenepa kapena wocheperako. Imawerengedwa pogawa kulemera kwa thupi mu kilogalamu ndi sikweya ya kutalika kwa mita; mwachitsanzo, munthu wolemera makilogalamu 70 ndi 1,75 mamita wamtali ali ndi BMI ya 70/1,752 = 22,86 kg/m2. BMI ya 18,5 mpaka 25 kg / m2 imaonedwa ngati yachibadwa. Mndandanda womwe uli pansipa 18,5 umasonyeza kusowa kwa misa, 25-30 imasonyeza kupitirira kwake, ndipo pamwamba pa 30 imasonyeza kunenepa kwambiri. Pakalipano, zakudya ndi masewera olimbitsa thupi zimagwiritsidwa ntchito pochiza kunenepa kwambiri. Pokhapokha ngati sakugwira ntchito, amatha kugwiritsa ntchito mankhwala osokoneza bongo kapena opaleshoni. Zakudya zochepetsera thupi zimagwera m'magulu anayi: mafuta ochepa, otsika kwambiri, otsika kwambiri, komanso otsika kwambiri. Zakudya zamafuta ochepa zimatha kuchepetsa thupi ndi pafupifupi ma kilogalamu atatu mkati mwa miyezi 2-12. Low-carb, monga momwe kafukufuku wasonyezera, amagwira ntchito pokhapokha ngati chakudya cha calorie chachepetsedwa, ndiko kuti, sichimayambitsa kuwonda paokha. Zakudya zopatsa mphamvu zochepa zimatanthawuza kuchepa kwa mphamvu yazakudya zomwe zimadyedwa ndi 500-1000 kilocalories patsiku, zomwe zimapangitsa kuti muchepetse kulemera kwa kilogalamu 0,5 pa sabata ndikuchepetsa pafupifupi 3 peresenti mkati mwa 12- XNUMX miyezi. Zakudya zotsika kwambiri zama calorie zili ndi ma kilocalories 200 mpaka 800 patsiku (pamlingo wa 2-2,5 zikwi), ndiye kuti, amafa ndi njala thupi. Ndi chithandizo chawo, mutha kutaya ma kilogalamu 1,5 mpaka 2,5 pa sabata, koma samalekerera bwino ndipo amadzaza ndi zovuta zosiyanasiyana, monga kutayika kwa minofu, gout kapena kusalinganika kwa electrolyte. Zakudya zimakulolani kuti muchepetse thupi mwachangu, koma kusunga kwawo ndikusunga misa yomwe yakwaniritsidwa kumafuna khama lomwe si aliyense amene amawonda amatha - makamaka, tikukamba za kusintha kwa moyo. Nthawi zambiri, ndi anthu makumi awiri okha pa zana aliwonse omwe amatha kuonda bwino ndikuchepetsa thupi ndi chithandizo chawo. Kuchita bwino kwa zakudya kumawonjezeka pamene akuphatikizidwa ndi masewera olimbitsa thupi. Kuchuluka kwa minofu ya adipose kumawonjezera chiopsezo chokhala ndi matenda ambiri: mtundu wa 2 shuga mellitus, matenda amitsempha yamagazi, matenda obanika kutulo (kupumira kwakanthawi kogona), osteoarthritis, mitundu ina ya khansa ndi zina. Choncho, kunenepa kwambiri kumachepetsa kwambiri moyo wa munthu ndipo ndi chimodzi mwa zifukwa zazikulu zomwe zingapewedwe za imfa komanso chimodzi mwazovuta kwambiri za thanzi la anthu. Payokha, masewera olimbitsa thupi, omwe amapezeka kwa anthu ambiri, amangochepetsa thupi pang'ono, koma akaphatikizidwa ndi zakudya zochepa zama calorie, zotsatira zake zimawonjezeka kwambiri. Komanso, zolimbitsa thupi n'kofunika kukhala yachibadwa kulemera. Kulemera kwakukulu kwa maphunziro kumatsimikizira kuchepa kwakukulu ngakhale popanda kuletsa kalori. Kafukufuku wina ku Singapore anasonyeza kuti pa milungu 20 yophunzitsidwa za usilikali, anthu onenepa kwambiri anataya pafupifupi ma kilogalamu 12,5 a kulemera kwa thupi, kwinaku akudya chakudya champhamvu. Zakudya ndi masewera olimbitsa thupi, ngakhale ndiwo njira zazikulu komanso zoyambirira zothandizira kunenepa kwambiri, sizingathandize odwala onse.
Mankhwala amakono ali ndi mankhwala atatu ochepetsa thupi omwe ali ndi njira zosiyanasiyana zochitira. Izi ndi sibutramine, orlistat ndi rimonabant. Sibutramine ("Meridia") imagwira ntchito m'malo a njala ndi kukhuta ngati amphetamines, koma nthawi yomweyo ilibe kutchulidwa kwa psychostimulating zotsatira ndipo sizimayambitsa kudalira mankhwala. Zotsatira zake ndi ntchito zingaphatikizepo youma pakamwa, kusowa tulo ndi kudzimbidwa, ndipo contraindicated anthu ndi matenda aakulu mtima. Orlistat ("Xenical") imasokoneza chimbudzi ndipo, chifukwa chake, kuyamwa kwa mafuta m'matumbo. Popanda kudya mafuta, thupi limayamba kugwiritsa ntchito nkhokwe zake, zomwe zimabweretsa kuwonda. Komabe, mafuta osagawika angayambitse kutsekula m'mimba, kutsekula m'mimba ndi kusadziletsa kwa chopondapo, zomwe nthawi zambiri zimafuna kusiyidwa kwamankhwala. Rimonabant (Acomplia, yomwe ikuvomerezedwa panopa ku EU) ndi mankhwala atsopano ochepetsa thupi. Imawongolera chikhumbo cha chakudya poletsa ma cannabinoid receptors muubongo, zomwe ndizosiyana ndi zomwe zimagwira mu chamba. Ndipo ngati kugwiritsa ntchito chamba kumawonjezera chilakolako, ndiye kuti rimonabant, m'malo mwake, amachepetsa. Ngakhale atayamba kugulitsa mankhwalawa pamsika, zidapezeka kuti zimachepetsanso chilakolako cha fodya kwa osuta. Kuipa kwa rimonabant, monga momwe zasonyezedwera ndi kafukufuku wotsatsa pambuyo pa malonda, ndikuti kugwiritsidwa ntchito kwake kumawonjezera mwayi wa kuvutika maganizo, ndipo kwa odwala ena kungayambitse maganizo ofuna kudzipha. Kuchita bwino kwa mankhwalawa kumakhala kochepa kwambiri: kuchepa kwa thupi ndi nthawi yayitali yoyendetsera olistat ndi 2,9, sibutramine - 4,2, ndi rimonabant - 4,7 kilogalamu. Pakalipano, makampani ambiri opanga mankhwala akupanga mankhwala atsopano ochizira kunenepa kwambiri, omwe ena amachita mofanana ndi omwe alipo, ndipo ena ali ndi njira yosiyana. Mwachitsanzo, zikuwoneka kuti zikulonjeza kupanga mankhwala omwe amagwira ntchito pa zolandilira leptin, timadzi timene timayang'anira kagayidwe kachakudya ndi mphamvu. Njira zothandiza kwambiri komanso zodalirika zochizira kunenepa kwambiri ndi opaleshoni. Maopaleshoni ambiri apangidwa, koma onsewa amagawidwa m'magulu awiri osiyana molingana ndi njira yawo: kuchotsedwa kwa minofu ya adipose yokha komanso kusinthidwa kwa m'mimba kuti muchepetse kudya kapena kuyamwa kwa michere. Gulu loyamba limaphatikizapo liposuction ndi abdominoplasty. Liposuction ndi kuchotsa ("kuyamwa") kwa minofu yamafuta ochulukirapo kudzera pakhungu laling'ono pogwiritsa ntchito pampu ya vacuum. Mafuta osapitirira ma kilogalamu asanu amachotsedwa nthawi imodzi, chifukwa kuopsa kwa zovuta kumadalira kuchuluka kwa minofu yomwe yachotsedwa. Liposuction yosachita bwino imadzaza ndi mapindikidwe a gawo lofananira la thupi ndi zina zosafunika. Abdominoplasty ndi kuchotsa (kuchotsa) khungu lochulukirapo ndi minofu yamafuta akunja kwa m'mimba khoma kuti kulilimbitsa. Opaleshoniyi imatha kuthandiza anthu omwe ali ndi mafuta ochulukirapo am'mimba. Ilinso ndi nthawi yayitali yochira - kuyambira miyezi itatu mpaka isanu ndi umodzi. Opaleshoni yosintha m'mimba ikhoza kukhala cholinga chochepetsa kuchuluka kwa m'mimba kuti muyambe kukhuta. Njirayi ikhoza kuphatikizidwa ndi kuchepa kwa mayamwidwe a michere. Pali njira zingapo zochepetsera kuchuluka kwa m'mimba. Mu ofukula ya Mason gastroplasty, gawo la m'mimba limasiyanitsidwa ndi voliyumu yake yayikulu yokhala ndi zida zopangira opaleshoni, ndikupanga thumba laling'ono momwe chakudya chimalowera. Tsoka ilo, "m'mimba-m'mimba" iyi imatambasuka mwachangu, ndipo kulowererapo komwe kumalumikizidwa ndi chiopsezo chachikulu cha zovuta. Njira yatsopano - yomanga chapamimba - imaphatikizapo kuchepetsa voliyumu yake mothandizidwa ndi bandeji yosunthika yozungulira m'mimba. Bandeji ya dzenje imalumikizidwa ndi posungira pansi pa khungu la khoma la m'mimba, zomwe zimapangitsa kuti pakhale zotheka kuwongolera kuchuluka kwa chapamimba podzaza ndi kukhetsa posungiramo ndi physiological sodium chloride solution pogwiritsa ntchito singano wamba ya hypodermic. Amakhulupirira kuti bandeji ndiyoyenera kugwiritsidwa ntchito pokhapokha ngati wodwalayo ali ndi chidwi chochepetsa thupi. Kuphatikiza apo, ndizotheka kuchepetsa kuchuluka kwa m'mimba pochotsa ambiri mwa opaleshoni (nthawi zambiri pafupifupi 85 peresenti). Opaleshoni imeneyi imatchedwa sleeve gastrectomy. Zitha kukhala zovuta ndi kutambasula m'mimba yotsala, kupsinjika kwa seams, etc. Njira zina ziwiri zimaphatikiza kuchepetsa kuchuluka kwa m'mimba ndi kupondereza kwa mayamwidwe a michere. Mukamagwiritsa ntchito gastric bypass anastomosis, thumba limapangidwa m'mimba, monga vertical gastroplasty. Jejunamu amasokedwa m’thumba ili, momwe chakudya chimalowera. Duodenum, yolekanitsidwa ndi jejunum, imalowetsedwa mu "mtsinje" wowonda. Chifukwa chake, ambiri a m'mimba ndi duodenum amazimitsidwa kuchokera pakugaya chakudya. Mu gastroplasty ndi duodenal kuchotsedwa, mpaka 85 peresenti ya m'mimba imachotsedwa. Zina zonse zimagwirizana mwachindunji ndi gawo la m'munsi mwa matumbo aang'ono mamita angapo kutalika, omwe amakhala otchedwa. kugaya chakudya. Mbali yaikulu ya matumbo aang'ono, kuphatikizapo duodenum, yotsekedwa kuti isagayidwe, imadulidwa mwakhungu kuchokera pamwamba, ndipo gawo la pansi limasokedwa mu lupu ili pamtunda wa mita imodzi isanalowe m'matumbo akuluakulu. Njira za chimbudzi ndi mayamwidwe pambuyo pake zidzachitika makamaka mu gawo la mita iyi, popeza ma enzymes am'mimba amalowa mu lumen ya m'mimba kuchokera ku kapamba kudzera mu duodenum. Kusintha kotereku komanso kosasinthika kwa dongosolo la m'mimba nthawi zambiri kumabweretsa kusokonezeka kwakukulu pantchito yake, ndipo, chifukwa chake, mu metabolism yonse. Komabe, maopaleshoniwa ndi othandiza kwambiri kuposa njira zina zomwe zilipo kale, ndipo zimathandiza anthu omwe ali ndi kunenepa kwambiri. Yopangidwa ku USA, EndoBarrier, motere kuchokera ku mayesero oyambirira, ndi othandiza monga chithandizo cha opaleshoni, ndipo nthawi yomweyo sichifuna opaleshoni pamimba ya m'mimba ndipo ikhoza kuchotsedwa nthawi iliyonse.
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