Method of medical-psychological normalisation and support of weight

FIELD: medicine.

SUBSTANCE: invention relates to field of medicine, namely to preventive, rehabilitative, general therapeutic (family) practice, endocrinology, neurology and psychotherapy, and can be used for medical-psychological normalisation and support of weight, as well as for prevention of consequences to which patient's organism can be brought by: incorrect nutrition, extra weight and obesity as disease. Patient's anthropometric parameters are measured: height, weight, chest circumference, waist circumference, index of cardiovascular system activity - pulse. Obtained data are used to calculate patient's individual digital series (IDS). Methodology of IDS calculation is explained to patient and session of psychotherapy is started. During session patient in convenient pose, relaxed state sits down in front of computer screen and whispers IDS, with IDS being periodically displayed on screen, to stop session patient makes quiet deep inhalation and exhalation.

EFFECT: method makes it possible to increase physical stamina, improve functional state of vegetative system and reduce level of emotional stress from food dependence.

5 cl, 1 ex

The invention relates to medicine, namely to preventive, restorative, General medical (family) practice, endocrinology, neurology and psychotherapy, and can be used for medico-psychological normalization and weight maintenance and prevention of the impacts of the patient: poor diet, overweight and obesity as a disease.

The urgency of the problem of improving approaches to nutrition, obesity prevention and consequences that result from overweight person, great. Global socio-economic transformation, intensification in production, education, and the accessibility of the population to various and unlimited food determine obesity as one of the main Pestovsky diseases of global social space.

In the structure of morbidity of the population in economically developed countries, obesity is one of the first places. If before the Second world war people with overweight was 7-12 %, currently overweight and obesity affects about 60 % of the world population. According to many authors, the frequency of obesity in Russia amounted to about 50 % by the beginning of the new Millennium, and in the U.S. more than 60 %. Moreover, the number of obese is not reduced, and Eesa explicit progressive growth and rejuvenation of this pathology. To study the prevalence of obesity by numerous scientists conducted a detailed statistical analysis of hospital or hospital morbidity for the period from 1933 at the 1972 Proved that the minimum number of cases of obesity had on the war and early postwar years. Since 1955, marked by rapid growth of the number of people with overweight. In Russia as a whole by 2010 obesity suffered more than 50 % of the population, men over 40 % women 60 %.

Medical science based on the analysis of a large number of clinical data have clearly established that co-morbidities in people with overweight are much more likely than persons of normal fatness. For example, it is estimated that 40-45 % of men and 70-76 % of women with diabetes mellitus developed on the background of overweight. Found the following correlation: the higher the body weight of patients with obesity, the more often they have diabetes. Thus, if the excess weight is 15 %, diabetes develops in 2 times, and when the excess body mass to 25 % in 10 times more often than those with normal weight. Note that the mortality rate of patients with diabetes mellitus in combination with obesity is also higher as compared to that in patients with the same pathology, but with normal body weight. Among patients with diabetes with body mass, pre is usausa rate of 25 %, the mortality rate is 10 times higher than the normal weight.

Significant impact on the change in body mass have age and gender. At the age of 20-29 years body mass in women at average of 64 kg, men 74 kg, and 50-60 years, respectively 76 and 82 kg Established that "physiological" obesity often develops after age 40-45. This is due to the changes in the activity of the glands of internal secretion, reduction of oxidative processes in tissues and weakening the mobilization of fat.

Obesity occurs more often in women than in men. The number of women with excessive body weight (in some age groups) 3 times more than men, and women more often expressed by the degree of obesity. According to our data, the excess weight is observed in 70 % of women and 40 % men. These differences are apparently due to age-related changes in the function of the endocrine glands, primarily sexual.

Is overweight for humanity and modern medicine is extremely large and hardly has decreased significantly over the last decade. Due to changes in lifestyle of the modern man, rich nutrition, replacement labor, characterized by significant physical, skilled labour, mechanization of life and hypokinesia there is a growing prevalence of obesity. Not the only arterial hypertension, diabetes mellitus, atherosclerosis, gallstone disease and other diseases often affect fat than normal well-fed people, but also a number of other dangers lurking patients with obesity, which may seem at first sight strange. In particular, the results of surgical intervention in these patients is less favorable patients with overweight are more likely to die from accidents. The combination of obesity with hypertension and diabetes increases the risk of myocardial infarction in 9-11 times. The possible role of obesity in the development of this complex disease is understandable due to the fact that obesity contributes to the development of both hypertension and diabetes.

Achievements of the scientists of our country in the development of the fundamental problems in the study of pathogenesis, clinical picture and treatment of obesity are very high. Obesity affects the human Constitution, leads to changes in the function of virtually all organs and systems. In this regard, it should be clear outstanding importance for the study of this disease studies the General laws of the organism, as reflected in the concepts of the Russian physiological school, especially in the writings of I.P. Pavlov, V.M. Bekhterev and other

The problem of overweight and obesity at the present level of study is very difficult. Alongside with the territorial aspects it requires consideration of a number of clinical and theoretical endocrinology, neurology, largely based on the achievements of biochemistry and anthropology, physiology, particularly of the higher nervous activity of digestion, clinical and theoretical gastroenterology, medical psychology, genetics, mathematics, etc. however, it can be argued that not only the treatment of obesity, which must be given special attention, but also its prevention can be effective now. Suffice it to say that the formation of the patient's correct eating behavior and rational mode of the motor, which should be critical components of education, is an important method of preventing the disease. When normalization and maintenance of weight loss, first of all, you must remember that, essentially, this disease involves changing anthropometric indicators of the patient's life stereotypes and therefore is characterized by considerable stability. For its effective prevention required a radical psychological turning point in the minds of doctors still do not pay enough attention to this dangerous consequences of the disease, and in the consciousness of the patient and his environment.

In General, however, questions the effectiveness of preventive and remedial medical interventions, psycho methods n the normalization and weight maintenance using mathematical information-digital computer models based on individual anthropometric and physiological parameters of the patient, not well understood or simply not available.

Closest to the proposed method method no. Today's trendy diets and weight loss methods (Montignac, Atkin, Ornish, "Zone", Dr. Perricone, Hamoked, weight loss, blood group, Trennkost (separation food diet, macrobiotics, starvation, "Cambridge diet", Eurodata, "Fit well", "the Kremlin diet, Chinese and Thai tablets etc., etc., can be endless), based on a grueling starvation, rejecting a full physiological nutrition, supplementation, do not give long-lasting results: only "fell" to the diet immediately gained weight as often in the body occur irreparable consequences that are difficult to correct. They are all shared similar for all patients according to the method and type of impact and have nothing to do with information and digital technologies with use of individual anthropometric parameters of the patient and his physiological parameters.

Achievable with implementation of the proposed method the technical result is the provision of medico-psychological normalization and weight maintenance. The task of the invention is expected normalization of terms PR is a preventive activities (up to one year) and improving efficiency by increasing individual motivation and responsibility of the patient for preventive sessions and by reducing the average frequency emotionally-food-reactions to psychological and physiological monographie attack, self-control for state-level emotional food addiction.

The developed method is the individual preventive courses for normalization and maintenance of weight loss, self-control gain emotional resilience to food addiction and inclusion in the course mediated psychotherapy - training using a variety of methods, the emotional-volitional relaxation and breathing exercises.

Mediated psychotherapy includes: psychological impact, deliberately raising the self-esteem of the patient using a playback of at least four types of physiological conditions associated with satisfaction the leading types of physiological and social needs (security; freedom and independence; in goal achievement and self-realization; approval, recognition and love, family and others), and then dynamically and verbal fixation resulting psychophysiological States; indirect psychological effects that increase the motivation of the patient to normalize and maintain weight; psychological effects that enhance the skills psycho-physiologist is over-regulation.

Emotional addiction to food is largely caused by violation of satisfying the current needs, the inability to control and manage. To meet their key needs and reduce the impact of monohromnyh attacks a person needs to change or extend its repertoire of methods focused cognitive and behavioral response that is possible only together with improve its self-esteem.

In order to help the patient to improve self-esteem, it is proposed to induce his memories of situations in which he, after a period of its activity meets any of the leading needs. During such memories is reproduced corresponding to this need comfortable psychophysiological state of saturation. Multiple replay in combination with adequate associated with individual digital phrase and gesture leads to the formation of the conditioned reflex. The repetition of individual digital phrase and gesture in the future in and of itself helps to reproduce the specified comfort saturation and increase the confidence of the patient in that it can achieve such a state, that is, his self-esteem. At the same time, the patient learns to change the slightest signs of the emergence of disco is the certain level of status in the corresponding comfortable condition in everyday life in dealing with any fine, seemingly everyday tasks that establishes a high level of self-esteem based on the acquisition of new experience.

Depending on the semantic orientation can be roughly divided into four types of leading medical and social needs: 1 - the need for security in isolation from food addiction, implemented by suppressing your own food aggression and his invisible care or escape from obstacles; 2 - the need for freedom and independence from others and the environment, implemented by active-aggressive confrontation and the desire to normalize and weight maintenance, release your own personal internal and external space; 3 - the need for self-realization and achievement of objectives, implemented through its own monitoring and control over food emotions and their active-aggressive modification; 4 - the need for approval, acceptance and love from family and others, implemented by suppressing food aggression, expressing their benevolence and rapprochement with the social environment. Depending on what the need of the patient is important and how the emotional-cognitive-behavioral response he prevail, there are four personality types.

The satisfaction of physiological and social needs of the SOP is vozdaetsja the emergence of different psychophysiological States, different its own characteristics vegetovisceral, neurohumoral, neuromuscular control. With this in mind self-esteem are encouraged to use play at least four types of physiological conditions associated with satisfaction the four basic types of medical and social needs. Patients are stimulated memories of situations in which he felt a sense of one's own attractiveness, success, independence, and security. Dynamic (using the same type adopted a relaxing posture and calm breathing, sitting at the computer) and verbal (using monotonically associated mental repetition of individual digital number) conditioned reflex aggravation of confrontation and containment Pestovsky emotions will contribute to the stabilization of the positive self-assessment, i.e. assessment of their abilities to interact successfully with the environment, while also meeting a corresponding need for normalization and weight maintenance.

Motivation to improve the attractiveness, efficiency, improved attention, sleep, improve their own health is of particular importance for patients who usually do not believe in all these things and so do not expect it and does not make Akti the endeavour to achieve it. In addition to unbelief in his power passivity patients also often contributes unconscious conditional inevitability of a particular disease.

To increase the motivation to strengthen their health, improve sleep, and improve efficiency, attractiveness, if you link in the mind of the patient's sensations, emotions and thoughts related to health, attractiveness, sleep, attention and performance with other sensations, emotions, images and thoughts related to the satisfaction of any of its actual needs, i.e. to achieve a very important task. Such a connection can be set using informed regular indirect suggestion. You must help the patient to form an idea of his state of health and attractiveness, that is, to consciously feel the feelings, emotions, thoughts, whom he defines it. Targeted self-training patients to normalize and weight maintenance helps to reduce severity of food addiction and in a broad sense is a skill psychophysiological self-regulation.

Especially important is the learning of patients the skills of self-observation. Improving the skill of self-observation and observation of the surrounding world promotes adequate is arnosti reaction and training of human purposeful perception is not only negative, but also positive signals from the external and internal environment of the body allows you to increase the weight of positive emotions in his psychological condition, reducing the share is negative.

For the subconscious correction of cognitive style response possible learning positive thinking. Replacing negative thoughts and beliefs into positive also leads to a decrease in the intensity of negative Pestovsky emotions and reduced severity of emotional food addiction. The patient consciously aims to normalize and maintain weight: opportunity wisely and effectively, to eat; the ability to relax, be satisfied, and to focus at the right moment; conserving strength and quick recovery; freedom and independence from the emotionally-food spikes. This goal allows the patient to improve their ability to realize the desired activity and to diversify the ways of its achievement. This independently produced and permanently fixed skill allows you to increase the efficiency of solving many of life's problems and thereby reduce the level of emotional food addiction, as well as regularly resorting to rethink the events of his recent past (from one hour to several day is up to a month), the patient reduces the adverse effects experienced emotional and psychological food attacks.

The proposed method is as follows:

Carry out the measurement of anthropometric indicators of patient height, weight, chest circumference, waist circumference; measure of the performance of the cardiovascular system - the heart rate. On the basis of the received data to calculate individual digital number (DDI) of the patient according to the formula:

$$\mathrm{And}CP=((\beta \times (r+o+t+v)+\gamma \times (r+o+t+v)):p/n):k,$$

where β is the individual rate of birth date in the form "xy", x - date of birth, and y is the month of birth of the patient, γ - individual coefficient year of birth, presents a four-digit number of the year of birth of the patient, r is the patient's height (cm), o - circumference of the chest of the patient (cm), t is the waist circumference (cm), v is the weight of patient (kg), p - pulse (BPM) of a patient, measured in the morning after 5-7 min after awakening, n - lowering the age factor: when the age of 30 Le is n=1; 30-39 years n=2; 40-49 years n=3; 50-59 years n=4; 60 years and older n=5, k - decreasing weighting factor: before the sessions aimed at keeping the weight k=1, before the sessions aimed at normalization of weight k=2.

The patient is introduced to the calculation method of DDI. Then begin a psychotherapy session. The main thing is the patient aware of their choice, their freedom and responsibility.

The introductory part. The patient sits in front of his computer at home or in the workplace. Posture should be comfortable, muscles relaxed. It is advisable that the patient will not be distracted and did not disturb him. The patient should be configured: a sober assessment of the situation, the desire to contribute to the success of the normalization and weight maintenance.

The main part. The patient adjusts his breathing and breathing evenly at a leisurely pace. The patient speaks in a whisper their individual digital number, which is periodically displayed on the screen of his computer. The playback procedure must be repeated 2 times per day depending on the time he spends at the computer. The process is mediated relaxation of 1.5-3 min of Elementary exercises for indirect impacts their individual digital near consciously on my mind is monotonous, even at a leisurely pace repeating in a whisper for 1.5 to 3 minutes in the strict consequences of the successive individual digital number. To run hidden adaptive-compensatory capacity that is sufficient. Preferably the use of individual digital number for 1.5-2.0 hours before bedtime will help to improve sleep, attention and memory after 4-6 weeks after the start of the prevention program.

The final part. 1.5-3 min manages to repeat his individual digital series about 35-40 times (the number of times the patient to count optional). The program stops itself, it is so configured. The patient makes a quiet deep breath and exhale in and out of the program, getting to his normal duties.

Sessions are conducted to achieve the desired weight reduction, then when there is need for maintaining weight sessions repeat.

Instructions for use of individual digital number

1. The patient got your individual digital number, therefore, his consciousness can, and he can learn to control and manage their food with emotions.

2. First of all, the patient must realize that he really overweight. His lifestyle is built incorrectly. Mode (not diet, and mode) power supply needs to be changed. Correctly will move onto the national traditional type of food.

3. The patient should try to never eat after 21h of the evening (or two hours before bedtime and at night, as if he was not the hunger is.

4. The main range of products should be national.

5. The patient should move more (morning gymnastics (7-10 min or 10-12 exercises, Jogging, fast walking, walking, walking, any physical labour, etc.). Movement is life.

6. The rules are very simple:

Awareness of the patient that he is overweight,

not to overeat,

national traditional food,

after 21h (or two hours before sleep) at night is not there,

movement is life.

7. The digital correction of a number of desirable once during the season (summer, autumn, winter, spring).

8. Individual digital next, it is desirable to use in the morning after sleep and in the evening before going to sleep for 1.5-3 minutes, and in any spare time working on the computer (but not more than 4-5 times a day).

9. If the weight of the patient within twelve months came to an ideal average norm and seasonal variations are within ±3-5 %, the patient has achieved the result.

10. The digital correction of a number of desirable after the normalization and stabilization of weight.

Detailed description of the results of the application of the method.

Validation and testing of the invention "Method of medico-psychological normalization and maintenance of weight loss" was held in the conditions of the institutions of the Russian Academy of medical Sciences Institute of medical-ecological problems of the North" (IMAPS RAMS) harm the NSC. The study included 100 patients with abdominal obesity (AO) aged 30-55 years. Of these 50 women and 50 men waist circumference (FROM)>80 cm in women and > 94 cm in men. 37,0 % of patients were overweight - body mass index (BMI) of 28.0±0.2 kg/m²and 63,0 % are obese (BMI of 35.1+0.5 kg/m²). Testing and the test was conducted with the financial support of the Russian Government ("the Fund of assistance to development of small forms of enterprises in scientific-technical sphere", State contract No. R/9021 28. 12. 2008, the state registration of computer programs certificate No. 2009612659, registration number R & d 01200951860). Diagnosis associated with overweight was defined according to the International statistical classification of diseases, tenth revision (E, E-E, E68). Along with clinical neurological, endocrinological and standard laboratory and instrumental diagnostic survey was carried out psychodiagnostic examination. Conducted polysomatism study, representing a variety of kardiointervalografii with the subsequent mathematical analysis of the data in a special program.

The main purpose of normalization and weight maintenance was normalization of weight, reduction of risk related to obesity diseases and increasing life expectancy, PA the rate. The application of the proposed method allowed the patients gradually by 0.5-1.0 kg per week to reduce your weight within 6-12 months to maintain the result, adhere to the new lifestyle.

Depending on the degree of deviation from normal weight and degree of changes in heart rate (heart rate) in terms of behavioral temporal segments all subjects were divided into four groups. The first group were classified as subjects, in which the heart rate was slightly increased (p<0,05). Men in this group was 5, and women 15. The second group of men - 10 women 20 was presented to examinees whose heart rate increased significantly, but did not exceed 90 beats per minute. The third group presents subjects with fluctuations of heart rate in the range from 90 to 100 beats per minute men 10 and women 10. In the fourth group of subjects heart rate exceeding 100 beats per minute and she was represented by only 30 women (p<0,001).

In accordance with the recommendation of the who expert Committee (2000), changes in heart rate and registered kardiogemodinamicheskuyu manifestations in the first and the second group was regarded as a weak degree of food addiction, the third as the "danger zone" or the average degree of food addiction and the fourth as changes specific to dramatically food addiction.

In the description of the results of PR is changing the way the data are provided on only the third and fourth groups, as in prognostic terms, they are of the greatest interest. In women with type of reaction estimated as "danger zone", kardiogemodinamicheskuyu changes occur already at the stage of "afferent synthesis and characterized by a significant increase in heart rate (p<0,05). At subsequent stages kardiogemodinamicheskuyu change continue to grow, reaching the greatest shifts in "socially significant" activity: heart rate increases by 30 %. The data obtained indicate that despite a significant reduction in heart rate, food addiction in women continues to increase, reaching "dangerous" values.

Men with changes kardeogemodyinamiki characteristic of the "danger zone"on stage "afferent synthesis, increase in heart rate by 20 % (p<0,05). The maximum deviation curves of the examined patients observed at the stage of "decision making" and "success" by 38 %. Thus, the increase in heart rate to values characteristic of the "danger zone"that occurs in women on a background of sharply pronounced degree of food addiction. However, women tend to and more appropriate behavior than men. However, the importance of heart rate in women is more pronounced than in men.

In the study, only women (30 people) react by increasing heart rate to values characteristic of d is expressed to food addiction (100 beats per minute or more). In this case kardiogemodinamicheskuyu providing heart rate is characterized by stability. The greatest intensity changes kardeogemodyinamiki marked by "socially important" activities. Changes in heart rate remains significantly high and in the recovery period. Evidence suggests that women with increased heart rate to values inherent dramatically food addiction, kardiogemodinamicheskuyu the attitudinal time steps maximum mobilization of blood circulation apparatus. Therefore, women with similar manifestations of kardeogemodyinamiki that occur in response to emotional and nutritional stress due to "socially significant" activities should be considered "at risk" for complications that result from overweight or obesity.

All groups identified the types of adaptive responses at the time of the study, finally, 2-3 weeks - the period of formation of urgent adaptation finally, 6-8 weeks - interim period and in the period of over 11 weeks - the formation of long-term adaptation.

The pattern of "decompensation" were classified as: food addiction medium, low and very low levels of reactivity, reaction activation very low levels of reactivity, reaction training the very low levels of reactivity; the pattern "subcompensation" - food addiction high levels of reactivity, reaction activation low levels of reactivity, reaction training medium and low levels of reactivity; the pattern of the "compensation" food addiction high and medium levels of reactivity, reaction training high levels of reactivity.

The analysis of reactions in the intermediate adaptation period (6-8 weeks) showed the important role to predict the outcome of extreme conditions. So, addiction to food was fine and was as follows: at the reactions to the pattern of "decompensation" food addiction is 75.0 %, pattern "subcompensated" food addiction to 90.0%, the pattern of "compensation" food addiction is 100%.

When analyzing the duration of food addiction in patients noted that with the development of reactions to the pattern of "compensation" in the interim period of adaptation, the average recovery period is much smaller and has $ 120.0±60,0 min, subcompensated" - 270,0±90,0, "decompensation" -3 60,0±120,0 (p<0,001)). Patients using "Method medico-psychological normalization and weight maintenance", set: in the first month of the medico-psychological prevention of body weight was decreased extremely rarely (1-2 kg), mainly in individuals with increased physical activity. Some patients body weight "stabilized the camping", i.e. not decreased, but not increased. In the analysis of the diet was that of a person whose body weight is "stabilized", violated regulations: some drinking regime, other - power mode. Almost all patients reported significant improvement of health, increase vitality, improve the work of the digestive tract; reduce irritability, temper, fatigue; improved sleep, memory; increased efficiency; disappeared apathy, appeared self-confidence, etc.

From the 2nd month of the medico-psychological prevention of body weight was reduced more intensively, patients get used to the unusual diet. Body weight was decreased by 0.5-1 kg per week. In persons with excess body weight 10-15 kg weight normalization occurred within 4-6 months with subsequent stabilization of body weight.

To study the psychological characteristics of patients used an abbreviated multifactor questionnaire for personality research (TAR) in adaptation VP Zaitseva, vosmiruchevoj lüscher test. Level of depression was determined by the scale of Zhang. Test of Spilberger Hanina revealed the increase or decrease of reactive and personal anxiety. The said examination was performed before and after a three-week, 2-3-6-month course of application of the developed methods.

The degree of normalization of relations between ergotamine and triotropium autonomic effects were determined on the basis of an integrated assessment of the dynamics of indicators of the provisional mathematical analysis of heart rate and assessed as significant (1 point) or insignificant (0 points). Changes in the psychological status of the patient was assessed as a significant improvement (1 point) or marginal improvement (0 points) based on the results of clinical observation of the patient, as well as comparative analysis of the performance of the test RESINS and Luscher test before and after a course of application of the developed methods.

General assessment of the effectiveness of normalization and maintain weight by the end of 6 months, the rate of application of the developed methods were conducted in accordance with those of the listed options, which have undergone significant improvement, and implemented on a 5-point scale (0 points - no improvements, 4 points - a significant improvement).

When assessing differences in the indicators used student test t for related and unrelated selection is OK, as well as nonparametric test Mann-Whitney (criterion of homogeneity T). Evaluating the significance of differences share (%) was produced according to the method of the angular transformation Fischer. To study the dependence between random variables was determined by Pearson correlation coefficient.

When analyzing the dynamics of indicators of the test RESINS patients found a significant decrease of the values of the first, second, third, sixth, and seventh basic scales after application of the developed technique. By reducing the "neurotic skew and reduce the Express lift to the sixth and seventh happened smoothing of the General configuration of the average personality profile that reflected the tendency to decrease the level of stress food addiction, increasing the overall behavioral activity and increase the level of medical-psychological rehabilitation of patients of all groups. According to the integral evaluation of the results of all used psychodiagnostic methods a significant improvement in psychological status after 6 months of application of the developed methods was noted in 88,3 % of patients.

The obtained results indicate that in patients after prophylactic use of the developed technique observed significant, increase physical endurance, improve functional the state of the autonomic system and the reduction of emotional stress food addiction, that testifies to the effectiveness of the proposed method "Method medico-psychological normalization and maintaining weight."

One of the possible mechanisms of therapeutic effect may be caused by the use of mediated psychotherapy optimization of the functional state of regulatory systems of the brain. These data are consistent with the view according to which therapeutic associated indirect psychotherapeutic load, capable of modulating the level of excitability of the various divisions of the cerebral cortex, to change the nature of the neuroendocrine, vegetovisceral reactions, destabilizing pathological hyperactive neuronal systems responsible for chronic food addiction. Restoration of natural patterns of afferent flow and normalization of the functional state of the Central nervous system contributed, special attention, he was focused to improve the ability of patients to understand their internal and external sensations and feelings. Typically, people with weak controllability food emotions has high sensitivity to negative (nociceptive) physiological and negative mental stimuli. It is possible that attract the attention of patients to positive incentives helped stabilize the air traffic management balance ergo - and trophotropic systems at the physiological level and improve their emotional background of a food mood on a psychological level.

Thus, the results obtained indicate that the application of the developed technique which is based on the invention "Method of medico-psychological normalization and maintaining weight allows individually, taking into account comorbidities to systematize the process of normalization of body weight, metabolic processes; allows the patient to actively and consciously participate in the health promotion contributes to the learning of rational eating, drinking, breathing and movement mode. The patient decreases irritability, temper, fatigue, improves sleep, memory; increased efficiency; apathy disappears, appears self-confidence, etc.

Clinical example of a specific use "method medico-psychological normalization and weight maintenance".

Patient 3-n I.N., 38 years old, a resident of the city, the United accountant accounting of a large enterprise. Used method during the test in terms of the Institutions of the Russian Academy of medical Sciences Institute of medical-ecological problems of the North" (IMAPS RAMS) Murmansk within six months.

Complaints about the extra weight (if ro is those 168 cm patient weighed 102 kg), increased appetite, fatigue, irritability, headache by the end of the working week, which was accompanied by the rise of a/D up to 150/90 mm RT. senior Overall health is relatively satisfactory. All the listed signs were attributed to the symptoms manifested by chronic food addiction, what test did not agree and considered this a regularity run it difficult professional duties. Preventive, curative and other Wellness activities to strengthen health test is not conducted, drugs without doctor's prescription was not accepted.

Tried various diets to lose weight, but after some time everything went back to normal condition.

The history of life. Born into an intact family, had a younger brother. His mother worked as an economist, was a strict woman, loved order and constantly monitored their daughter's life. Father was an engineer - railwayman. He often abused alcohol, but the character was a man soft and pliable, his wife and children were not hurt.

I.N. he studied at the school for good, he graduated from the Institute of Finance and Economics. He started work as a bookkeeper in a small private company, and then joined the bole of a large commercial brokerage company, where he works.

She got married for love in 18 years, she has one daughter. The relationship with her husband in recent years has deteriorated. I.N. upset due to the fact that he was inattentive, indifferent to it. My daughter married, she lives alone and rarely visits his mother.

The nature I.N. always differed responsibility and sociability. Loves all order and good food. The house contains almost perfect purity. At home and at work does a lot of cases and assignments, often not only for themselves but also others, not knowing how to refuse others in requests. Different softness and pliability. These qualities, as well as external prettiness was always attracted to her friends and acquaintances. Accustomed to restrain their negative emotions, afraid to offend the other person. Childhood is characterized by a high level of anxiety, tendency to worry for any occasion. Recently became very tired and experience a constant feeling of hunger (feeling grows dramatically, if you see something edible or hear talk about food), to the end of the week notes increased irritability, anxiety, slezlivo, worsening of mood. All this relates to family relationships.

When viewed in neurological status there was almost a slight tremor of the outstretched hands fingers, even the revival of the tendon reflexes of the hands and feet without their asymmetry. Motor case is valid disorders and disorders of the cranial nerves were not identified.

Changes by the common blood and urine tests are not detected. The patient revealed a clear violation of all types of metabolism: carbohydrate, lipid and protein exchanges (excess levels of reactive insulin in serum 1.5 times; increased rates of cholesterol, triglycerides 2.5 times, low-density lipoprotein, the content of uric acid in 1.5 times from the norm; reduced content of high density lipoprotein).

At the time the analysis pulsogram found increased compared with srednerazmernymi the values of the following parameters: amplitude fashion (AM) - 50 %; index of autonomic balance (IVN) - 340,8 units; vegetative indicator rhythm (CDF) - up to 11.6 units, tension index (ti) - up to 332 units. At the same time found a decrease in indicators such as the standard deviation of the dynamic range of the R-interval, (RMS) to 0.03 s; variational scale pulsogram (GRP) to 0.01; the coefficient of variation (KB) - up to 3.5 %. These results evidenced the background activation newsegments mechanisms of regulation of heart rhythm, increased tone of the sympathetic division of the ANS and a slight activation of the parasympathetic division of the ANS.

When psychodiagnostic study, the color range of preferences according to Luscher test was the following posledovatelno the ü: brown, grey, green, purple, red, blue, black, yellow. The indicator "alarm" was equal to 10 points (when Sredneuralsk score 0-3 points). The level of depression on a scale of Zhang was equal to 62 points, indicating that the average situational depression or neurotic origins. Test of Spilberger Hanina revealed a moderate increase of reactive anxiety (40 points) and a high degree of personal anxiety (65 points).

Personality profile test RESINS had a sawtoothed edge" character, situated between 65 and 85 T-scores, with peaks in the second and seventh scales, testified to the condition of moderate emotional tension with the prevalence of anxiety and depressive personality traits.

Started a course of medical and psychological normalization and weight maintenance along with the application program on the normalization of personal power, work, leisure and sleep included the use of mediated psychotherapy according to the proposed method.

After the initial conversation with the patient was told about the nature of chronic psycho-emotional food addiction and obesity, its negative physiological consequences and adverse effects on overall health. Together with the test analyzed the most obvious reasons available for it, chronic the Russian psycho-emotional food addiction and the most exciting of her problems. The patient realized that along with the depressing action of the state of her family life and the resulting limitations in daily activity on addiction to food is affected by many factors and lifestyle.

By the end of the 6-month independent (daily during working hours I.N. paid twice for 7-8 min to work on the developed methodology) medical and psychological course of normalization and weight maintenance in the intensity of emotional food addiction in the workplace, in the evening after 21 h and at night almost disappeared.

In the diet provided by the predominance of national-traditional products and dishes, with a sufficient quantity of proteins, reducing the consumption of carbohydrates (bread, cakes etc), limit consumption of salt and fat (cakes, pastries etc). Due to the fact that physical activity increases the intensity of metabolic processes and helps convert fat into energy, the patient on the recommendation to increase the level of impellent mode included in the daily routine of morning and evening exercises (10-12 min) for correction (waist, hips, abdomen, buttocks).

In the first month of using the proposed method, the mass of the body I. stabilized and there is a tendency to decrease (weight decreased by 0.5 kg). I.N. noted a significant improvement of health, povsemestnogo tone, the improvement of the digestive tract. From the 2nd month in I.N. body weight was reduced more intensively, weekly 0.5-1 kg monitor I.N. showed that by the end of the 6th month she lost 15 pounds. We Orient I.N. extend the normalization of body weight for another 4-6 months and assigned the result to try to hold, as the body for nearly 15 years to get used to the excess weight and he needs help to function in the new environment.

By the end of the 6th month of the violation of all types of metabolism is almost back to normal. Racing blood pressure ceased to bother. A/D in the survey did not exceed 140/85 mm RT. Art.

The analysis of the dynamics of indicators WHALE showed a reduction compared to the baseline amplitude value fashion (AMO) - 44 %, index of autonomic balance (IIA) - 178,0, vegetative indicator rhythm (Hungary) - 6,5, tension index (ti) - 163 and at the same time increasing the values of the standard deviation of the dynamic range of the R-interval (RMS) - 0.04, ANOVA scale (BP) - 0.02 s, the coefficient of variation (KB) is 7.5 %, which indicates a reduction of the initial excess sympathetic and increase initial lack of parasympathetic activity, and the reduction the degree of centralization of heart rhythm management. Heart rate spectrum was characterized by a compensatory increase on the Yes relative values of power LW - 12 % and no change in the relative power values MB₁- 13 % and MB₃- 11 %. Minor dynamics of the index of centralization (CI) after medico-psychological normalization and weight maintenance (up to 308,29 and after 314,55).

When re psychodiagnostic examination after completing the course under the proposed method detected a decrease in the source-increased personal profile of the RESINS according to the scale F and all the basic scales on average 25-35 T points. Received when you checked the profile was located within 45-55 T points and was characterized by significantly smaller than in the primary study, the severity of the peaks in the second and seventh scales. The results evidenced a decrease in the intensity of emotional food addiction and improving psychological adaptation of the patient.

1. The way medico-psychological normalization and weight maintenance, including the measurement of anthropometric indicators of patient height, weight, chest circumference, waist circumference; measure of the performance of the cardiovascular system - heart rate, on the basis of the received data to calculate individual digital number (DDI) of the patient according to the formula:

where β is the individual rate of birth date in the form "xy", x - date of birth, and y is the month of birth of the patient, γ - individual coefficient year of birth, presents a four-digit number of the year of birth of the patient, r is the patient's height (cm), o - circumference of the chest of the patient (cm), t is the waist circumference (cm), v is the weight of patient (kg), p - pulse (BPM) of a patient, measured in the morning after 5-7 min after awakening, n - lowering the age factor: when the age of 30 years (n=1; 30-39 years n=2; 40-49 years n=3; 50-59 years n=4; 60 years and older n=5, k - decreasing weighting factor: before the sessions aimed at keeping the weight k=1, before the sessions aimed at normalization of weight k=2; the patient is introduced to the calculation method of DDI and begin a psychotherapy session, during which the patient into a comfortable position, relaxed seated in front of a computer screen and speaks in a whisper DDI, with on the screen periodically displayed DDI, for the end of the session, the patient makes a quiet deep breath and exhale, sessions are conducted to achieve the desired reduction in ve is a, then, when there is need for maintaining weight sessions repeat.

2. The method according to claim 1, characterized in that the psychotherapy session is held twice a day.

3. The method according to claim 1, characterized in that the duration of a single session of psychotherapy is 1.5-3 minutes

4. The method according to claim 1, characterized in that therapy sessions are held five days in a row, two days break in a period of 8-12 weeks.

5. The method according to claim 1, characterized in that the value of DDI adjust once in the season, after normalization of the weights, before every beginning of the session, aimed at maintaining weight.