Overweight and obesity in children. Hypotrophy Increased nutrition microbial

International Classification of Diseases 10th Revision (ICD-10)

Version 2016

E65-E68 Obesity and other types of malnutrition

Including: fat pads

E66 Obesity

Excluded:
E66.0 Obesity due to excess intake of energy resources

E66.1 Drug-induced obesity

If necessary, to identify the medicinal product, use an additional external cause code (class XX).

E66.2 Extreme obesity with alveolar hypoventilation

pickwick syndrome

Simple obesity NOS

Excluded:

overeating NOS (R63.2)
consequences of overnutrition (E68)

E67.1 Hypercarotenemia

E67.2 Vitamin B6 megadose syndrome

E67.3 Hypervitaminosis D

E67.8 Other specified forms of overnutrition
E68 Consequences of oversupply

Note. Should not be used for chronic overeating. This code is for the current overeating.

Notes. 1. This version corresponds to the 2016 version of the WHO (ICD-10 Version: 2016), some positions of which may differ from the version of the ICD-10 approved by the Ministry of Health of Russia.

2. NOS - without additional specifications.

3. The translation into Russian of some terms in this article may differ from the translation in the ICD-10 approved by the Ministry of Health of Russia. All comments and clarifications on translation, design, etc. are accepted with gratitude by e-mail.

4. An asterisk marks optional additional codes related to the manifestation of the disease in a separate organ or area of ​​the body, which is an independent clinical problem.

Class IV. Diseases of the endocrine system, eating disorders and metabolic disorders (E00-E90)

Note. All neoplasms (both functionally active and inactive) are included in class II. Appropriate codes in this class (for example, E05.8, E07.0, E16-E31, E34.-) can be used as additional codes, if necessary, to identify functionally active neoplasms and ectopic endocrine tissue, as well as hyperfunction and hypofunction of the endocrine glands, associated with neoplasms and other disorders classified elsewhere.
Excludes: complications of pregnancy, childbirth and the puerperium (O00-O99), symptoms, signs and abnormal findings from clinical and laboratory investigations, not elsewhere classified (R00-R99), transient endocrine and metabolic disorders, specific for fetus and newborn (P70-P74)

This class contains the following blocks:
E00-E07 Diseases of the thyroid gland
E10-E14 Diabetes mellitus
E15-E16 Other disorders of glucose regulation and pancreatic endocrine secretion
E20-E35 Disorders of other endocrine glands
E40-E46 Malnutrition
E50-E64 Other types of malnutrition
E65-E68 Obesity and other types of malnutrition
E70-E90 Metabolic disorders

The following categories are marked with an asterisk:
E35 Disorders of the endocrine glands in diseases classified elsewhere
E90 Nutritional and metabolic disorders in diseases classified elsewhere

THYROID DISEASES (E00-E07)

E00 Congenital iodine deficiency syndrome

Includes: endemic conditions associated with iodine deficiency in the natural environment, both directly and
and due to iodine deficiency in the mother's body. Some of these conditions cannot be considered true hypothyroidism, but are the result of inadequate secretion of thyroid hormones in the developing fetus; there may be a connection with natural goiter factors. If necessary, to identify the accompanying mental retardation, use an additional code (F70-F79).
Excludes: subclinical hypothyroidism due to iodine deficiency (E02)

E00.0 Syndrome of congenital iodine deficiency, neurological form. Endemic cretinism, neurological form
E00.1 Syndrome of congenital iodine deficiency, myxedematous form.
Endemic cretinism:
. hypothyroid
. myxedematous form
E00.2 Syndrome of congenital iodine deficiency, mixed form.
Endemic cretinism, mixed form
E00.9 Congenital iodine deficiency syndrome, unspecified.
Congenital hypothyroidism due to iodine deficiency NOS. Endemic cretinism NOS

E01 Thyroid disorders associated with iodine deficiency and related conditions

Excludes: congenital iodine deficiency syndrome (E00.-)
subclinical hypothyroidism due to iodine deficiency (E02)

E01.0 Diffuse (endemic) goiter associated with iodine deficiency
E01.1 Multinodular (endemic) goiter associated with iodine deficiency. Nodular goiter associated with iodine deficiency
E01.2 Goiter (endemic) associated with iodine deficiency, unspecified. Endemic goiter NOS
E01.8 Other thyroid diseases associated with iodine deficiency and related conditions.
Acquired hypothyroidism due to iodine deficiency NOS

E02 Subclinical hypothyroidism due to iodine deficiency

E03 Other forms of hypothyroidism

Excludes: hypothyroidism associated with iodine deficiency (E00-E02)
hypothyroidism following medical procedures (E89.0)

E03.0 Congenital hypothyroidism with diffuse goiter.
Goiter (non-toxic) congenital:
. NOS
. parenchymal
E03.1 Congenital hypothyroidism without goiter. Aplasia of the thyroid gland (with myxedema).
Congenital:
. atrophy of the thyroid gland
. hypothyroidism NOS
E03.2 Hypothyroidism caused by drugs and other exogenous substances.
If it is necessary to identify the cause, use an additional external cause code (class XX).
E03.3 Post-infectious hypothyroidism
E03.4 Thyroid atrophy (acquired).
Excludes: congenital atrophy of thyroid gland (E03.1)
E03.5 Myxedema coma
E03.8 Other specified hypothyroidisms
E03.9 Hypothyroidism, unspecified. Myxedema NOS

E04 Other forms of non-toxic goiter

Excludes: congenital goiter:
. NOS )
. diffuse ) (E03.0)
. parenchymal)
goiter associated with iodine deficiency (E00-E02)

E04.0 Non-toxic diffuse goiter.
Goiter non-toxic:
. diffuse (colloidal)
. simple
E04.1 Non-toxic single nodular goiter. Colloidal node (cystic) (thyroid).
Non-toxic mononodous goiter. Thyroid (cystic) nodule NOS
E04.2 Non-toxic multinodular goiter. Cystic goiter NOS. Polynodous (cystic) goiter NOS
E04.8 Other specified forms of non-toxic goiter
E04.9 Nontoxic goiter, unspecified. Goiter NOS. Nodular goiter (nontoxic) NOS

E05 Thyrotoxicosis [hyperthyroidism]

Excludes: chronic thyroiditis with transient thyrotoxicosis (E06.2)
neonatal thyrotoxicosis (P72.1)

E05.0 Thyrotoxicosis with diffuse goiter. Exophthalmic or toxic call NOS. Graves' disease. Diffuse toxic goiter
E05.1 Thyrotoxicosis with toxic single-nodular goiter. Thyrotoxicosis with toxic mononodous goiter
E05.2 Thyrotoxicosis with toxic multinodular goiter. Toxic nodular goiter NOS
E05.3 Thyrotoxicosis with ectopic thyroid tissue
E05.4 Thyrotoxicosis artificial
E05.5 Thyroid crisis or coma
E05.8 Other forms of thyrotoxicosis. Hypersecretion of thyroid-stimulating hormone.

E05.9 Thyrotoxicosis, unspecified. Hyperthyroidism NOS. Thyrotoxic heart disease (I43.8)

E06 Thyroiditis

Excludes: postpartum thyroiditis (O90.5)

E06.0 Acute thyroiditis. Thyroid abscess.
Thyroiditis:
. pyogenic
. purulent
If necessary, an additional code (B95-B97) is used to identify the infectious agent.
E06.1 Subacute thyroiditis.
Thyroiditis:
. de Quervain
. giant cell
. granulomatous
. nonpurulent
Excludes: autoimmune thyroiditis (E06.3)
E06.2 Chronic thyroiditis with transient thyrotoxicosis.
Excludes: autoimmune thyroiditis (E06.3)
E06.3 Autoimmune thyroiditis. Hashimoto's thyroiditis. Chasitoxicosis (transient). Lymphoadenomatous goiter.
Lymphocytic thyroiditis. Lymphomatous struma
E06.4 Medical thyroiditis
E06.5 Thyroiditis:
. chronic:
. NOS
. fibrous
. woody
. Riedel
E06.9 Thyroiditis, unspecified

E07 Other thyroid disorders

E07.0 hypersecretion of calcitonin. C-cell hyperplasia of the thyroid gland.
Hypersecretion of thyrocalcitonin
E07.1 Dishormonal goiter. Family dyshormonal goiter. Syndrome Pendred.
Excludes: transient congenital goiter with normal function (P72.0)
E07.8 Other specified diseases of the thyroid gland. Tyrosine-binding globulin defect.
hemorrhage)
Heart attack) (in) the thyroid gland (s)
Syndrome of impaired euthyroidism
E07.9 Thyroid disease, unspecified

DIABETES (E10-E14)

If necessary, to identify the drug that caused diabetes, use an additional external cause code (class XX).

The following fourth characters are used with categories E10-E14:
.0 Coma
Diabetic:
. coma with or without ketoacidosis (ketoacidotic)
. hypermolar coma
. hypoglycemic coma
Hyperglycemic coma NOS

1 With ketoacidosis
Diabetic:
. acidosis)
. ketoacidosis) with no mention of coma

2 With kidney damage
Diabetic nephropathy (N08.3)
Intracapillary glomerulonephrosis (N08.3)
Kimmelstiel-Wilson syndrome (N08.3)

3 With ocular lesions
Diabetic:
. cataract (H28.0)
. retinopathy (H36.0)

4 With neurological complications
Diabetic:
. amyotrophy (G73.0)
. autonomic neuropathy (G99.0)
. mononeuropathy (G59.0)
. polyneuropathy (G63.2)
. autonomous (G99.0)

5 With peripheral circulatory disorders
Diabetic:
. gangrene
. peripheral angiopathy (I79.2)
. ulcer

6 With other specified complications
Diabetic arthropathy (M14.2)
. neuropathic (M14.6)

7 With multiple complications

8 With unspecified complications

9 No complications

E10 Insulin-dependent diabetes mellitus

[cm. the above headings]
Includes: diabetes (diabetes):
. labile
. with onset at a young age
. prone to ketosis
. type I
Excludes: diabetes mellitus:
. newborns (P70.2)
period (O24. -)
glycosuria:
. NOS (R81)
. renal (E74.8)

E11 Non-insulin dependent diabetes mellitus

Includes: diabetes (diabetes) (non-obese) (obese):
. with onset in adulthood
. not prone to ketosis
. stable
. type II
Excludes: diabetes mellitus:
. associated with malnutrition (E12. -)
. neonates (P70.2)
. during pregnancy, during childbirth and postpartum
period (O24. -)
glycosuria:
. NOS (R81)
. renal (E74.8)
impaired glucose tolerance (R73.0)
postoperative hypoinsulinemia (E89.1)

E12 Diabetes mellitus associated with malnutrition

[cm. above subheadings]
Includes: diabetes mellitus associated with malnutrition:
. insulin dependent
. non-insulin dependent
Excludes: diabetes mellitus during pregnancy, during childbirth
and in the puerperium (O24.-)
glycosuria:
. NOS (R81)
. renal (E74.8)
impaired glucose tolerance (R73.0)
neonatal diabetes mellitus (P70.2)
postoperative hypoinsulinemia (E89.1)

E13 Other specified forms of diabetes mellitus

[cm. above subheadings]
Excludes: diabetes mellitus:
. insulin dependent (E10.-)
. associated with malnutrition (E12. -)
. neonatal (P70.2)
. during pregnancy, during childbirth and postpartum
period (O24. -)
glycosuria:
. NOS (R81)
. renal (E74.8)
impaired glucose tolerance (R73.0)
postoperative hypoinsulinemia (E89.1)

E14 Diabetes mellitus, unspecified

[cm. above subheadings]
Includes: diabetes NOS
Excludes: diabetes mellitus:
. insulin dependent (E10.-)
. associated with malnutrition (E12. -)
. neonates (P70.2)
. non-insulin dependent (E11.-)
. during pregnancy, during childbirth and postpartum
period (O24. -)
glycosuria:
. NOS (R81)
. renal (E74.8)
impaired glucose tolerance (R73.0)
postoperative hypoinsulinemia (E89.1)

OTHER DISORDERS OF GLUCOSE AND INTERNAL SECRETION REGULATION

PANCREAS (E15-E16)

E15 Non-diabetic hypoglycemic coma. Non-diabetic insulin coma caused by drugs
means. Hyperinsulinism with hypoglycemic coma. Hypoglycemic coma NOS.
If necessary, to identify the drug that caused non-diabetic hypoglycemic coma, use an additional external cause code (class XX).

E16 Other disorders of internal secretion of the pancreas

E16.0 Medical hypoglycemia without coma.
If it is necessary to identify the medicinal product, use an additional code for external causes (class XX).
E16.1 Other forms of hypoglycemia. Functional non-hyperinsulinemic hypoglycemia.
Hyperinsulinism:
. NOS
. functional
Hyperplasia of pancreatic islet beta cells NOS. Encephalopathy after hypoglycemic coma
E16.2 Hypoglycemia, unspecified
E16.3 Increased secretion of glucagon.
Pancreatic islet cell hyperplasia with glucagon hypersecretion
E16.8 Other specified disorders of the internal secretion of the pancreas. Hypergastrinemia.
Hypersecretion:
. growth hormone releasing hormone
. pancreatic polypeptide
. somatostatin
. vasoactive intestinal polypeptide
Zollinger-Ellison Syndrome
E16.9 Violation of the internal secretion of the pancreas, unspecified. Islet cell hyperplasia NOS.
Hyperplasia of pancreatic endocrine cells NOS

DISORDERS OF OTHER ENDOCRINE GLANDS (E20-E35)

Excludes: galactorrhea (N64.3)
gynecomastia (N62)

E20 Hypoparathyroidism

Excludes: Di George syndrome (D82.1)
hypoparathyroidism following medical procedures (E89.2)
tetany NOS (R29.0)
transient hypoparathyroidism of the newborn (P71.4)

E20.0 Idiopathic hypoparathyroidism
E20.1 Pseudohypoparathyroidism
E20.8 Other forms of hypoparathyroidism
E20.9 Hypoparathyroidism, unspecified. Parathyroid tetagy

E21 Hyperparathyroidism and other disorders of the parathyroid [parathyroid] gland

Excludes: osteomalacia:
. in adults (M83.-)
. in childhood and adolescence (E55.0)

E21.0 Primary hyperparathyroidism. Hyperplasia of the parathyroid glands.
Generalized fibrous osteodystrophy [Recklinghausen's bone disease]
E21.1 Secondary hyperparathyroidism, not elsewhere classified.
Excludes: secondary hyperparathyroidism of renal origin (N25.8)
E21.2 Other forms of hyperparathyroidism.
Excludes: familial hypocalciuric hypercalcemia (E83.5)
E21.3 Hyperparathyroidism, unspecified
E21.4 Other specified parathyroid disorders
E21.5 Disease of the parathyroid glands, unspecified

E22 Hyperfunction of the pituitary gland

Excludes: Itsenko-Cushing's syndrome (E24.-)
Nelson's syndrome (E24.1)
hypersecretion:
. adrenocorticotropic hormone [ACTH], unrelated
with Itsenko-Cushing's syndrome (E27.0)
. pituitary ACTH (E24.0)
. thyroid-stimulating hormone (E05.8)

E22.0 Acromegaly and pituitary gigantism.
Arthropathy associated with acromegaly (M14.5).
Hypersecretion of growth hormone.
Excluded: constitutional:
. gigantism (E34.4)
. tall (E34.4)
hypersecretion of growth hormone-releasing hormone (E16.8)
E22.1 Hyperprolactinemia. If necessary, to identify the drug that caused hyperprolactinemia, use an additional code of external causes (class XX).
E22.2 Syndrome of inappropriate secretion of antidiuretic hormone
E22.8 Other states of hyperfunction of the pituitary gland. Precocious puberty of central origin
E22.9 Hyperfunction of the pituitary gland, unspecified

E23 Hypofunction and other disorders of the pituitary gland

Includes: listed conditions due to diseases of the pituitary and hypothalamus
Excludes: hypopituitarism following medical procedures (E89.3)

E23.0 Hypopituitarism. Fertile eunuchoid syndrome. Hypogonadotropic hypogonadism.
Idiopathic growth hormone deficiency.
Isolated deficiency:
. gonadotropin
. growth hormone
. other pituitary hormones
Kalmann syndrome
Short stature [dwarfism] Loreina-Levi
Pituitary necrosis (postpartum)
Panhypopituitarism
Pituitary :
. cachexia
. insufficiency NOS
. short stature [dwarfism]
Sheehan's syndrome. Simmonds disease
E23.1 Medical hypopituitarism.
E23.2 Diabetes insipidus.
Excludes: nephrogenic diabetes insipidus (N25.1)
E23.3 Hypothalamic dysfunction, not elsewhere classified.
Excludes: Prader-Willi syndrome (Q87.1), Russell-Silver syndrome (Q87.1)
E23.6 Other diseases of the pituitary gland. Abscess of the pituitary gland. Adiposogenital dystrophy
E23.7 Pituitary disease, unspecified

E24 Itsenko-Cushing's syndrome

E24.0 Itsenko-Cushing's disease of pituitary origin. Hypersecretion of ACTH by the pituitary.
Hyperadrenocorticism of pituitary origin
E24.1 Nelson syndrome
E24.2 Drug Itsenko-Cushing's syndrome.
If necessary, to identify the medicinal product, use an additional external cause code (class XX).
E24.3 Ectopic ACTH syndrome
E24.4 Cushingoid syndrome caused by alcohol
E24.8 Other Conditions Characterized by Cushingoid Syndrome
E24.9 Itsenko-Cushing syndrome, unspecified

E25 Adrenogenital disorders

Includes: adrenogenital syndromes, virilization or feminization acquired or due to hyperplasia
adrenal glands, which is a consequence of congenital enzyme defects in the synthesis of hormones
female(s):
. adrenal false hermaphroditism
. heterosexual precocious false genitalia
maturity
male(s):
. isosexual precocious false genitalia
maturity
. early macrogenitosomia
. precocious puberty with hyperplasia
adrenal glands
. virilization (female)

E25.0 Congenital adrenogenital disorders associated with enzyme deficiency. Congenital adrenal hyperplasia. Deficiency of 21-hydroxylase. Congenital adrenal hyperplasia causing salt loss
E25.8 Other adrenogenital disorders. Idiopathic adrenogenital disorder.
If necessary, to identify the drug that caused the adrenogenital disorder, use an additional code of external causes (class XX).
E25.9 Adrenogenital disorder, unspecified. Adrenogenital syndrome NOS

E26 Hyperaldosteronism

E26.0 Primary hyperaldosteronism. Conn's syndrome. Primary aldosteronism due to hyperplasia of the supra-
kidney (bilateral)
E26.1 Secondary hyperaldosteronism
E26.8 Other forms of hyperaldosteronism. Barter syndrome
E26.9 Hyperaldosteronism, unspecified

E27 Other adrenal disorders

E27.0 Other types of hypersecretion of the adrenal cortex.
Hypersecretion of adrenocorticotropic hormone [ACTH] not associated with Itsenko-Cushing's disease.
Excludes: Itsenko-Cushing's syndrome (E24.-)
E27.1 Primary adrenal insufficiency. Addison's disease. Autoimmune inflammation of the adrenal glands.
Excludes: amyloidosis (E85.-), Addison's disease of tuberculous origin (A18.7), Waterhouse-Friderichsen syndrome (A39.1)
E27.2 Addisonian crisis. Adrenal crisis. adrenocortical crisis
E27.3 Drug insufficiency of the adrenal cortex. If necessary, to identify the medicinal product, use an additional external cause code (class XX).
E27.4 Other and unspecified insufficiency of the adrenal cortex.
Adrenal(th):
. bleeding
. heart attack
Adrenocortical sufficiency NOS. Hypoaldosteronism.
Excludes: adrenoleukodystrophy [Addison-Schilder] (E71.3), Waterhouse-Friderichsen syndrome (A39.1)
E27.5 Hyperfunction of the adrenal medulla. Hyperplasia of the adrenal medulla.
Catecholamine hypersecretion
E27.8 Other specified disorders of the adrenal glands. Impaired cortisol-binding globulin
E27.9 Adrenal gland disease, unspecified

E28 Ovarian dysfunction

Excludes: isolated gonadotropic insufficiency (E23.0)
ovarian failure following medical procedures (E89.4)

E28.0 Excess estrogen. If necessary, to identify the drug that caused the excess estrogens, use an additional code of external causes (class XX).
E28.1 An excess of androgens. Hypersecretion of ovarian androgens. If necessary, to identify the drug that caused the androgen excess, use an additional code of external causes (class XX).
E28.2 Polycystic ovarian syndrome. Sclerocystic ovarian syndrome. Stein-Leventhal syndrome
E28.3 Primary ovarian failure. Low estrogen content. Premature menopause NOS.
Persistent ovarian syndrome.
Excl.: menopause and female climacteric status (N95.1)
pure gonadal dysgenesis (Q99.1)
Turner's syndrome (Q96.-)
E28.8 Other types of ovarian dysfunction. Ovarian hyperfunction NOS
E28.9 Ovarian dysfunction, unspecified

E29 Testicular dysfunction

azoospermia or oligospermia NOS (N46)
isolated gonadotropic insufficiency (E23.0)
Klinefelter's syndrome (Q98.0-Q98.2, Q98.4)
testicular hypofunction following medical procedures (E89.5)
testicular feminization (syndrome) (E34.5)

E29.0 Testicular hyperfunction. Hypersecretion of testicular hormones
E29.1 Testicular hypofunction. Impaired biosynthesis of testicular androgen NOS
5-alpha reductase deficiency (with male pseudohermaphroditism). Testicular hypogonadism NOS.
If necessary, to identify the drug that caused testicular hypofunction, use an additional
external cause code (class XX).
E29.8 Other types of testicular dysfunction
E29.9 Testicular dysfunction, unspecified

E30 Disorders of puberty, not elsewhere classified

E30.0 Delayed puberty. Constitutional delay in puberty.
Delayed puberty
E30.1 Precocious puberty. Premature menstruation.
Excludes: Albright(-McCune)(-Sternberg) syndrome (Q78.1)
precocious puberty of central origin (E22.8)
female heterosexual precocious false puberty (E25.-)
male isosexual precocious false puberty (E25.-)
E30.8 Other disorders of puberty. Premature thelarche
E30.9 Disorder of puberty, unspecified

E31 Polyglandular dysfunction

Excludes: telangiectatic ataxia [Louis Bar] (G11.3)
myotonic dystrophy [Steinert] (G71.1)
pseudohypoparathyroidism (E20.1)

E31.0 Autoimmune polyglandular insufficiency. Schmidt syndrome
E31.1 Polyglandular hyperfunction.
Excludes: multiple endocrine adenomatosis (D44.8)
E31.8 Other polyglandular dysfunction
E31.9 Polyglandular dysfunction, unspecified

E32 Diseases of the thymus

Excludes: aplasia or hypoplasia with immunodeficiency (D82.1), myasthenia gravis (G70.0)

E32.0 Persistent hyperplasia of the thymus. Hypertrophy of the thymus
E32.1 Abscess of the thymus
E32.8 Other diseases of the thymus
E32.9 Thymus disease, unspecified

E34 Other endocrine disorders

Excludes: pseudohypoparathyroidism (E20.1)

E34.0 carcinoid syndrome.
Note. If necessary, to identify the functional activity associated with a carcinoid tumor, you can use an additional code.
E34.1 Other conditions of hypersecretion of intestinal hormones
E34.2 Ectopic hormonal secretion, not elsewhere classified
E34.3 Short stature [dwarfism], not elsewhere classified.
Short stature:
. NOS
. constitutional
. laron type
. psychosocial
Excludes: progeria (E34.8)
Russell-Silver syndrome (Q87.1)
limb shortening with immunodeficiency (D82.2)
short stature:
. achondroplasty (Q77.4)
. hypochondroplastic (Q77.4)
. with specific dysmorphic syndromes
(code these syndromes; see index)
. alimentary (E45)
. pituitary (E23.0)
. renal (N25.0)
E34.4 Constitutional tallness. Constitutional gigantism
E34.5 Syndrome of androgen resistance. Male pseudohermaphroditism with androgen resistance.
Violation of peripheral hormonal reception. Reifenstein syndrome. Testicular feminization (syndrome)
E34.8 Other specified endocrine disorders. Dysfunction of the pineal gland. Progeria
E34.9 Endocrine disorder, unspecified.
Violation:
. endocrine NOS
. hormonal NOS

E35 Disorders of endocrine glands in diseases classified elsewhere

E35.0 Thyroid disorders in diseases classified elsewhere.
Thyroid tuberculosis (A18.8)
E35.1 Adrenal disorders in diseases classified elsewhere.
Addison's disease of tuberculous etiology (A18.7). Waterhouse-Friderichsen syndrome (meningococcal) (A39.1)
E35.8 Disorders of other endocrine glands in diseases classified elsewhere

malnutrition (E40-E46)

Note. The degree of malnutrition is usually assessed in terms of body weight, expressed in standard deviations from the mean value for the reference population. Lack of weight gain in children or evidence of decreased
A decrease in body weight in children or adults with one or more previous body weight measurements is usually an indicator of malnutrition. If there is evidence from only a single measurement of body weight, the diagnosis is based on assumptions and is not considered definitive unless other clinical and laboratory studies are performed. In exceptional cases, when there is no information about body weight, clinical data are taken as the basis. If an individual's body weight is below the mean for the reference population, then severe malnutrition is highly likely when the observed value is 3 or more standard deviations below the mean for the reference group; moderate malnutrition if the observed value is 2 or more but less than 3 standard deviations below the mean, and mild malnutrition if the observed body weight is 1 or more but less than 2 standard deviations below the mean for the reference group.

Excludes: intestinal malabsorption (K90.-)
nutritional anemia (D50-D53)
consequences of protein-energy malnutrition (E64.0)
wasting disease (B22.2)
starvation (T73.0)

E40 Kwashiorkor

Severe malnutrition accompanied by alimentary edema and pigmentation disorders of the skin and hair

E41 Alimentary insanity

Severe malnutrition accompanied by insanity
Excluded: senile kwashiorkor (E42)

E42 Marasmic kwashiorkor

Severe protein-energy malnutrition [as in E43]:
. intermediate form
. with symptoms of kwashiorkor and marasmus

E43 Severe protein-energy malnutrition, unspecified

Severe weight loss in a child or adult or no weight gain in a child that results in detectable weight being at least 3 standard deviations below the mean for the reference group (or similar weight loss reflected by other statistical methods) . If only a single measurement of body weight is available, severe wasting is highly likely when the detected body weight is 3 or more standard deviations below the mean for the reference population. hungry edema

E44 Moderate and mild protein-energy malnutrition

E44.0 Moderate protein-energy insufficiency. Weight loss in children or adults or lack of weight gain in a child that results in detectable body weight below the mean
for a reference population by 2 standard deviations or more but less than 3 standard deviations (or
similar weight loss reflected by other statistical methods). If only a single measurement of body weight is available, then moderate protein-energy malnutrition is highly likely when the detected body weight is 2 or more standard deviations below the mean for the reference population.

E44.1 Mild protein-energy malnutrition. Weight loss in children or adults or lack of weight gain in a child that results in detectable body weight below the mean
for a reference population by 1 or more but less than 2 standard deviations (or similar weight loss reflected by other statistical methods). If data from only a single measurement of body weight are available, then mild protein-energy malnutrition is highly likely when the detected body weight is 1 or more, but less than 2 standard deviations, below the mean for the reference population.

E45 Developmental delay due to protein-energy malnutrition

Alimentary:
. short stature (dwarfism)
. growth retardation
Delayed physical development due to malnutrition

E46 Protein-energy malnutrition, unspecified

Malnutrition NOS
Protein-energy imbalance NOS

OTHER MALNUTRITIONS (E50-E64)

Excludes: nutritional anemia (D50-D53)

E50 Vitamin A deficiency

Excludes: consequences of vitamin A deficiency (E64.1)

E50.0 Vitamin A deficiency with conjunctival xerosis
E50.1 Vitamin A deficiency with Byto's plaques and conjunctival xerosis. Bitot's plaque in a young child
E50.2 Vitamin A deficiency with corneal xerosis
E50.3 Vitamin A deficiency with corneal ulceration and xerosis
E50.4 Vitamin A deficiency with keratomalacia
E50.5 Vitamin A deficiency with night blindness
E50.6 Vitamin A deficiency with xerophthalmic corneal scars
E50.7 Other ocular manifestations of vitamin A deficiency. Xerophthalmia NOS
E50.8 Other manifestations of vitamin A deficiency.
Follicular keratosis) due to insufficiency
Xeoderma) vitamin A (L86)
E50.9 Vitamin A deficiency, unspecified. Hypovitaminosis A NOS

E51 Thiamine deficiency

Excludes: consequences of thiamine deficiency (E64.8)

E51.1 Take it.
Take take:
. dry form
. wet form (I98.8)
E51.2 Wernicke's encephalopathy
E51.8 Other manifestations of thiamine deficiency
E51.9 Thiamine deficiency, unspecified

E52 Nicotinic acid deficiency [pellagra]

Failure:
. niacin (-tryptophan)
. nicotinamide
Pellagra (alcoholic)
Excludes: consequences of nicotinic acid deficiency (E64.8)

E53 Deficiency of other B vitamins

Excludes: consequences of vitamin B deficiency (E64.8)
vitamin B12 deficiency anemia (D51.-)

E53.0 Riboflavin deficiency. Ariboflavinosis
E53.1 Pyridoxine deficiency. Vitamin B6 deficiency.
Excludes: pyridoxine-responsive sideroblastic anemia (D64.3)
E53.8 Deficiency of other specified B vitamins.
Failure:
. biotin
. cyanocobalamin
. folate
. folic acid
. pantothenic acid
. vitamin B12
E53.9 B vitamin deficiency, unspecified

E54 Ascorbic acid deficiency

Vitamin C deficiency. Scurvy.
Excludes: anemia due to scurvy (D53.2)
consequences of vitamin C deficiency (E64.2)

E55 Vitamin D deficiency

osteoporosis (M80-M81)
effects of rickets (E64.3)

E55.0 Rickets is active.
Osteomalacia:
. children's
. youthful
Excludes: rickets:
. intestinal (K90.0)
. Crown (K50.-)
. inactive (E64.3)
. renal (N25.0)
. vitamin D-resistant (E83.3)
E55.9 Vitamin D deficiency, unspecified. Avitaminosis D

E56 Deficiency of other vitamins

Excludes: consequences of other vitamin deficiencies (E64.8)

E56.0 Vitamin E deficiency
E56.1 Vitamin K deficiency.
Excludes: clotting factor deficiency due to vitamin K deficiency (D68.4)
vitamin K deficiency in newborn (P53)
E56.8 Deficiency of other vitamins
E56.9 Vitamin deficiency, unspecified

E58 Nutritional calcium deficiency

Excludes: disorders of calcium metabolism (E83.5)
consequences of calcium deficiency (E64.8)

E59 Alimentary deficiency of selenium

Keshan disease
Excludes: sequelae of selenium deficiency (E64.8)

E60 Nutritional zinc deficiency

E61 Insufficiency of other batteries

If necessary, to identify the medicinal product that caused the failure, use an additional external cause code (class XX).
Excludes: disorders of mineral metabolism (E83.-)
thyroid dysfunction associated with iodine deficiency (E00-E02)

E61.0 copper deficiency
E61.1 iron deficiency.
Excludes: iron deficiency anemia (D50.-)
E61.2 Magnesium deficiency
E61.3 Manganese deficiency
E61.4 Chromium deficiency
E61.5 Molybdenum deficiency
E61.6 Vanadium deficiency
E61.7 Deficiency of many nutrients
E61.8 Deficiency of other specified nutritional elements
E61.9 Deficiency of batteries, unspecified

E63 Other malnutrition

Excludes: dehydration (E86)
growth disorders (R62.8)
feeding problems of the newborn (P92. -)
consequences of malnutrition and other nutritional deficiencies (E64. -)

E63.0 Deficiency of essential fatty acids
E63.1 Unbalanced intake of food elements
E63.8 Other specified malnutrition
E63.9 Malnutrition, unspecified. Cardiomyopathy due to malnutrition NOS+ (I43.2)

E64 Sequelae of malnutrition and deficiencies of other nutrients

E64.0 Consequences of protein-energy insufficiency.
Excludes: developmental delay due to protein-energy malnutrition (E45)
E64.1 Consequences of vitamin A deficiency
E64.2 Consequences of vitamin C deficiency
E64.3 Consequences of rickets
E64.8 Consequences of other vitamin deficiencies
E64.9 Sequelae of nutritional deficiencies, unspecified

OBESITY AND OTHER OVERNUTRITION (E65-E68)

E65 Localized fat deposition

Fat pads

E66 Obesity

Excludes: adiposogenital dystrophy (E23.6)
lipomatosis:
. NOS (E88.2)
. painful [Dercum's disease] (E88.2)
Prader-Willi syndrome (Q87.1)

E66.0 Obesity due to excess intake of energy resources
E66.1 Obesity caused by medication.
If necessary, to identify the medicinal product, use an additional external cause code (class XX).
E66.2 Extreme obesity accompanied by alveolar hypoventilation. pickwick syndrome
E66.8 Other forms of obesity. Morbid obesity
E66.9 Obesity, unspecified. Simple obesity NOS

E67 Other types of power redundancy

Excludes: overeating NOS (R63.2)
consequences of overnutrition (E68)

E67.0 Hypervitaminosis A
E67.1 Hypercarotenemia
E67.2 Syndrome of megadoses of vitamin B6
E67.3 Hypervitaminosis D
E67.8 Other specified forms of overnutrition

E68 Consequences of oversupply

METABOLIC DISORDERS (E70-E90)

Excludes: androgen resistance syndrome (E34.5)
congenital adrenal hyperplasia (E25.0)
Ehlers-Danlos syndrome (Q79.6)
hemolytic anemias due to enzyme disorders (D55.-)
Marfan syndrome (Q87.4)
5-alpha-reductase deficiency (E29.1)

E70 Disorders of aromatic amino acid metabolism

E70.0 Classic phenylketonuria
E70.1 Other types of hyperphenylalaninemia
E70.2 Tyrosine metabolism disorders. Alkaptonuria. Hypertyrosinemia. Ochronosis. Tyrosinemia. Tyrosinosis
E70.3 Albinism.
Albinism:
. ophthalmic
. dermo-ocular
Syndrome:
. Chediaka (-Steinbrink) -Higashi
. cross
. Hermanski-Pudlaka
E70.8 Other metabolic disorders of aromatic amino acids.
Violations:
. histidine metabolism
. tryptophan metabolism
E70.9 Disorders of aromatic amino acid metabolism, unspecified

E71 Disorders of branched-chain amino acid metabolism and fatty acid metabolism

E71.0 Maple Syrup Disease
E71.1 Other types of metabolic disorders of branched chain amino acids. Hyperleucine isoleucinemia. Hypervalinemia.
Isovaleric acidemia. Methylmalonic acidemia. propionic acidemia
E71.2 Disorders of branched-chain amino acid metabolism, unspecified
E71.3 Fatty acid metabolism disorders. Adrenoleukodystrophy [Addison-Schilder].
Deficiency of muscle carnitine palmityltransferase.
Excludes: Refsum's disease (G60.1)
Schilder's disease (G37.0)
Zellweger syndrome (Q87.8)

E72 Other disorders of amino acid metabolism

Excludes: abnormal without evidence of disease (R70-R89)
violations:
. aromatic amino acid metabolism (E70. -)
. branched-chain amino acid metabolism (E71.0-E71.2)
. fatty acid metabolism (E71.3)
. metabolism of purines and pyrimidines (E79. -)
gout (M10.-)

E72.0 Amino acid transport disorders. cystinosis. Cystinuria.
Fanconi syndrome (-de Toni) (-Debre). Hartnap's disease. Low's syndrome.
Excludes: disorders of tryptophan metabolism (E70.8)
E72.1 Metabolic disorders of sulfur-containing amino acids. Cystationinuria.
Homocystinuria. Methioninemia. Deficiency of sulfite oxidase.
Excludes: transcobalamin II deficiency (D51.2)
E72.2 Urea cycle metabolic disorders. Argininemia. Argininosuccinic aciduria. Citrullinemia. Hyperammonemia.
Excludes: disorders of ornithine metabolism (E72.4)
E72.3 Metabolic disorders of lysine and hydroxylysine. Glutaric aciduria. Hydroxylysinemia. Hyperlysinemia
E72.4 Ornithine metabolism disorders. Ornithinaemia (types I, II)
E72.5 Glycine metabolism disorders. Hyperhydroxyprolinemia. Hyperprolinemia (types I, II). Non-ketone hyperglycinemia.
Sarcosinemia
E72.8 Other specified disorders of amino acid metabolism.
Violations:
. beta amino acid metabolism
. gamma-glutamyl cycle
E72.9 Amino acid metabolism disorders, unspecified

E73 Lactose intolerance

E73.0 Congenital lactase deficiency
E73.1 Secondary lactase deficiency
E73.8 Other types of lactose intolerance
E73.9 Lactose intolerance, unspecified

E74 Other disorders of carbohydrate metabolism

Excludes: increased secretion of glucagon (E16.3)
diabetes mellitus (E10-E14)
hypoglycemia NOS (E16.2)
mucopolysaccharidosis (E76.0-E76.3)

E74.0 Diseases of glycogen storage. Cardiac glycogenosis.
Disease:
. Andersen
. Corey
. Forbes
. Gersa
. McArdle
. pompe
. Tauri
. Gierke
Liver phosphorylase deficiency
E74.1 Fructose metabolism disorders. Essential fructosuria.
Fructose-1,6-diphosphatase deficiency. hereditary fructose intolerance
E74.2 Disorders of galactose metabolism. Galactokinase deficiency. Galactosemia
E74.3 Other disorders of absorption of carbohydrates in the intestine. Malabsorption of glucose-galactose.
Deficiency of sucrose.
Excludes: lactose intolerance (E73.-)
E74.4 Disorders of pyruvate metabolism and gluconeogenesis.
Failure:
. phosphoenolpyruvate carboxykinase
. pyruvate:
. carboxylase
. dehydrogenases
Excludes: with anemia (D55.-)
E74.8 Other specified disorders of carbohydrate metabolism. Essential pentosuria. Oxalosis. Oxaluria.
Renal glucosuria
E74.9 Disorder of carbohydrate metabolism, unspecified

E75 Disorders of sphingolipid metabolism and other lipid storage diseases

Excludes: mucolipidosis types I-III (E77.0-E77.1)
Refsum's disease (G60.1)

E75.0 Gangliosidosis-GM2.
Disease:
. Sendhoff
. Thea-Saxa
GM2 gangliosidosis:
. NOS
. adults
. juvenile
E75.1 Other gangliosidoses.
Gangliosidosis:
. NOS
. GM1
. GM3
Mucolipidosis IV
E75.2 Other sphingolipidoses.
Disease:
. Fabri(-Anderson)
. Gaucher
. Crabbe
. Niman-Peak
Faber syndrome. Metachromatic leukodystrophy. sulfatase deficiency.
Excludes: adrenoleukodystrophy (Addison-Schilder) (E71.3)
E75.3 Sphingolipidosis, unspecified
E75.4 Lipofuscinosis of neurons.
Disease:
. Batten
. Bilshovsky-Yansky
. Kufsa
. Spielmeier-Vogt
E75.5 Other disorders of lipid accumulation. Cerebrotendinous cholesterosis [Van Bogart-Scherer-Epstein]. Volman disease
E75.6 Lipid storage disease, unspecified

E76 Disorders of metabolism of glucosaminoglycans

E76.0 Mucopolysaccharidosis, type I.
Syndromes:
. Gurler
. Gurler-Sheie
. Sheye
E76.1 Mucopolysaccharidosis, type II. Gunther's syndrome
E76.2 Other mucopolysaccharidoses. Deficiency of beta-glucuronidase. Mucopolysaccharidoses types III, IV, VI, VII
Syndrome:
. Maroto-Lami (light) (heavy)
. Morchio (-similar) (classic)
. Sanfilippo (type B) (type C) (type D)
E76.3 Mucopolysaccharidosis, unspecified
E76.8 Other disorders of glycosaminoglycan metabolism
E76.9 Disorder of glycosaminoglycan metabolism, unspecified

E77 Disorders of glycoprotein metabolism

E77.0 Defects in post-translational modification of lysosomal enzymes. Mucolipidosis II.
Mucolipidosis III [Hurler pseudopolydystrophy]
E77.1 Defects in the degradation of glycoproteins. Aspartyl glucosaminuria. Fucosidosis. Mannosidosis. Sialidosis [mucolipidosis I]
E77.8 Other disorders of glycoprotein metabolism
E77.9 Disorders of glycoprotein metabolism, unspecified

E78 Disorders of lipoprotein metabolism and other lipidemias

Excludes: sphingolipidosis (E75.0-E75.3)
E78.0 pure hypercholesterolemia. Familial hypercholesterolemia. Hyperlipoporteinemia Fredrickson, type Iia.
Hyper-beta-lipoproteinemia. Hyperlipidemia, group A. Hyperlipoproteinemia with low-density lipoprotein
E78.1 pure hyperglyceridemia. endogenous hyperglyceridemia. Hyperlipoporteinemia Fredrickson, type IV.
Hyperlipidemia, group B. Hyperpre-beta-lipoproteinemia. Hyperlipoproteinemia with very low lipoproteins
density
E78.2 Mixed hyperlipidemia. Extensive or floating beta-lipoproteinemia.
Hyperlipoporteinemia Fredrickson, types IIb or III. Hyperbetalipoproteinemia with pre-beta lipoproteinemia.
Hypercholesterolemia with endogenous hyperglyceridemia. Hyperlipidemia, group C. Tuboeruptive xanthoma.
Tuberous xanthoma.
Excludes: cerebrotendinous cholesterosis [Van Bogart-Scherer-Epstein] (E75.5)
E78.3 Hyperchylomicronemia. Hyperlipoporteinemia Fredrickson, types I or V.
Hyperlipidemia, group D. Mixed hyperglyceridemia
E78.4 Other hyperlipidemias. Familial combined hyperlipidemia
E78.5 Hyperlipidemia, unspecified
E78.6 Lack of lipoproteins. A-beta-lipoproteinemia. Deficiency of high density lipoproteins.
Hypo-alpha-lipoproteinemia. Hypo-beta-lipoproteinemia (familial). Deficiency of lecithincholesterol acyltransferase. Tangier disease
E78.8 Other disorders of lipoprotein metabolism
E78.9 Disorders of lipoprotein metabolism, unspecified

E79 Disorders of purine and pyrimidine metabolism

Excludes: kidney stone (N20.0)
combined immunodeficiencies (D81.-)
gout (M10.-)
orotaciduric anemia (D53.0)
xeroderma pigmentosum (Q82.1)

E79.0 Hyperuricemia without signs of inflammatory arthritis and gouty nodes. Asymptomatic hyperuricemia
E79.1 Lesch-Nychen syndrome
E79.8 Other metabolic disorders of purines and pyrimidines. hereditary xanthinuria
E79.9 Disturbance of purine and pyrimidine metabolism, unspecified

E80 Disorders of porphyrin and bilirubin metabolism

Includes: catalase and peroxidase defects

E80.0 Hereditary erythropoietic porphyria. Congenital erythropoietic porphyria.
Erythropoietic protoporphyria
E80.1 Porphyria cutaneous slow
E80.2 Other porphyrias. hereditary coproporphyria
Porfiria:
. NOS
. acute intermittent (hepatic)
If it is necessary to identify the cause, use an additional external cause code (class XX).
E80.3 Catalase and peroxidase defects. Acatalasia [Takahara]
E80.4 Gilbert's syndrome
E80.5 Crigler-Najjar Syndrome
E80.6 Other disorders of bilirubin metabolism. Dubin-Johnson Syndrome. Rotor syndrome
E80.7 Disorder of bilirubin metabolism, unspecified

E83 Disorders of mineral metabolism

Excludes: malnutrition (E58-E61)
parathyroid disorders (E20-E21)
vitamin D deficiency (E55.-)

E83.0 Copper metabolism disorders. Menkes disease [curly hair disease] [steel hair]. Wilson's disease
E83.1 Iron metabolic disorders. Hemochromatosis.
Excludes: anemia:
. iron deficiency (D50. -)
. sideroblastic (D64.0-D64.3)
E83.2 Disorders of zinc metabolism. Enteropathic acrodermatitis
E83.3 Phosphorus metabolism disorders. Acid phosphatase deficiency. Familial hypophosphatemia. Hypophosphatasia.
Vitamin D resistant:
. osteomalacia
. rickets
Excl.: adult osteomalacia (M83.-)
osteoporosis (M80-M81)
E83.4 Magnesium metabolism disorders. Hypermagnesemia. Hypomagnesemia
E83.5 Calcium metabolism disorders. Familial hypocalciuric hypercalcemia. Idiopathic hypercalciuria.
Excludes: chondrocalcinosis (M11.1-M11.2)
hyperparathyroidism (E21.0-E21.3)
E83.8 Other disorders of mineral metabolism
E83.9 Mineral metabolism disorder, unspecified

E84 Cystic fibrosis

Includes: cystic fibrosis

E84.0 Cystic fibrosis with pulmonary manifestations
E84.1 Cystic fibrosis with intestinal manifestations. Meconium ileus(P75)
E84.8 Cystic fibrosis with other manifestations. Cystic fibrosis with combined manifestations
E84.9 Cystic fibrosis, unspecified

E85 Amyloidosis

Excludes: Alzheimer's disease (G30.-)

E85.0 Hereditary familial amyloidosis without neuropathy. Familial Mediterranean fever.
hereditary amyloid nephropathy
E85.1 Neuropathic hereditary familial amyloidosis. Amyloid polyneuropathy (Portuguese)
E85.2 Hereditary familial amyloidosis, unspecified
E85.3 Secondary systemic amyloidosis. Amyloidosis associated with hemodialysis
E85.4 limited amyloidosis. Localized amyloidosis
E85.8 Other forms of amyloidosis
E85.9 Amyloidosis, unspecified

E86 Reducing the volume of liquid

Dehydration. Decreased volume of plasma or extracellular fluid. hypovolemia
Excludes: dehydration of newborn (P74.1)
hypovolemic shock:
. NOS (R57.1)
. postoperative (T81.1)
. traumatic (T79.4)

E87 Other disorders of water-salt metabolism or acid-base balance

E87.0 Hyperosmolarity and hypernatremia. Excess sodium. Sodium overload
E87.1 Hypoosmolarity and hyponatremia. Sodium deficiency.
Excludes: syndrome of impaired secretion of antidiuretic hormone (E22.2)
E87.2 Acidosis.
Acidosis:
. NOS
. lactic acid
. metabolic
. respiratory
Excludes: diabetic acidosis (E10-E14 with common fourth character.1)
E87.3 Alkalosis.
Alkalosis:
. NOS
. metabolic
. respiratory
E87.4 Mixed acid-base imbalance
E87.5 Hyperkalemia. Excess potassium [K]. Potassium overload [K]
E87.6 Hypokalemia. Potassium deficiency [K]
E87.7 Hypervolemia.
Excludes: edema (R60.-)
E87.8 Other disorders of water-salt balance, not elsewhere classified.
Electrolyte imbalance NOS. Hyperchloremia. Hypochloremia

E88 Other metabolic disorders

Excludes: histiocidosis X (chronic) (D76.0)
If necessary, to identify the drug that caused the metabolic disorder, use an additional code of external causes (class XX).

E88.0 Disorders of plasma protein metabolism, not elsewhere classified. Alpha-1 antitrypsin deficiency.
Bis-albuminemia.
Excludes: disorders of lipoprotein metabolism (E78.-)
monoclonal gammopathy (D47.2)
polyclonal hyper-gamma globulinemia (D89.0)
Waldenström's macroglobulinemia (C88.0)
E88.1 Lipodystrophy, not elsewhere classified. Lipodystrophy NOS.
Excludes: Whipple's disease (K90.8)
E88.2 Lipomatosis, not elsewhere classified.
Lipomatosis:
. NOS
. painful [Derkum's disease]
E88.8 Other specified metabolic disorders. Adenolipomatosis Lonua-Bansod. Trimethylaminuria
E88.9 Metabolic disorder, unspecified

E89 Endocrine and metabolic disorders following medical procedures, not elsewhere classified

E89.0 Hypothyroidism following medical procedures.
Radiation-induced hypothyroidism. Postoperative hypothyroidism
E89.1 Hypoinsulinemia after medical procedures. Hyperglycemia after removal of the pancreas.
Hypoinsulinemia postoperative
E89.2 Hypoparathyroidism following medical procedures. Parathyroid tetany
E89.3 Hypopituitarism after medical procedures. Radiation-induced hypopituitarism
E89.4 Ovarian dysfunction following medical procedures
E89.5 Testicular hypofunction following medical procedures
E89.6 Hypofunction of the adrenal cortex (medulla) after medical procedures
E89.8 Other endocrine and metabolic disorders resulting from medical procedures
E89.9 Endocrine and metabolic disorder occurring after medical procedures, unspecified

Obesity is a condition in which excess body fat accumulates in the human body. A person is recognized as having this disease if his weight exceeds the maximum allowable for his height by at least 20 percent.

Causes

Obesity occurs when the energy value of food entering the body exceeds the needs of the body. Predisposition to obesity can be inherited both as a result of established eating habits and through the fault of a genetic factor. In rare cases, obesity can be a symptom of a hormonal disorder such as hypothyroidism. Some drugs, especially, can also lead to obesity.

Risk factors

The risk of developing the disease increases with age. Women are more often affected. Sometimes the predisposition to obesity is inherited. The main risk factors are intemperance in eating and a sedentary lifestyle.

Complications

Obesity can be the cause of various health problems, because of it, the organs and joints of the human body experience additional stress. For example, the most common such problems include shortness of breath, back pain, hip and knee pain. Obesity increases the risk of developing some common, potentially life-threatening diseases such as arteritis, stroke, and high blood pressure.

Diagnostics

With the development of obesity, you should consult a doctor. To exclude concomitant diseases, the patient will take a blood test for sugar (to rule out diabetes) and cholesterol. Additionally, blood tests may be taken to detect other hormonal disorders. At the appointment, most likely, the patient's weight and height will be measured, and an individual diet will be developed. In addition, physical activity of a certain intensity will be recommended.

Non-drug methods treatment

Most often, obesity is treated with a weight-reducing diet and increased exercise. Typically, daily calorie intake is reduced by 500-1000 of the number recommended for people of the same height, sex and age as the patient. An individual diet is designed in such a way as to ensure a slow, gentle weight loss. The diet can be adjusted by a doctor or nutritionist, although in addition the patient can join a self-help group. Regular moderate-intensity exercise is essential for weight loss.

Pharmacotherapy

Medications that suppress appetite may be effective. regulates appetite by acting on neurotransmitters in the brain. In addition, medications, such as those that impair the digestive tract's ability to absorb nutrients, may be helpful. In rare cases, obesity is treated with surgery. For example, the stomach may be braced to reduce its size.

Obesity. A condition in which excess body fat accumulates in the human body. The risk of developing the disease increases with age. Women are more often affected. Sometimes the predisposition to obesity is inherited. Risk factors are intemperance in eating and a sedentary lifestyle.
A person is considered obese if his weight exceeds the maximum allowable for his height by at least 20 percent.
Obesity can be the cause of various health problems, as of. For him, the organs and joints of the human body experience additional stress. For example, the most common such problems include: shortness of breath, pain in the back, as well as in the hip and knee joints. Obesity increases the risk of developing some common, potentially life-threatening diseases such as arteritis, stroke, and high blood pressure.
Obesity occurs when the energy value of food entering the body exceeds the needs of the body. The main causes of the disease include intemperance in food, as well as a sedentary lifestyle. The predisposition to obesity can be inherited, both as a result of established eating habits and through the fault of a genetic factor. In rare cases, obesity can be a symptom of a hormonal disorder, such as hypothyroidism. Some drugs, especially corticosteroids, can also lead to obesity.
With the development of obesity, you should consult a doctor. At the appointment, most likely, the patient's weight and height will be measured, and an individual diet will be developed. In addition, physical activity of a certain intensity will be recommended. To exclude concomitant diseases, the patient will take a blood test for sugar (to rule out diabetes) and cholesterol. Additionally, blood tests may be taken to detect other hormonal disorders.
Most often, obesity is treated with a weight-reducing diet and increased exercise. Typically, daily calorie intake is reduced by 500-1000 of the number recommended for people of the same height, sex and age as the patient. An individual diet is designed in such a way as to ensure a slow, gentle weight loss. The diet can be adjusted by a doctor or nutritionist, although in addition the patient can join a self-help group. Regular moderate-intensity exercise is essential for weight loss.
Medications that suppress appetite may be effective. Sibutramine regulates appetite by acting on neurotransmitters in the brain. In addition, medications, such as orlistat, which reduce the ability of the digestive tract to absorb nutrients, may be helpful. In rare cases, obesity is treated with surgery. For example, the stomach may be braced to reduce its size.

Hypotrophy is a chronic eating disorder characterized by varying degrees of weight loss. As a rule, young children suffer from malnutrition.

Code according to the international classification of diseases ICD-10:

Causes

Etiology, pathogenesis. The disease is polyetiological. There are congenital (prenatal) and acquired (postnatal) malnutrition. Congenital malnutrition is most often caused by maternal diseases or associated with intrauterine hypoxia, fetal infection, genomic and chromosomal mutations. Among the causes of acquired malnutrition, exogenous and endogenous are distinguished. The first include nutritional factors (hypogalactia in the mother, incorrectly calculated diet for artificial feeding, unilateral feeding, etc.), pyloric stenosis and pylorospasm, drug poisoning (hypervitaminosis D, etc.), infections of the gastrointestinal tract, deficiencies in care, regimen, education etc. Endogenous causes of malnutrition can be malformations of the gastrointestinal tract and other organs, CNS lesions, hereditary metabolic anomalies and immunodeficiency states, endocrine diseases, etc. The pathogenesis of malnutrition is based on a decrease in the utilization of nutrients with impaired processes digestion, absorption and assimilation of them under the influence of various factors. There are I, II and III degrees of severity of malnutrition.

Symptoms (signs)

Clinical picture. Hypotrophy of the 1st degree is characterized by a loss of body weight by no more than 20% of the due age. The subcutaneous fat layer on the abdomen becomes thinner, tissue turgor decreases. The weight gain curve is flattened. Other indicators are usually within the normal range or slightly reduced. With malnutrition of the II degree, the loss of body weight is 25 - 30% compared with the age norm. The subcutaneous layer is preserved only on the face, it is especially thinned on the abdomen and limbs. The skin is dry, easily gathers into folds, hangs down in some places. There is a lag in growth, appetite decreases, the child becomes irritable, loses previously acquired skills, and thermoregulation is disturbed. The stool is unstable: "hungry" stool (scanty, dry, discolored, with a sharp and unpleasant odor) is replaced by dyspeptic (green, undigested food particles, with mucus). With malnutrition of the III degree, the loss of body weight is more than 30% of the due to age. There is no increase in body weight, the child is significantly behind in growth. Outwardly - an extreme degree of exhaustion, the skin is pale gray in color, the subcutaneous fat layer is completely absent. The mucous membranes are pale, dry, in the mouth there are elements of candidal stomatitis (thrush). Breathing is shallow, heart sounds are muffled, blood pressure is reduced. The body temperature is lowered, there are periodic rises to subfebrile numbers, there is no difference between the axillary and rectal temperatures. Infectious processes are asymptomatic. Often there are signs of subacute current rickets.

Diagnostics

Diagnosis malnutrition is usually not difficult. It is much more difficult to find out the causes of malnutrition.

Treatment

Treatment patients should be comprehensive and include measures aimed at "eliminating or correcting causally significant factors, diet therapy, prescribing restorative procedures, enzymes and symptomatic agents, eliminating foci of infection, vitamin therapy. In all cases, when prescribing a diet, it is necessary to determine food tolerance. During the period increased nutritional load requires coprological control.In case of malnutrition of the 1st degree, the amount of proteins and carbohydrates is usually calculated per 1 kg of body weight due to age, and fats - per 1 kg of existing body weight.In case of malnutrition of the II degree, the establishment of food tolerance is carried out for 3 - 5 days. As a rule, breast milk or sour mixtures are prescribed (kefir, acidophilic "Baby", biolact, etc.).The calculation is first carried out on the existing body weight of the child, then on the approximately due (existing +20) and only then on the due From the 3rd - 4th day, the protein load is gradually increased, then the carbohydrate load and then ice queue fat. With malnutrition of the III degree, it is preferable to start diet therapy with the introduction of breast milk every 2 hours, 20-30 ml. Bringing the amount of food to 50 ml, reduce the number of feedings. The order of increasing the load of proteins, carbohydrates and fats is the same as with stage II malnutrition, but more gradual. Food tolerance is clarified within 2 weeks. With malnutrition II and III degree, the missing amount of fluid, nutrients and electrolytes is injected intravenously: 5 - 10% glucose solution, isotonic sodium chloride solution, Ringer's solution, protein hydrolysates, albumin, protein, etc. (albumin 3 - 5 ml /kg; hemodez up to 15 ml/kg, but not more than 200 ml; reopoliglyukin 3 - 8 ml/kg). Insulinglucosotherapy is shown (s / c 1 unit of insulin per 5 g of glucose administered).

Treatment malnutrition II - III degree must be carried out in a hospital. In the presence of foci of infection, antibiotics are prescribed (avoid nephro-, hepato- and ototoxic drugs), if necessary, surgical intervention is performed. Enzyme therapy, vitamin therapy are widely used. Of the stimulants, apilac, gamma globulin, albumin, plasma, blood transfusions are prescribed. In some cases, it is advisable to use anabolic hormones (retabolil 1 mg/kg once every 2 weeks, etc.). Showing massage and exercise therapy, staying in the fresh air.

Forecast depends on the cause that led to malnutrition, and the possibilities of its elimination. With primary hypotrophy of the III degree, the prognosis is always serious; lethality is up to 30%.

Prevention. If possible, ensure natural feeding, treatment of hypogalactia, rational feeding, early diagnosis of diseases of newborns and infants.

Diagnosis code according to ICD-10. E46