Tag: bariatric surgery

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Wellness

A city of overweight children?

Leading surgeon finds young children in Mumbai and other cities are more prone to obesity; calls it a ‘generational curse’.
by The Editors | editor@themetrognome.in

We see them everywhere. On their way back from school, or rooted firmly to their seats in front of their computers, or lounging for hours in front of the television – fat children, with ever-expanding waistlines and astounding weights for people so young.

When children are infants, a bit of extra weight seemingly adds to their chubby charm. What is alarming is, however, that some children are not just unable to shed the baby fat, they are unable to stop expanding at all.

Dr Shashank ShahSays Dr Shashank Shah (in pic on left), noted laparoscopic and bariatric surgeon with a huge practice in Mumbai and Pune, “In my practice, and overall, the trend we are observing is that this current generation of adolescent and pre-adolescent children is afflicted not just by an unhealthy lifestyle, but a ‘generational curse’. It seems to be a shift in evolution that is prompting their metabolism to not function at peak optimum levels.”

What does this mean?
This simply means that the metabolic set point for this generation has moved; doctors are increasingly seeing children with BMIs (Body to Mass Index) of 28 and above; 28 is considered the ideal BMI for adults. “There is a shift of the BMI to a higher level. This does not happen suddenly – it is both genetic and evolutionary in nature,” Dr Shah explains.

Not eating the right foods, not exercising enough or at all, and not being encouraged to lead a healthy lifestyle, are all combining to create obese childfatter, diseased kids. “Recently, at my clinic in Mumbai, there was a 12-year-old boy who came to see me,” Dr Shah says. “It seems difficult to believe, but 100 kgs is fast becoming an average weight for children.”

Diseases galore
A worrying trend, apart from the excess weight obese children are lugging around, is that they have several diseases right from a tender age. “Hypertension, diabetes, cardiac disorders…all of these are very common among obese children,” Dr Shah says. “Other problems that come at a later stage are fertility issues. Besides this, the fact that they are overweight and unable to do most activities that their peers can, also plays on them psychologically. However, many parents are slow to react to the problem. I have had several parents tell me that they enrolled their child in the gym because the weight was embarrassing,” Dr Shah explains.

He adds that most parents hardly ever realise that obesity is not an isolated disease – it brings with it other life-threatening conditions. “Their priority is weight loss. But why do they wait till the child becomes obese? They should see a doctor the moment they notice excessive weight loss,” Dr Shah says.

eating junkWhy is Mumbai at risk?
Simply because there are so many food choices and not enough spaces for recreation and outdoor play. “Working parents also have no time to see what their children are eating every day. Children also have liberal amounts of money to spend, so they tend to buy unhealthy junk food with friends,” says Dr Shah, adding that the cities in India and also Tier II cities like Pune are showing an upwards obesity trend in children due to poor eating choices.

(Pictures courtesy www.ibcclub.org, www.hindustantimes.com, infozone.wordpress.com, navimumbaicity.com. Pictures are used for representational purpose only)

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Wellness

Fat. So?

Obesity causes serious disorders, and goes beyond weight issues alone. Here’s how you can get out of the fat trap.
by Dr Jayashree Todkar

Part II

In the previous part, I mentioned my patient Priyanka Gupta (name changed), a 28-year-old suffering from severe emotional and physical troubles due to her obese condition, which had further wrecked havoc with her menstrual cycle and caused acute hirsuitness. She hadn’t had a regular period in a decade, and she had had to wax her facial hair every alternate day. Besides, she had to keep her face covered once she stepped out of her house.

I recommended that she undergo bariatric surgery to correct her condition. She decided to do it after a couple of visits, and she recuperated from the operation for two days. After this, she got back to her routine. But about two months after the surgery, she called me excitedly and said, “Dr Todkar, today for the first time in 10 years, I got my period without taking any medicines!” Elated that her body was indeed coming back to normal, she went on to say that her facial hair growth had also reduced, and that she needed to wax just once a week. She is doing very well now; her earlier problems have all but disappeared.

A surprising disease

Several people who come to me for treatment are surprised to discover that they have diabetes, or pre-diabetic symptoms. Also, apart from the embarrassment of having excess weight, young obese people, especially, struggle with sexual disorders – there is little to no desire for sex, their sexual performance is low, and on the other end of the scale, there may be infertility, a few cancers, the development of opposite-sex characteristics, and so on. The disease can cause severe inferiority complexes, cause trouble in personal relationships, and it is a major cause of depression among the youth.

While men’s testosterone levels may dip, women may struggle to conceive naturally, and even an IVF-assisted pregnancy may not carry for the full term. Several pregnant obese women develop gestational diabetes, high blood pressure and other factors that lead to miscarriages.

The cure

– Accept that obesity is a disease, and should be treated like one. Being in denial will only delay the treatment process.

– Understand that the disorders you are suffering from – PCOS, PCOD, respiratory problems, diabetes, obstructive sleep apnea – may not be isolated incidents, but may be linked to obesity.

– Consult a good surgeon to explore options to improve metabolism, and this includes bariatric surgery. Do this before you make exercise and diet plans. Some obese people’s metabolism is better than others, so they lose weight in the gym while others don’t. Once your metabolism is corrected, all exercise and diet efforts will yield better results.

– Discipline and diet are key to good recovery and maintaining good health after treatment. Once your health begins to improve, other things fall into place one by one – your looks will improve, your self-confidence will rise, you will want to rebuild your social life, and your performance in all spheres will improve.

– Above all, don’t lose hope. Seek a scientific solution to the problem, and don’t feel victimised by your condition. There are fantastic solutions available to treat obesity, you just have to seek help before it is too late.

Dr Jayashree Todkar is visiting bariatric and laparoscopic surgeon, and Director of Obesity and Diabetes Care Center, Dr L H Hiranandani Hospital, Powai. She holds the distinction of being the first female bariatric surgeon in India.  

Categories
Wellness

Fat. So?

A two-part series that looks at what obesity is doing to young Mumbai, and how to get help in time.
by Dr Jayashree Todkar

Part I

Obesity is striking the young much more than it used to. Today, I am constantly counselling and treating men and women in the 20 to 30 age group, and they are wishing to be treated for a variety of disorders and diseases stemming from obesity or increased weight gain. This age group is the most ‘active’ age group – socially and sexually – but it also the age group that is increasingly sedentary in its lifestyle. Eating the wrong kind of food, little to no exercise, rising amounts of stress, not seeing a doctor for niggling ailments on time – all of these are contributing to the problem.

Obese people also do not link their condition with other things like infertility and diabetes, but there is enough evidence to show that obesity does cause hormonal imbalances, thereby leading to infertility and some cancers, both in men and women.

In women, especially, the incidence of Polycistic Ovary Syndrome (PCOS) is steadily going up, and several times, the reason is linked to obesity. We feel that obesity only manifests itself in weight gain, but the other physical and psychological impacts it has on the sufferer are complex and immense. For instance, several of my patients who suffer from PCOS take medications to get their menstrual periods on track. Once the medication is taken and the period arrives, they feel they have been cured. But stop the medication, and the problem resurfaces. A woman suffering like this has a harrowing time trying to conceive or take the pregnancy to term. Several times, pregnancy becomes impossible without IVF intervention.

The ovaries are amongst the first to show signs of hormonal distress. Irregular periods are a sign of a lack of healthy egg production; eggs are not fertilised naturally and hence, medications help to fertilise them artificially. I have seen young women show symptoms like highly irregular periods, scanty periods (where the period ends in a day), pre-diabetic conditions and worse, developing sexual characteristics of the opposite sex, such as hirsuitism. In young men, these characteristics could be a large enlargement of breasts (commonly referred to as ‘man boobs’) and deposition of fat around the penis. Men also experience decreased levels of testosterone.

Priyanka Gupta (name changed) called my clinic a few months ago, wanting to meet me but hesitating to come to my clinic. I agreed to meet her at a hotel. When she arrived, her face was entirely draped by a scarf. When she took the scarf off, I had tears in my eyes – her face was very hairy and she needed to wax it every alternate day. She was 28 years old, and her condition had primarily beaten her self-confidence, she couldn’t control her weight, and she hadn’t had a period in 10 years without popping pills. A month after undergoing treatment with me, she called to say that she had had her first period in 10 years without taking medication. Also, her facial hair growth had reduced quite a lot.

Next: How was Priyanka cured? Do you think your health problems could be linked to obesity? Find out in the concluding part of this series, tomorrow.

Dr Jayashree Todkar is visiting bariatric and laparoscopic surgeon, and Director of Obesity and Diabetes Care Centre, Dr L H Hiranandani Hospital, Powai. She holds the distinction of being the first female bariatric surgeon in India.   

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