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3 Obesity and Diabetes surgery

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    Obstructive sleep apnea (OSA) is the most common type of sleep apnea and is caused by complete or partial obstructions of the upper airway. It is characterized by repetitive episodes of shallow or paused breathing during sleep, despite the effort to breathe, and is usually associated with a reduction in blood oxygen saturation. These episodes of decreased breathing, called "apneas" (literally, "without breath"), typically last 20 to 40 seconds. Individuals with OSA are rarely aware of difficulty breathing, even upon awakening. It is often recognized as a problem by others who observe the individual during episodes or is suspected because of its effects on the body. OSA is commonly accompanied with snoring. Some use the term obstructive sleep apnea syndrome to refer to OSA which is associated with symptoms during the daytime. Symptoms may be present for years or even decades without identification, during which time the individual may become conditioned to the daytime sleepiness and fatigue associated with significant levels of sleep disturbance. Individuals who generally sleep alone are often unaware of the condition, without a regular bed-partner to notice and make them aware of their symptoms. As the muscle tone of the body ordinarily relaxes during sleep, and the airway at the throat is composed of walls of soft tissue, which can collapse, it is not surprising that breathing can be obstructed during sleep. Although a very minor degree of OSA is considered to be within the bounds of normal sleep, and many individuals experience episodes of OSA at some point in life, a small percentage of people have chronic, severe OSA. Many people experience episodes of OSA for only a short period. This can be the result of an upper respiratory infection that causes nasal congestion, along with swelling of the throat, or tonsillitis that temporarily produces very enlarged tonsils. The Epstein-Barr virus, for example, is known to be able to dramatically increase the size of lymphoid tissue during acute infection, and OSA is fairly common in acute cases of severe infectious mononucleosis. Temporary spells of OSA syndrome may also occur in individuals who are under the influence of a drug (such as alcohol) that may relax their body tone excessively and interfere with normal arousal from sleep mechanisms.
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    Why you don't lose weight despite best diet and exercise efforts For years you have tried various very low calorie diets and restriction to achieve weight loss, and to no avail.  It seems despite the decrease in intake and several hours in gym, your weight still was not dropping as you would have anticipated. With these severe habits, it's likely that it never really resulted in great weight loss and when it did, you may have found that you gained it back in no time at all. What actually is happening is related to your metabolism regulating hormones.  As you take in less and less, your body's hormones, such as thyroid and leptin, begin to drop in an effort to create homeostasis in the body.  At the same time the muscle tissue begins to break down and be used for energy (which will lead to an even slower, more depressed metabolism).   this slowing of your metabolism can turn into a vicious cycle.   So is it possible to fix this broken metabolism: Let’s start with exercise, taper it to about 3-5 days a week, maximum, with an hour at a time - as a maximum. Really,  30-45 minute workouts are more than enough. Keep in mind that resistance and weight training is the best way to enhance metabolism, while cardio workouts should be considered secondary and can be added in as part of the 3-4 day regimen, but a combination is best.  The next step is to look at your caloric intake, and be prepared to increase this slowly.  It is important to take this slow as to not gain weight back too rapidly, which will discourage you and may lead to another cycle of restricting your intake.  Try to calculate how many calories you are taking in and add about 50-100 calories a week. The goal will be to have added about 500 calories after the course of a few weeks. Author (Dr Abhishek katakwar) is a bariatric & metabolic surgeon based at Asian institute of gastroenterology, Hyderabad. abhishekkatakwar@gmail.com +91-8087358725
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