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3 Obesity and Diabetes surgery

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    CHILDHOOD OBESITY: Childhood obesity is a serious medical condition that affects children and adolescents. Children who are obese are above the normal weight for their age and height. Childhood obesity is particularly troubling because the extra pounds often start children on the path to health problems that were once considered adult problems — diabetes, high blood pressure and high cholesterol. Many obese children become obese adults, especially if one or both parents are obese. Childhood obesity can also lead to poor self-esteem and depression. One of the best strategies to reduce childhood obesity is to improve the eating and exercise habits of your entire family. Treating and preventing childhood obesity helps protect your child's health now and in the future. Risk factors: Many factors — usually working in combination — increase your child's risk of becoming overweight: Diet. Regularly eating high-calorie foods, such as fast foods, baked goods and vending machine snacks, can easily cause your child to gain weight. Candy and desserts also can cause weight gain, and more and more evidence points to sugary drinks, including fruit juices, as culprits in obesity in some people. Lack of exercise. Children who don't exercise much are more likely to gain weight because they don't burn as many calories. Too much time spent in sedentary activities, such as watching television or playing video games, also contributes to the problem. Family factors. If your child comes from a family of overweight people, he or she may be more likely to put on weight. This is especially true in an environment where high-calorie foods are always available and physical activity isn't encouraged. Psychological factors. Personal, parental and family stress can increase a child's risk of obesity. Some children overeat to cope with problems or to deal with emotions, such as stress, or to fight boredom. Their parents may have similar tendencies. Socioeconomic factors. People in some communities have limited resources and limited access to supermarkets. As a result, they may opt for convenience foods that don't spoil quickly, such as frozen meals, crackers and cookies. In addition, people who live in lower income neighborhoods might not have access to a safe place to exercise.
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    Q1. How are work stress and food eating habits related? What happens in the body due to stress, which makes a person eat more food?  While short-term stress can cause a person to lose their appetite, chronic stress can have the opposite effect. Ever notice that when you're really stressed, you tend to crave comfort foods that are high in fat or sugar? Researchers have found that specific hormones may play a role in this process. When you eat carbohydrates, it raises the body's serotonin’s level, “Serotonin” is the body's feel-good chemical. Chronic stress can cause the body to release excess “cortisol”, a hormone critical in managing fat storage and energy use in the human body. Cortisol is known to increase appetite and may encourage cravings for sugary or fatty foods. More recent studies also suggest hormone called “Neuropeptide-Y” that is released from nerve cells during stress and encourages fat accumulation. A diet high in fat and sugar appears to further promote the release of neuropeptide Y. q2. What are the kind of foods that people are found to eat and why? Is it out of necessity, taste buds or habit?  Not surprisingly, people under stress don't tend to make smart food choices. Very often the carbohydrates that people go for are laden with fat, like muffins, pastries, doughnuts, and cookies, which are easily available at workplace. When individuals get stressed, they often act in impulsive ways because they do not know how to transform the stress into something productive. For people diagnosed with an eating disorder, these impulses from environmental and social stressors can cause individuals to not eat enough food, purge after a meal, or engage in a binge-eating episode. Sometimes It's a very high-pressure environment at workplace says Dr Abhishek katakwar. "For a lot of new software or IT recruits, it's their first time being away from home, so that can contribute to stress, and also the work performance and social pressures. All those things compound to lead to some unhealthy behaviours, whether it's full-blown eating disorders or disordered eating." q3. Is there evidence suggesting that overweight and obesity is due to work related stress. If so, what are the changes that the management needs to opt for and what does the employee need to do - do destress and bring their life on track.  According to a new study from the Montreal, office-workers have become less active over the last three decades and this decreased activity may partly explain the rise in obesity. "People eat better and exercise more today than they did in the 1970's, yet obesity rates continue to rise, " "My hypothesis is that our professional life is linked to this seemingly contradictory phenomenon." Also nightshift work is associated with a 29% increased risk of becoming obese or overweight. The findings, which are published in Obesity Reviews, suggest that modifying working schedules to avoid prolonged exposure to long-term night shift work might help reduce the risk of obesity. q4. What are the behavioural changes that they must opt for? And how do deadline based, emergency based jobs make a person opt for these changes?  Effective programs take a multidisciplinary approach that focuses on providing workers with the knowledge, skills, and support to eat a healthier diet and be more active. This can include nutrition classes, onsite exercise facilities and changing rooms, access to nutritionists and other counsellors, and worksite or company-wide policies that provide healthier food options and reimburse exercise-related expenses. q5. What are best methods to opt for during these conditions? What can be done in terms of behaviour change and also change in eating habit.?  In the movie Die Hard, Bruce Willis once said: “If you’re not a part of the solution than you’re part of the problem”. Unless you are currently underemployed, retired, or too young to be employed, you typically will spend at least a third of your time at your workplace. That means your workplace governs a large part of what you eat and drink and how much physical activity you have. For example, you may have heard the saying that “sitting is the new smoking”. Answer to this stress is practicing relaxation techniques like yoga or tai chi, meditation, muscle relaxation to help relieve stress, enjoy nature, get out of the cocoon and connect with world. Dr Abhishek Katakwar Bariatric and Metabolic surgeon Lifestyle expert and motivational speaker Asian Institute of Gastroenterology, Hyderabad abhishekkatakwar@gmail.com Cell: +91-8087358725
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    Obesity is a common but often underestimated condition of clinical and public health importance in many countries around the world. Its general acceptance by many societies as a sign of well-being or a symbol of high social status, and the denial by healthcare professionals and the public alike that it is a disease in its own right, have contributed to its improper identification and management and the lack of effective public health strategies to combat its rise to epidemic proportions. In general, obesity is associated with a greater risk of disability or premature death due to type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVD) such as hypertension, stroke and coronary heart disease as well as gall bladder disease, certain cancers (endometrial, breast, prostate, colon) and non-fatal conditions including gout, respiratory conditions, gastro-esophageal reflux disease, osteoarthritis and infertility. Obesity also carries serious implications for psychosocial health, mainly due to societal prejudice against fatness. The body mass index (BMI) is a simple and commonly used parameter for classifying various degrees of adiposity. It is derived from the weight of the individual in kilograms divided by the square of the height in metres (kg/m2). By the current World Health Organisation (WHO) criteria, a BMI <18.5kg/m2 is considered underweight, 18.5–24.9 kg/m2 ideal weight and 25–29.9kg/m2 overweight or pre-obese. The obese category is sub-divided into obese class I (30–34.9kg/m2), obese class II (35–39.9kg/m2) and obese class III (≥40kg/m2). A BMI greater than 28kg/m2 in adults is associated with a three to four-fold greater risk of morbidity due to T2DM and CVDs than in the general population
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