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Doctor, in my
case obesity runs in the family. What can I do?
It is possible that obesity could run in a family.
But it is of utmost importance to understand the reasons
which collectively make this mere possibility into a
harsh reality as in the case of Mr. R.K.
Mr. R.K. the financier, and his brothers V.K. and J.K.
the diamond merchants all weighed over 100 kilos. His
mother, Mrs. T.K. five feet three inches weighed 85
kilos.
At social functions they were an eye filling sight. Said
many a guests to one another, "Wow! Fat certainly
runs in that family. Look at them ! They are fat" !
Of course they were. But just look at what they ate. They
always liked fatty greasy dishes,and plenty of naans,
parathas, bread, rice and sweets. Mrs. T.K. weighed only
50 kilos when she was married, but she gained 7 kilos the
first year and she reached 75 kilos before R.K. passed
from higher secondary school. She usually ate a bite of
breakfast with each one of the boys and was likely to
sample her own cooking quite frequently.
As for the boys, well, babies are not born with a taste
for foods. They develop tastes. The kind of food that is
served in the home will largely determine what the
children learn to like. The boys usually ate rich gravied
dishes, potatoes, and sweet desserts and plenty of them.
They just hated salads and fruits. When Mr.R.K. grew up
to be a man, he began to order double portions of the
Moghlai dishes at restaurants. "A big guy like me
has got to eat", was his excuse. He started work as
an assistant in his fathers finance business. He
was active and worked hard. Soon, R.K. was made a
financial advisor and partner.
As he divested himself of details and sat long in
conferences, he grew less and less active. Five years
later his major work was to help direct policies and
shape the course of the business.
R.K. was more than satisfied. He had not only the means
but also the time to eat more. He liked a lavish dinner
and a few pegs of whiskey. It helped him to sleep. R.K.
gradually developed a paunch, haunch, and jowls.
When he passed the 100 kilos mark, R.K. took the gentle
ribbing of his friends quite seriously. "Yes ! I am
overweight. Not enough exercise. I could work this fat
off in no time, if I didnt have to be so busy at
work".
When I first examined him, R.K. weighed 120 kilos and had
developed diabetes and high levels of blood cholesterol
and serum triglycerides. He was put on proper medical
treatment for diabetes, along with a special food
programme to control his blood sugar, blood cholesterol
and serum triglycerides, and help him lose weight. He was
also advised under medical supervision and monitoring, to
undertake 30 minutes brisk walk every day. Within
twenty-four months, he had lost his excess 35 kilos, and
his diabetes was well under control. For the past three
years, he has maintained his ideal weight of 85 kilos.
Studies of body weight within families have led to some
interesting findings-adopted children are more similar to
their biological than their adoptive parents in the
amount and distribution of fat as well as the size of
their fat cells. Identical twins remain remarkably close
in weight until early puberty when environmental factors
exert a stronger pull. "You may not be a master of
your weight at age ten, but later on in life you are
certainly much so." explains Dr. Bray of U.S.A.
Queen Elizabeth II of England inherited a tendency to
plumpness from her mother. She married Prince Philip,
ascended the throne, and is the lovely slender queen she
is today.
You dont inherit fatness. You may have inherited a
tendency toward being overweight. But many people with a
tendency toward being overweight have slim bodies. IN
other words, you are not locked into a hereditary pattern
you cant escape.
A scientific and medically supervised programme should
take fat off any obese person regardless of heredity.Does heredity
influence the distribution of fat?
Yes, ancestry is a powerful factor in shaping human
bodies. Heredity seems to be particularly influential in
where fat settles. The overweight generally fall into two
categories. "Apples", mostly men have
beer-belly profiles, carrying the extra kilos in the
upper torso and around the abdomen. "Pears"
usually women, collect excess weight below the waist, in
chunky thighs,buttocks and hips. Fat deposited in the
thighs and buttocks is more stable and as women have long
lamented, more difficult to get rid of. Medically it is
better to be a "pear" than an "apple"
since "apples" carry higher health risk. Men
whose waists are bigger than their hips fall into the
danger zone, as do women whose waist measurement is more
than 85% of their hip size.
Is it
true that fat people are fat because they have developed
an increase in the number of fat cells at a certain stage
of their body growth?
Adults have anywhere from 30 billion to 40 billion
fat or adipose cells. They swell or shrink like sponges
with the amount of fat inside them.
Fat cells appear in early childhood, but more develop
later, particularly at puberty. In all overweight people,
the cells expand to hold more fat. Additional cells are
found only when a person is at least 60% above ideal
weight for his height and age. The notion that an overfed
infant will develop new cells and doom the grown person
to plumpness is no longer accepted. There are no certain
predictors of who will be far or slim. A 15 year survey
of 180 infants by researchers at the University of
California Berkley, revealed that babies who were abese
at six months or one year of age were likely to be normal
weight or thin by age of nine. Lean toddlers also did not
necessarily grow in to slender children. "This is a
big step away from the long held belief that fat babies
become fat children become fat adults, declares Research
Nutritionist Leons Shapino. Just because you have a fat
baby doesnt mean you should become alarmed and
immediately try to thin that child down. Yet obesity does
not strike from the blue. Statistics have shown that a
fat child most probably will grow into a fat adult.
Is a
fat baby a healthy baby?
Every parent wants her baby to be "Cuddly",
Cherubic and "Chubby" equating with this a
picture of health. But if your baby qualifies for any of
these adjectives you must be warned, because a fat baby
runs health risks in infancy and later through life.
Science has conclusively shown that a fat baby, because
of his bulk, will crawl, stand and walk later than a
normal child. This apart, excessive weight gain in
infancy may also predispose a child to later problems -
shortness of breath, hypertension,diabetes, cardiac
problems, adult obesity and even early death.
What is
the ideal weight for a child?
The weight chart by the Indian Academy of Paediatrics
can provide a fair guage of a childs weight. The
further a babys weight is from normal, the more his
chances of being obese. However, the degree of obesity is
best obtained not on the weighing scale, but by
measuring, as in adults, the skin fold thickness with the
thumb and index finger, the pinch test or with specially
designed calipers.
What
can I do to prevent my children from getting fat?
Perhaps the most important treatment for overweight
and obesity is prevention. The best place to start is
with the child. It is important that children, from
infancy itself, should be taught good eating habits and
it is equally important that mothers should appreciate
that a child does not have to be fat to be healthy; in
fact, he may be less healthy than the lean child. Parents
must be made to realise that forced feeding initiates a
life long disability.
Excessive weight gain in children usually begins between
seven and eight years of age. This is the period of
"filling out" in the growth process. In
addition, children of this age become less active due to
their sitting in a classroom for the greater part of the
day, and then, sitting down to do homework or watch
television programmes. For this reason, physical fitness
exercise programme should be an important part of a
school curricular. Once a child becomes overweight he is
obviously less inclined to exercise and so the vicious
cycle begins.
In families where one or both parents are obese or
inclined to be overweight, it is even more important to
control carefully a childs diet, since he may be
predisposed to obesity because of hereditary factors. If
he is taught basic nutrition and good eating habits, he
may well be able to control his tendency to become fat.
If heredity is a factor for his overweight, he must face
the fact that his problem is a lifelong one and needs
constant attention.
Occasionally childhood obesity may be blamed on glandular
malfunction, but such cases are extremely rare.
My
pre-teenager had been thin all along but is now growing
fatter day by day. What can I do?
Sometimes a mother and father can be the cause of a
childs overweight even though the parents are
unaware of the fact. The child may be forced to consume
more food than he or she really wants because the
parents, unconsciously feel that encouraging the child to
eat is a mark of concern and love. Many Indian mothers
start overfeeding their school going children thinking
that the poor child needs more energy because he is using
the "brain" so much. Little do they realise
that the brain is the only organ in the body which hardly
needs any "fuel" even if you make it work 19
hours a day.
The following case history will demonstrate such an
example. N.C. was a pre-teen girl of eleven years. She
was a victim of almost too much love on the part of her
mother. When her mother first sought medical help for her
daughters problems, the child was fifteen kilos
over her ideal weight. Her eating habits were terrible.
She constantly ate between meals, actually consuming more
between meals than at meal time. The pattern had
developed early in life when her mother gave her sweets
and chocolates as a reward for her good behaviour, and to
pacify her when she hurt herself and cried.
Eating habits of small children are largely developed in
the house environment. Over and above N.C. was given the
freedom to visit the local ice-cream parlor, for
after-school milkshake or syrup and whipped- cream-laden
ice-cream sundaes.
A complete physical checkup revealed that the child was
physically normal except for obesity.
I placed her in a well -balanced nutritional programme
involving three-meals-a-day with no in-between snacks.
Her parents, relatives, well-wishers and friends were
admonished not to criticize her diet or to comment or
tease her about her weight.
Before her consultation with me, this girl had been
uninterested in any active sport and did not take part in
any. Once her treatment began, she confessed an interest
in swimming and this was encouraged.
The child proved to be a co-operative patient and lost
three kilos a month. At the end of six months she had
reached her ideal weight and for the past three years has
been able to maintain the correct weight consistent with
her growth and development.
My
teenage daughter is obsessed with her weight. She is
figure-conscious and indulges in all sorts of reducing
diets on her own. She says she has to be careful because
obesity runs in our family. How do I handle this problem?
The answer is Education. Education in good nutrition,
which begins at home. Most adolescent girls go through an
"awkward age" before the body matures into the
pleasing proportion of the youthful feminine figure.
There is a little too much there, and not enough there,
before the curves come into the right places. At this
stage, a young teenager may try to starve herself, or
start on a magic diet or fast or whatever, as advised by
some glamorous personality or movie queen.
Any teenager obsessed with weight should :
- be sure fat is
present before they reduce.
- find a hobby if they
find themselves eating because they are bored.
- eat tempting
confections after they eat necessary healthy and
nutritive foods, not in place of them.
- eat fresh fruits to
starve off hunger between meal.
I am a
thirty-year-old-woman. In the past on a well balanced
nutritional diet I had shed off excess weight on several
occasions. But since last one year I have failed to shed
off even a kilo of excess weight inspite of all possible
efforts. Could this be because of a strong hereditary
factor that runs in my family?
Your inability now to shed off excess weight is not
in the fact that you have a strong hereditary
predisposition to obesity, but in the possibility that
you are one of the Yo-Yos.
Who are
the Yo-Yos?
A person who loses weight, gains it, loses it again
and gains it all over again is said to be having the
Yo-Yo syndrome. Repeated bouts of Yo-Yo dieting for
weight control may aggravate such physiological changes
amounting to aberration of metabolism in the body, making
it harder to lose weight and even easier to regain it.
After noticing that obese women who had been continual
dieters were failing to lose weight despite drastically
restricted meals of 600 to 800 calories per day, members
of the University of Pennsylvania Obesity Research Group
devised an animal experiment that puts rats through two
reducing cycles. On the first round, it took the animals
21 days to lose a specified amount of weight and 46 days
to regain it. On the second cycle, to lose the same
weight the animals needed 46 days, to gain it back took
only 14. According to Psychologist Kelly Brownwell, these
studies suggest that the phenomenon which he calls
"diet-induced obesity " may occur in human
beings as well.
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