I’m fat. So what? I’m just one of those people who were born to be fat. My mother and my grandmother were also fat. Anyway I’ve tried to lose weight but nothing really works so I’ve decided to be fat but happy. You know what I mean ! The happy-go-lucky type.
You admit you’re too fat. But your attitude towards your extra kilos can endanger your health and indirectly cut your life short. You may have decided to be happy, but may not for sure be lucky.
Most of the obese people who die before their time are killed either by diabetes, diseases of the digestive tract or heart disease. A study of serious and sometimes fatal ailments, by the Metropolitan Life Insurance U.S.A. showed this :
The incidence of cerebral hemorrhage - bleeding within the brain, which can kill or paralyse the victim - runs 60 per cent higher among the over weight. The incidence of chronic nephritis - inflammation of the kidneys, which can lead to an agonizing death runs 90 per cent higher among the overweight.
There are four times as many overweight diabetics than of normal weight.
In February 1995 a panel of doctors and nutritionists met at the National Institute of Health, U.S.A. and concluded that even being "20" percent above desirable body weight constitutes an established health hazard." The dangers associated with excess weight are - heart disease, diabetes, gallstones, respiratory disorders and degenerative changes in the joints especially the hip and the knees. Some of these ailments are usually serious and sometimes fatal.

Now that I have gained weight I have trouble in breathing. Why? Could this be harmful?
You have to breathe to live. For the obese person breathing is difficult because there is more weight on his body than he can carry. Frequently this extra load is on the chest wall and abdomen. When breathing decreases, less oxygen is taken into the blood stream and carbon dioxide builds up. When this happens, the person becomes sluggish and lethargic. However, it is possible in most cases to reverse the situation by weight reduction.
Too much fat can cause other worse complications due to lack of oxygen in the blood of the arteries. When this happens, the number of blood cells increases and in turn, the danger of thrombosis or a blood clot increases, leading possibly to heart-attack stroke (brain) and death.

I am suffering from Arthritis. Would my loosing weight help?
Arthritis, in simple language,is an inflammation, deformity, and stiffening of the joints, often causing considerable pain. As the joints stiffen and become more difficult and painful to move, any additional weight imposed on them naturally increases the pain. Losing weight won’t cure arthritis of any kind but it will lessen the discomfort in most cases.
Take the case of Mrs. L.V. a forty-five-year-old housewife who experienced severe pain in both her knee joints since six months. Walking and climbing stairs had become progressively difficult. Her own physician advised her to get her knee joints X-rayed and certain blood-tests done. He diagnosed her case as osteoarthritis of the knee joint - a degenerative condition which is common with aging. She was given proper medication, advised physiotherapy and referred to me for weight reduction.
When I first examined her she was 20 kilos overweight. Mrs. L.V. was placed on proper treatment for weight loss and a well-balanced diet and within ten months was down to her desired body weight. In addition she no longer experienced the unbearable pain resulting from her arthritic condition.
The case of Mrs. L.V. illustrates that it is not uncommon, if you are seriously overweight and arthritic to notice a difference in the amount of pain and in the case of moving about once weight reduction is achieved.

I’m 65 and feel I could move around more easily if I got rid of 6 kilos. But a friend tells me that I’m too old to slim-down and that I’ll only upset my system. Apart from some arthritic pains, I’m quite fit.
Don’t listen to your friend! It’s sheer nonsense to suppose that anyone is too old to improve his or her health.
Losing weight gradually over a period of time under the guidance of a well-qualified doctor will do you good.
And yes, losing that surplus weight should also give considerable relief from arthritic pain and improve your mobility.

Can my extra weight cause heart disease or a heart attack?
It must be emphasized that being too fat will not not cause heart disease at least at present there is no evidence which says it will. Heart disease remains a mystery and as such, remains a killer. There are many factors that play a part in the development of heart disease, such as stress, heredity, smoking cigarettes, drinking alcohol, lack of exercise, and so on. Controlled scientific studies of men and women with both mild and serious heart conditions have shown that reduction in weight does help in the control of the disease and cuts down the frequency of heart attack.
Take the case of O.S. for example. He was a busy 60- year-old overweight businessman. A routine examination in my clinic revealed that he was 25 kilos overweight. Blood tests showed elevated levels of cholesterol and sugar. His blood pressure was also high - 190 mm of mercury over 100 mm of mercury and his pulse rate was 90 beats per minutes, indicating a poor physical condition and an overworked heart.
O.S. was advised to lose weight or warned that it could lead to a heart attack. "Right now I am busy at my shop. Just as soon as Diwali sales are over, I’ll do something about my weight." O.S. promised. Diwali festival brought along with it sweets and goodies which O.S. could not resist, and he ate to his heart’s content. As a result he put on further weight. A year later his family doctor telephoned to inform me that O.S. had suffered a heart attack. P.K. chose to live.
P.K. was also in a poor physical condition when I first examined him in my clinic. Blood reports revealed that he was a borderline diabetic. I told P.K. that if he lost excess body fat the chances were he would automatically reduce his blood sugar. I didn’t have to repeat this advice twice. P.K. was placed under treatment for weight loss and he willingly followed the diet given to him by a diabetic specialist based on the principles of balanced nutrition. Three months later, he had reduced his body weight by 10 kilos.
After six months he had shed a total of 16 kilos, and has maintained his ideal weight since three years. "My family physician now says that my blood sugar is normal, and my heart which had shown a decrease in function, has returned to its normal functioning, now that I have lost weight." P.K. expressed a new enthusiasm for life.

What will extra kilos do to my blood pressure?
In general your blood pressure tends to go up as your weight increases. A survey on the effects of weight was made on 22,741 officers in the United States Army, both men and women. It showed that among men and women of every age group, blood pressure increased steadily in proportion to their body weight. Hypertension, the medical term for high blood pressure, develops in overweight people two and a half times as often as it does in people of normal weight.
Fat people have higher blood pressure probably because the extra fat puts a special burden on the circulatory system; there is more tissue for the blood to reach. Fat people suffer from arteriosclerosis or hardening of arteries. No one is quite sure of the reason, but doctors are sure that a relationship between this disease and obesity exists.
Based on various research studies of blood pressure measurements of 746 men who worked for Chicago utility company; the United States Department of Health has concluded :

1. More hypertension ( high blood pressure ) exists among the obese than among the non-obese.
2. The obese person with high blood pressure experiences a greater risk of coronary heart disease and heart attacks than the non-obese person with high blood pressure.
3. Death rates for obese persons with high blood pressure are higher than those for persons who are only obese and those with high blood pressure, without the complicating obesity.

What is diabetes? How is it related to my obesity?
Diabetes mellitus is today the third major killer of human beings. In India alone, there are over 15 million persons suffering from the disease and an equal number who are not even aware of it.
There are several distinct varieties of diabetes. Diabetes affecting young children called Juvenile Diabetes is usually insulin-dependent type. These children succumb to their disease if not treated with insulin. Diabetes affecting most adult, the Maturity Onset Diabetes is usually not insulin dependent. It is also heartening to note that 95% of all the diabetics in our country belong to the non-insulin dependent group. They can survive without insulin. The juvenile diabetic is more often thin than fat, whereas the Maturity Onset Diabetic is more often fat than thin.
Research studies have shown that eight out of ten persons - the Maturity Onset Type, are obese when symptoms first appear and that among people who are forty or over, nine out of ten who are down with diabetes are overweight. Diabetes often described as a "fat man’s folly" is a reasonable name.
Amongst the non-insulin dependent diabetics, the lean or normal weight patients are very different from the obese diabetics. The undernourished diabetics often have marked rise in blood sugar and although not dependent on insulin for their survival, they often require oral drugs or even insulin to achieve normal sugar levels. The obese diabetics, in contrast hardly ever require insulin. The fasting blood sugar is often normal and only the "post" meal blood sugar is mildly or moderately elevated in the obese diabetics. Experimentally it has been shown that the obese Maturity Onset Diabetics most often have an abundance of insulin in their blood. But in the presence of obesity the action of insulin is blunted and the body fails to use sugar properly. It is fairly easy to achieve a "cure" for diabetics in this group. Even a modest weight loss causes a distinct improvement in their diabetes. If the weight loss is maintained , the "cure" of diabetes is permanent. Although we do not talk in terms of cure in other forms of diabetes, obesity-related diabetes is indeed curable. Of course we assume here that the obese patient has lost weight and is able to maintain this weight loss.
R.S. was a fifty-year-old man, who had steadily gained weight in the form of a paunch since the age of forty.
He was fifteen kilos overweight when I first examined him. Blood tests revealed a raised level of blood sugar indicating that he had become a borderline Maturity Onset Diabetic.
R.S. was put on a weight loss treatment. He was given special diet devised for him by a diabetic specialist. He was advised under medical supervision to begin a ten-minute walk each evening.
The result was a weight loss of two kilos a month so that eight months time he was down to his desired weight. In the past five years he has kept to his recommended weight.
This case history clearly shows what you can do to help yourself lessen the risk of Maturity - Onset Diabetes. In an adult, diabetes can cause complications like stroke, heart attack, blindness, kidney failure and even gangrene.

What is the relation between obesity and gall-stones?
A woman who is seven to nine kilos overweight doubles her risk of developing gall-stones, according to the Nurses Health study at Birmingham and Woman’s Hospital at Boston. A woman twenty-three to thirty-four kilos overweight is about six times more likely to develop gall-stones than a woman of normal weight.
According to a second study led by Dr. Rodger Liddle, of Duke University Medical Centre in Durham, thirteen out of fifty-one obese persons, who resorted to extreme measures of losing, weight such as extended fasting or severe food restriction for eight weeks, developed gal-stones. Fasting and obesity change the composition of bile, making it more likely to form gall-stones.

Can obesity cause irregular menstrual periods in women?
It cannot be said for certain that obesity can cause menstrual periods to be irregular in women but an interesting observation suggests that women who are malnourished - the low socio - economic group or the affluent because they are on some quick weight loss, crash diet, have irregular periods, and in some cases cease to menstruate at all.
Lets take the case of V.A. a twenty-five-year-old girl who was thirty kilos overweight when First examined by me. During a five - year period before her examination she had gained and lost over thirty kilos, going from one crash diet to another. When she was not on a crash diet she subsisted on a nutritionally poor diet o pizzas, hamburgers, chaats, sweets and carbonated soft drinks.
During this five year period, she had experienced irregular menstrual periods and complained of excessive weakness, giddiness, irritation and constipation.
Laboratory tests showed that her ovaries were not functioning properly, which explained, for her irregular menstrual periods.
She was placed on medical guidance for obesity and a nutritionally, balanced diet. She was given no hormonal treatment whatsoever. Within fifteen months she had lost excess weight, her menstrual cycle returned to normal, and she has remained at fifty-two kilos over three years. This is a case where the menstrual problem was due to bad nutrition and wrongly managed approach towards her obesity and the "correct" and "only" required treatment was, medically supervised treatment for her obesity and proper nutrition.

My Gynaecologist says that I should not put on excess weight during pregnancy. Why?
If you are of child bearing age, it is extremely important that you do not become obese. A normally proportioned woman is more likely to give birth to a healthy baby than a woman who is obese. She is more likely to have a safe comfortable pregnancy and far less likely to be stricken by serious complications.
Obesity can lead to serious complications during pregnancy. Still-births occur more frequently when the mother is fat. Delivery is also often complicated. Other complications of a serious nature include taxaemia of pregnancy - high blood pressure, serious water retention and kidney failure.

Why might there be a lack of sex drive in a fat man?
It is common knowledge among physicians that there is a decided lack of sex drive in the extremely obese individual, particularly in men.
Sometimes the lack of sex drive in the obese male is due to more than just being fat. Obesity may well be due to a physiological cause and the lack of sex drive in some instances can be blamed on a lack of male sex hormone.
Fat is a tissue which converts testosterone (male sex hormone) into oestradiol ( the female sex hormone estrogen). This creates a hormonal imbalance which may reduce sexual drive and libido. In severe cases, some men may develop gynaeconmastia-false or pseudo-breasts and reduced facial hair.
K.P. was forty-five years old and twenty kilos over his ideal weight. In fact, just two years before he visited my clinic, he had felt well and had no trouble keeping his weight under control. Then he began slowly but surely to gain weight. For the past year, he had experienced marked sex decrease and sex drive.
Laboratory test showed his sex hormone testosterone, to be normal but a slightly raised level of oestradiol. I did not find it necessary to give him any hormonal treatment. He was placed on medical guidance for obesity and a nutritionally balanced diet. Within seven months, his weight of a had returned to normal and so had his sexual drive. He has maintained his desired weight for the past five years.

Does obesity cause cancer?
Cancer remains a medical mystery. No doctor or medical researcher would be able to assert that obesity by it self causes, cancer. However statistical evidence regarding obesity and cancer reveals that extra weight appears to make people more prone to death from the disease. The cancer death rate is 10 per cent higher among the obese than it is among the normal.
Research studies at the Natural Institute of Health, Baltimore City Hospital, U.S.A. indicate that obese men have a higher incidence of certain cancers, including those of colon (large intestine ), rectum and prostate. Overweight women run a greater risk of cancer of ovaries, uterus, and after menopause, of the breasts.

Are there any special hazards if I am obese and undergoing surgery?
Many surgeons are reluctant to perform certain types of surgery on the obese. The surgeon’s job becomes difficult as he must cut through thick layers of fat. But the real problem is the anaesthetist’s. Most deep anaesthesia involves the inhalation of a gas and for normal people the anaesthesia is quite safe. But for a fat person who is often short of breath anaesthesia can become a risky business. An obese person’s breathing mechanism is always under strain. Anaesthesia increases the strain, and there have been cases in which extra strain has proved fatal.

I am fed up with being fat. I feel too weary and tired to do a day’s housework. I need more than normal amounts of sleep. My house is in a mess. My husband is angry at my weight. He says it is all my fault. My family life is ruined. I have tried everything to lose weight and failed. I am desperate and in tears. Is there hope for me?
I am often visited by unhappy obese housewives whose problems are as real as the tears they shed. A man marries a woman, because, among other things, he likes her figure. Then perhaps during pregnancy, perhaps gradually, she puts on a great deal of fat that she is unable to lose. The man looks at his wife one evening, and sees not the figure he had liked. Where there were once curves, there is now flab. What was graceful has become repulsive. The result of such circumstances are not pleasant for either the husband or his wife. The disturbed husband attacks his wife for a variety of things; her weight, of course, but more than that her dress, her posture, her ability as a homemaker and as a mother. An obese woman in a messy house is not the average man’s idea of marriage.
If you are a grossly obese person you will find your sex drive diminishing. You just aren’t interested. This can create a problem, especially if your husband is thin. The lack of sexual response on the part of one partner in a marriage can be devastating to the relationship. I do not think I am overstating when I say that this is a marital tragedy.
Frustrated fatties have long been told that being fat is their own fault. They eat too much. There are lazy. They have no will-power. People are quite ready to make fun of fat people. No one today makes fun of a drunkard, but many think that fat people are voluntarily fat, which is not often the case. What is true about obesity is :

1. "Being obese is not just the question of gluttony (overeating) or lack of exercise", declares Obesity Researcher Julas Hirsch of Rockfeller University in New York City.
2. Being obese is not your fault.
3. It is due to medical ignorance and metabolism that people are fat. Remember obesity is a disease - a bodily condition and hence your only hope is expert medical guidance.

My family doctor has advised me to lose 12 kilos. But my husband actively resents the idea of my losing weight. He says he likes me as far as I am and insists that he is the best judge of my well-being. What would I say to such a man.
I’m sorry to say this sort of attitude suggests a man who wouldn’t mind his wife searching for a gas leak with a lit candle ...
A truly devoted husband would, in my view, accept that a doctor’s education, training and experience is bound to provide a better judgement on whether a woman is well and also on how long she will continue well with her excess weight.
As it is evident from this chapter, "why should I reduce", it is unfortunately a medical fact that a woman with extra weight has a greater chance of developing some serious disorders such as diabetes, heart disease or high blood pressure. And even certain cancers than a woman who weighs less. Perhaps someone could persuade your husband to talk to your doctor. A very tactful doctor might help him to understand why he so much resents the idea of his wife losing weight. It’s my bet that he is plain old-fashioned and jealous - afraid that his slimmer wife will attract extra attention from other men. He is probably right too.
But in my view, he should be man enough to put your precious health before other considerations. Many women on the other hand convince themselves that their man prefers them plump. In that case ask yourself whether he likes you because you are plump or despite the fact that you are plump. Remember too, that often when a man tells a woman that he likes her fat, what he really means is that he feels comfortable and unthreatened when she is overweight. Perhaps he feels he would have to try harder to keep her if she were slim and shapely. Finally to clear all your doubts, do this simple trick. Take off all your clothes and stand in front of a full- length mirror. That is what he sees. Now ask yourself whether or not he is seeing you at your best. Be sure to be honest with yourself.

If I am fat will I age faster?
Most people do not realise that when they turn obese, their physiology (body functions) as well as their outward appearance changes. Excess fat is a silent killer. Gradually but surely the efficiency of life processes of the body - respiratory, cardiovascular, digestive system, etc. diminish. This was dramatically demonstrated by a research study. In the study of twelve obese patients in their thirties, it was found that their psycho-physiological profile was startlingly like that of healthy seventy-one-year old men who had been observed at the Gerontology Centre of the National Institute of Health located at Baltimore City Hospital.
The effects of excess weight are clearly seen on the skin-excessive perspiration, heat rashes, stretch marks and wrinkling. There is premature graying and loss of scalp hair, diminished sexual drive and pain in the lower back and knee joints - all signs of premature aging. What else can be expected of a person carrying an extra load of 15 to 30 kilos every moment of his life, year after year.
Ms. J.K. was a well-known model whose livelihood depended on her appearance and personality. Hectic shooting schedules, irregular working hours, fault eating habits and strong predisposition to obesity had contributed to her weight gain over the past two years.
She called in at my clinic to see me. "I’m in desperate trouble" she told me. "I’m losing my looks - growing old before my time - and nothing seems to help me !" Fading beauty is a misfortune to many women, but for this girl it was a genuine tragedy.
"My whole future is at stake", J.K. continued.
"My work assignments are diminishing and it’s easy to see why."
"Every time I look in the mirror I see a new bulge that refuses to go away - and those wrinkles on my face and neck. I’m not old enough for these wrinkles. I don’t know why I have them all of a sudden."
"The wrinkles" I said " are a sign of premature aging, and that is because of your excess weight."
"Is it possible," she asked, "that excess fat can do all that to my looks?"
"That" I replied, "and much more." The signs of obesity are often those typical of old age.
Ms. J.K. was placed on weight reduction treatment. She was advised to eat regular balanced nutrient meals rich in vitamins, minerals and proteins. Within four months she had lost excess fat and gained back her personality and enthusiasm - the two things required to be beautiful. Modern science believes that treatment of obesity and proper balanced nutrition helps to delay premature aging.

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