Saturday, March 27, 2010


A recent report implicates food contaminants as one of the causes of uncontrolled weight gain and these include thousands of chemicals used in foods during processing for achieving different functional features and these include growth hormones, antibiotics and migratory chemicals from plastic packing materials. This is contrary to the common wisdom that is prevalent currently blaming over consumption of high calorie foods much beyond the normal needs of the body. These unnatural substances introduced into the food under one or the other justification are collectively being classified under "obesogens" and they are capable of causing heart disease, diabetes and high cholesterol that can lead to further complications with aging.

If this is true, exercising control over eating may not be sufficient to deal with the problem. Though statistics about "fat" population in India cannot be reliable in the absence of any organized survey by government agencies, it is guesstimated that it could be around 1% working out to a staggering number of 11 millions. Percentage-wise Americans score over Indians in this regard as 3% of males and 7% of females are reported to be obese with a Body Mass Index (BMI) of more than 40. Being thin is often taken as healthy or slim to distinguish from being fat and many thin looking people could be afflicted with the so called "normal weight obesity"(NWO) which is difficult to be noticed under normal health check up regime.

There is a mistaken impression that BMI is the most reliable indicator of a healthy body and those with BMI less than 25 live blissfully thinking that they are immune to disorders commonly associated with over weight. Those with low BMI can have high visceral fat content or the so called 'internal' fat surrounding the internal organs which can be equally dangerous if not treated in time. How ever no reliable information is available regarding the number of people affected by NWO. This probably explains increasing number of patients looking normal, undergoing cardiac by-pass surgery these days because of arterial blocks, caused by high triglycerides and cholesterol. Most commonly adopted procedure to treat over weight problem is controlled dieting, physical exercise and resorting to drug therapy. In a freak finding, scientists from Germany have recently reported that fat people can lose their body weight significantly by spending some time in mountainous places, much above sea level because of the rarefied air that enhances metabolism and reduces appetite.

Dieting itself is under a cloud because of the potential for dieters becoming compulsive over eaters after denying food for themselves for some time, probably due to changes in brain activity involving the hormone norepinephrine. Such considerations compel people to go for Bariatric surgery which is emerging as a drastic remedy to overcome obesity in people desperately trying to shed their weights after failing to do so through conventional weight reduction programs. Such procedures are carried out mainly to reduce the size of the stomach or removal of a part of the stomach or resecting and re-routing the small intestine, all aimed at cutting down on food intake in one sitting. Lap-Band system and Intragastric balloon inserted into the stomach and inflated after wards can also reduce stomach volume. 5-9 BMI reduction is possible through these surgical techniques. It is unbelievable that more than 1.5 lakh people undergo such surgeries in the US with about 0.2% mortality. What is causing concern is that that many of those undergoing the surgery develop complications such as vomiting,diarrhea, dysphagia, reflux, leaking at the surgical connection between stomach and intestine and abdominal hernia.

It is a Hobson's choice for many obese people between living under great risk of dying due to diseases like CVD, diabetes, and serious disorders early in life and going for intervention surgery with reasonable assurance of a normal life though it involves hospitalization and unpredictable after effects.


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