Twelve years from now, 4 billion people, or more than half the world’s population, will be overweight or obese, according to a recent report. While obesity is an issue more commonly associated with high-income countries, the World Obesity Federation (WOF) points out that lower income countries are facing rapid increases in its prevalence. The economic and environmental costs of obesity aside, there is also the impact on the climate to contend with in the battle of the bulge. A $4tn crisis
The World Obesity Atlas 2023 says the cost of obesity-related issues would be more than $4 trillion globally by 2035. Apart from health, high BMI – obesity is defined as a Body Mass Index (BMI) equal to or more than 30 – also impacts economic productivity, including through premature retirement or death. The biggest presence of obese people will continue to be in high-income countries, the report says, but it is the low and lower middle income countries that are likely to experience major increases in the prevalence of obesity by 2035. The total economic costs linked to a rise in obesity in these countries would be more than $350 billion but the burden for upper middle and high income countries would be close to $4 trillion. The share of obese people in middle-income countries could jump to 66% among men and 70% for women even as the rate of increase in obesity prevalence appears to be slowing down in some rich countries. The chief reasons for rising obesity in poorer countries include a shift towards more highly processed foods and greater levels of sedentary behaviour.
Rising temperature and rainfall due to climate change could lead to higher obesity rates by hampering physical activity, studies say. The impact of extreme weather on fruit and vegetable production could also make it harder to maintain a healthy diet owing to rising prices. Higher prices could prompt a shift towards processed foods, which are linked to obesity. A 2019 Lancet report says severe food insecurity and hunger are associated with lower obesity prevalence, but mild to moderate food insecurity is “associated with higher obesity prevalence”. Another 2019 study says obesity is linked to about “20% greater GHG emissions compared with the normal weight state”. The total impact of obesity “may be extra emissions of (about) 700 megatons per year of CO2 equivalent. about 1. 6% of worldwide GHG emissions”.
A long-held belief has been that women are less prone to heart attacks, because of their so-called oestrogen advantage. Heart attacks in men is much higher than women. By classic teaching women have an advantage of 10 years in terms of getting cardiovascular disease (CVD), usually around the age of 55, compared to men who can get a CVD around the age of 45. That is partially correct as well, but one should be extra careful about the hugely increased vulnerability of post-menopausal women. More recent research findings that even younger #Sushmita Sen shared that she has had to undergo angioplasty, much public surprise centred on her age.
As a Lancet global commission has emphasised, despite being responsible for causing 35% of deaths in women each year, their cardiovascular disease remains understudied, under-recognised, under-diagnosed, and under-treated, with women also under-represented in clinical trials.
Heart disease may be considered by some to be more of a problem for men. Because some heart disease symptoms in women can differ from those in men, women may not know what to look for.
The following discussion is about the differences in cardiovascular disease between men and women.
How is the cardiovascular system different in women vs. men?
Researchers have found many sex-related differences in the cardiovascular system. These complex differences, often at a microscopic level, can affect how women and men experience heart disease. A few examples include:
Anatomy. Women have smaller blood vessels and heart chambers. The walls of their ventricles are also thinner.
Blood count. Women have fewer red blood cells. As a result, women can’t take in or carry as much oxygen at any given time.
Cardiovascular adaptations. Changes in altitude or body position (like quickly standing up after lying down) affect women more than men. Women are more likely to have sudden drops in blood pressure or faint.
Hormones. Estrogen and progesterone dominate in women and people AFAB, while testosterone dominates in men and people AMAB. These hormones can impact many aspects of heart health and overall health.
Heart attack symptoms for women
The most common heart attack symptom in women is the same as in men — some type of chest pain, pressure or discomfort that lasts more than a few minutes or comes and goes.
But chest pain is not always severe or even the most noticeable symptom, particularly in women. Women often describe heart attack pain as pressure or tightness. And it’s possible to have a heart attack without chest pain.
Women are more likely than men to have heart attack symptoms unrelated to chest pain, such as:
Neck, jaw, shoulder, upper back or upper belly (abdomen) discomfort
Shortness of breath
Pain in one or both arms
Nausea or vomiting
Sweating
Lightheadedness or dizziness
Unusual fatigue
Heartburn (indigestion)
These symptoms may be vague and not as noticeable as the crushing chest pain often associated with heart attacks. This might be because women tend to have blockages not only in their main arteries but also in the smaller ones that supply blood to the heart — a condition called small vessel heart disease or coronary microvascular disease.
Compared with men, women tend to have symptoms more often when resting, or even when asleep Emotional stress can play a role in triggering heart attack symptoms in women.
Because women’s heart attack symptoms can differ from men’s, women might be diagnosed less often with heart disease than are men. Women are more likely than men to have a heart attack with no severe blockage in an artery (nonobstructive coronary artery disease).
Several traditional risk factors for coronary artery disease — such as high cholesterol, high blood pressure and obesity — affect both women and men. But other factors may play a bigger role in the development of heart disease in women.
Heart disease risk factors for women include:
Diabetes. Women with diabetes are more likely to develop heart disease than are men with diabetes. Also, because diabetes can change the way women feel pain, there’s an increased risk of having a silent heart attack — without symptoms.
Emotional stress and depression. Stress and depression affect women’s hearts more than men’s. Depression may make it difficult to maintain a healthy lifestyle and follow recommended treatment for other health conditions.
Smoking. Smoking is a greater risk factor for heart disease in women than it is in men.
Inactivity. A lack of physical activity is a major risk factor for heart disease.
Menopause. Low levels of estrogen after menopause increase the risk of developing disease in smaller blood vessels.
Use of Contraceptives – They do tend to increase a woman’s blood pressure. If a woman has other risk factors for heart disease, taking birth control pills can compound that risk of heart disease.
Pregnancy complications. High blood pressure or diabetes during pregnancy can increase the mother’s long-term risk of high blood pressure and diabetes. These conditions also make women more likely to get heart disease.
Family history of early heart disease. This appears to be a greater risk factor in women than in men.
Inflammatory diseases. Rheumatoid arthritis, lupus and other inflammatory conditions may increase the risk of heart disease in both men and women.
Women of all ages should take heart disease seriously. Women under age 65 — especially those with a family history of heart disease — also need to pay close attention to heart disease risk factors.
Lifestyle remedies
Living a healthy lifestyle can help reduce the risk of heart disease. Try these heart-healthy strategies:
Quit smoking. If you don’t smoke, don’t start. Try to avoid exposure to secondhand smoke, which also can damage blood vessels.
Eat a healthy diet. Opt for whole grains, fruits and vegetables, low-fat or fat-free dairy products, and lean meats. Avoid saturated or trans fats, added sugars, and high amounts of salt.
Exercise and maintain a healthy weight. If you’re overweight, losing even a few pounds can lower heart disease risks. Ask your health care provider what weight is best for you.
Manage stress. Stress can cause the arteries to tighten, which can increase the risk of heart disease, particularly coronary microvascular disease. Getting more exercise, practicing mindfulness and connecting with others in support groups are some ways to tame stress.
Avoid or limit alcohol. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men.
Follow your treatment plan. Take medications as prescribed, such as blood pressure medications, blood thinners and aspirin.
Manage other health conditions. High blood pressure, high cholesterol and diabetes increase the risk of heart disease.
Exercise and heart health
Regular activity helps keep the heart healthy. In general, aim for at least 30 minutes of moderate exercise, such as walking at a brisk pace, on most days of the week. If that’s more than you can do, start slowly and build up. Even five minutes a day of exercise has health benefits.
For a bigger health boost, aim for about 60 minutes of moderate to vigorous exercise a day, five days a week. Also do strength training exercises two or more days a week.
It’s OK to break up your workouts into several 10-minute sessions during a day. You’ll still get the same heart-health benefits.
Interval training — which alternates short bursts of intense activity with intervals of lighter activity — is another way to maintain a healthy weight, improve blood pressure and keep the heart healthy. For example, include short bursts of jogging or fast walking into your regular walks.
You can also add exercise to your daily activities with these tips:
While pharmaceuticals and scientific drugs are regulated to some extent, side effects and harms associated with various health products worth billions of market remain untested and unregulated.
It has become a common practice to advertise health products that claim to be panacea for all ailments, enhance immunity, to increase power and health by creating an impression on minds on various platforms. Instead of producing scientific evidence, such products and therapies are sold under disguise of natural therapies or alternate medicines. Needless to say, the objective evidence or global neutral trial for the claimed efficacy or about real side effects is always missing.
No one can deny that the knowledge circulated through various media plays an important role in reframing the narrative in patient’s or people’s mind. These can be in form of advertisements in television or articles in newspapers. The subjectivity of such advertisements creating new impressions and replacing previous ones, right or wrong cannot be denied.
Companies have created huge fortunes based on circulation of such pedagogic narratives and social knowledge. But in real sense, these are actually chemical and have biological actions and reactions. Chemical derived from natural sources can have side effects and contain impurities. Global neutral trials to validate effects and side effects remain an urgent need of the hour for all health products.
A frightening scenario is emerging as there seems to be an epidemic about fake or substandard medicines, spurious drugs and heightened belief in marketed therapies by advertisements. An epidemic of ignorance that causes people to believe in pseudoscience or merely in projected promise of cure. A hope of miracle is flashed to patients, who have been given a ‘no hope’ by scientific medicine. Such patients are an easy prey for such fraudsters. It is not uncommon that lethal substances like steroids, hormones and heavy metals are given in dangerous doses.
In the absence of strict Government control, all kinds of dubious assertions are available about curing all types of ailments. These alleged remedies, and the belief systems they are based on, are based on the facts that can neither be proved nor disapproved. They are dangerous to life of patients, which is why it is necessary to fight them and refute them. But who should fight? Patients themselves are blinded by a projected faith and false belief about definite cure.
NEW DELHI: A youth with a history of taking excessive gym supplements and protein powder was brought to the emergency ward of Hospital in south Delhi in a comatose and critical condition. Doctors said the unconscious 22-year-old youth had extremely low oxygen levels, necessitating ventilatory support. He was immediately shifted to intensive care, where he stayed for almost a week. The patient was eventually discharged with no neurological deficit of any kind, said doctors at the hospital.
Citing the youth’s case, doctors caution against excessive use of fitness supplements and said that this can cause serious neurological damages besides proving fatal in some cases. He was found to be suffering from multiple severe metabolic derangement, including very high level of muscle enzymes, creatine phosphokinase, suggesting breakdown of muscle tissue. Further investigations revealed extremely low calcium levels which were also responsible for his deteriorating state. The patient was diagnosed as having toxic encephalopathy (brain dysfunction caused by toxic exposure) and rhabdomyolysis (a serious medical condition that can be fatal or result in permanent disability) which, occurred after excessive consumption of gym supplements. After stabilising the patient in the ICU, the youth was treated for correction of these medical issues, leading eventually to his recovery. The patient had no history of substance abuse and the toxicology screening of his urine also returned negative. After regaining consciousness after two days, the 22-year-old confessed to excessive intake of gym supplements and various types of protein powders. The case highlighted the hazards of use of body-building supplements, which could have catastrophic consequences. There was a strong possibility that significant muscle breakdown resulted in depletion of calcium levels which manifested with convulsions and altered level of consciousness. This can be labelled as toxic encephalopathy.
In another example of Medical Industry exploiting masses by false projection of Modern Medicine, the formula milk industry uses poor science to suggest, with little supporting evidence, that their products are solutions to common infant health and developmental challenges.
The CMF industry generates revenues of about $55 billion annually, with about $3 billion spent on marketing activities every year,” stated a Lancet editorial. The series details how marketing practices in violation of the voluntary Code of Marketing of Breast-milk Substitutes, developed by the World Health Assembly in 1981, have continued in nearly 100 countries and in every region of the world since the adoption of the code more than forty years ago.
A Lancet series on breastfeeding details strategies used by commercial formula manufacturers to undermine breastfeeding to turn the feeding of infants and young children into a multibillion-dollar business generating revenues of about $55 billion each year.
Lancet has issued an urgent call to protect breastfeeding. Formula milk marketing tactics are exploitative, and regulations need to be urgently strengthened and properly implemented, the three-paper series argued. The authors of the series argue that apart from influencing political organisations, formula milk companies also draw on credibility of science by sponsoring professional organisations, publishing sponsored articles in scientific journals, and inviting leaders in public health onto advisory boards and committees, leading to unacceptable conflicts of interest.
“The formula milk industry uses poor science to suggest, with little supporting evidence, that their products are solutions to common infant health and developmental challenges. Adverts claim specialised formulas alleviate fussiness, help with colic, prolong night-time sleep, and even encourage superior intelligence. Labels use words like ‘brain’, ‘neuro’ and ‘IQ’ with images highlighting early development, but studies show no benefit of these product ingredients on academic performance or long-term cognition,” stated Professor Linda Richter, Wits University, South Africa. “Breastfeeding has proven health benefits across high-income and low-income settings alike: it reduces childhood infectious diseases, mortality, and malnutrition, and the risk of later obesity; mothers who breastfeed have decreased risk of breast and ovarian cancers, type 2 diabetes, and cardiovascular disease. However, less than 50% of babies worldwide are breastfed according to the WHO recommendations, resulting in economic losses of nearly US$350 billion each year. Meanwhile, the CMF industry generates revenues of about $55 billion annually, with about $3 billion spent on marketing activities every year,” stated a Lancet editorial. The series details how marketing practices in violation of the voluntary Code of Marketing of Breast-milk Substitutes, developed by the World Health Assembly in 1981, have continued in nearly 100 countries and in every region of the world since the adoption of the code more than forty years ago. The series says that voluntary uptake of the Code is not enough and calls for an international legal treaty on the commercial marketing of food products for babies to protect the health and wellbeing of mothers and families. “Only 32 countries have legal measures that substantially align with the Code. A further 41 countries have legislation that moderately aligns with the Code and 50 have no legal measures at all. As a result, the Code is regularly flouted without penalty,” pointed out the editorial. An analysis in the series describes how profits made by the formula milk industry benefit companies located in high-income countries while the social, economic and environmental harms are widely distributed and most harmful in low and middle income countries. The authors stress that breastfeeding is a collective responsibility of society and call for more effective promotion, support and protection for breastfeeding, including a much better trained healthcare workforce and an international legal treaty to end exploitative formula milk marketing and prohibit political lobbying.
Obesity is a complex disease involving an excessive amount of body fat. Obesity isn’t just a cosmetic concern. It’s a medical problem that increases the risk of other diseases and health problems, such as heart disease, diabetes, high blood pressure and certain cancers.
There are many reasons why some people have difficulty losing weight. Usually, obesity results from inherited, physiological and environmental factors, combined with diet, physical activity and exercise choices.
The good news is that even modest weight loss can improve or prevent the health problems associated with obesity. A healthier diet, increased physical activity and behavior changes can help you lose weight. Prescription medications and weight-loss procedures are additional options for treating obesity.
Symptoms
Body mass index (BMI) is often used to diagnose obesity. To calculate BMI, multiply weight in pounds by 703, divide by height in inches and then divide again by height in inches. Or divide weight in kilograms by height in meters squared.
BMI
Weight status
Below 18.5
Underweight
18.5-24.9
Normal
25.0-29.9
Overweight
30.0 and higher
Obesity
Asians with BMI of 23 or higher may have an increased risk of health problems.
For most people, BMI provides a reasonable estimate of body fat. However, BMI doesn’t directly measure body fat, so some people, such as muscular athletes, may have a BMI in the obesity category even though they don’t have excess body fat.
Many doctors also measure a person’s waist circumference to help guide treatment decisions. Weight-related health problems are more common in men with a waist circumference over 40 inches (102 centimeters) and in women with a waist measurement over 35 inches (89 centimeters).
Although there are genetic, behavioral, metabolic and hormonal influences on body weight, obesity occurs when you take in more calories than you burn through normal daily activities and exercise. Your body stores these excess calories as fat.
In the United States, most people’s diets are too high in calories — often from fast food and high-calorie beverages. People with obesity might eat more calories before feeling full, feel hungry sooner, or eat more due to stress or anxiety.
Many people who live in Western countries now have jobs that are much less physically demanding, so they don’t tend to burn as many calories at work. Even daily activities use fewer calories, courtesy of conveniences such as remote controls, escalators, online shopping and drive-through banks.
Risk factors
Obesity usually results from a combination of causes and contributing factors:
Family inheritance and influences
The genes you inherit from your parents may affect the amount of body fat you store, and where that fat is distributed. Genetics may also play a role in how efficiently your body converts food into energy, how your body regulates your appetite and how your body burns calories during exercise.
Obesity tends to run in families. That’s not just because of the genes they share. Family members also tend to share similar eating and activity habits.
Lifestyle choices
Unhealthy diet. A diet that’s high in calories, lacking in fruits and vegetables, full of fast food, and laden with high-calorie beverages and oversized portions contributes to weight gain.
Liquid calories. People can drink many calories without feeling full, especially calories from alcohol. Other high-calorie beverages, such as sugared soft drinks, can contribute to significant weight gain.
Inactivity. If you have a sedentary lifestyle, you can easily take in more calories every day than you burn through exercise and routine daily activities. Looking at computer, tablet and phone screens is a sedentary activity. The number of hours spent in front of a screen is highly associated with weight gain.
Certain diseases and medications
In some people, obesity can be traced to a medical cause, such as Prader-Willi syndrome, Cushing syndrome and other conditions. Medical problems, such as arthritis, also can lead to decreased activity, which may result in weight gain.
Some medications can lead to weight gain if you don’t compensate through diet or activity. These medications include some antidepressants, anti-seizure medications, diabetes medications, antipsychotic medications, steroids and beta blockers.
Social and economic issues
Social and economic factors are linked to obesity. Avoiding obesity is difficult if you don’t have safe areas to walk or exercise. Similarly, you may not have been taught healthy ways of cooking, or you may not have access to healthier foods. In addition, the people you spend time with may influence your weight — you’re more likely to develop obesity if you have friends or relatives with obesity.
Age
Obesity can occur at any age, even in young children. But as you age, hormonal changes and a less active lifestyle increase your risk of obesity. In addition, the amount of muscle in your body tends to decrease with age. Generally, lower muscle mass leads to a decrease in metabolism. These changes also reduce calorie needs and can make it harder to keep off excess weight. If you don’t consciously control what you eat and become more physically active as you age, you’ll likely gain weight.
Other factors
Pregnancy. Weight gain is common during pregnancy. Some women find this weight difficult to lose after the baby is born. This weight gain may contribute to the development of obesity in women.
Quitting smoking. Quitting smoking is often associated with weight gain. And for some, it can lead to enough weight gain to qualify as obesity. Often, this happens as people use food to cope with smoking withdrawal. In the long run, however, quitting smoking is still a greater benefit to your health than is continuing to smoke. Your doctor can help you prevent weight gain after quitting smoking.
Lack of sleep. Not getting enough sleep or getting too much sleep can cause changes in hormones that increase appetite. You may also crave foods high in calories and carbohydrates, which can contribute to weight gain.
Stress. Many external factors that affect mood and well-being may contribute to obesity. People often seek more high-calorie food when experiencing stressful situations.
Microbiome. Your gut bacteria are affected by what you eat and may contribute to weight gain or difficulty losing weight.
Even if you have one or more of these risk factors, it doesn’t mean that you’re destined to develop obesity. You can counteract most risk factors through diet, physical activity and exercise, and behavior changes.
Complications
People with obesity are more likely to develop a number of potentially serious health problems, including:
Heart disease and strokes. Obesity makes you more likely to have high blood pressure and abnormal cholesterol levels, which are risk factors for heart disease and strokes.
Type 2 diabetes. Obesity can affect the way the body uses insulin to control blood sugar levels. This raises the risk of insulin resistance and diabetes.
Certain cancers. Obesity may increase the risk of cancer of the uterus, cervix, endometrium, ovary, breast, colon, rectum, esophagus, liver, gallbladder, pancreas, kidney and prostate.
Digestive problems. Obesity increases the likelihood of developing heartburn, gallbladder disease and liver problems.
Sleep apnea. People with obesity are more likely to have sleep apnea, a potentially serious disorder in which breathing repeatedly stops and starts during sleep.
Osteoarthritis. Obesity increases the stress placed on weight-bearing joints, in addition to promoting inflammation within the body. These factors may lead to complications such as osteoarthritis.
Severe COVID-19 symptoms. Obesity increases the risk of developing severe symptoms if you become infected with the virus that causes coronavirus disease 2019 (COVID-19). People who have severe cases of COVID-19 may require treatment in intensive care units or even mechanical assistance to breathe.
Quality of life
Obesity can diminish the overall quality of life. You may not be able to do physical activities that you used to enjoy. You may avoid public places. People with obesity may even encounter discrimination.
Other weight-related issues that may affect your quality of life include:
Depression
Disability
Shame and guilt
Social isolation
Lower work achievement
Diagnosis
To diagnose obesity, your doctor will typically perform a physical exam and recommend some tests.
These exams and tests generally include:
Taking your health history. Your doctor may review your weight history, weight-loss efforts, physical activity and exercise habits, eating patterns and appetite control, what other conditions you’ve had, medications, stress levels, and other issues about your health. Your doctor may also review your family’s health history to see if you may be predisposed to certain conditions.
A general physical exam. This includes measuring your height; checking vital signs, such as heart rate, blood pressure and temperature; listening to your heart and lungs; and examining your abdomen.
Calculating your BMI. Your doctor will check your body mass index (BMI). A BMI of 30 or higher is considered obesity. Numbers higher than 30 increase health risks even more. Your BMI should be checked at least once a year because it can help determine your overall health risks and what treatments may be appropriate.
Measuring your waist circumference. Fat stored around the waist, sometimes called visceral fat or abdominal fat, may further increase the risk of heart disease and diabetes. Women with a waist measurement (circumference) of more than 35 inches (89 centimeters) and men with a waist measurement of more than 40 inches (102 centimeters) may have more health risks than do people with smaller waist measurements. Like the BMI measurement, waist circumference should be checked at least once a year.
Checking for other health problems. If you have known health problems, your doctor will evaluate them. Your doctor will also check for other possible health problems, such as high blood pressure, high cholesterol, underactive thyroid, liver problems and diabetes.
Treatment
The goal of obesity treatment is to reach and stay at a healthy weight. This improves overall health and lowers the risk of developing complications related to obesity.
You may need to work with a team of health professionals — including a dietitian, behavioral counselor or an obesity specialist — to help you understand and make changes in your eating and activity habits.
The initial treatment goal is usually a modest weight loss — 5% to 10% of your total weight. That means that if you weigh 200 pounds (91 kilograms), you’d need to lose only about 10 to 20 pounds (4.5 to 9 kilograms) for your health to begin to improve. However, the more weight you lose, the greater the benefits.
All weight-loss programs require changes in your eating habits and increased physical activity. The treatment methods that are right for you depend on your obesity severity, your overall health and your willingness to participate in your weight-loss plan.
Dietary changes
Reducing calories and practicing healthier eating habits are vital to overcoming obesity. Although you may lose weight quickly at first, steady weight loss over the long term is considered the safest way to lose weight and the best way to keep it off permanently.
There is no best weight-loss diet. Choose one that includes healthy foods that you feel will work for you. Dietary changes to treat obesity include:
Cutting calories. The key to weight loss is reducing how many calories you take in. The first step is to review your typical eating and drinking habits to see how many calories you normally consume and where you can cut back. You and your doctor can decide how many calories you need to take in each day to lose weight, but a typical amount is 1,200 to 1,500 calories for women and 1,500 to 1,800 for men.
Feeling full on less. Some foods — such as desserts, candies, fats and processed foods — contain a lot of calories for a small portion. In contrast, fruits and vegetables provide a larger portion size with fewer calories. By eating larger portions of foods that have fewer calories, you reduce hunger pangs, take in fewer calories and feel better about your meal, which contributes to how satisfied you feel overall.
Making healthier choices. To make your overall diet healthier, eat more plant-based foods, such as fruits, vegetables and whole grains. Also emphasize lean sources of protein — such as beans, lentils and soy — and lean meats. If you like fish, try to include fish twice a week. Limit salt and added sugar. Eat small amounts of fats, and make sure they come from heart-healthy sources, such as olive, canola and nut oils.
Restricting certain foods. Certain diets limit the amount of a particular food group, such as high-carbohydrate or full-fat foods. Ask your doctor which diet plans are effective and which might be helpful for you. Drinking sugar-sweetened beverages is a sure way to consume more calories than you intended. Limiting these drinks or eliminating them altogether is a good place to start cutting calories.
Meal replacements. These plans suggest replacing one or two meals with their products — such as low-calorie shakes or meal bars — and eat healthy snacks and a healthy, balanced third meal that’s low in fat and calories. In the short term, this type of diet can help you lose weight. But these diets likely won’t teach you how to change your overall lifestyle. So you may have to stay on the diet if you want to keep your weight off.
Be wary of quick fixes. You may be tempted by fad diets that promise fast and easy weight loss. The reality, however, is that there are no magic foods or quick fixes. Fad diets may help in the short term, but the long-term results don’t appear to be any better than other diets.
Similarly, you may lose weight on a crash diet, but you’re likely to regain it when you stop the diet. To lose weight — and keep it off — you must adopt healthy-eating habits that you can maintain over time.
Exercise and activity
Increased physical activity or exercise is an essential part of obesity treatment:
Exercise. People with obesity need to get at least 150 minutes a week of moderate-intensity physical activity to prevent further weight gain or to maintain the loss of a modest amount of weight. You probably will need to gradually increase the amount you exercise as your endurance and fitness improve.
Keep moving. Even though regular aerobic exercise is the most efficient way to burn calories and shed excess weight, any extra movement helps burn calories. Park farther from store entrances and take the stairs instead of the elevator. A pedometer can track how many steps you take over the course of a day. Many people try to reach 10,000 steps every day. Gradually increase the number of steps you take daily to reach that goal.
Behavior changes
A behavior modification program can help you make lifestyle changes and lose weight and keep it off. Steps to take include examining your current habits to find out what factors, stresses or situations may have contributed to your obesity.
Counseling. Talking with a mental health professional can help address emotional and behavioral issues related to eating. Therapy can help you understand why you overeat and learn healthy ways to cope with anxiety. You can also learn how to monitor your diet and activity, understand eating triggers, and cope with food cravings. Counseling can be one-on-one or in a group.
Support groups. You can find camaraderie and understanding in support groups where others share similar challenges with obesity. Check with your doctor, local hospitals or commercial weight-loss programs for support groups in your area.
Weight-loss medication
Weight-loss medications are meant to be used along with diet, exercise and behavior changes, not instead of them. Before selecting a medication for you, your doctor will consider your health history, as well as possible side effects.
The most commonly used medications approved by the U.S. Food and Drug Administration (FDA) for the treatment of obesity include:
Bupropion-naltrexone (Contrave)
Liraglutide (Saxenda)
Orlistat (Alli, Xenical)
Phentermine-topiramate (Qsymia)
Weight-loss medications may not work for everyone, and the effects may wane over time. When you stop taking a weight-loss medication, you may regain much or all of the weight you lost.
These types of procedures don’t require any incisions in the skin. After you are under anesthesia, flexible tubes and tools are inserted through the mouth and down the throat into the stomach. Common procedures include:
Endoscopic sleeve gastroplasty. This procedure involves placing stitches in the stomach to reduce the amount of food and liquid the stomach can hold at one time. Over time, eating and drinking less helps the typical person lose weight.
Intragastric balloon for weight loss. In this procedure, doctors place a small balloon into the stomach. The balloon is then filled with water to reduce the amount of space in the stomach, so you’ll feel full eating less food.
Weight-loss surgery
Also known as bariatric surgery, weight-loss surgery limits the amount of food you’re able to comfortably eat or decreases the absorption of food and calories. However, this can also result in nutritional and vitamin deficiencies.
Common weight-loss surgeries include:
Adjustable gastric banding. In this procedure, an inflatable band separates the stomach into two pouches. The surgeon pulls the band tight, like a belt, to create a tiny channel between the two pouches. The band keeps the opening from expanding and is generally designed to stay in place permanently.
Gastric bypass surgery. In gastric bypass (Roux-en-Y), the surgeon creates a small pouch at the top of the stomach. The small intestine is then cut a short distance below the main stomach and connected to the new pouch. Food and liquid flow directly from the pouch into this part of the intestine, bypassing most of the stomach.
Gastric sleeve. In this procedure, part of the stomach is removed, creating a smaller reservoir for food. It’s a less complicated surgery than gastric bypass.
Weight-loss success after surgery depends on your commitment to making lifelong changes in your eating and exercise habits.
Hydrogels. Available by prescription, these edible capsules contain tiny particles that absorb water and enlarge in the stomach, to help you feel full. The capsules are taken before meals and are passed through the intestines as stool.
Vagal nerve blockade. This involves implanting a device under the skin of the abdomen that sends intermittent electrical pulses to the abdominal vagus nerve, which tells the brain when the stomach feels empty or full.
Gastric aspirate. In this procedure, a tube is placed through the abdomen into the stomach. A portion of the stomach contents are drained out after each meal.
Diarrhea — loose, watery and possibly more-frequent bowel movements — is a common problem. It may be present alone or be associated with other symptoms, such as nausea, vomiting, abdominal pain or weight loss.
Luckily, diarrhea is usually short-lived, lasting no more than a few days. But when diarrhea lasts beyond a few days into weeks, it usually indicates that there’s another problem — such as irritable bowel syndrome (IBS) or a more serious disorder, including persistent infection, celiac disease or inflammatory bowel disease (IBD).
Symptoms
Signs and symptoms associated with diarrhea (loose, watery stools) may include:
Your diarrhea persists beyond two days with no improvement
You become dehydrated
You have severe abdominal or rectal pain
You have bloody or black stools
You have a fever above 102 F (39 C)
In children, particularly young children, diarrhea can quickly lead to dehydration. Call your doctor if your child’s diarrhea doesn’t improve within 24 hours or if your child:
Becomes dehydrated
Has a fever above 102 F (39 C)
Has bloody or black stools
Causes
A number of diseases and conditions can cause diarrhea, including:
Viruses. Viruses that can cause diarrhea include Norwalk virus (also known as norovirus), enteric adenoviruses, astrovirus, cytomegalovirus and viral hepatitis. Rotavirus is a common cause of acute childhood diarrhea. The virus that causes coronavirus disease 2019 (COVID-19) has also been associated with gastrointestinal symptoms, including nausea, vomiting and diarrhea.
Bacteria and parasites. Exposure to pathogenic bacteria, such as E. coli or parasites through contaminated food or water, leads to diarrhea. When traveling in developing countries, diarrhea caused by bacteria and parasites is often called traveler’s diarrhea. Clostridioides difficile (also known as C. diff) is another type of bacterium that causes diarrhea, and it can occur after a course of antibiotics or during a hospitalization.
Medications. Many medications, such as antibiotics, can cause diarrhea. Antibiotics alleviate infections by killing bad bacteria, but they also kill good bacteria. This disturbs the natural balance of bacteria in your intestines, leading to diarrhea or a superimposed infection such as C. diff. Other drugs that cause diarrhea are anti-cancer drugs and antacids with magnesium.
Lactose intolerance. Lactose is a sugar found in milk and other dairy products. People who have difficulty digesting lactose have diarrhea after eating dairy products. Lactose intolerance can increase with age because levels of the enzyme that helps digest lactose drop as you get older.
Fructose. Fructose is a sugar found naturally in fruits and honey. It’s sometimes added as a sweetener to certain beverages. Fructose can lead to diarrhea in people who have trouble digesting it.
Artificial sweeteners. Sorbitol, erythritol and mannitol — artificial sweeteners are nonabsorbable sugars found in chewing gum and other sugar-free products — can cause diarrhea in some otherwise healthy people.
Surgery. Partial intestine or gallbladder removal surgeries can sometimes cause diarrhea.
Other digestive disorders. Chronic diarrhea has a number of other causes, such as IBS, Crohn’s disease, ulcerative colitis, celiac disease, microscopic colitis and small intestinal bacterial overgrowth (SIBO).
Diarrhea can cause dehydration, which can be life-threatening if untreated. Dehydration is particularly dangerous in children, older adults and those with weakened immune systems.
If you have signs of serious dehydration, seek medical help.
Indications of dehydration in adults
These include:
Excessive thirst
Dry mouth or skin
Little or no urination
Weakness, dizziness or lightheadedness
Fatigue
Dark-colored urine
Indications of dehydration in infants and young children
These include: Not having a wet diaper in three
or more hours
Dry mouth and tongue
Fever above 102 F (39 C)
Crying without tears
Drowsiness, unresponsiveness or irritability
Sunken appearance to the abdomen, eyes or cheeks
Prevention
Preventing infectious diarrhea
Wash your hands to prevent the spread of infectious diarrhea. To ensure adequate hand-washing:
Wash frequently. Wash your hands before and after preparing food. Wash your hands after handling uncooked meat, using the toilet, changing diapers, sneezing, coughing and blowing your nose.
Lather with soap for at least 20 seconds. After putting soap on your hands, rub your hands together for at least 20 seconds. This is about as long as it takes to sing “Happy Birthday” twice through.
Use hand sanitizer when washing isn’t possible. Use an alcohol-based hand sanitizer when you can’t get to a sink. Apply the hand sanitizer as you would hand lotion, making sure to cover the fronts and backs of both hands. Use a product that contains at least 60% alcohol.
Vaccination
You can help protect your infant from rotavirus, the most common cause of viral diarrhea in children, with one of two approved vaccines. Ask your baby’s doctor about having your baby vaccinated.
Preventing traveler’s diarrhea
Diarrhea commonly affects people who travel to countries where there’s inadequate sanitation and contaminated food. To reduce your risk:
Watch what you eat. Eat hot, well-cooked foods. Avoid raw fruits and vegetables unless you can peel them yourself. Also avoid raw or undercooked meats and dairy foods.
Watch what you drink. Drink bottled water, soda, beer or wine served in its original container. Avoid tap water and ice cubes. Use bottled water even for brushing your teeth. Keep your mouth closed while you shower.
Beverages made with boiled water, such as coffee and tea, are probably safe. Remember that alcohol and caffeine can aggravate diarrhea and worsen dehydration.
Ask your doctor about antibiotics. If you’re traveling to a developing country for an extended time, ask your doctor about antibiotics before you go, especially if you have a weakened immune system.
Check for travel warnings. The Centers for Disease Control and Prevention maintains a travelers’ health website where disease warnings are posted for various countries. If you’re planning to travel outside of the United States, check there for warnings and tips for reducing your risk.
Diarrhoea –loose motions has many causes. Bacterial, protozoal or viruses all can cause diarrhoea. Infections like cholera caused by bactweria Vibrio cholera can be life threatening. Similarly Shigella, another bacteria can be fatal occasionally, if treatment is delayed. Shigellosis is not a very common infection, and it can be treated easily, doctors say. But a delay in getting to a doctor can complicate the effects of the food poisoning. Young children and those with weakened immune systems are more vulnerable.
The Kerala health department on Tuesday (May 3) identified Shigella bacteria as the cause for the food poisoning incident in Kasaragod, which claimed the life of a 16-year-old girl and led to 30-odd others being admitted to hospital.
The presence of the bacteria was confirmed in the blood and faeces of people undergoing treatment after they consumed chicken shawarma from an eatery at Cheruvathur in Kasaragod last week. Police have arrested the owner and staff of the eatery.
While food poisoning is fairly common and can occur in a range of situations, how common is Shigella infection, what are its symptoms, and when should you consult a doctor?
Shigella is a bacterium that belongs to the Enterobacter family — a group of bacteria that reside in the intestine, not all of which cause disease in humans. It mainly affects the intestine and results in diarrhoea, sometimes bloody, stomach pain, and fever.
The infection spreads easily as it takes only “a small number of bacteria to make someone ill”, says the US Centres for Disease Control and Prevention (CDC). It is a food- and water-borne infection, and can happen when someone consumes contaminated food — like in the case from Kerala — unwashed fruit or vegetables.
The disease is easily spread by direct or indirect contact with the excrement of the patient. You can get the infection if you swim or take a bath in contaminated water.
How widespread is Shigella infection?
Shigella outbreaks appear to be exacerbated during pregnancy and in children under five years of age, and in those with weakened immune systems.
There are four types of Shigella bacteria that affect humans — Shigella sonnei, Shigella flexneri, Shigella boydii, and Shigella dysenteriae. The fourth type causes the most severe disease because of the toxin it produces.
But is it common for people to die of the infection?
It is not. Doctors say that the infection does not generally kill, unless the patient has a weak immune system or the pathogen is resistant to the antibiotics that are prescribed. It is a very treatable condition; if a patient reaches hospital on time they can effectively be treated using IV antibiotics.
He said that doctors usually send samples of patients with severe diarrhoea for culture to see what pathogen is causing the symptoms, in order to decide which antibiotics were likely to work the best. In the meanwhile, doctors prescribe antibiotics for the most common infections that cause diarrhoea, and they will generally work for Shigella as well.
The problem though, occurs when the antibiotics do not work because the bacteria are resistant to it.
The problem with Shigella is that it produces a lot of toxins that can affect all other organs. So, if the bacteria continue to proliferate in the body even after giving the antibiotics, it will continue to produce toxins, which can then affect the kidney, cause seizures, lead to multi-organ failure, and shock, and even turn fatal. This, however, does not happen in most cases, the mortality of the infection is less than 1%.
So if you have abdominal discomfort or an upset stomach, at which point should you start worrying?
There is no need to rush to a doctor or a hospital every time you have loose motions. However, if you have loose motions accompanied with high fever, blood in the stool, or constant vomiting such that you cannot keep any fluids down, you must get yourself to a doctor.
A person who has severe diarrhoea — which means 20 or more bowel movements in a day — must see a doctor within a day; a patient with mild diarrhoea may wait for three to four days before going to a doctor.
This is true of any diarrhoea, whether it is because of Shigella or any other reason. It is possible that the student from Kerala who died after eating the shawarma did not get medical treatment in time, he said.
What precautions should you take?
The measures to prevent a Shigella infection are the same as that of any other food- and water-borne infection. Wash your hands thoroughly before and after a meal. Wash your hands properly after a bowel movement. Ensure the water that you drink is clean and the fruits and vegetables are fresh.
“Products such as milk, chicken, and fish can get infected easily and must be kept at a proper temperature. They must also be properly cooked.
Evolution of Medical profession-Extinction of good doctors 