MY SCHOOL by Dr .Nilesh Gopal das Joshi (beginner reading books for adults .txt) 📕

fat. Both terms mean that a person’s weight is higher than what is thought to be healthy for his or her height.

Obesity is defined as having a body mass index (BMI) of 30 or more.  BMI is a calculation that takes a person’s weight and height into account.  However, BMI does have some limitations.  According to the centres for Disease Control and Prevention (CDC), “Factors such as age, sex, ethnicity, muscle mass can influence the relationship between BMI and body fat, muscle, or bone mass, nor does it provide any indication of the distribution of fat among individuals.” Despite these limitations, BMI continues to be widely used as an indicator of excess weight. 

BMI provides a most useful population-level measure of overweight and obesity as it is the same for both sexes and for all ages of adults.  However, it should be considered a rough guide because it may not correspond to the same degree of fatness in different individuals.

Causes of obesity

Obesity is generally caused by eating too much and moving too little.  If you consume high amounts of energy, particularly fat and sugar but don’t burn off the energy through exercise and physical activity, much of the surplus energy will be stored by the body as fat.

Genetics – a person is more likely to develop obesity id one or both parents are obese. Genetics also affect hormones involved in fat regulation.  For example, one genetic cause of obesity is leptin deficiency.  Leptin is a hormone produced in fat cells and also in the placenta.  Leptin controls weight by signalling the brain to eat less when body fat stores are too high.  If, for some reason, the brain to eat less, this control is lost, and obesity occurs.  The role of leptin replacement as a treatment for obesity occurs.  The role of leptin replacement as a treatment for obesity is currently being explored. Overeating – Overeating leads to weight gain, especially if the diet is high in fat. Foods high in fat or sugar (for example, fast food, fried food, and sweets)        have high energy density (food that have a lot of calories in a small amount of food).  Epidemiologic studies have shown that diets high in fat contribute to weight gain. A diet high in simple carbohydrates - The role of carbohydrate in weight gain is not clear carbohydrate increase blood glucose levels, which in turn stimulate insulin release blood glucose levels, which in turn stimulate insulin release by the pancreas, and insulin promotes the growth of fat tissue and can cause weight gain. Some scientists believe that simple carbohydrates (sugars, fructose, desserts, soft drinks, beer, wine, etc.) contribute to weight gain because they are more rapidly absorbed into the bloodstream than complex carbohydrates (pasta, brown rice, grains, vegetables, raw fruits, etc.) and thus cause a more pronounced insulin release after meals than complex carbohydrates.  This higher insulin release, some scientists believe, contributes to weight gain. Frequency of eating – The relationship between frequency of eating and weight is somewhat controversial. There are many reports of overweight people eating less often that people with normal weight.  Scientists have observed that people who eat small meals four or five times daily, have lower cholesterol levels and lower and or more stable blood sugar levels than people who eat less frequently (two or three large meals daily).  One possible explanations that small frequent meals produce stable insulin levels, whereas large meals cause large spikes of insulin levels, whereas large meals cause large spikes of insulin after meals. Physical inactivity – sedentary people burn fewer calories than people who are active. The National Health and Nutrition Examination Survey (NHANES) showed that physical inactivity was strongly correlated with weight gain in both sexes. Medications – Medication associated with weight gain include certain antidepressants (medications used in treating depression), anticonvulsants (medication used in controlling seizures such as carbamazepine (Tegretol, Tegretol XR, Equetro, carbatrol) and valproate (Depacon, Depakene), some diabetes medications (medications used in lowering blood sugar such as insulin sulfonylureas, and thiazolidinediones), certain hormones such as oral contraceptives, and most corticosteroids such as prednisone. Weight gain may also be seen with some high blood pressure medications and antihistamines.  The reason for the weight gain with the medications differs for each medication with your physician rather than discontinuing the medication, as this could have serious effects. Physiological factors – for some people, emotions influence eating habits. Many people eat excessively in response to emotions such as boredoms, sadness, stress, or anger. While most overweight people, about have no more psychological disturbance than normal weight people, about 30% of the people who seek treatment for serious weight problems have difficulties with binge eating.  Diseases such as hypothyroidism, insulin resistance, polycystic ovary syndrome, and Cushing’s syndrome are also contributors to obesity. Social issues – A link between social issues and obesity has been established. Lack of money to purchase healthy foods or lack of safe places to walk or exercise can increase the risk of obesity.

Signs and test of obesity

The health care provider will perform a physical exam and ask questions about your medical history, eating habits, and exercise routine.  The two most common ways to assess your weight and measure health risks related to your weight are:

Body mass index (BMI) Waist circumference

BMI is calculated using height and weight.  You and your health care provider can use your BMI to estimate how much body fat you have.  Waist measurement is another way to estimate how much body fat you have.  Extra weight around your middle or stomach area increases your risk for type 2 diabetes, heart disease, and strike.  People with “apple shaped” bodies also have an increased risk for these diseases.  Skin fold measurements may be taken to check your body fat percentage. Blood test may be done to look for third or hormone problems that could lead to weight gain.  However these tests are usually normal.

Commonly suggested treatment for obesity

Changing your lifestyle: An active lifestyle and plenty of exercise, along with healthy eating, is the safest way to lose weight.  Even modest weight loss can improve your health you will need a lot of support from family and friends. When dieting your main goal should be to earn new, healthy ways of eating and make them a part of your daily routine.  Many people find it hard to change their eating habits and behaviours.  You may have practiced some habits for so long that you may not even know they are unhealthy, or you do them without thinking.  You need to be motivated to make lifestyle changes.  Make the behaviour change part of your life over the long term.  Know that it takes time to make and keep a change in your lifestyle. 

Work with your health care provider and dietician to set realistic, safe daily calorie counts that help you lose weight while staying healthy.  Remember that if you drop pounds slowly and steadily, you are more likely to keep them off.

Medication and herbal remedies: You may see ads for supplements and herbal remedies that claim they will help you lose weight. Many of these claims are not true.  Some of these supplements can have serious side effects.  Talk to your health care provider before using them. You can discuss weight loss drugs with your doctor.  Most people lose betwe5 and 10 pounds by taking these drugs.  Most people also regain the weight when they stop taking the medicine, unless they have made lasting lifestyle changes. Surgery: Bariatric surgery can reduce the risk of disease in people with severe obesity. These risks include Arthritis, Diabetes, Heart disease, High blood pressure, sleep apnea, some cancers, and stroke.  Surgery may help people who have been very obese for 5 years or more and have not lost weight from their treatments, such as diet exercise, or medicine.  Surgery alone is not the answer for weight loss.  It can train you to eat less, but you still have to do much of the work.  You must be committed to diet and exercise after surgery.  Talk t your doctor to learn of this is a good option for you.

DIABETES

Diabetes often referred to by doctors as diabetes mellitus, describes a group of metabolic diseases in which the person has high blood glucose (blood sugar), either because insulin production is inadequate, or because the body’s cells do not respond properly, to insulin, or both. Patientswith high blood sugar will typically experience polyuria (frequent urination), they will become increasingly thirsty (polydipsia) and hungry (polyphagia).

There are three types of diabetes:

Type 1 diabetes: the body does not produce insulin. Some people may refer to this type as insulin-dependent diabetes, juvenile diabetes, or early onset diabetes, people usually develop type 1diabetes before their 40th year, often in early adulthood or teenage years. Type 2 diabetes: the body does not produce enough insulin for proper function, or the cells in the body do not react to insulin (insulin resistance). Gestational diabetes :  this type affects females during pregnancy. Some women have very high levels of glucose in their blood, and their bodies are unable to produce enough insulin to transport all the glucose into their cells, resulting in progressively rising levels of glucose.

Diabetes mellitus is a chronic disease, for which there is no known cure except in very specific situations. Management concentrates on keeping blood sugar levels as close to normal, without causing low blood sugar. This can usually be accomplished with a healthy diet, exercise, weight loss, and use of appropriate medications (insulin in the case of type 1 diabetes; oral medications, as well as possibly insulin, in type 2 diabetes).

Attention is also paid to other health problems that may accelerate the negative effects of diabetes. These include smoking, elevated cholesterol levels, obesity, high blood pressure, and lack of regular exercise. Specialized footwear is widely used to reduce the risk of ulceration, or re-ulceration, in at-risk diabetic feet.

Common diabetes symptoms include

Frequent urination Intense thirst and hunger Weight gain Unusual weight loss Fatigue Cuts and bruises that do not heal Male sexual dysfunction Numbness and tingling in hands and feet.

 

Complications faced for diabetic patients are as listed

Eye complications: glaucoma, cataracts, diabetic retinopathy, and some others. Foot Complications: neuropathy, ulcers, and sometimes gangrene which may require that the foot be amputated. Skin complications: people with diabetes are most susceptible to skin infections and skin disorders. Heart problems: such as ischemic heart disease, when the blood supply to the heart muscle is diminished Hypertension: common in people with diabetes, which can raise the risk of kidney disease, eye problems, heart attack and stroke Mental health: uncontrolled diabetes raises the risk of suffering from depression, anxiety and some other mental disorders Hearing loss- diabetes patients have higher risk of developing hearing problems Gum disease: there is a much higher prevalence of gum disease among diabetes patients Gastro paresis: the muscles of the stomach stop working properly Ketoacidosis: a combination of ketosis and acidosis; accumulation of ketone bodies and acidity in the blood Neuropathy: diabetic neuropathy is a type of nerve damage which can lead to several different problems. HHNS (Hyperosmolar Hyperglycemic Nonketotic Syndrome: blood glucose levels shoot up too high, and there are no ketones present in the blood or urine. It is an emergency condition Nephropathy: uncontrolled blood pressure can lead to kidney disease PAD (Peripheral Arterial Disease): Symptoms may include pain in the leg, tingling and sometimes problems walking properly Stroke: if blood pressure, cholesterol; levels, and blood glucose levels are not controlled, the risk of stroke increases significantly Erectile dysfunction: male impotence Infections: people with badly controlled diabetes are much more susceptible to infections. Healing of wounds: cuts and lesions take much longer to heal

Methods to control sugar level for a diabetic patient

Make diabetes meal plan with help from your health care team Choose foods that are lower in calories, saturated fat, transfat, sugar, and salt. Eat foods with more fiber, such as whole grain cereals, breads, crackers, rice or pasta Choose foods such as fruits, vegetables, whole grains, bread and cereals, and low-fat or skimmed milk and cheese Drink water instead of juice and regular soda. Do regular exercise and workout

These patients can also face different health problems such as

Heart disease Stroke Kidney disease Eye problems Dental disease Nerve damage poor problem

HYPERTENSION

Hypertension is another name for high blood pressure. Medical guidelines define hypertension