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 father’s 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 didn’t 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 don’t 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 can’t 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 doesn’t 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 child’s weight. The further a baby’s 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 child’s 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 child’s 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 daughter’s 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.