No Magic Weight-Loss Pill

All the overweight and the obese love the idea of losing weight and fitting into the clothes they are no longer to fit. If a magic pill were available to lose weight, it would be like a dream come true for them. Control on diet and exercising are the mantras used since time immemorial, and are indeed the best safest and most effective ways for losing weight. In the earlier days people used to maintain weight as there was a balance between the energy intake (food intake, homemade food, eating at regular intervals, occasional partying ) and energy expenditure( walking , exercising , outdoor soprts etc). But with the introduction of fast foods, increased sedentary life – be it for on line studying , online games, online software jobs, online projects, we have seen a mismatch in the energy intake and expenditure. Hence the energy intake is much more than the energy expenditure. Moreover the demands of the present day high salaried jobs are highly stressful. This stress leads to binge eating and this binge eating or giving vent to stress by overeating goes unnoticed and over a few months or years people do put on weight. Lets get our thought process clear. There is no Magic Pill to lose weight. So, discipline in our lifestyle on a day to day basis is key to maintaining health and thus good health. Based on height and weight , one can calculate the Body mass Index ( BMI). This BMI determines whether a person is normal weight , overweight, obese. In the obese category we have the morbidly obese, superobese and above. Why this categorizatio of BMI??? The simple reason is that the BMI gives an insight to which method of weight loss one can opt for and which method will be successful. A BIG mistake people are making is that without consulting the doctor, people are opting for ways and means of weight loss as per their knowledge , not taking into consideration the BMI, and whether there are medical conditions or medications that could be the reason for weight gain.

Obese people are at a higher risk of covid 19

These are few reasons to substantiate .

 Open surgery Hernia
  • Mechanical compression: Covid 19 virus affects many organgs , but the worst and mist affected is the lungs. Obesity causes substantial changes to the mechanics of the lungs and chest wall, leading to mechanical compression of the diaphragm, lungs, and chest cavity, which can lead to restrictive lung  (pulmonary) damage. These  changes lead to difficulty in breathing called dyspnoea, which initially is only on exertion , but in later stages leads to heavy breathing even at rest. This makes them more prone to contract the Covid virus.

  • Obesity is associated with  impaired immunity

  • Chronic inflammation: Excess adiposity is also associated with increased production of inflammatory cytokines causing a continuous state of inflammation in an obese person, including lung tissue inflammation and more tendency to develop covid 19 

  • Insulin resistance and diabetes: It is seen that diabetics are more affected by the covid 19 virus . Obesity leads to insulin resistance and type 2 diabetes . Insulin is a critical regulator of many cellular pathways. This is another reason which makes the obese mote prone to develop the covid 19 infection

  • Vascular damage and clotting : Increase in circulating free fatty acids are seen in obesity. Also,  the chronic inflammatory state seen in obesity damages the endothelium of blood vessels. Both these factors lead  to an increased tendency for blood clotting in the vessels of obese people . This superadds to  the increased clotting seen in Covid 19 disease , making the obese more prone to contract covid 19 virus.

  • Leptin : Increased leves of leptin are seen in obese patients . High levels of Leptin are  associated with increase in pulmonary inflammation , which again predisposes the obese to Covid 19 virus To summarise, obesity is a mojor risk factor to develop corona infection . Obese people  once they develop corona infection, it is very difficult to treat them because of the reduced and restricted  lung function . Obesity s treatable , whayever be the severity of obesity. It is easier and safer to treat obesity rather than to treat an obese person affected with the covid 19 virus . You can make the right decision - decision is entirely yours. Prevention is better than cure . Treatment to get rid of morbid obesity even in the covid pandemic is absolutely safe.

  • Obesity and Piles

     Open surgery Hernia

    Piles / Haemorrhoids is a common term, known by many, as it is seen to affect a good percentage of the population. The common causes of piles are well known like low fibre in the diet, less water intake, constipation, straining while passing stools, Piles are also commonly seen in pregnant women as the pregnancy advances.

    Here we are dealing in details with the correlation between obesity and piles.
    To have a better understanding of how obesity affects piles, it is better to have an understanding of the anal cushions which have a major role to play.

     Open surgery Hernia
     Open surgery Hernia

    The blood supply is derived from the superior rectal artery, the middle rectal arteries, and the inferior rectal arteries arising. The venous drainage is to the portal venous system above the dentate line and to the systemic circulation below the dentate line.

    There are three vascular cushions in the anus, positioned at the 3-, 7- and 11- o'clock positions
    The pathologic, downward displacement of these cushions is probably caused by factors such as constipation, prolonged straining, pregnancy, ageing, and increased intraabdominal pressure. This displacement is thought to result in the distension of cushion venules, which causes symptomatic haemorrhoids.

    The cushions are supported by a well-developed arrangement of smooth muscle and elastic tissue. It emerges from the inner surface of the internal sphincter as a series of bands in 2 or 3 overlapping rows to coalesce lower down in a web-like scaffold around the dilatations of the venous plexus. Encircled by the internal and external sphincters it assists in anal closure and adjustment of continence.

    Normally, on defaecation, the anal cushions are held out of the way by the anal submucosal muscle, whose contraction flattens and braces them against the internal sphincter. Contractions of the anal submucosal muscle flatten the cushions and hold them up against the internal sphincter.

    'First-degree piles': only the mucosal moiety of a cushion is descending and bleeding occurs in the absence of detectable prolapse.

    'Second or third-degree piles': the entire cushion is disrupted from its attachments. The venous saccules, no longer supported, are engorged.

    How Obesity contributes to the aggravation of piles? Haemorrhoids

    Obesity exerts a forced pressure on the veins and blood vessels around your anus and colon due to the raised intraabdominal pressure in the obese. This leads to enhanced engorgement of the vascular cushions in the anal submucosa. As the degree of obesity increases, i.e as the BMI increases, the chances of the increased pressure on the cushions is higher.

    Among the obese, the people having a greater degree of central obesity are affected more. Central obesity translates to more amount of visceral fat to an extent. Visceral fat is known to secrete inflammatory factors/ adipokines and that is why obesity is considered a chronic inflammatory state.

    These inflammatory factors affect the vessels in the anal cushion and further aggravate the already increased squeezing pressure on the anal cushions caused by increased intraabdominal pressure in obesity. These changes include abnormal venous dilatation, a severe inflammation involving the vascular wall and surrounding connective tissue in haemorrhoids, vascular thrombosis, a degenerative process in the collagen fibres and fibroelastic tissues.

    In addition to this, obese individuals are more susceptible to developing haemorrhoids as a result of poor nutrition consisting of foods rich in fat, high carbs, fermented sugars, salt and low fibre, which enhances the risk of piles by the formation of hard stools and constipation, leading to straining and damage to the anal cushions.

    To summarise, the chances of piles in obesity could be increased due to the following factors:

  • Increased intraabdominal pressure translating to the vessels around the rectum and anal canal, in turn, transferred to the anal cushions.

  • Inflammatory adipokines secreted in obese by increased visceral fat cause inflammation in the vessels in the anal cushions.

  • Excess weight and tendency to choose sedentary jobs, leave the obese population sitting for prolonged hours and adding pressure to the veins in the anal cushions pushing them downwards.

  • Less fibre and fatty diet choice in the obese can lead to constipation, hard stools, more straining and eventually piles and bleeding.

  • Precautions that can be taken in the obese having piles:

  • Reduce weight.
  • Exercise regularly to help bowel movement.
  • Avoiding sedentary jobs or sitting for long hours.
  • Increase fibre in the diet
  • Increase water intake
  • Medications like laxatives, ointments, sitz bath, surgery if all the above are not working.

  • People who suffer from hemorrhoids can significantly reduce the risk of this health condition by increasing fiber intake, drinking more water, and exercising regularly.

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