Obesity in children is a rising issue in India, with projections showing that over 27 million Indian children will be obese by 2030, making up one in ten obese children globally. 

The National Family Health Survey shows that the number of overweight children under five years old increased from 2.1% in 2015-16 to 3.4% in 2019-21. Another study highlights that urban families, particularly those with higher incomes, have higher rates of childhood obesity.

But why is this happening?

It’s easy to assume that diets high in fats, sugars, and salts, along with sedentary lifestyles caused by excessive technology use, are the main culprits. However, these are not the only reasons for weight gain in children.

Many children face factors beyond their control that cause their bodies to store fat, even when they eat a healthy diet and are physically active.

Let’s dive into some key factors that may be contributing to childhood obesity:

1. Genetics

When obesity runs in the family, certain genes may be passed down, causing:

• Increased hunger or a feeling of not being satisfied after eating.
• More fat stored around the belly.
• A slower metabolism, meaning fewer calories burned and more fat stored.

2. Hormonal Imbalance

• Hypothyroidism: When the thyroid gland doesn’t produce enough hormones, metabolism slows down, making weight gain easier.
• Insulin Resistance: This condition leads to high blood sugar levels, and the excess sugar gets stored as fat.
• Leptin Deficiency: Leptin regulates hunger. A lack of leptin can cause constant hunger, leading to overeating.

3. Early Life Influences

• Maternal Health During Pregnancy: If the mother had diabetes or gained excessive weight during pregnancy, the child’s risk of obesity later in life increases.
• Birth Weight: Babies born with very low or very high birth weights are at greater risk of becoming obese.
• Feeding Patterns in Infancy: Studies suggest that bottle-fed babies may face a slightly higher risk of obesity later in life than breastfed babies, though this is not a strict rule.

4. Environmental Toxins and Chemicals

Exposure to chemicals known as endocrine disruptors can interfere with how the body stores fat.

• BPA (Bisphenol A), commonly found in plastics, disrupts the body’s hormones, making it more likely to store fat.
• Phthalates, found in personal care products, can also contribute to obesity by altering hormone balance.

5. Psychological and Emotional Factors

Stress, family problems, or bullying can lead to emotional eating in children. Those dealing with depression or anxiety may turn to food for comfort, which can result in overeating.

6. Socioeconomic Factors

• Family Lifestyle and Habits: Kids usually adopt the eating and exercise habits of their family. If the family practices unhealthy habits, it’s tough for children to break these patterns, which can lead to obesity.
• Lack of Safe Spaces for Physical Activity: In many neighborhoods, kids don’t have access to parks, sports facilities, or safe areas to play. This lack of physical activity makes it hard to burn off the calories they consume.

7. Puberty and Development

During puberty, hormonal changes can naturally cause weight gain as the body prepares for growth spurts. If genetic or hormonal factors are involved, fat storage can increase in certain areas of the body, even when children are active and eating well.

8. Gut Microbiome

Research shows that the bacteria in our gut, largely determined by genetics and early environment, can impact how we process food and store fat.

Takeaway

Obesity is not always caused by overeating or a lack of exercise. Many factors are beyond your child’s control. 

Understanding this can help remove the guilt or shame associated with childhood obesity. 

If your child is struggling with obesity, Dr. Shashank Shah, a leading expert in childhood and teenage obesity, can provide the right guidance and treatment to manage these complex factors.

Take Action Now

If your child is facing obesity, it’s important to seek help from specialists who understand the broader causes. Get in touch with Dr. Shashank Shah at Lapro obeso Center, Pune, India to begin the journey toward better health for your child.

Benefits of Bariatric Surgery for Hypertension 

You have hypertension, or high blood pressure when the pressure in your arteries is too high for a long time. Your heart is like a pump pushing blood through hoses (your arteries). Imagine your heart has to consistently push too hard. It can cause problems. 

The blood pressure is measured with two numbers: systolic (when your heart beats) and diastolic (when your heart rests). 

If your blood pressure is 130/80 mm Hg or higher, you might have hypertension.

How Obesity Affects Blood Pressure

Research shows that being very overweight, or obese, is a major cause of high blood pressure, or hypertension. 

In fact, up to 75% of people with high blood pressure are also obese. 

Obesity and blood pressure affect each other: being obese can lead to high blood pressure, and having high blood pressure can make people gain weight. This creates a cycle that makes it harder to treat and manage both conditions.

Let’s understand how obesity, or being very overweight, can lead to hypertension

Here are 5 factors that affect the blood pressure.

1. Renin-Angiotensin-Aldosterone System (RAAS): This system helps control blood pressure and fluid balance. Extra fat can make this system work too much. When it’s overactive, it raises blood pressure by holding onto sodium and making blood vessels tighter.
2. Sympathetic Nervous System: Extra belly fat can make this part of your body work harder, speeding up your heart and raising blood pressure.
3. Hormones: Obesity messes with hormones, causing insulin problems and inflammation, which can damage blood vessels and increase blood pressure.
4. Kidney Pressure: Extra weight puts pressure on your kidneys, making them less effective at controlling blood pressure.
5. Endothelial Dysfunction: Obesity can inflame your blood vessels, making them less flexible, which raises blood pressure.

Blood pressure is one of the most common issues in India and people live with it and accept it as part of their normal life.

However, when someone is obese and has a BMI of 35 kg/m² or more, the situation may get worse.

Complications of High Blood Pressure

Let’s understand why it is critical to manage hypertension if you are also obese.

Heart Disease: Over time, high blood pressure can damage your arteries, leading to reduced blood flow. This can lead to serious heart problems, like heart attacks and heart failure. 

Stroke: There is a risk of stroke because of blocking or bursting blood vessels in the brain, which can cause brain damage.

Kidney Damage: High blood pressure can harm the small blood vessels in your kidneys, leading to kidney disease or failure.

Vision Problems: It can damage the blood vessels in your eyes, which might lead to vision problems or even loss of sight.

Cognitive Decline: When the brain receives less blood flow than needed, it can cause memory problems and increase the risk of dementia.

Peripheral Artery Disease (PAD): Arteries in your legs may become narrow, making walking painful.

Hypertensive Crisis: Extremely high blood pressure (180/120 mm Hg or more) can cause an emergency that needs immediate treatment.

At the Laparo-Obeso Centre in Pune, India, Dr Shahsank Shah has operated on thousands of patients who were obese and had hypertension.

When Bariatric Surgery Might Help

Dr Shashank Shah recommends bariatric surgery as a great option for people with severe obesity and high blood pressure. 

Here are the situations in which you may consider bariatric surgery:

Uncontrolled Hypertension: You are taking several medications, but your blood pressure is still high 

Resistant Hypertension: If you consistently need three or more medicines to control your blood pressure.

Obesity Levels: If you have a BMI between 30 and 39.9 kg/m² and high blood pressure, and exercise and diet aren’t working for you.

This means if you are obese and fighting with high blood pressure and even multiple medications are not getting things in control, you should consider bariatric surgery.

What Are the Benefits of Bariatric Surgery for Hypertension 

Possible Remission: Many people see their high blood pressure go away after surgery. About 60-70% of patients have their blood pressure controlled within the first year.

Less Medication: About 83.7% of patients who had gastric bypass surgery reduced their blood pressure medications, compared to only 12.8% who used just medicine.

Long-Term Results: The rates of getting rid of high blood pressure can be as high as 50% within a year, and 31.9% after around 6.5 years.

How Surgery Helps Lower Blood Pressure

Weight Loss: Losing a lot of weight can lower blood pressure.

Better Insulin Sensitivity: Improved insulin use can help manage blood pressure.

Less Inflammation: Surgery can reduce inflammation in the body, which is linked to high blood pressure.

Hormonal Changes: Surgery increases hormones that help get rid of sodium, which can lower blood pressure.

Kidney Function: Less fat around the kidneys means less pressure on them, improving blood pressure control.

What Are The Changes You Feel After Treating Hypertension

Here’s what we have observed about our patients once they manage or cure high blood pressure.

Physical Changes:

More Energy: Your organs and tissues get better oxygen and nutrition with better blood flow.  You feel more energetic and less tired.

Better Sleep: Your sleep may improve, as high blood pressure often disrupts sleep.

Fewer Symptoms: Headaches, dizziness, or nosebleeds might go away, making you feel better overall.

Weight Loss: Imagine 60 to 80% of extra weight is shredded from your body – you feel lighter, more energetic and 

Easier Physical Activity: With better blood pressure, physical activities may become easier and more enjoyable.

And it doesn’t stop at the physical changes.

Emotional and Psychological Changes Of Managing or Curing Hypertension:

Increased Confidence: You feel more in control of your health.

Less Anxiety: You feel more relaxed rather than being anxious most of the time.

Improved Mood: Since you feel better physically it often leads to a better mood and outlook on life.

Sense of Accomplishment: Successfully managing or curing hypertension can make you feel proud and motivated to keep up with healthy habits.

Understanding how hypertension works, and how obesity affects it, can help in managing and preventing serious health issues. 

Whether through lifestyle changes or medical interventions, taking steps to control blood pressure can lead to a healthier and happier life.

If you are struggling with obesity and hypertension, consulting with Dr. Shashank Shah could be the first step towards better health.

Evaluation of the incidence of low testosterone levels in young male adults with moderate-to-severe obesity – single centre study from India.

Abstract

Purpose – With the increase in the obesity epidemic among Asians, it is necessary to evaluate the impact of obesity on this population. Low testosterone levels are known to be associated with obesity. 

This is the first study from Asia to evaluate the incidence and magnitude of hypotestosteronemia in young adults with a BMI of more than 32.5 kg/m2 defined as moderate to severe obesity in Asians.

Materials and methods 

One hundred and thirty-four male patients with BMI more than 32.5 Kg/m2 between 18 and 30 years old who visited a single bariatric facility between 2010 and 2020, were evaluated with BMI, total and free testosterone levels and clinical features of gynecomastia, hypogonadism and thinning of pubic and armpit hair. 

Statistical analysis was performed using SPSS, Spearman’s correlation coefficient, and ANOVA test.

Results – 

60.4% of patients (84/134) had low testosterone level (less than 300ng/dl) and 23.9% (32/134) had levels between 300 and 400 ng/dl, 89.6% patients (120/134) had gynecomastia, 60.4% (81/134) had thinning of pubic and armpit hair, and 62.7% (84/134) had hypogonadism. 

Testosterone levels showed a decreasing trend with increasing BMI, but it was not statistically significant.

Conclusion 

Obesity is one of the important etiologies of hypotestosteronemia and its manifestation in young adults. The actual incidence may be significantly higher than what is reported in the literature. High-quality research is required to address questions of diagnosis and the best treatment options.