Sir can you throw some light on obesity and factors related to the cause of obesity?
All these disease obesity, diabetes, sleep apnea metabolic disease they all are related to each other and the starting point is obesity. The epidemic which you see whether in India or the western world starts with obesity. And the question is why do we have that kind of epidemic, one of the nice parts about this discussion in this meeting is, not only we are talking about the solutions to the problem like bariatric surgery and medications. The two major things that we learnt over the last few years, is one; change in the modern environment and the second thing is some if us respond to the environment changes massively.
India is facing this problem and the United States as well, can you suggest some pathways how to tackle obesity?
In the US and the developed world the problem has been there for longer period of time, we haven’t done very well. We continue to see its growth; yes India and other countries are catching up with the US. In the US, obesity is a rural and urban problem; it’s a problem of rich and poor people. In India this primarily is an urban problem, and in last decade or so it’s been developing in rural areas as well. One of the things that we learnt in this meeting is how rapidly obesity and diabetes are growing in rural areas. This problem is because the rural areas are now becoming modernised. The cities become modernised first and then the rural areas become mordernised, and they get the same influences which are effectively related with obesity and diabetes. We see this in China, where modernisation starts in the cities and then obesity, and when modernisation reaches rural areas we see obesity and diabetes occurring there too.
The problem is not that people are lazy, and they don’t want to control their appetite, the problem is that many things in our modern environment are changing the physiology of our brain and our body. We need to look into the aspect that how the changes in various environments convert into a change in metabolic balance of the body and block that. I think rapid changes in India and elsewhere, have given us a unique opportunity to study things in better details.
People from East Asia, South East Asia, and South Asia, all are predisposed to metabolic diseases. So with the small amount of body fat due to obesity they undergo metabolic disease. So if you see Indians living in Europe and US, they are likely to develop diabetes, though they have very small amount of body fat increase caused by obesity, so this is embedded in the genes of people from this region.
So what would be your suggestions?
I think we need to be smart, and recognise that obesity is a disease, with 200 complications, and diabetes is well-known, but there are 200 other complications. It is devastating and damaging people’s health, increasing healthcare cost throughout the world, and damaging the quality of life.
We need to take more efforts to solve this problem. Solutions could be complex series of solutions. Some people will develop obesity for different reasons. Obesity can develop because of your stress; it can change due to your diet and exercise. Everyone is different, and we need to understand and use every toll that we have to treat people. Prevention, early childhood prevention, we have to put more exercise in peoples’ lives as a child and beyond. We have to focus on healthier eating and stress reduction, better sleeping patterns and surgery on those people for who it is necessary. Prevention and therapy, drugs and lifestyle, surgery and are the combinations we have to use.
Sir, what is your message for the public?
Obesity is becoming the number one medical problem across the world. It is exceeding malnutrition. We need to get serious about it. It’s a war on obesity, diabetes and diabesity.