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Is your young son or daughter over weight? (September, 2006)

If your young son or daughter is looking well fed and possibly bordering on being Obese, it may just mean nothing more than some imbalance in intake of food and physical activity to burn excess calorie intake. But it could also mean that there is something radically wrong and which can be set right partially or even completely if only you take expert help to diagnose and take corrective action. The best way to do is to have a thorough medical check up. This will tell us if the problem is simple and can be controlled by some simple measures in life style or serious enough to get expert treatment.

Two common causes in the young: Whether in young girls or boys, some basic hormonal imbalance maybe the cause of simple obesity or obesity associated with some other features. In girls it may be early signs of P.C.O.D or in boys Hypogonadism with gynaecomatia (prominent breasts); in both it may indicate early “syndrome X” (please read earlier Newsletter on this).

P.C.O.D.:
This is Poly Cystic Ovarian Disease, wherein multiple small fluid containing cavities called “cysts” occur in both the ovaries. The development of eggs gets arrested & results in multiple small cysts, which are less than 1 cm in size. This results in hormonal abnormalities resulting in no menstrual cycles or irregular cycles, abnormal hair growth (called as “hirsuitism”) and obesity. As the egg does not mature and get released, these girls will find it difficult to get pregnant. The risk of abortion is also high. This maybe a genetically determined condition or a young diabetic started on insulin may develop this condition in due course. In addition to obesity and menstrual problems, they tend to develop insulin resistance and Type II diabetes and high BP, increased levels of blood clotting and more risk of heart disease and stroke too.

When suspected by a doctor, in addition to a detailed examination, some tests like hormone profile, blood sugar and insulin levels and an Ultrasound Scan of abdomen would be done to confirm the diagnosis.

We can possibly get the condition of PCOD under control; earlier we diagnose, more chances of its control. The best treatment for the problem is weight loss. Even a 5% reduction in weight can help. Hence proper diet and some exercise regime to control body weight is of utmost importance. Some drugs are used for treating insulin resistance; these drugs also helps in weight loss. It is important to have amenstrual bleed once in 2-3 months at least to avoid complications like cancer or hyperplasia of the uterine lining. So hormone tablets will are prescribed for inducing periods. Birth control pills may be needed for regularizing periods.Waxing or electrolysis treats abnormal hairs. Drugs are used to control the abnormal hair growth. For women who wish to conceive ovulation is induced using medicines. These fertility drugs taken under medical supervision may result in successful pregnancy. Chances of pregnancy may also increase by taking supplements of Folic Acid or diet rich in this vitamin, limiting coffee and caffeine intake and an exercise regime and suitable balanced diet. In those who fail to respond and conceive, surgery on the affected ovaries called “wedge resection” or a procedure called LEOS (Laparoscopic Electrocoagulation of Ovarian Stroma) are successful in restoring regular periods. This also increases chances of conceiving and normal childbirth. If pregnancy and childbirth still does not occur, she may have to resort to assisted reproduction.

Obesity in young boys:
In most instances obesity is associated with prominent breasts (called “Gynaecomastia”), the boy being normal in all other respects. But in a few of them there are other features suggestive of hormonal imbalance, like sparse hairs in facial and genital regions, underdeveloped testes and genitals. Estimation of Hormonal profile would show that there is gross abnormality. If already married, we may also do seminal analysis and a testicular biopsy and these would show very poor sperm count and an under developed testes.

If diagnosed early, hormone imbalance is treated by administration of hormone supplements. This may help to some extent. Life style changes, diet and exercises help in correcting obesity. And gynaecomastia can be easily corrected by liposuction, whether or not there is any hormonal imbalance. In the great majority of patients with Gynaecomastia, cosmetic correction of the breast would give full relief.

Other causes for obesity:
Disease of the adrenal glands and syndrome x are two other conditions associated with obesity. These need to be investigated extensively and treated by an endocrinologist and a surgeon if needed.

Management of Obesity in others in general will be explained in our forthcoming Newsletters.

Ref.:www.fertilitythoughts.com, www.obgyn.net/pcos
Be well informed on health matters and be healthy,

Dr. M.Mohan Rao, MBBS,MS,FICS,MCH,

Director & Senior Surgeon (Retired but not tired),
Dr. U Mohan Rau Memorial Hospital.
Email: mmr@mohanraohospital.com




 

Updated on 01.09.2006.
 

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