Doctor, I am a man of 26 years of age and weigh more than 120kgs. I have been obese since my late teens. I have tried various exercises and dieting in the past couple of years, but of no avail. My friend suggested liposuction. What is your suggestion and how safe is it for me? I am also a diabetic. Please help. - Vijay Paul.
Overweight is defined as a body mass index (BMI) of 25 or more, thus it includes pre-obesity defined as a BMI between 25 and 30 and obesity as defined by a BMI of 30 or more. Pre-obese and overweight however are often used interchangeably thus giving overweight a common definition of a BMI of 25 to 30. People who have insulin dependent diabetes and chronically overdose insulin may gain weight, while people who already are overweight may develop insulin tolerance and in the long run develop Type II diabetes.
Other causes for being overweight include limited physical exercise and sedentary lifestyle, overeating, poor nutrition, genetic predisposition, hormonal imbalances (e.g. hypothyroidism), metabolic disorders, which could be caused by repeated attempts to lose weight by weight cycling, eating disorders (such as binge eating), alcoholism, stress, insufficient or poor-quality sleep, psychotropic medication (e.g. olanzapine), smoking cessation and other stimulant withdrawal.
It is the visceral fat (fat around internal organs) which is more dangerous than fat on abdominal wall since this leads to coronary artery disease (heart problems). Coming to your question about liposuction and diabetes, it depends on many factors. Firstly, the control of blood sugar levels of not just recent but over the past three to four month’s period. Secondly, any associated metabolic problems such as lipid profile, associated kidney function and cardiac function. Apart from these, diabetics do have a problem of wound healing but with modern techniques the wounds are generally very less. Last but not least, it all depends on the surgeon who is doing the liposuction. You better consult a good plastic surgeon for further opinion.
Doctor, I have brown discolorations of the skin which are visible on the back of my hands, neck and face. I am 40 years old. I have worked outdoors for many years. Are they age spots? I am worried now, since the age spots (if it is that) are getting bigger. Please suggest a remedy. - Surya Prakash.
Usually frequent exposure to sunlight can precipitate seborrheic keratosis, a condition characterized by slightly elevated to almost flat skin, coloured to brownish patches on sun exposed parts; apart from this one may also develop actinic keratosis and freckles. Seborrheic keratosis can be treated by simple light electro cautery, electro dissection or cryotherapy. Avoiding the sun is best; also use a good sun screen lotion when you go outdoors during the daytime. I advise you to visit a dermatologist for proper diagnosis.
Doctor, I am in my fifth month of pregnancy and I have noticed that my face has become darker than it used to be. My skin colour was earlier light wheatish brown but now it is more dark wheatish brown. It was a little lighter in winter but now it is getting worse in summer. What is this disorder? Is it anything to be worried about? Can I take medication without any complications to my baby? - P. Suguna.
Usually there are certain hormone changes which are absolutely physiological during pregnancy due to which one may experience hyperpigmentation, that is increased colour. Apart from this, females can develop localized hyperpigmentation on both cheeks called pregnancy mask or chloasma. There is increase in redness of palms and soles. Because of progressive weight gain there is hyperpigmentation and thickening of the skin in the body folds such as neck and axillae. One need not worry about these changes as these are physiological and spontaneously resolve after pregnancy. No treatment may be necessary. Kindly consult a dermatologist or your gynecologist for proper evaluation and further management.
Doctor, I have warts on my hand and the local doctor I visit suggested that I get cryosurgery done. I wanted a second opinion so I am writing to you. Is it a safe procedure and how much would it cost? Could you please advice? Thank you. - Aditya S.
Cryotherapy is a safe procedure. If done by an experienced person, you can be rest assured. Though post procedure you might experience some pain, it is manageable with good medicines. Other methods for wart removal are electrocautery, radiofrequency cautery, laser removal and chemical cautery. You may speak with a doctor and decide the best option.
Month: June 2010.