The Dangers of Overfeeding: Mohammed’s Journey Through Bariatric Surgery

Mohammed’s Early Years

Mohammed is an 18 year boy from Afghanistan, he is shy, simple, has an easy smile, and is full of life. As a toddler he grew up active and playful, he was 15 kgs when he was 4. Then he steadily started gaining weight. Slowly but relentlessly, he over-grew. At 15 years he was 115 kgs at 5 feet 6. Very very obese indeed. When he came to us 3 years later, he could barely walk, sleep only sitting, sweat all day, and couldn’t speak without losing breath. He had become a giant, he weighed a huge 185 kgs at a BMI of 71.

Understanding the Cause of Obesity: Overfeeding

His tests for genetic or hormonal problem came out normal. We looked into his life history, didn’t have much clue about he being so obese. On further questioning we found that Mohammed was born after eight sisters but he was born normal, a precious male child. Hence he was fed too much with food, love and affection by his doting mother and sisters. We have this gender issue in this part of the world, a male child is the preferred one, he is the natural heir, is supposed to look after parents in old age, and fetch dowry. Hence he was pampered. Initially, he must have resisted but later on, yielded to pressure and temptations of calorie rich sumptuous food. As it happens, his sense of satiety slowly got blunted and he could eat all day without feeling full, a condition known as hyperphagia. He was suffering from what I call the curse of overfeeding.

The Bariatric Surgery Experience

Mohammed underwent a difficult Bariatric surgery, he was kept on ventilator support for the next three days, before he could breath on his own. he made a slow recovery. Our psychologists and nutritionists mean while gave counselling sessions to Mohammed and his mother regarding his feeding and after-care.
Two weeks later they returned home.

A New Beginning

Mohammed did well, 2 months later he had lost 21 kgs , now he could walk without help, and sleep undisturbed.
Five months later he had joined back his elementary school which he had left years ago owing to his crippling obesity. He was well on his way to return to a normal life. Then we lost contact with them.we hope and pray the parents haven’t gone back to their old ways.

The Impact of Misplaced Love

This story of Bariatric surgery is unique, so many times our misplaced love can ruin our children’s life. Our myths and false beliefs, force us to overfeed them. An over weight child is likely to become obese adult, will suffer from premature ageing diabetes hypertension, heart diseases and more.

Guidelines for Preventing Overfeeding

Now how much is good enough for our children, is a contentious issue, but here are some simple rules of thumb. If we follow them we are going do well.

Avoid Overfeeding

There is a natural tendency to overfeed children. We are always worried if we are feeding them enough, so if in doubt stop.

Respect Toddler’s Satiety Signals

Toddlers by and large have a well developed sense of feeling full, and stop as soon as they lose interest in their meal.

Feed on Demand

Feed on demand is the ideal way, like all ideals difficult to follow. But worth pursuing.

Be Mindful of Pre-School Children’s Diet

Pre-school children are at risk of obesity more than ever before. they get bored easily. Do not feed to appease, reward, or pacify your children with snacks. it creates an unhealthy craving for snacks.

Limit Sweets and Chocolates

Give them sweets and chocolate strictly only “once a week”.

Portion Control: Avoid Overfeeding

Don’t push the food around on their plates and don’t force them to finish what you give them. Don’t overfill their plates and ask them to finish every time, instead serve a smaller portion and refill.

What you can hold in your palm is a good enough portion to star with.

Monitor Weight Gain

If your child is gaining weight steadily, her clothes are getting short instead of tight at the waste, bravo !! You have done well.

Navigating Fasting During Ramadan After Bariatric Surgery: Tips for a Safe and Healthy Experience

We are into the middle of the holy month of Ramadan, and the Eid is around the corner, Delhi and the walled city, in particular, are celebrating Ramadan with full fervor and gaiety. The day begins well before sunlight with Sahrei the morning prayer and a succulent meal of Nihaari a special meat dish cooked in overnight slow fire; and then the Roza or day-long fast ,without food and water begins. Many relax at home and take a siesta, but most continue with their daily grind. It is summer in Delhi at its peak with relentless sultry heat; there is hardly any breeze though occasionally a dust storm Luu brings welcome relief. The lanes are sleepy. Occasionally one encounters a rickshaw puller in a white cap silently trudging along, his face dry and flushed, his Lips parched with almost no sweat on the brow.

All this makes fasting even more arduous. Faithful offer their ritual after- noon namaz and patiently wait for the evening. At last the Sun goes down and here comes the welcome Iftar hour. The city wakes-up from its deep slumber, the shops open in tandem and the streets in Ballimairan, Hauz Kazi and Chandni Chowk come alive with decorations, lights and flowers. Slowly the scent of Ittar and of freshly made kababs, jalebis and naans from numerous stalls wafts all over in the welcome breeze.

Presently you see waves of men in white thronging to Jama Masjid for their evening namaaz. Often you see a few tired faces with gleam in their eyes and a sense of accomp//ishment, reminding me of our bariatric surgery patients who visit us after two weeks of liquid diet with same calm and serene face and the same sense of pride; they too are waiting for their puree diet.

This brings me to the question many of my patients ask, whether they can observe religious fasts. My advice to them is clear

• Visit your physician; take a fitness check before you have a go at it
• It is best to wait for one year till you are settled with your normal diet.
• If you are observing fast do not go out in the sun for long hours, don’t undertake strenuous work.
• Keep a watch on your hydration; you should pass urine at least two or three times during the daytime. It should be clear or light yellow.
• Drink at least two liters of fluids in the Night, to make up the deficit
• Open your fast with fruits like apples and water-melon
• Take high protein food; avoid oil rich curries, fries and pastries to prevent dumping
• Eat slowly, chew well otherwise you tend to vomit and your dehydration will worsen
• If you are suffering from severe Kidney disease, better not do it.
• Diabetics should take special care to avoid hypoglycemia, or keto- acidosis. Check your sugar levels twice a day and urine for ketones. Your insulin and medicine requirements will change.
• Better still consult your physician before you begin with your fasts.

Enjoy your fasts and feast this Ramadan and Eid and take care.