Why obesity cases have shot up in Mumbai (source:Times of India)

Why obesity cases have shot up in Mumbai

Mumbai has seen a 100 per cent rise in Obesity Hypoventilation Syndrome cases. We break down the lifestyle disorder by talking to an entrepreneur who overcame it

While driving to his relative's Thane residence on a winter afternoon, Anand Premani, a 31-year-old Kurla-based textile businessman, suddenly dozed off. Premani says, "Thank God I did not crash into someone." That particular drive, a year and a half ago, pulled him down with sleep so uncontrollable that he had to halt every 10 minutes to recover.

Unfortunately for Premani, this was not meant to be a one-off episode. Soon, he realised he could not sit at his shop for more than 20 minutes because he would doze off. At family functions, Premani would be found napping in a corner. "I was perpetually fatigued. After climbing two flights of stairs, I had to wait 10 minutes to just be able to talk," he says.

A blood test informed Premani that he had developed Obesity Hypoventilation Syndrome (OHS).

OHS simplified
OHS is a condition in which the blood's oxygen level dips and carbon dioxide (CO2) level rises due to poor breathing. This leads to toxicity in the blood, resulting in excessive drowsiness, tiredness, mood swings, and memory, learning, and concentration problems.

The normal blood oxygen level is supposed to be above 90 per cent, while the carbon dioxide level should remain below 40 per cent. In Premani's case, while the CO2 levels rose to 52 per cent, the oxygen levels fell under 85 per cent.

Cause concerns
Obesity is the prime factor for causing OHS. Premani weighed 200 kilos when he developed OHS. However, he wasn't always on the heavier side. He weighed less than 100 kilos until four years ago. "Bad eating habits did me in," he says. "I couldn't help but hog all day. If I had lunch at 1 pm, I would feel hungry again at 2 pm and wolf down three bhajia or vada pavs. I feasted on fried mutton or chicken for dinner," he recounts.

Dr Ramen Goel, head of bariatric surgery, Nova Specialty Surgery, who treated Premani, says that OHS is the next stage of Obstructive Sleep Apnoea (OSA). "Sleep deprivation, as a result of sleep apnoea, tinkers with hormones that suppress appetite. Over time, those suffering from sleeplessness tend to make poor food choices which may lead to weight gain and OHS, like in Premani's case," says Dr Goel.

When Premani started gaining weight around the stomach, it pushed his diaphragm upwards during sleep and squeezed his lungs to less than half their capacity. "At rest, a normal person breathes in about 500 ml of air in one breath. Premnani was inhaling only 200 ml of air," says Dr Goel.

Rising instances
Premani's battle with OHS is far from rare. City doctors report an almost 100 per cent rise in OHS cases in five years. Dr Shashank Shah, HOD, metabolic surgery, Fortis Hospital, Mulund, says that the number of OHS cases have gone from 40 to 80-90 a month. "Unlike Westerners who tend to gain weight all over the body, Indians have a higher tendency of gaining weight around the belly, which may lead to OHS," says Dr Shah.

According to Shah, people with a BMI of 29-32 stand a 50 per cent more chance of developing OHS than others. And, those with a BMI of 33 or above have a 90 per cent or more chance of developing the condition.

Dr Anil Ballani, a general physician at Lilavati Hospital, is seeing 15-20 cases of OHS a month, up from seven a month, five years ago. "One reason for the spike is better diagnosis. Five years ago, most people didn't bother going to a doctor even if they had sleep problems, such as snoring. Now with the help of sleep studies, sleep disorders can be easily identified," says Dr Ballani.

In Premani's case, prolonged toxicity of blood could have also caused leg oedema and pulmonary hypertension, among other serious health issues. But he was lucky to have it diagnosed soon.

The way out
Weight loss is the only treatment of for OHS. Seven months ago, Premani underwent a bariatric surgery. Since his stomach size was reduced by about 75 per cent, his food intake dropped by twothirds. "I have quit eating junk. I have little poha for breakfast. For lunch, it's one chapati, daal and sabzi. Dinner is one chapati with roasted chicken," he says.

Seven months after surgery, he weighs 135 kilos because his belly size has reduced, his lungs now have space to expand and expel excess CO2. He hopes to lose another 50 in the coming months. He says, "I will work towards reaching the ideal weight, which is 80-90 kilos."

Source : Times of india