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Obesity and Empathy

DR BOIMA

HEALTH ISSUES

It is that time of the year when resolutions have been set and the implementation is at its peak. One such popular resolution that makes top of the list is weight loss. Many people in our country are struggling with excess weight but unfortunately they do rarely involve their doctors in their journey to weightloss.

 

I have seen many obese patients coming into the consultation room for a ‘sprained ankle’, and not mention anything about their weight, and the whole time my thinking is, “that is not a big deal, the elephant in the room is your weight, for it is the one that has potential to kill you”. People generally do not view obesity as a disease. For many, the main reason of losing weight would solely be cosmetic rather than medical; perhaps explaining their hesitancy in bringing their general practitioners on board.


Doctors (and other health professionals) on the other hand can have a tendency to judge unnecessarily and scare off the potential clients. Though with conflicting evidence, there are some studies that have shown that it is not only the society that can be biased against people who are fat, but even doctors. They may associate obese patients with being lazier, dumber, and more worthless than thin patients, an article in the online journal Stat reported.

 

We can often times assume some symptoms in an overweight patient are exclusively as a result of them being fat without even trying to explore for other causes. Sometimes when we do diagnose certain pathologies, we blame the patients for their condition, which impedes on the principle of “empathy”. Empathy is the cornerstone of quality patient care. It is no surprise that the fundamental moral code that has facilitated human kindness for thousands of years is what drives physicians to commit to their oath today; Treat others as you would want to be treated yourself.


When it comes to the disease that is obesity, I choose to take my empathy to another level. I tend to believe obese people did not intend to be obese to start with. I do believe they would genuinely be open to being helped. So my approach is to understand their life and physiological circumstances first before dwelling on the obesity itself. One American sufferer who also happens to be a physician herself wrote in her blog, “Obesity is a disease that is not that simple.

 

It is not like we want to be unhealthy. We don’t want to be looked at differently. We don’t want simple tasks like sitting on an airplane and putting on the seatbelt to be difficult. We don’t want to go home and cry with our spouses every few weeks. We don’t want our significant others to be judged. We don’t want to die early”.


Indeed obesity is a complex health phenomenon! There are many factors that can lead to one being obese and it should not be assumed that it is solely the fault of the individual that they are like that. There is generally a combination of genetic predisposition, knowledge, resources, eating habits, activity level and even medical and psychological reasons.


Genetics – Most people claim that there is no point trying to lose weight because "it runs in my family" or "it's in my genes". This is true to an extent (though for a very small fraction), that certain genetic traits inherited from the parents like having a large appetite may make losing weight more difficult, but it certainly does not make it impossible. Most obesity however, still results from environmental factors such as sedentary lifestyle and poor eating habits learnt during childhood.


Medical – In some cases, underlying medical conditions may contribute to weight gain. These include hypothyroidism, polycystic ovarian syndrome and  HYPERLINK "http://www.nhs.uk/conditions/Cushings-syndrome/Pages/Introduction.aspx" Cushing's syndrome. Unless physicians look out for them and make proper diagnoses it would not be too clear why an individual just cannot keep the weight off.

 

These conditions are treatable, and if proper liaison is made between the patient and their doctor, they should pose less of a barrier to weightloss. There are certain medications too that can contribute to weight gain like corticosteroids, psychiatric medications etc. A gym instructor would not know this, but only a doctor can review one’s medication list and scrape off the offending drugs.


Lack of knowledge – A few studies have shown that some patients genuinely perish in ignorance of not being aware of the health implications of obesity. So patient's insufficient knowledge is considered one of the causes of obesity, with the only solution being through proper education.


Food Addiction –  Research has implicated ’food addiction’ as a potential contributor to the obesity epidemic. Some people can be addicted to food just like some are addicted to drugs. A food addict experiences a compulsive need to eat, even when they are not hungry. Food, like drugs and alcohol, can trigger the release of dopamine in the brain; a chemical related to pleasure. This is a psychiatric condition that needs formal medical diagnosis and extensive intervention.


Inactivity –  Starting a regular program at the gym is another common New year's resolution that most people are unable to stick with for very long. Now a study done in mice is providing clues about one of the reasons why it may be hard for so many people to stick with an exercise program. The study found that in obese mice, physical inactivity results from altered dopamine receptors rather than excess body weight.

 

The same study concluded that in lean mice with the same dopamine receptor defect, weight was not readily gained despite their lack of activity. There is a common belief that obese people became obese because of their prolonged inactive life, and they continue to be obese because carrying extra body weight is physically disabling for them to move about,  but the study findings discussed here suggest that there is more to this than meets the eye.


Obesity is a serious public health concern because it is associated with poorer mental health outcomes, reduced quality of life, and is the leading cause of death in the U.S. and worldwide, including secondary conditions like diabetes, heart disease, stroke, and some types of cancer.I would like to urge anyone and everyone who is overweight (concerned or not) to make the first stop with the doctor’s room.

 

If GP rooms could be full at the beginning of each year like we see at gyms, we could be getting somewhere as a nation. I’d also like ourselves, as physicians, to make a resolution too; We will empathize with the obese in 2017. We will accomplish this inside, and outside of the patient encounters!

For comments or questions please email agboima@yahoo.com.

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Export Processing Zones: How to Get SEZA to Sizzle

23rd September 2020
Export Processing Zone (EPZ) factory in Kenya

In 2005, the Business & Economic Advisory Council (BEAC) pitched the idea of the establishment of Special Economic Zones (SEZs) to the Mogae Administration.

It took five years before the SEZ policy was formulated, another five years before the relevant law was enacted, and a full three years before the Special Economic Zones Authority (SEZA) became operational.

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Egypt Bagged Again

23rd September 2020
Samson

… courtesy of infiltration stratagem by Jehovah-Enlil’s clan

With the passing of Joshua’s generation, General Atiku, the promised peace and prosperity of a land flowing with milk and honey disappeared, giving way to chaos and confusion.

Maybe Joshua himself was to blame for this shambolic state of affairs. He had failed to mentor a successor in the manner Moses had mentored him. He had left the nation without a central government or a human head of state but as a confederacy of twelve independent tribes without any unifying force except their Anunnaki gods.

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‘RO, ‘RO ‘RO YOUR ‘BOT

23rd September 2020

If I say the word ‘robot’ to you,  I can guess what would immediately spring to mind –  a cute little Android or animal-like creature with human or pet animal characteristics and a ‘heart’, that is to say to say a battery, of gold, the sort we’ve all seen in various movies and  tv shows.  Think R2D2 or 3CPO in Star Wars, Wall-E in the movie of the same name,  Sonny in I Robot, loveable rogue Bender in Futurama,  Johnny 5 in Short Circuit…

Of course there are the evil ones too, the sort that want to rise up and eliminate us  inferior humans – Roy Batty in Blade Runner, Schwarzenegger’s T-800 in The Terminator,  Box in Logan’s Run,  Police robots in Elysium and  Otomo in Robocop.

And that’s to name but a few.  As a general rule of thumb, the closer the robot is to human form, the more dangerous it is and of course the ultimate threat in any Sci-Fi movie is that the robots will turn the tables and become the masters, not the mechanical slaves.  And whilst we are in reality a long way from robotic domination, there are an increasing number of examples of  robotics in the workplace.

ROBOT BLOODHOUNDS Sometimes by the time that one of us smells something the damage has already begun – the smell of burning rubber or even worse, the smell of deadly gas. Thank goodness for a robot capable of quickly detecting and analyzing a smell from our very own footprint.

A*Library Bot The A*Star (Singapore) developed library bot which when books are equipped with RFID location chips, can scan shelves quickly seeking out-of-place titles.  It manoeuvres with ease around corners, enhances the sorting and searching of books, and can self-navigate the library facility during non-open hours.

DRUG-COMPOUNDING ROBOT Automated medicine distribution system, connected to the hospital prescription system. It’s goal? To manipulate a large variety of objects (i.e.: drug vials, syringes, and IV bags) normally used in the manual process of drugs compounding to facilitate stronger standardisation, create higher levels of patient safety, and lower the risk of hospital staff exposed to toxic substances.

AUTOMOTIVE INDUSTRY ROBOTS Applications include screw-driving, assembling, painting, trimming/cutting, pouring hazardous substances, labelling, welding, handling, quality control applications as well as tasks that require extreme precision,

AGRICULTURAL ROBOTS Ecrobotix, a Swiss technology firm has a solar-controlled ‘bot that not only can identify weeds but thereafter can treat them. Naio Technologies based in southwestern France has developed a robot with the ability to weed, hoe, and assist during harvesting. Energid Technologies has developed a citrus picking system that retrieves one piece of fruit every 2-3 seconds and Spain-based Agrobot has taken the treachery out of strawberry picking. Meanwhile, Blue River Technology has developed the LettuceBot2 that attaches itself to a tractor to thin out lettuce fields as well as prevent herbicide-resistant weeds. And that’s only scratching the finely-tilled soil.

INDUSTRIAL FLOOR SCRUBBERS The Global Automatic Floor Scrubber Machine boasts a 1.6HP motor that offers 113″ water lift, 180 RPM and a coverage rate of 17,000 sq. ft. per hour

These examples all come from the aptly-named site www.willrobotstakemyjob.com    because while these functions are labour-saving and ripe for automation, the increasing use of artificial intelligence in the workplace will undoubtedly lead to increasing reliance on machines and a resulting swathe of human redundancies in a broad spectrum of industries and services.

This process has been greatly boosted by the global pandemic due to a combination of a workforce on furlough, whether by decree or by choice, and the obvious advantages of using virus-free machines – I don’t think computer viruses count!  For example, it was suggested recently that their use might have a beneficial effect in care homes for the elderly, solving short staffing issues and cheering up the old folks with the novelty of having their tea, coffee and medicines delivered by glorified model cars.  It’s a theory, at any rate.

Already, customers at the South-Korean  fast-food chain No Brand Burger can avoid any interaction with a human server during the pandemic.  The chain is using robots to take orders, prepare food and bring meals out to diners.  Customers order and pay via touchscreen, then their request is sent to the kitchen where a cooking machine heats up the buns and patties. When it’s ready, a robot ‘waiter’ brings out their takeout bag.   

‘This is the first time I’ve actually seen such robots, so they are really amazing and fun,’ Shin Hyun Soo, an office worker at No Brand in Seoul for the first time, told the AP. 

Human workers add toppings to the burgers and wrap them up in takeout bags before passing them over to yellow-and-black serving robots, which have been compared to Minions. 

Also in Korea, the Italian restaurant chain Mad for Garlic is using serving robots even for sit-down customers. Using 3D space mapping and other technology, the electronic ‘waiter,’ known as Aglio Kim, navigates between tables with up to five orders.  Mad for Garlic manager Lee Young-ho said kids especially like the robots, which can carry up to 66lbs in their trays.

These catering robots look nothing like their human counterparts – in fact they are nothing more than glorified food trolleys so using our thumb rule from the movies, mankind is safe from imminent takeover but clearly  Korean hospitality sector workers’ jobs are not.

And right there is the dichotomy – replacement by stealth.  Remote-controlled robotic waiters and waitresses don’t need to be paid, they don’t go on strike and they don’t spread disease so it’s a sure bet their army is already on the march.

But there may be more redundancies on the way as well.  Have you noticed how AI designers have an inability to use words of more than one syllable?  So ‘robot’ has become ‘bot’ and ‘android’ simply ‘droid?  Well, guys, if you continue to build machines ultimately smarter than yourselves you ‘rons  may find yourself surplus to requirements too – that’s ‘moron’ to us polysyllabic humans”!

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