• Submitted by: admin
• Health and Medicine
• 07 / 18 / 2007

«I used to be chubby, then I went thin, and after that I grew fat again. As a child I was plump, quite sturdy and red-cheeked, and had to wear custom-made clothes bought in a store for fat people. I was not the only one, for my two brothers were prone to be fat; one of them is even following in my footsteps. My folks? They were big too. Thats why I think fatness runs in the family.

«Look, this is the way it goes. In my teenage years I started losing weight by myself. I got so thin I looked like a lightning rod, weighing only 110 or 115 pounds until I turned 20 and got married. Then I got pregnant and started to put on weight, but I became careless. You see, I like eating so much that I just cant stop... Theres simply no stopping me».

The above came from Ania Pérez Ortiz, 49, who lives in Ciego de Ávila province. Shes a diabetic now, and although shes yet to be detected a heart disorder, a few days ago her physiatrist [?] found out her leg ligaments had stretched and ordered her to lose 40 pounds, lest the treatment be useless.

SURGERY IS NOT A SOLUTION

Nutritionists, endocrinologists and even heart and hypertension specialists, are all increasingly concerned about the growing number of obese or overweight people. And for a very simple reason: an obese or overweight person faces a higher risk of suffering one of the said pathologies than those whose lifestyle is better balanced, says Dr. Malicela Barceló, an endocrinologist and holder of a Masters Degree in Obesity Studies, at «Hermanos Ameijeiras» Hospital in Havana.

However, even worse than seeing more and more Cubans getting fat nowadays is that theres no specialized center for this pathology. It's only exceptionally treated in our healthcare institutions -including those in Havana- since the Clinic for the Obese, once managed by the above-mentioned hospital, was closed before a general remodeling plan and reopened afterward with a new, different line of treatment.

«There are several classes of obesity: light, moderate, severe, and morbid, when the patients bodily mass is so big that his organs are affected, which gives rise to a number of illnesses. In the 1980s and 1990s we treated many people here, some of them so fat that they needed months to lose any weight. And we always worked with a multidisciplinary team, for thats the only way to treat obesity», explains Dr. Malicela.

Obesity, she assures, is one of the hardest conditions to tackle, not only because many experts are required, but also for the patients themselves, who want to lose weight without going on a diet or exercising.

«Its treated with drugs and even surgery, using procedures like a gastric bypass, an operation to reduce the size of your stomach that we used here in Cuba today for very specific cases. Nevertheless, this is an extreme solution for cases when the patients life is in danger and we have run out of choices.

«The best way to go about it is to change your lifestyle by means of a diet and exercise under an experts permanent supervision. Were against some peoples decision to stop eating or resorting to extreme diets. Giving up food is not the solution: eating whats right and proper is what counts».

DOUBLE FARE

«Being fat has both its charms and setbacks», said Xiomara as she recalled what happened recently to her and her daughter in a Chinese Yutong bus. «My daughter Nadia and I had it all figured out. We had bought a ticket to Havana more than 15 days in advance, but we had to get off the bus when we realized there was no way to fit in those very narrow seats. It was OK before, but nobody heeds fat people anymore. We havent been able to travel yet, and private cars? Fat chance!».

For all the weight they have managed to lose, mother and daughter have the same biotype: theyre both tubby, each weighing over 250 pounds. «Thats what were like, thickset by tradition. Mom and I have been fat since back when we were conceived: she weighed 12 pounds and I weighed a little more than 9 pounds at birth.

«In our case its a family trend. In the late 1980s we had a series of tests done in a hospital, but all our plans went down the drain with the special period, and its been impossible to get back in lane since», Nadia remarked.

Why?

«Well, its true theres no shortage of diets and dietitians, and even counseling to help you take the pick of the bunch. But none of those choices proves a good solution. Obesity requires a multidisciplinary approach to zero in on its root causes. Take my case: I have endocrine disorders, and every specialist Ive seen tells me its because of my being obese, but thats as far as they get. Why I keep gaining weight is a question that remains to be answered.

«I agree theres a high level of expertise and plenty of human quality, but obesity is yet to be deemed a disease that calls for a great deal of monitoring and study».

Is being so heavy difficult to cope with?

«Your clothes, for instance, are a big problem for fat people. Before the special period, we had special shops like one called El Sol, but they all vanished without trace in the 1990s, and with them went our peace of mind.

«We often have to wear second-hand clothes, or else buy the fabric. Things are more complicated now, because even those shops have been passing out of sight lately. La Ópera, a nearby place where they sell top-quality recycled garments, seldom has anything for people like us anymore. What we will wear is a worry we cant get out of our mind. And never mind underwear, now thats a real tragedy and a problem we cant solve, not even if we have CUCs^[1].

«Moving around in or outside the province is another hassle. There are many thoughtful people who charge us for only one fare, unlike others who drive coaches and bicycles, who charge us both. And needless to say, a diet of fruits and vegetables is a very expensive luxury that we cant afford. Its really hard to make ends meet the way things are».

A BIG PROBLEM

Keeping a well-balanced diet in todays Cuba given the economic situation facing the country is indeed a difficult task. «We have fruits and vegetables the whole year long, but theyre quite expensive», Dr. Malicela acknowledges.

«I think its a bit odd that despite a gradual economic improvement in the last few years the number of overweight and obese people -even children, which is even worse-, has kept rising».

Its more and more frequent to see minors whose body mass is too large for their age just because they spend too much time in front of TV sets and computers, and the lack of an adequate physical education program in some schools, something rarely seen in years past, only makes things worse.

«Obesity and excess weight stem from many causes, either hereditary or environmental, but all of them are conducive to fatal illnesses. Even in Cuba, 80% of the diabetics are fat», remarks the doctor.

She assures, however, that the lack of both a national coordinating center and a system to keep track of critical patients who suffer from disorders ranging from hypertension to diabetes has made many obese people feel as if they were in a sort of no mans land.

The current number of «fat» citizens is growing at a steady rate, as befits the evolution of an increasingly sedentary society, and becoming a «bigger» problem so far obstructed by no effective strategy designed to stop it from spreading.

Source: By Yahily Hernández, Luis Raúl Vázquez Muñoz and Amaury E. del Valle, Juventud Rebelde