exudates and Obesity--Morbid

Living with morbid obesity is challenging since it affects various dimensions of life. Sustainable weight loss via bariatric surgery helps people suffering from morbid obesity to lead a healthy and meaningful life. This study highlights the challenges before bariatric surgery and the impact on one's life. A phenomenological approach was employed using in-depth interviews with 21 participants (15 females and 6 males) who had undergone surgery at least 6 months prior to the study with the mean age of 42.6 years. Due to excess body weight, the physical limitation had a serious negative impact on their social life, making them targets of bias and stigmatisation. Surgery was the best option for them to attain sustainable weight loss and to lead a new life. However, a few participants struggled with the side effects of surgery. Five themes were discovered, namely, (1) social restraint; (2) experiencing bias and stigmatisation; (3) bringing new life; (4) boosting self-esteem; and (5) facing the negative side of surgery. This study serves as a platform to explore the difficulties faced by people with morbid obesity and the changes that the participants experienced after the surgery for future intervention to curb the rising number of people with morbid obesity.

Topics: Adult; Bariatric Surgery; Female; Humans; Malaysia; Male; Obesity, Morbid; Qualitative Research; Weight Gain; Weight Loss

Female sexual dysfunction (FSD) among the obese women is often under diagnosed and ignored especially in Malaysia, a nation of conservative multiethnic society. There are only a few studies on FSD resolution post-bariatric surgery. The objective was to identify the rate and resolution or improvement of FSD, among obese multiethnic Malaysian women post-bariatric surgery.. This is a prospective study of women undergoing bariatric surgery, between May 2017 and April 2018. FSD was diagnosed using the Malay version of Female Sexual Function Index (MVFSFI) questionnaire. Patients filled up the questionnaire before and 6 months after surgery. Association between BMI reduction and FSFI score improvement was measured using Fisher's exact test. Outcomes between types of surgery (sleeve gastrectomy and gastric bypass) was compared.. Fifty-two women completed the study. The mean age was 38.77 ± 6.7. There were 44 (84.6%) Malay patients, 7 (13.5%) Indian patients, and 1 (1.9%) Chinese patient. There was a significant reduction in mean BMI, 39.89 ± 6.9 pre-surgery to 30.32 ± 5.4 post-surgery (p value < 0.001). The rate of FSD among the obese is 75.0% pre-surgery compared to 36.0% post-surgery. There was a significant improvement in mean FSFI score pre- and post-surgery: 18.73 and 25.93 respectively and in each of all 6 domains (p value < 0.001). There was a significant association between BMI reduction and improvement in FSFI score (p = 0.019). There was no difference in outcomes between types of surgery.. FSD is highly prevalent among the obese multiethnic Malaysian women. Bariatric surgery has proven benefit in resolving FSD across all sexual domains and should be considered as a management option in this group of women.

Topics: Adult; Bariatric Surgery; Comorbidity; Female; Humans; Malaysia; Middle Aged; Obesity, Morbid; Pilot Projects; Prospective Studies; Sexual Behavior; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological; Surveys and Questionnaires

Socioeconomic factors and nutritional status have been associated with childhood cognitive development. However, previous Malaysian studies had been conducted with small populations and had inconsistent results. Thus, this present study aims to determine the association between socioeconomic and nutritional status with cognitive performance in a nationally representative sample of Malaysian children.. A total of 2406 Malaysian children aged 5 to 12 years, who had participated in the South East Asian Nutrition Surveys (SEANUTS), were included in this study. Cognitive performance [non-verbal intelligence quotient (IQ)] was measured using Raven's Progressive Matrices, while socioeconomic characteristics were determined using parent-report questionnaires. Body mass index (BMI) was calculated using measured weight and height, while BMI-for-age Z-score (BAZ) and height-for-age Z-score (HAZ) were determined using WHO 2007 growth reference.. Overall, about a third (35.0%) of the children had above average non-verbal IQ (high average: 110-119; superior: ≥120 and above), while only 12.2% were categorized as having low/borderline IQ (< 80). Children with severe obesity (BAZ > 3SD), children from very low household income families and children whose parents had only up to primary level education had the highest prevalence of low/borderline non-verbal IQ, compared to their non-obese and higher socioeconomic counterparts. Parental lack of education was associated with low/borderline/below average IQ [paternal, OR = 2.38 (95%CI 1.22, 4.62); maternal, OR = 2.64 (95%CI 1.32, 5.30)]. Children from the lowest income group were twice as likely to have low/borderline/below average IQ [OR = 2.01 (95%CI 1.16, 3.49)]. Children with severe obesity were twice as likely to have poor non-verbal IQ than children with normal BMI [OR = 2.28 (95%CI 1.23, 4.24)].. Children from disadvantaged backgrounds (that is those from very low income families and those whose parents had primary education or lower) and children with severe obesity are more likely to have poor non-verbal IQ. Further studies to investigate the social and environmental factors linked to cognitive performance will provide deeper insights into the measures that can be taken to improve the cognitive performance of Malaysian children.

Topics: Body Mass Index; Child; Child Development; Child, Preschool; Cognition; Cognition Disorders; Female; Humans; Income; Intelligence Tests; Malaysia; Male; Nutrition Surveys; Nutritional Status; Obesity, Morbid; Parents; Poverty; Prevalence; Social Class; Surveys and Questionnaires

Obesity is becoming more prevalent world wide. Bariatric surgery is one treatment option for patients with severe or morbid obesity. There have been few comprehensive studies examining prevalence and risk factors for obstructive sleep apnea (OSA) in the multiracial Singaporean bariatric surgery population.. We performed full polysomnography on 176 consecutive patients undergoing assessment for bariatric surgery. Questionnaires regarding snoring, the presence of witnessed apneas and the Epworth Sleepiness Scale (ESS) were administered. Anthropometric and demographic measurements include age, sex, race, body mass index (BMI) and neck circumference.. The prevalence of OSA was 72%, and 49% of the 176 patients had an AHI >= 15. There was a male predominance of OSA (X(2) = 29.7; p<0.001). OSA subjects had larger neck circumference (43.9 +/- 4.5 vs. 39.4 cm +/- 3.3; p<0.001) and higher BMI (43.1 +/- 7.6 vs. 39.1 +/- 5.4 kg/m(2); p<0.001). The neck circumference (OR = 1.37; p<0.001), presence of snoring (OR = 8.25; p<0.001) and an ESS >10 (OR = 3.24; p = 0.03) were significant independent predictors of an AHI >= 15. A neck circumference of 43 cm had an 80% sensitivity and 83% specificity for predicting an AHI >= 15.. OSA is common amongst Singaporeans undergoing evaluation for bariatric surgery, with a high prevalence of moderate and severe disease. An increased neck circumference is a strong independent predictor for an AHI >= 15, with a neck circumference of greater than 43 cm being a sensitive and specific predictor. Race was not found to be a risk factor.

Topics: Adolescent; Adult; Bariatric Surgery; China; Cohort Studies; Ethnicity; Female; Humans; India; Malaysia; Male; Middle Aged; Obesity, Morbid; Prevalence; Risk Factors; Singapore; Sleep Apnea, Obstructive; Young Adult

To identify factors associated with raised alanine transaminase, aspartate transaminase, and gamma-glutaryl transferase in severely obese children. In all, 201 children with early-onset obesity and greater than 140% ideal weight for height were recruited. Anthropometric and body fat measurements, fasting blood tests, and oral glucose tolerance tests were performed.. The mean and standard deviation (SD) for age was 11.1 (3.0) years, for weight for height 170.5% (22.7%), and for percentage body fat was 40.7% (5.2%). Elevated liver transaminases were present in 53 subjects (26.4%), who were therefore at risk for nonalcoholic fatty liver disease, and was associated with male sex (odds ratio [OR] 2.144, 95% confidence interval [CI] 1.033-4.448), Chinese ethnicity (OR 2.062, 95% CI 1.038-4.096), reduced physical activity (OR 2.389, 95% CI 1.163-4.909), insulin resistance (P < 0.05), elevated triglyceride levels (P = 0.029), and increased waist-hip ratio (P = 0.005). Stepwise logistic regression analysis of the main factors as covariates revealed Chinese ethnicity, waist-hip ratio, reduced physical activity, and homeostasis model assessment index were significant predictors. Alanine transaminase/aspartate transaminase were not well correlated with percentage body fat and weight for height. Subjects with type 2 diabetes mellitus and impaired glucose tolerance were more likely to have raised hepatic transaminases (OR 6.176, 95% CI 1.326-28.754). The severity of metabolic syndrome correlated with increasing aspartate transaminase, alanine transaminase, and gamma-glutaryl transferase (P < 0.01).. Insulin resistance, truncal adiposity, and physical inactivity are major determinants potentially modifiable to reduce risk of nonalcoholic fatty liver disease. Increasing physical activity levels were associated with decreasing insulin resistance and transaminases, despite lack of correlation with waist-hip ratio, which supports the direct benefit of regular physical activity in preventing nonalcoholic fatty liver disease.

Topics: Adolescent; Alanine Transaminase; Aspartate Aminotransferases; Child; Child, Preschool; China; Confidence Intervals; Ethnicity; Exercise; Fatty Liver; Female; gamma-Glutamyltransferase; Humans; India; Liver; Logistic Models; Malaysia; Male; Metabolic Syndrome; Obesity, Morbid; Odds Ratio; Risk Factors; Sex Factors; Singapore; Transaminases; Waist-Hip Ratio