Background: Individual with morbid obesity and type 2 diabetes benefits from weight loss, as this allows better glycemic control and modifies the coexisting risk factors for coronary heart disease, namely hypertension, dyslipidemia, insulin resistance, sleep apnea, and other comorbidities that constitute the metabolic syndrome. Aims: The purposes of the present study were to investigate whether weight loss after bariatric surgery can correct glycemic control and reduces the need of antidiabetic treatment in morbidly obese patient with type 2 diabetes, and whether sleeve gastrectomy or gastric bypass is associated with better control. Settings and Design: This study was performed in Sri Aurobindo Medical College, Indore, India. Sampling taken was nonrandom and purposive. Subjects and Methods: Forty patients with diabetes type-2 and body mass index (BMI) >35 (20 of which undergone sleeve gastrectomy and other 20 undergone gastric bypass) were enrolled in study, all these patient had undergone bariatric surgery. Their obesity status in terms of height, weight and BMI, Glycemic status and glycosylated hemoglobin (HbA1c), and treatment status in terms of oral hypoglycemic agents and insulin were noted in details preoperatively. Qualitative variables were tested using Chi-square test and P values were calculated between two groups. P ≤0.05 was considered statistically significant. Results: This study showed good control of glycemic status with mean HbA1c within desired level after 6 months of bariatric surgery, while gastric bypass surgery was associated with better glycemic control and weight loss. Conclusions: This study showed that the bariatric surgery was an effective option for morbidly obese patients with type 2 diabetes mellitus. Gastric bypass surgery was associated with better diabetic control and weight loss than sleeve gastrectomy.

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Background: Dual burden of malnutrition comprising of both under nutrition and over nutrition constitutes an important public health problem among Indian adolescents. Objective: The objective of this study is to determine the prevalence of dual burden of malnutrition (underweight and overweight/obesity) among adolescents and to understand the role of dietary habits and physical activity in this regard. Methodology: A cross-sectional survey was conducted in Shimla district of North India. A total of 720 adolescents aged 14-19 years were selected to participate in the study. Data were collected on sociodemographic status, physical activity, dietary intake, and anthropometry. Statistical analysis was done using Epi info software for windows (version 6.0, Centre for Disease Control, Atlanta, USA). Results: A total of 298 (41.3%) of the adolescents were suffering from dual burden of malnutrition. The binary logistic regression revealed a statistically significant positive association of overweight/obesity with frequent fast food consumption (odds ratio [OR] = 4.45, confidence interval [CI] = 2.42-8.18). Individuals consuming less salt in the diet had lower odds of being overweight/obese (OR = 0.47, CI = 0.25-0.87). Similarly, individuals frequently consuming fruits in the diet had lesser odds of being underweight (OR = 0.61, CI = 0.42-0.86). Conclusion: The high prevalence of the dual burden of malnutrition in this study stresses the need for policy makers in India to adapt the current adolescent program so as to focus on both ends of the nutrition spectrum.

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Obesity is one of the common health problems in Saudi Arabia. It affects almost one third of adult population and one tenth of children and adolescents. In order to prevent and control obesity among Saudi population, it is mandatory to have national program with definite objectives and strategies. The aim of this paper is to identify priorities for integrated strategies to prevent and control obesity and to define roles and responsibilities of various stakeholders including individuals, families, community, organizations and agencies in KSA as the first step in a process to develop integrate national program to prevent obesity.

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Background: Obesity is one of the most common chronic diseases that could be managed at PHCC settings. Objectives: The objective of this study was to explore knowledge, attitudes, and practice of PHCC physicians in Aseer region, regarding obesity. Materials and Methods: This cross-sectional study was conducted among physicians working at PHCC in 2012. In order to achieve the objectives of this study, the investigators designed a questionnaire which composed of three parts namely; sociodemographic data, knowledge related questions, attitude related questions, practice related questions in addition to some questions related to infrastructures, and barriers facing management of obesity at PHCC. Questionnaire was distributed to all PHCC doctors using post. Data entry and statistical analysis was carried out using SPSS version 21. Results: The total number of doctors responded was 294 out of 339, giving a response rate of (87%). Mean age of participants was 38 year, male represented 63%, 61% had no post MBBS qualification and one third are working in big cities. More than 50% of centers were having registers, guidelines and screening program for obesity. The most common encountered barriers to care for obesity at PHCC were lack of (time, health education materials, guideline and referral system). Most of physicians showed good attitude regarding management of obesity compared to knowledge which was inadequate as reflected by total knowledge score which was less than 7 points among 64% of participants. More than half of participants reported that they gave advices about the roles of diet, exercise in management of obesity to their clients. Conclusion: This study revealed that PHCCs in Aseer region need adequate infrastructures to care for obese patients while PHCC doctors are in need of training to improve their knowledge and develop their skills in order to introduce good care for their obese patients.

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Five A's technique was first used for smoking cessation. Later on this approach was practiced by health professional to manage obese patients. The objective of this paper is to demonstrate how to manage obese patient by using five A's approach based on clinical scenario.

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