To add to the problem, we live in a hi-tech world where one does not have to move from the chair even to switch on the idiot box that gives us most of our knowledge - not wisdom. Even our women do not have to do any physical effort as we have all the gadgets for the daily chores.

This paradox has put additional burden on our health; so much so almost every other person in the affluent West is obese. Weight gain seems to be their only pre-occupation. Most people in those societies have become couch-potatoes. With the opening of the doors for Americanization of our mother India, the new disease is catching up fast among our rich and the famous. The tendency, naturally, will become hereditary. Some of us would have to inherit the tendency from our parents.

I have good news as well as bad news for those rounded people around:

Good News:

Obesity, in its own right, is not a risk factor.
An active obese individual does not run any additional risk of killer diseases, if he keeps himself active and exercises regularly. Regular exercise keeps even an obese person healthy and fit. The latter’s risk of precocious mortality and morbidity does not go up if when active.

Bad News

Once one is obese it is very difficult to get rid of the extra tyres on the belly ! Heredity, mentioned earlier, might play a role here.

The `quick-fixes’ advertised everyday for losing weight without sweat, are only advertisement tricks to sell their products. It could even be risky to loose weight very fast. Fat mobilization, a necessary evil in drastic weight reduction, could be dangerous. Gradual loss of weight is our best bet.

The only way one could lose weight with profit is to eat less and, work more. There are no short cuts at all. Body weight is like bank balance. The more you spend and the less you deposit, the lower will be your bank balance. The reverse is also true. This rule holds good for body weight with but one exception. Some people who eat a lot may still not put on weight. These are the lucky ones who were thin babies during infancy. (First year of life) It is during the first year of one’s life that the total number of fat depot cells are formed. If one has been a bonny baby, one would have had large number of fat cells formed in the first year itself. They would be waiting to grab any opportunity to store fat from the extra food that we take. The moral of the story is not to feed your baby by the clock, but only on demand - preferably only mother’s milk and not cow’s or buffalo’s.

Exercise is a very good method to lower weight but is not a very economical way. One has to walk for an hour, or swim for fifteen minutes, or dance for 10 minutes, to get rid of one extra slice of bread eaten during breakfast. On the contrary regular exercise, coupled with a parsimonious diet would be an ideal combination. Similarly to lose weight it is more important to eat less. Picking and choosing food articles might result in an imbalance in the diet, giving rise to deficiency diseases. Mixed diet, preferably vegetarian, with a good helping of fresh fruits and vegetables, would be the best bet. The ready-made weight watcher’s junk food could be dangerous in the long run. Exercise should be sustained - and not in bouts. Vigorous and strenuous exercise may even harm the system.

Another new fad, aided and abetted by the media hype of the drug industry, is to take drugs for losing weight. While it looks easy, I was always uneasy even to think of prescribing these drugs. The drug company personnel have always thought that I was a therapeutic nihilist. Far from it ! I would always use my intuition, the latter tells me that one could not possibly have a "safe" drug to reduce weight.

A recent report, yet to be published, (accepted for publication by the leading American medical Journal. New England Journal of Medicine) throws new light on this drama. The most talked of and advertised weight reducing drug, Fenfluramine has been implicated in the causation of a rare heart valve disease, based on very hard scientific evidence. The Mayo Clinic cardiologists and cardiac surgeons were non-plussed to see deformed heart valves in patients taking the above drug on a long term basis, although with very good reduction in their body weight. The valves were so badly damaged to be leaky or even distorted to produce and obstruction, stenosis, to the onward flow of blood inside the heart. The study of these valves, taken out during surgery for replacing the valves with artificial ones, clearly showed that the damage was drug induced.

With this clue they were able to collect data on more than forty patients within a short span of time. As this study will take some time to be published and then get into medical texts, the editor of the journal took an unusual step of informing the media in advance to warn the public and the doctors. I had a talk with one of the deputy editors recently and was able to collect the following data, which may help thousands taking that drug in our country as well.

1. Fenfluramine could cause heart valve damage in the long run.
2. The drug should not be used for weight reduction, except in those above 200 lb. Having a weight related acute problem. In the latter situation the drug could be used purely on temporary basis.
3. Those who are already on the drug should not stop it suddenly, as the withdrawal effects may even be disastrous. (cold turkey) The drug could be gradually tapered off and stopped.

Every drug goes through different phases during its life. After the initial discovery of the molecule, animal studies and selected volunteer studies, the drug is released to the market. (Of course, with regulatory body’s approval). Then the drug company mounts a marathon promotion drive and the medical profession believes that the drug is a panacea for all ills (the gee phase)

Then someone discovers the dangerous side effect and many times the drug is labeled as a poison and forgotten. It has done the damage anyway ! Eventually, years later, the same drug may come back as a good drug for some other disease in a limited way. Lot of drugs go through these phases. We only hope that Fenfluramine will come back in a different garb after some years.

The best bet for couch potatoes who are overweight is to remember to share their food with others and work very hard to be in good health if lucky. Disease and death are only accidents. Have you read the cowboy song?