Changing perceptions of obesity--recollections of a paediatrician.

摘要

It's a Monday morning. I'm in my clinic and the consultation with my first patient is just ending. We've discussed management of his obesity (body-mass index [BMI] 34 kg/m~2) and prediabetes, and review the healthy lifestyle changes that have been made. There's been an encouraging reduction in weight and waist circumference since I last saw him. I emphasise the importance of ongoing support from the dietitian and clinical psychologist, adjust metformin dosage, and discuss follow up arrangements. The next patient is new to the clinic and is more severely obese (BMI 44 kg/m~2). She is referred from a sleep physician and has recently started continuous positive airway pressure therapy for her obstructive sleep apnoea. That treatment at least is going well-she recounts being more refreshed in the morning and less sleepy during the day.