NEW YEAR, NEW HEALTH RESOLUTIONS

It is a beautiful new year and we are all grateful for various things.

Armanda* is grateful for good health. 2018 was an extremely difficult year for her. Armanda had always been an active person, playing basketball for the school team throughout high school. When she joined university, she carried on the trend and soon she was appointed the team captain.

Armanda has always been a disciplined person. It takes a lot of self-drive and initiative to attend practice daily even when everyone else was off having a good time. While her friends hit the clubs on weekends and slept all day nursing hangovers, Armanda was shooting hoops and swimming.

Despite such an active lifestyle, Armanda noted that she was putting on weight. She was distressed when she had to change her wardrobe. Her mother took her shopping without fuss but she was worried. Her mother had been diabetic for the past 12 years and it was not an easy journey. She changed her lifestyle and by extension, that of her family. She ensured she served healthy meals at home and encouraged everyone to keep fit to protect them from diabetes.

So far, Armanda had been her mother’s success story. She ate right and was physically fit. Her mother worried that maybe, being away from home was making Armanda’s diet inappropriate, hence the weight gain. However, she did not want to make her daughter feel judged.

Things got worse when Armanda suffered injury to her ankle and could no longer play basketball. She had minor surgery and the recovery took several weeks. During her convalescence, Armanda added yet another twelve kilograms. She felt terrible and the stress began to affect her. She slept a lot, spent all her free time in bed and wore big clothes to conceal the weight.

Though she lost her appetite, the pounds kept piling. She lost interest in many of the fun things she did and she even avoided swimming altogether despite the doctor recommending it. At least she could work out without straining her ankle in the pool. Armanda could not fathom buying a bigger swimming costume and expose expanding waistline.

As she battled with weight and self-esteem issues, a new problem was creeping up which took her a while to get her attention. She started missing her monthly periods and when they did come, they were excruciatingly painful. She had always suffered discomfort during menses but suddenly they got out of order.

As if that was not enough, she developed bad acne that was unresponsive to any home remedies she could think of. She noticed that the three strands of hair on her chin that she had meticulously managed to conceal all these years with the help of her trusty tweezers had suddenly multiplied while the one on her head was falling off in clumps!

In the wake of all these unwelcome changes, Armanda was struggling to keep her grades up. Her social life suffered as she gave up basketball for good and preferred spending her weekends at home curled up on the couch with a blanket, watching movies on Netflix. She would struggle to get through assignments and concentrate in class.

Her mother intervened and brought her for a consultation one afternoon. It was the start of a long-term relationship. Imaging tests and several blood tests later and Armanda was diagnosed to have multiple hormonal problems.

She suffered from polycystic ovarian syndrome, a condition that caused her the menstrual problems she was experiencing, coupled with the acne and facial hair. The imbalance of her reproductive hormones and an excess of testosterone in the system were wrecking havoc in her body.

As a result of the polycystic ovarian syndrome, her risk of getting diabetes was increased sevenfold. This, in addition to the fact that she already had a family history of diabetes, and the huge weight increase she had experienced, made her the perfect candidate for the condition. She was diagnosed with diabetes much to her mother’s distress.

As if that was not enough, Armanda was also diagnosed with hypothyroidism, a condition where the thyroid gland was unable to make enough thyroid hormones. Thyroid hormones are responsible for driving metabolism in the body. In Armanda’s case her metabolism was slowing down, making her put on even more weight.

Armanda is currently under the care of a multidisciplinary team. As we manage her gynaecological problems, she also sees an endocrinologist for her thyroid and her diabetes, a health and fitness doctor for her weight management and a dermatologist for her hair and skin problems.

As she bids farewell to 2018, she is ecstatic. She has lost 10% of her body weight, her skin is much better, her menses are back on track and she is back to the swimming pool! She no longer needs to take diabetes medication as she can now manage her blood sugar on diet alone. And her grades are back on track.

Armanda is a perfect example of the complexities that can result in weight issues. Not all weight gain is a result of a careless lifestyle. Sometimes it is just a symptom of an underlying medical problem. Therefore, as you make your new year’s resolutions to lose weight, it is wise to ensure you are not masking a bigger problem.

Do not blindly join the dietary fads without talking to your doctor. You could easily find yourself in a coma in the intensive care unit as you attempt to starve yourself out of obesity!