Adult Weight Management India Story

CASE 20 Adult Weight Management (India)

Mr Swami is a 65-year-old retiree who lives with his wife, Lakshmi.

While he was in the workforce, Mr Swami’s job as a construction overseer kept him active for several hours a day. Since retiring six months ago, his activity levels have significantly reduced and he can now be categorized in “sedentary” lifestyle. He also has a large social circle and large part of his time is spent in social events [holidays, festivities, and celebrations].

Mr Swami sees his family doctor for a general medical examination. He believes he is in good health, and wishes to remain so in his retirement years. He gave up smoking 20 years ago. His father died from a myocardial infarction at age 55, while his mother and older brother were both diagnosed with type2 diabetes in their sixties; so he has concerns about the possible significance of his family history.

The doctor undertakes a physical examination that includes blood pressure, weight and height. Blood pressure measures 130/85 mmHg; weight is 90kg [198 lb]: both are higher than previous recordings. The doctor thinks that, if there is any further increase in blood pressure, an-hypertensive medication will be called for; but as the first point of intervention he recommends that Mr Swami see a dietician about losing some weight. Mr Swami schedules a consultation. This is his first visit to a dietitian.

You collect a diet history and the following anthropometric measurements: height 175cm [5’ 9”] and weight 90kg [198lbs]. The patient reports his weight six months ago as 78kg [172 lbs]. You measure his waist-hip ratio as 1.0 and calculate BMI at 29 kg/m.

Mr Swami tells you how much he is enjoying his retirement. He loves spending more me with family and friends. However, he has been gaining weight. His weight was never a problem during his working life. He didn’t “diet” or have to think about what he ate. But the weight gain since retirement is bothering him. His old clothes are tight, and he needs increasingly larger sizes. He is considering modifying his eating habits but does not know where to start.

He and his wife, Lakshmi, go grocery shopping every Friday. She does the Home cooking, and he describes his diet as “good basic meals.” You discuss recreational activities and physical activity level. Most days, Mr Swami does chores around his small garden, and he maintains a busy social life. Every Monday, he goes meets friends at a part for a morning walk, and afterwards has a cup of coffee with milk and a vegetable puff with friends.

He walks briskly for a total of 60 minutes weekly. He walks slowly for 30 minutes per week and gardens daily for 15 minutes. Apart from this, he does not participate in any other physical activity.

On Wednesdays, Mr Swami goes to the cinema with his film club. He has samosas as a snack. During the Friday grocery-shopping trip, the couple likes to buy a Biryani and milkshake for when they get home.

On Friday and Saturday nights, Mr Swami watches cricket on television and snacks on potato chips [crisps] and beer. He loves treating the grandchildren with chocolates on Sundays, and he enjoys a chocolate bar with them.