Objective: To examine the perceptions of body size among adolescents in Trinidad and to determine whether there were ethnic differences. Design: Cross-sectional survey. Setting: Secondary schools in Trinidad. Subjects: A stratified random sample of 1139 adolescents, aged 14 -17 y. Measurements: Silhouettes of different body sizes were used to determine perceptions of body size, while weights and heights were measured to determine actual body size. Results: A total of 1090 students (96% response rate) participated, comprising 578 (53%) females. The main ethnic groups were South Asian (49%), African (25%) and persons of mixed ethnicity (23%). The calculated body mass index (BMI) indicated that 14% were thin, 73% normal and 13% overweight; however there was a preponderance of thinness among South Asian males (28%). Whereas 68% of students correctly identified their body size, South Asian males were also more likely to overestimate their body size than the other adolescents, ie they were thinner than they thought. Overall, 64% of the sample was satisfied with their current size, but thin South Asians were more likely to be satisfied with their size than other thin adolescents (P ¼ 0.04), while overweight Africans were more likely to be satisfied than other overweight persons (P ¼ 0.03). The majority of the sample associated the normal body size with good health, but the majority also associated the overweight and obese silhouettes with wealth. In addition, 40% of them associated the male overweight and obese silhouettes with happiness. Conclusion: Although the prevalence of overweight=obesity was not high, the perception of the Trinidadian adolescent that obesity was associated with wealth, and to a lesser extent happiness, and the satisfaction of the overweight African females with their size, were all causes for concern.
We describe a case of non-alcoholic steatohepatitis detected incidentally during laparoscopic Roux-en-Y gastric bypass (LRYGBP). A 51-year-old female patient was scheduled for elective LRYGBP. Her weight was 144.9 kg and her body mass index was 56. Liver function tests showed mild elevation in alanine transaminase. The patient had a history of hypertension and insulin resistance and had no history of alcohol abuse. During LRYGBP, the gross appearance of the liver resembled metastatic lesions but the histology confirmed the diagnosis of non-alcoholic steatohepatitis. The appearance of the liver necessitated taking biopsies, which showed Von Meyenburg complexes and moderate macrovesicular steatosis. This patient made an uneventful recovery and was discharged 2 days postoperatively.
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