Dr. Reema Kashiva

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Understanding Obesity: Causes, Health Impact, and the Need for Structured Care

Obesity is a complex health condition that goes far beyond body weight or appearance. It is influenced by a combination of lifestyle habits, genetics, metabolism, environment, and emotional well-being. In recent years, urban areas have seen a steady rise in obesity due to sedentary routines, irregular eating patterns, high stress levels, and reduced physical activity. This has led many individuals to seek reliable information from an obesity clinic in Pune to better understand the condition and its long-term impact on health.  What Is Obesity?  Obesity is typically defined as excessive body fat that increases the risk of medical complications. It is commonly assessed using Body Mass Index (BMI), waist circumference, and body fat analysis. However, obesity is not the same for everyone. Two individuals with the same BMI may have very different health risks depending on fat distribution, muscle mass, and metabolic health.  Common Causes of Obesity  Obesity develops gradually and often results from multiple overlapping factors:  Unbalanced diet with high intake of refined carbohydrates, sugars, and processed foods   Physical inactivity due to desk-based work and reduced daily movement   Hormonal imbalances, including thyroid disorders and insulin resistance   Genetic predisposition, which can affect appetite regulation and metabolism   Emotional eating and stress can affect food choices as well as portion sizes   Poor sleep patterns, known to disrupt hunger hormones   Understanding these causes helps individuals move away from self-blame and toward informed health decisions.  Health Risks Associated With Obesity  Obesity is linked to several chronic conditions that can affect quality of life and long-term health outcomes. These include:  Type 2 diabetes and insulin resistance   High blood pressure and cardiovascular disease   Joint pain, osteoarthritis, and mobility issues   Fatty liver disease   Hormonal disturbances and reproductive health concerns   Breathing disorders such as sleep apnea   Early identification and structured medical guidance can help reduce these risks over time.  Why a Structured Medical Approach Matters  Managing obesity is not about short-term dieting or rapid weight loss. Sustainable outcomes often require a medically guided, personalized approach. An obesity clinic in Pune typically focuses on understanding individual health profiles rather than offering generic solutions. This may include:  Detailed medical history and lifestyle assessment   Evaluation of metabolic and hormonal factors   Nutritional education tailored to cultural and daily routines   Gradual physical activity planning based on ability and health status   Long-term monitoring and adjustments   Such an approach supports consistency and realistic progress.  Role of Medical Expertise  Medical professionals play an important role in identifying underlying contributors to weight gain that may not be obvious. For example, guidance from specialists such as Dr. Reema Kashiva emphasizes the importance of looking at obesity as a metabolic condition rather than a cosmetic concern. Clinical experience highlights how early intervention can help prevent future complications.  Institutions like Noble Hospital are known for integrating medical evaluation with lifestyle-based management, helping patients understand their condition in a structured and evidence-based manner.  Lifestyle Changes That Support Long-Term Health  While medical guidance is important, daily habits remain central to obesity management. Small, consistent changes often have a greater impact than extreme measures:  Eating balanced meals with adequate protein, fiber, and healthy fats   Practicing mindful eating and recognizing hunger cues   Incorporating regular movement, even low-intensity activities   Managing stress through relaxation techniques   Maintaining regular sleep schedules   These habits support metabolic health and improve overall well-being.  Breaking Common Myths About Obesity  Several misconceptions can delay effective care:  Myth: Obesity is only caused by overeating Reality: Hormones, genetics, and metabolism play major roles   Myth: Rapid weight loss is the best solution Reality: Gradual, sustained changes are more effective long term   Myth: Obesity only affects older adults Reality: It can impact all age groups, including young adults   Correct information helps individuals make informed health choices.  When to Seek Professional Guidance  If weight gain is persistent despite lifestyle efforts, or if obesity-related health conditions are present, seeking structured medical advice can be helpful. An obesity clinic in Pune can provide clarity, realistic goal-setting, and ongoing support based on individual health needs.  Conclusion  Obesity is a multifactorial condition that requires understanding, patience, and a comprehensive approach. Moving away from stigma and focusing on health-based care allows individuals to make sustainable improvements. With the right information, medical guidance, and lifestyle support, long-term health outcomes can be positively influenced. 

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मधुमेह व्यवस्थापनामध्ये वैयक्तिकृत दृष्टीकोन महत्त्वाचा : तज्ञ

मधुमेह व्यवस्थापनामध्ये वैयक्तिकृत दृष्टीकोन महत्त्वाचा : तज्ञ पुणे,12 नोव्हेंबर 2025 : औषधोपचाराच्या बाबतीतच नव्हे तर मधुमेह व्यवस्थापनामध्ये आहार आणि व्यायामाच्या बाबतीत देखील वैयक्तिकृत दृष्टीकोन महत्त्वाचा असल्याचे मत नोबल हॉस्पिटल येथील सेंटर ऑफ एक्सलन्स फॉर डायबेटिस ॲन्ड ओबेसिटी विभागाच्या संचालिका डॉ.रीमा काशिवा यांनी व्यक्त केले. अधिकाधिक तरुण लोक टाईप 2 मधुमेहाने ग्रस्त होत असताना त्याचे व्यवस्थापन नीट न केल्यास दीर्घकालीन गुंतागुंतीची जोखीम वाढू शकते.डॉ.काशिवा म्हणाल्या की,यात सर्वांत महत्त्वाची बाब म्हणजे लवकर मधुमेहाचे निदान करून लगेचच त्याचे व्यवस्थापन सुरू करणे.उदा.एखाद्याची एचबीए1सीची पातळी 6.5 ते 7.5 दरम्यान असेल आणि बीएमआय 35 असेल तर ते खाली आणण्याची ही योग्य वेळ असून त्यासाठी तज्ञांच्या सल्ल्याने योग्य व्यवस्थापन सुरू केले पाहिजे. आपला आहार आणि व्यायाम कसा आहे,अशा साध्या साध्या गोष्टींकडे नीट लक्ष दिल्यास त्याचा फायदा होऊ शकतो.कधीकधी तोचतोच व्यायाम उपयुक्त ठरत नाही आणि म्हणूनच त्यात काही बदल आवश्यक असतात.याचा प्रभाव मधुमेहाची जोखीम वाढविणाऱ्या सर्वांत महत्त्वाच्या घटकांपैकी एक म्हणजे आपल्या वजनावर पडू शकतो. आजकाल लहान मुले,किशोरवयीन व तरूण प्रौढांमध्ये टाईप 2 मधुमेहासाठी वजन ही एक मोठी जोखीम आहे.इतर जोखीमकारक घटकांमध्ये कामामुळे येणारा तणाव,मुलांमध्ये कामगिरीचा तणाव इत्यादींचा समावेश असून याबाबत शाळेतच जागरूकता निर्माण झाली पाहिजे.या जोखीमकारक घटकांमध्ये वाढणारा स्क्रीन टाईम, कमी होत चाललेले मैदानी खेळ व कमी होत चाललेल्या एकमेकांच्या प्रत्यक्ष भेटी-गाठी भर घालत आहेत. ग्रामीण भागातील मधुमेहींना टेलिमेडिसिनची मदत होऊ शकते. फक्त शहरी भागात नाही तर ग्रामीण भागात देखील मधुमेह झपाट्याने वाढत आहे.कोविड काळात व्यापकपणे वापरले गेलेले टेलिमेडिसिन येथे महत्त्वाची भूमिका बजावू शकते.प्राथमिक केंद्रांमधील चिकित्सकांना योग्य माहिती व प्रशिक्षण आणि ग्रामीण भागातील मधुमेहींना एकत्रितपणे समुपदेशन हे टेलिमेडिसिनद्वारे होऊ शकते.यात जोखीमकारक घटक,लक्षणे आणि मधुमेहाच्या इतर पैलूंबाबत माहिती दिली जाऊ शकते.गरज पडल्यास त्यांना टर्शरी केअर युनिटसमध्ये उपचारासाठी आपण पाठवू शकतो. डॉ.रीमा काशिवा म्हणाल्या की,यावर्षीची संकल्पना डायबेटिस ॲन्ड वेलबिंग असून फक्त शारीरिकच नव्हे तर मानसिक,सामाजिक व आर्थिक अशा संपूर्ण कल्याणाबाबत महत्त्व अधोरेखित करते.माझ्या मते,गेल्या अनेक वर्षातील ही सर्वोत्कृष्ट संकल्पना आहे.

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CORONAVIRUS (COVID 19) OUTBREAK MYTHS VS FACTS

The COVID-19 pandemic has become one among the gravest health crises faced by humans. This pandemic is caused by a new form of coronavirus that was unknown to scientists until a months ago.So, along with the virus\’s spread across the growth, myths about the contagion, treatments for the Covid-19 infection and preventive measures to keep yourself safe from the novel coronavirus have proliferated. It is vital to refrain from placing your belief in any miraculous cures or conspiracy theories about the COVID-19 virus.Therefore, in this article we take a look at some widely shared myths about the novel coronavirus.   MYTH      FACT EATING GARLIC OR HOME REMEDIES food FOR FLU AND COMMON COLD) CAN HELP to  PREVENT INFECTION WITH THE NEW CORONAVIRUS.     Garlic is a healthy food that have antimicrobial properties. Also, vitamin C is an essential nutrient that supports immune function. However, there is no scientific evidence that eating garlic or lemon (or other foods for that matter) has protected people from the new coronavirus.  MYTH      FACT     REGULARLY GARGLING WITH SALT amd warm water WATER OR SALINE CAN HELP PREVENT INFECTION from CORONAVIRUS, AS WELL as it also helps TO “FLUSH” THE VIRUS FROM YOUR MOUTH.     There is no scientific evidence that regularly gargling has protected people from COVID-19  infection . This  helps to  soothe a sore throat and will not prevent the virus from entering ther lungs—neither  by  drinking frequent sips of warm water.  MYTH      FACT   COVID-19  CANNOT BE TRANSMITTED IN AREAS WITH HOT AND HUMID temperature.     The Corona virus can be transmitted in ALL AREAS, includinareas with hot and humid temperature. MYTH FACT     TAKING SUNBATH AND DRINKING HOT WATER CONTINUOUSLY ARE THE EFFECT WAYS FROM  PREVENTING CORONAVIRUS. There is no scientific data  that the COVID-19 can be killed at higher temperatures. Drinking warm water and taking sunbath may have other health benefits. For example, Sunbath is good to get Vitamin D, but excess exposure to sunlight may cause sunburn.     MYTH   FACT SPRAYING ALCOHOL OR CHLORINE on the BODY CAN KILL THE CORONAVIRUS. Spraying alcohol or chlorine all over the body will not kill the virus  that has already entered the body. Spraying such substances can be dangerous for our  clothes and  mucous membranes (i.e. eyes, mouth). MYTH FACT PNEUMONIAl vaccines  CAN PROTECT YOU from CORONAVIRUS. No it doesnot protect you from COVID-19. Vaccines against pneumonia, such as pneumococcal vaccine and Haemophilus influenza type B (Hib) vaccine, do not provide protection from COVID -19 virus.. The virus is new and for which it needs its own vaccine.

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Causes of Weight Gain and Obesity

Junk Foods   The food you eat has a major impact on your body and can make you put on or lose weight quite easily. By eating the wrong food you will accumulate a lot of fat around the hips, stomach and thighs area. Foods such as chips, ice cream, candies, cakes, pastries, cookies, red unprocessed meats in burgers or steaks and unprocessed meats found in bacon and salami can contribute to fat in the body rapidly. These food items are extremely high in calories, full of carbohydrates and lead to hip fat and Weight Gain and Obesity Lack of Physical Activity –   When a person remains inactive all day long or sits in one place for most of the time, the fat derived from the food he/she eats starts getting accumulated as it fails to get turned into energy which the body can use. People who do not exercise, sit in front of the TV all day or prefer lying in bed when doing nothing often complain that it took no time for them to gain weight and accumulate hip fat and fat around stomach and thigh region along with other body parts. Less Consumption of Water – Another one of the common causes of fat is reduced consumption of water, allowing toxins and wastes to remain in the body for long resulting in weight gain and also help in the accumulation of fat. Drinking loads of water every day helps to eliminate toxins and wastes products thereby keeping your body weight low and fat at bay. Menopause – For women who are about to experience or are already experiencing menopause, weight gain is a natural phenomenon. As the body undergoes several hormonal changes, a woman can gain weight and body fat, especially in the hip and belly region. Medical Ailments – People who suffer from medical ailments such as knee, ankle or back pain, Thyroid, Diabetes are unable to move around much and are confined to one place all day long are most likely to add hip fat. Such people should eat healthily and try to do some hand and leg exercises while sitting in place. Sedentary Work –   A sedentary worker is a person who sits in one place all day long to do his work and does not have much physical movement. People who have desk jobs be it of any kind which requires them to stay at one place often accumulate a lot of fat in various parts of the body.   How do I know if I am obese? Obesity can be measured using BMI. BMI is calculated by dividing body weight (kilograms) by height (metres) squared. BMI= WEIGHT(KG) / HEIGHT(m)2 World Health Organisation BMI classification system for adults  

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Diabetes Treatment in Pune

To achieve good metabolic control in diabetes and keep long term, a combination of changes in lifestyle and pharmacological treatment is necessary. Achieving near-normal glycated hemoglobin significantly, decreases risk of macrovascular and microvascular complications. At present there are different treatments, both oral and injectable, available for the treatment of type 2 diabetes mellitus (T2DM). Changes in lifestyle have proven to be beneficial, but for many patients is a complication keep long term.The evidence supporting the role of exercise, medical nutrition therapy, glucose monitoring, and antiobesity measures including pharmacotherapy and bariatric surgery.The optimum dietary macronutrient composition remains a subject of interest; however, several studies have shown that dietary measures are effective in weight reduction irrespective of the composition (low fat vs low carbohydrate), provided there is adequate energy restriction, reduction in saturated fat to less than 7%, and adequate provision of dietary fiber.Although low-fat and low-carbohydrate diets are both effective in producing weight loss, their effect on lipid profile may differ. Low-carbohydrate diet may yield greater reduction in triglyceride with higher improvement in high-density lipoprotein, but with higher low-density lipoprotein levels in comparison to low-fat diet. Lower consumption of total and saturated fat and processed foods, and higher consumption of fibers, whole grains, fruits, and vegetables have been shown to improve glycemic control in patients with diabetes. In clinical trials, nut consumption increases satiety, have a neutral effect on glucose and insulin, and a beneficial effect on lipid profile.Artificial sweeteners may cause diarrhea; otherwise, they are safe when used according to Food and Drug Administration (FDA) recommendation. Although diabetic subjects may have increased oxidative stress, placebo-controlled trials have not demonstrated any clear benefit attributable to antioxidant supplementation.

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Diabetes and Obesity

Diabetes is a disease characterized by high levels of blood glucose resulting from defects in insulin production, insulin action or both. Obesity and type 2 diabetes are diseases that can substantially decrease life expectancy, diminish the quality of life and increase healthcare costs. The incidence of obesity and diabetes continues to rise by epidemic proportions. The term “diabesity” has been coined to describe obesity-dependent diabetes. Body mass index has a strong relationship with diabetes and insulin resistance. In obese individuals, the amount of nonesterified fatty acids, glycerol, hormones, cytokines, proinflammatory markers, and other substances that are involved in the development of insulin resistance, is increased. The pathogenesis in the development of diabetes is based on the fact that the β-islet cells of the pancreas are impaired, causing a lack of control of blood glucose. The development of diabetes becomes more inevitable if the failure of β-islet cells of the pancreas is accompanied by insulin resistance. Weight gain and body mass are central to the formation and rising incidence of type 1 and type 2 diabetes. This literature review will demonstrate the facts that link obesity with insulin resistance and pancreatic β-cell dysfunction. In conclusion, new approaches in managing and preventing diabetes in obese individuals must be studied and investigated based on the facts.  

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Insulin Pump – Myths v/s Facts

Many People in India are not aware of what continuous Glucose Infusion or insulin pump means, what Is might be like and how would it work. An insulin pump is a device about the size of a cell phone that contains a cartridge of fast-acting Insulin. A Pump that has a screen and buttons for programming the pumps internal computer and a motor that pushes the insulin from the cartridge into your body through a thin plastic tube called INFUSION SET. Myth Wearing a pump will disclose physically that I am diabetic Fact A pump is of the size of a small cell phone, so wearing a pump can be very discreet. You can use both under your clothes and over your clothes. So you can keep it completely secret if you want to. It\’s just 5 buttons you have to learn (less than Remote Buttons or ATM Machine Button. Myth Can\’t use the pumps as! don\’t know the technology Fact When you buy the latest cell phone you start learning its use from the basics of dialing and gradually move on to its higher and advanced functions of using the advanced apps. Same way is Insulin pump learn to use the basics first and gradually move on to learn its higher functions. You will find that using an insulin pump is easier than using a cell phone. Myth Wearing an insulin pump will interfere with daily activities Fact These pumps can be worn under or over your skin. There are clips available to wear a pump. The pump can easily be disconnected from your body for up to an hour for activities like swimming, showering, exercise or others so that daily activities are not interfered with. Myth You still have to do shots and It\’s painful Fact Only on needle stick is there at the time of inserting which is virtually painless. You need an infusion set once every 3 days 120 needle stick/ month = 12 needle stick/month With insulin without pump with pump (90% reduction in pricks) Myth You have to get surgery Fact As I said before these pumps are of the size of a small cell phone or MP3 player. They deliver insulin continuously through a small tube placed under your skin. No surgery needed. Myth You forget you have diabetes Fact To use the pump you have to check your blood sugar before meals and at bedtime. Determine how many carbohydrates you\’ll eat and programme these values into your pump. The pump will then calculate and suggest therapy based on your individualize programme setting. It reminds you to programme your life with Diabetes and not to forget it. Myth It\’s uncomfortable to wear a pump Fact When you first start using a pump you may feel the insertion site. It just takes a little bit of time to get used to. Once you get used to, you just forget it until you need to give infusion absolute dose or have to change the infusion set. Myth All Insulin pumps are the same Fact There are various pumps available in the market. The differentiator to use which one you want Size of insulin Reservoir Number of infusion sets Minimum and maximum basal and bolus dose Pump\’s activity to communicate with CGM/ Meter Water Resistance Customer support and training available. Best is to visit your Doctor/educator which based suite your best. Myth Pumps are only for type 1 diabetes Fact Using insulin pumps you provide insulin to your body the way naturally ie insulin is secreted into your body in response to your food intake. So it can also be used in type 2 diabetes who are on multiple daily insulin pricks. IT also advised using in gestational diabetes to avoid multiple daily pricks of L4 insulin and meet up the insulin need like a normal person. Myth Insulin may be more for me as pump release insulin through the day Fact Pumps deliver incredibly precise dosages. Most pumps use 0.25 units / dose. Scientific data says pump users took 20% less insulin on an average compared to per or syringe uses.

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