^{3rd Middle East Obesity, Bariatric Surgery and Endocrinology Congress} June 22-23, 2020 Dubai, UAE

Neuroendocrinology is the branch of medicine concerned with the interactions between the nervous system and the endocrinology system. In a human body, nervous and endocrine systems often act together to regulate the physiologic processes. Human endocrine working has a strong foundation in the CNS, under the direction of the hypothalamus, which has coordinate control over the pituitary organ. The pituitary gland has two major lobes the anterior lobes (adenohypophysis) and posterior lobe called neurohypophysis.  The pituitary gland sometimes called master gland.

Circadian rhythms in human follow a near 24hrs cycle and may influence a variety of regulatory function, including the sleep-wake cycle, body temperature direction example of action, for example, eating and drinking, hormone discharge. This is because of the pacemaker in the cerebrum which gets projections of light through the retina and invigorates electrical impulses to neurotransmitters for various functions.     

Paediatric endocrinology is a branch of medical sciences that deals with endocrine-related conditions in children which also includes type 1 and type 2 diabetes, obesity, growth disorders, thyroid and adrenal problems, problems of puberty and many more. Children are having different psychological needs from those of adults. Paediatric endocrinologists have pervasive training and proficiency in dealing with children and in treating children with endocrine disorders and hormonal problems. Nutritional and dietary Conferences  interprets the interaction of nutrients and other substances in food in relation to maintenance, health and disease of an organism.

The endocrine system is a network of glands that produce and release hormones that help control many important body functions, including the body's ability to change calories into energy that powers cells and organs. The endocrine system influences how your heart beats, how your bones and tissues grow, even your ability to make a baby. It plays a vital role in whether or not you develop diabetes, thyroid and parathyroid disease, growth disorders, sexual dysfunction, and a host of other hormone-related disorders.

Comparative endocrinology encompasses research on the roles of hormones in regulating biological functions in a wide range of diverse vertebrate and invertebrate species. Thus, it becomes an unattainability to adequately describe and discuss within the confines of a single chapter the many endocrine control systems that exist in the animal kingdom. Consequently, an effort is made in this chapter to present some unique and novel aspects of endocrine function that contribute to behaviour, growth and reproduction in a few select species. Although much resemblances in endocrine organization and function exists among species, there are differences,

Endocrinology is the branch of medicine that deals with the study of hormones. Hormones are essential for our every-day survival. Hormones control our temperature, stress, sleep, mood, growth and more. The endocrine system is assessed primarily by measuring hormone concentrations. It is also concerned with the integration of developmental events proliferation, growth, and differentiation, and the physiological or behavioral activities of metabolism, growth, and development,  tissue function, sleep, digestion, respiration,  stress, lactation, excretion, mood, movement, reproduction, and sensory perception caused by hormones. The endocrine system comprises of several glands in all parts of the body those secretes hormones. Hormones which were secreted from the glands are responsible for performing several important functions in our body. if the behavior of hormones is not correct, then it leads to cause hormonal imbalance, due to hormonal imbalance the endocrine glands can lead to cause several diseases like Diabetes, thyroid, …etc. The Obesity Meeting 2020  highlights the evolving strategies for Obesity, Weight loss-management, childhood obesity, physical therapy, exercise, bariatric surgery and upcoming challenges in the field of Medicine & Healthcare

The optimal diet for prevention of weight gain, metabolic syndrome, obesity and type 2 diabetes is fiber-rich, fat-reduced,  high in low-energy density carbohydrates (fruit, vegetables, and whole grain products), and intake of energy-containing drinks is restricted. Weight management emphasizes the importance of healthy eating patterns that include a variety of nutrient-dense foods, limit portions of energy-dense foods, and reduce overall energy density. Weight loss is achieved by a negative energy balance. This, in turn, is attained in most by the reduction in calorie intake rather than an increase in physical activity. Nutritional Conferences interprets the interaction of nutrients and other substances in food in relation to maintenance, health, and disease of an organism.

Yoga means fusion between the mind, body and spirit. It involves the practice of physical postures and poses, As the name recommended, the ultimate aim of practicing Yoga is to create a balance between the body and the mind and to attain self-enlightenment. Yoga is related with a healthy and lively lifestyle with a balanced approach to life.

Low-fat diets have long been known as the key to a healthy weight and to good health. But the evidence just isn’t there: Over the past 30 years in the U.S., the percentage of calories from fat in people’s diets has gone down, but obesity rates have skyrocketed. Clinical trials have found that following a low-fat diet does not make it any easier to lose weight than following a moderate- or high-fat diet. Study volunteers who follow moderate- or high-fat diets lose just as much weight, and in some studies a bit more, as those who follow low-fat diets.

Obesity medicine is a field which dedicated to the comprehensive treatment of patients with obesity. Obesity medicine takes into account the multi-factorial etiology of obesity in which behaviour development, environment, epigenetic, genetic, nutrition, physiology, and psychosocial contributors all play a role. As time passes, we become more knowledgeable about the complexity of obesity, and we have ascertained that there is a certain skill set and knowledge base that is required to treat this patient population. Clinicians in the field should understand how a myriad of factors contribute to obesity including: regulation of food intake and energy balance through enteroendocrine and neuroregulation, and adipokine physiology. Obesity medicine physicians should be skilled in identifying factors which have contributed to obesity and know how to employ methods (behavior modification, pharmacotherapy, and surgery) to treat obesity. No two people with obesity are similar, and it is important to approach each patient as an individual to determine which factors contributed to their obesity in order to effectively treat each patient.

Obesity is very heritable. Obesity can be a complicating disorder which results from the interactions of a wide variety of hereditary and environmental factors. Polymorphisms in various genes controlling appetite and metabolism make susceptible to obesity under certain dietary conditions. The melanocortin 4 receptor gene mutation may be responsible for tens of thousands of cases of obesity. Monogenic type of genetic mutation is mainly responsible for severe forms of obesity that run in families. Occurrences of monogenic kinds of overweight are evidence that obesity may be caused by genetic mutations are mainly responsible for the occurrence of monogenic kinds of overweight. The most common forms of obesity are probably the result of variations in a large number of genes. The Obesity Meeting 2019 highlights the evolving strategies for obesity, weight loss-management, childhood obesity, exercise, physical therapy, bariatric surgery and upcoming challenges in the field of medicine & healthcare.

Childhood obesity is one of the most adverse therapeutic conditions that is influencing children and adolescents. Nowadays most of the children are suffering from obesity.  Due to genetical reasons, many obese children become obese adults, especially if one or both parents are obese. The early physical impacts of obesity in adolescence incorporate, the greater part of the child’s organs being influenced, apnoea, hepatitis, gallstones rest issues, malignancy, and different disorders like liver diseases, hypertension, coronary illness, early and expanded intracranial pressure. Childhood obesity can also result in serious conditions including diabetes, adolescence, dietary problems, for example, bulimia and anorexia, skin contaminations, asthma and other respiratory issues.  Obesity can be diminished by doing Physical action. Proposals from the experienced metabolic and  Bariatric Surgeons, enrolled dieticians, advertisers helps in the decrease of youth diabetes.

Obesity and overweight are related to several factors that increase ones risk for cardiovascular disease (coronary artery disease and stroke):

• High blood lipids, especially high triglycerides, LDL cholesterol, and total cholesterol and low HDL cholesterol
• High blood pressure
• Impaired glucose tolerance or type-2 diabetes
• Metabolic syndrome

Obesity and overweight are also related to hypertension and an enlarged left ventricle (left ventricular hypertrophy), increasing risk for heart failure.

In additionally, overweight and obesity can be related to some cancers, gallbladder disease and osteoarthritis.

Obesity is one of the health problems in the developing and developed countries. Obesity subjects the individuals with metabolic and endocrine disorders. It is clear that vitamin D deficiency or insufficiency may lead to secondary hyperparathyroidism. Thus, obesity increases the possibility of vitamin D deficiency. Considering the high commonness of vitamin D deficiency in children and adolescents with overweight or obesity, it seems logical to have treatment and prevention from vitamin D deficiency. This is similar to a study in adult vitamin D deficiency related with adiposity which also demonstrates the importance of vitamin D deficiency screening in children and adolescent obesity. Vitamin D replacement can decreases many complications in childhood (skeletal disorder, secondary hyperparathyroidism) and decreases metabolic disorder and cardiovascular disease incidence in later childhood. On the other hand, calcium has a key role in weight regulation, useful in replacement therapy, but there is a need for a further study to reveal exactly the effects in Pediatric obesity or overweight.

“Gastric bypass”, is one of the most commonly carry out bariatric procedures worldwide and has long been considered the “gold standard” of bariatric surgery. The gastric bypass was first innovated in 1967 and was performed as open surgery for several decades.  However, today, it is almost entirely performed by the laparoscopic (keyhole) approach. This gastric bypass is helps obese people lose weight in several different ways.  The small pouch restricts the amount of food that can be eaten. The connection between the small bowel and the gastric pouch re-routes the transit of food directly in to the small bowel.  Since the food does not go through the bypassed part of the stomach and duodenum there are metabolic and hormonal changes that lead to reduced appetite and an increased feeling of fullness.

An obese woman is about thrice as liable to be infertile as a normal woman. The obese woman has a lower possibility of pregnancy as well as has brought down the shot following in vitro treatment. They require higher amounts of gonadotropins and have an expanded unsuccessful labor rate. Whenever feasible, pregnancy should be delayed till weight loss stabilizes for 12 – 24 months after surgery. Weight loss is one of the cornerstones to achieve a healthy pregnancy and childbirth. Obesity Conferences aimed on policy and environmental strategies to make healthy eating and active living accessible and affordable for everyone.

Eating excessive fat-containing foods and lack of nutritional intake are the most common causes of obesity and overweight. Good nutrition, physical activity, and healthy body weight are important parts of a person’s overall health and well-being. Together, these can help decrease a person’s risk of developing serious health conditions, such as high blood pressure, high cholesterol, diabetes, stroke, heart disease and cancer. A controlled diet, dietary food, regular physical activity, and achieving and maintaining a healthy weight also are paramount to managing health conditions so they do not worsen over time. Nutritional Conferences interprets the interaction of nutrients and other substances in food in relation to maintenance, health, and disease condition of an organism.

A bariatric surgical procedure leads to weight loss by controlled the amount of food the stomach can hold, causing malabsorption of nutrients, or by a combination of both gastric restriction and malabsorption. Bariatric procedures also often cause hormonal changes. Today’s most weight loss surgeries are performed using minimally encroaching techniques (laparoscopic surgery). The most commonly used bariatric surgery procedures are gastric bypass, sleeve gastrostomy, adjustable gastric band, and biliopancreatic diversion with duodenal switch. Each surgery has its own advantages and disadvantages.

The aim of obesity treatment for obese patients is to reach and stay at a healthy weight. This improves your overall health and lowers your risk of developing complications related to obesity. You may need to work with a team of health professionals — including a dietician, behavioral counsellor or an obesity specialist — to help you understand and make changes in your eating and activity habits.

It has been many years since the resolution of type 2 diabetes was observed as an additional outcome of surgical treatment of morbid obesity. Moreover, it has been shown unequivocally that diabetes-related morbidity and mortality have declined significantly postoperatively, and this improvement in diabetes control is long lasting. Bypass procedures, the Roux-en-Y gastric bypass (RYGBP) and the biliopancreatic diversion (BPD), are more effective treatments for diabetes than other procedures and are followed by normalization of concentrations of plasma glucose, insulin, and HbA_1c in 85–100% of morbidly obese patients. Studies has been seen that return to euglycemia and normal insulin levels occurs within days after surgery, long before any significant weight loss takes place. This fact suggests that weight loss alone is not a sufficient explanation for this improvement. Other possible mechanisms effective in this phenomenon are decreased food intake, partial malabsorption of nutrients, and anatomical alteration of the gastrointestinal (GI) tract, which incites changes in the incretin system, affecting, in turn, glucose balance. Better understanding of those mechanisms may bring about a discovery of new treatment modalities for diabetes and obesity.

Metabolic/bariatric surgery is the most effective and long-lasting treatment for severe obesity resulting in significant weight loss and leading to the improvement, prevention or resolution of many related diseases including type 2 diabetes, heart disease, hypertension, sleep apnea, and certain cancers. Studies show bariatric surgery may reduce a patient’s risk of premature death by 30-50%3,4 Overall, bariatric surgery has complication and mortality rates (4% and 0.1%, respectively) comparable to some of the safest and most frequently performed surgeries in the U.S. including gallbladder surgery, appendectomy and knee replacement.

Obesity is a complex multifactorial disease. The worldwide prevalence of overweight and obesity has doubled since 1980 to an extent that nearly a third of the world's population is now classified as overweight or obese. Obesity rates have increased in all ages and both sexes irrespective of geographical locality, ethnicity or socioeconomic status, although the prevalence of obesity is generally greater in older persons and women. This trend was similar throughout the regions and countries, although absolute prevalence rates of overweight and obesity varied widely. For some developed countries, the prevalence rates of obesity seem to have levelled off during the past few years. Body mass index (BMI) is basically used to define overweight and obesity in epidemiological studies. However, BMI has decreased sensitivity and there is a large inter-individual variability in the per cent body fat for any given BMI value, partly attributed to age, sex, and ethnicity. For occurrence, Asians have greater per cent body fat than Caucasians for the same BMI. Greater cardio metabolic risk has also been associated with the localization of excess fat in the visceral adipose tissue and ectopic depots (such as muscle and liver), as well as in cases of increased fat to lean mass ratio. These data suggest that obesity may be far more common and requires more urgent attention than what large epidemiological studies suggest. Simply relying on BMI to assess its prevalence could hinder future interventions aimed at obesity prevention and control.