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# A seminar deveted to teenagers‘ article, one of a series to be printed in The Advertiser, contains the text of a speech delivered by Dr. A. M. sensitive problem of obesity during adolescence. (the odit-r):, Adolescence is the period beginâ€" PS EVE NC P1 3 T Mc o t ocm oo in s PR En sex characteristics and| although certain features are usuâ€" 'it.i.lt;hqe::smudlliy nnodu:nud with this clinical somatic growth. is process | picture, y of these youngsters of development from childhood to|are not only heavier than their adulthood, reflecting physiological | cohorts but also taller, with larger age but not chronological age, in | skeletal structures and even adâ€" that it does not take place routinely | vanced skeletal maturation. The at any particular year or at any | adiposity is usually quite generalâ€" :Mm speed, We must always|ized, but often sparing the distant aware of the variations in the | parts of the extremity. There may rates and attainment of height and| be a double chin. The adiposity weight in youngsters during ldO-‘in the mammary region is often lescence, plus the fact that the| suggestive of breast development, extremes in this physiological| a feature which is most embarrassâ€" wariation may cause considerable|ing for a boy. The abdomen beâ€" concern to the adolescent and his comes pendulous; white or purple parents. strize may develop. The external In a certain proportion of indiâ€"| genitalia of boys seem disproproâ€" viduals going through the period | tionately small although of average of adolescence, the accumulation of| size; they are simply lost in the adipose tissue is such that the body weight exceeds by 15 per cent the norm for the age, height and sex â€" in other words, in this certain proportion obesity develops. It is seen in about 9 per cent of adolescent boys and 12.5 per cent of adolescent girls. In many overweight teenagers, the obesity is part of the problem which has been present since early childhood and is accentuated durâ€" ing adolescence and these are the more difficult problems to deal with, whereas in some other childâ€" ren the obesity develops, usually to a less severe degree, simply as a moderate exaggeration of the usual adolescent fat spurt. In normal growth and developâ€" ment, just prior to the onset of puberty, there is an increase in the total bodyâ€"fat in boys and giris. In the adolescent male this increase in fat tends to decrease as the youngster nears the end of his physical growth with a concomiâ€" Mr. R. A. Herron is pleased to announce the appointment of Mr. Jack Woles to the soles staff. Mr, Wales has been associated with the car industry for a long time and is well known throughâ€" HERRON_ MOTORS _ _ LTD. CHEV. + OLDS 1525 DUNDAS HWY. E. COOKSVILLE APPOINTMENT sectional bedrooms JACK WALES was held recently at : General Hospital, This of a series to be printed Make your bedroom a dream room created to suit t own good taste . . . select . . . headboard with mh on nightâ€"tables or free standing night tables .. . single. double or triple dressers . . . low or high vanity with full length mirror . . . each piece craftâ€" ed in matching grain lustrous teak that grows more beautiful with age. Come in and browse through a distinctive display of livingroom, diningroom and bedroom furniture. Imported drapes, carpets, lamps and gifts. 322 Yonge Street 1 bleck N 625â€"1420 ediatrician Talks About Adolescent Obesityâ€" FURNITURE CENTRE say tant increase in lean body mass, bones and muscles in particular. In the female, the pattern is someâ€" what different and this fat spurt continues t adolescence. In the mt. there is a disturbance in this fat spurt and in both sexes, the accumulation of fat goes on to an excessive degree over an excessive period of How To Recognize Obesity There is no absolutely constant pattern for these young people although certain features are usuâ€" ally associated with this clinical picture, Many of these youngsters are not only heavier than their cohorts but also taller, with larger skeletal structures and even adâ€" vanced skeletal maturation. The gdi?o!ity is usually quite generalâ€" pubic fat; puberty may be delayed in some boys. On the other hand in girls, menstruation is not delayed. Arak Dr. Jean Mayer says that the best way to determine whether a person is fat is to look at him or her, and I think that most of us would agree. Wa can back this impression up by either or both of the following methods: a) The comparison of height and weight with appropriate growth charts, and b) An estimation of the skinâ€"fold thickness a) It is important not to deâ€" pend upon simple weight charts for the recognition of obesity. Even heightâ€"weight charts can be misleading, in that individuals with a stocky build will have a relatively large skeleton and relaâ€" tively more muscle tissue than average, with the resultant someâ€" what excessive weight for height â€" yet they are not to be considered obese â€" especially when one recalls that obesity is the presence of exâ€" cessive fat. If height, age, and sex, on the other hand, are taken into account, body weight can proâ€" vide a good index of obesity. The familiar _ anthropometric charts or percentile charts from the Children‘s Medical Centre, Boston, or the Towa charts, take weight and height, age and sex all into account and are very useful in recognizing deviation from the expectedâ€"or appropriate weight for particular builds. b) The technique of estimating the thickness of a layer of subâ€" cutaneous fat can be very useful both in the diagnosis and in the following of progress. By means of constant pressure calipers, a fold of skin with its underlying sucuâ€" taneous fat is assessed either over the abdomen below the umbilicus or over the triceps. Over the abdoâ€" men adolescent males and adult males should have a thickness of no more than 2%, em. (about an inch) whereas females may have a thickness of 4 em. (about an inch and a half); over the triceps muscle, a thickness greater than 2 cm. is significant. It has been proven that these measurements correspond to the increase by 15 per cent over the norm in weight and this has also been shown to be the stage in the development of obesity at which new adipose tissue cells are reâ€" quired for additional storage; until the obesity reaches this stage, cells already present are simply being filled and no new ones are being produced. 368â€"4177 104 Thers. Pri. 9 pm. lx‘-n of Obesity The of significant obesity in adults have been emphasized by the insurance companies and indeed a marked increase in premâ€" jums is one hazard for the candiâ€" date. There is a shortened life expectancy due to a definite inâ€" creased _ risk of _ cardidvascular disease (atheroscelerosis, hyperâ€" tension, etc.), diabetes and cancer. Also there is an increased risk of ostecarthritis in the lower limbs. The risks to the adolescent are somewhat. different. In the first place there is the risk of becoming an obese adult with the shortened life expectancy already mentioned. Most obese adolescents have a conâ€" tinuing problem . of â€" overweight throughout adult life â€" they do not easily outgrow their obesity and the longer the obesity has been present during childhood and adoâ€" lescence, the more resistant it will be to therapy â€" as opposed to the adolescent who develops his obesity just during adolescence, These facts concerning life expectâ€" ancy and the possibility of physical disease we must bear in mind, although the child or adolescent usually do not feel very impressed with such data. Parents also do not get concerned about these facts and sometimes regard their overâ€" weight child ‘or overweight adoâ€" lescent as a somewhat superior being reflecting their own successâ€" ful showering of love and food. upon him or her. Much more lig-| nificant to the child and adolescent are the hazards of an emotional nature, when the youngster is teased or rejected by playmates or not chosen for hockey and baseball teama because he is slow and. awkward, or unpopular at parties because of appearance. Some obese adolescents put on a facade of nonchalance or even seem happy and quite popular. Nevertheless, it is now appreciated that the psyâ€" chological effects of being obese have been underestimated. The importance of social pressures and their damaging effects on the psyche of obese adolescents are being studied, with a demonstraâ€" tion of personality characteristics strikingly similar to those recogâ€" I nized as typical of ethnic and racial iminorit.iel subjected to intense disâ€" \ erimination. . Passivity, withdrawal 'md obsessive concern about status are seen. it, we should conside mmd_&_i_-)_m The obese adolescent is Iooked‘ upon with scorn by his or her friends, especially when living in a society which idolizes the thin body beautiful in fashion magaâ€" zines, TV and movies and idolizes the lithe muscular athletic hero. Cause of Problem It is an accepted fact and yet an unjust oversimplification of the problem to point out that in every case excessive accumulation of fat is due to food intake exceeding physiological need. (Obesity is comâ€" parable to alcoholism in this sense â€"alcohol is only one step in the cause while a complex assortment of more basic physiological and psychological factors contribute the true addiction.) With regard to obesity, there simply are differâ€" ences in the metabolism of people, some growing differently than others, some eating more than others, some wanting more and seeming to need more, or absorpâ€" tion may differ with different peoâ€" ple, utilization and expenditure vary. The essential mechanisms leading to obesity lie in subtle maladjustments in the mechanisms that match food intake with energy output and these subtle maladjustâ€" ments are not too well understood. Even though the basic factors| cannot be really separated, it would | nevertheless be well for us to conâ€"| sider these facets of the problem | separately, namely: a) Constituâ€" tional factors; b) Dietary factors; c) Psychological factors; d) Glandâ€" ular influences; e) Influence of exercise; (f) Environmental and social factors. : Constitutional Factors Heredity plays a significant role in the development of obesity and the familial incidence of the probâ€"| lem is often observed. The data of Mayer would indicate that a youngster has a 10 per cent chance of being obese when the parents | are of normal weight, but the risk increases to 50 per cent i!l ome parent is obese and to 80 per | cent when both parents are obne.} Obviously, family eating habits have an effect but the significant role of heredity is shown in studies of lâ€"egg twins and 2â€"egg tvins,} where the genetically identical 3:1 egg twins follow similar growth patterns, even when reared sepaâ€" | rately. For example, Gordon reâ€" ported a set of twins who were raised in separate foster homes where the families were thin â€" and both twins became obese. The mode of . transmission | is obscure and the mechanism by which the inherited tendency is mediated is not understood â€" (it may be a glandular phenomenmon, gastroâ€"intestinal function, a matter of appetite.) The fact that the inherited conâ€" Now that we have defined obesity Diet and Appetite Usually, the appetite serves as a reliable mechanism for balancing the intake of food to the M{- needs so as to prevent e storage of fat or excessive utilizâ€" ation of stored fat. In most people and at most ages of development, appétite works very well in this respect. There are physiological variations in appetite and we are accustomed to the loss of appetite towards the end of the first year and during the second year when rapid early growth of the infant slows down. stitutional makeâ€"up has a regulaâ€" should not be taken to mean that heredity fixes accurately the patâ€" tern of growth but in this matter of weight regulation, as with other biological processes, the, genetic endowment probably delineates not a point but a zone within which an individual may fall, according to influences of other factors such We are aware of the increase of appetite during the adolescent spurt of growth. The regulatory mechanism of appetite, however, may be upset by various causes. One of the commonest upsetting factors is simply habit in that a person‘s appetite may be condiâ€" tioned by custom. A person can become accustomed to small meals without becoming hungry; this same person may, under the influence of his friends or family or possibly in response to altered stress, get into the habit of eating large meals and even craving snacks between . meals. Healthy children develop habits similar to the rest of the family. Parents help to condition their children and adoâ€" lescents to eat heartily because they are proud of chubby infants and big children and they are relucâ€" tant to recognize obesity ‘as a problem until it has become obvious and well established. Sometimes overâ€"eating becomes established as a habit after an illness or operation at which time the increased intake was the exâ€" pected physiological response to bring about repair. _ While the importance of overâ€" eating has been accepted for years, recent investigations have cast great doubt upon its significance in this complex problem. When food intakes of obese individuals were accurately assessed and comâ€" pared with the intakes of people with normal weights, the intakes were identical. There are thin peoâ€" ple who eat excessively ("he has a huge appetite and never puts on a pound") and there are fat people who eat too much. Likewise there are thin and fat people who have small intakes. These observations would suggest that most obese perâ€" By GEORGE GRAHAM Member American Gem Society One of the colored gems that seems to stay in favor over the centuries is the golden topaz. This is also one of the oldest known gems, and one much sought after in Pliny‘s time,. Pliny, in case you don‘t recall the name from your school days, was the Romoan historian who lived in 23â€"79 A.D. One of his most important works (at least to jewelers) was his 37th book on "Natural History‘‘. This chronicled all of the early beliefs and legends about the various gemstones and minerals known at that time in the world. The nome topor means "to seek". In the early days, topor was found on one island in the Red Seo. This was so fogged in that sailors had difficulty in finding it. When they did manage to get through the fog bonk and land, they found the island inhobitants waiting with the topar stomes since they were under command to find and mine the stomes for export. Today, very often the equally attractive Citrine (topor quartz) is honestly offered instead of the rarer, more expensive, genuine topor. Cairmgorm, a Scottish name for the popular smokey quartz, should not be confused with true topaz. As a member of the American Gem Society, we are of course, conâ€" cerned with the proper nomenâ€" clature of gemstones. We alâ€" ways explain to customers the s e correct mineral name and charâ€" j P acter of the gem being purâ€" I & chased. The world of gems is $ so unique and fascinating, there is no reason for one gem to masquerode . under _ another‘s name. For that reason, when we say topor or citrine, we sell exactly that; when it is smokey quartz, that is what we call it. In any man‘s languoge, they are all very pretty gems CL. 9â€"1121 â€" OPEN THURS. & FRIDAY UNTIL 9 P.M 2905 LAKE SHORE BLVD. WEST, NEW TORONTO TOPAZ PERENNIALLY POPULAR at 6th Street sons are underexpending energy relative to their intake: Factors and . peychiatric study of unselected groups of obese individuals show the full range of . emotional‘ adjustment from apparent stability to marked disturbance, so that a blanket exâ€" planation of obesity on psychiatric grounds is impossible. It is the conclusion of certain workers that psychic mechanisms can play some Tane Tat sis: ts qilks s flexes that adjust food to energy needs. It is Mayer‘s conâ€" tention, on the other hand, that a great deal of what has been said concerning psychogenic factors in obesity is unsupported by controlâ€" led evidence. At the same time, he feels that, even in the most nonâ€" disturbed obese youngsters, the psychological effects of being obese have been. underestimated, The importance of social pressures and their damaging effects on the psyche of obese adolescents are now well documented. The obese girls were found to exhibit perâ€" sonality characteristics strikingly ethnic and racial minority subâ€" jected to intense discrimination. They had an obsessive concern with their status. Other characterâ€" istics were passivity and withâ€" drawal. It is certainly much easier for us to understand the psychoâ€" logical disturbance which is secâ€" ondary to the obesity but possibly psychological disturbances m a y play a primary role in a few cases and a secondary role in the vast majority. Glandular Influences Appetite and food intake are to some extent adjusted to the needs of the tissues by relex arcs under the _ control _ of _ hypothalamic centres. The hypothalamic influâ€" ence is seen in experimental aniâ€" mals with hypothalamic lesions and in a very few clinical situaâ€" tions, and might well be suspected when there is other evidence of C.N.S. disease such as sleepiness, polydypsia, and an unstable body temperature. The integration of these neural mechanisms with beâ€" havioural mechanisms, with appeâ€" tite and various metabolic pheâ€" nomena is all in an interesting experimental stage. Facts of proâ€" ‘found clinical significance might conceivably turn up over the next few years to help us understand these aspects of the problem of obesity. Exercise I feel that, in the recent overâ€" simplification of the obesity probâ€" lem (blaming it all on overeating and/or a psychological compulsion) we have greatly underestimated the importance of exercise, parâ€" trubnr:!'in-h" ing or playing l:lilwmuilho'lflubfluinu defeating as a means of weight control. Physiological experiments whose activities varied from hard work (lifting their body weight for 9 hours a day) to sedentary work have been carried out. Data from exercise, the dietary intake makes an appropriate increase; but this correlation breaks down in the ingctive group below a certain point of activityâ€"the more inâ€" active the rats the more they tend to eat and the more inactive the people the more they tend to eat â€"and, of course, weight goes up accordingly. This was found to be true also among children and adolescents in the Boston area where the vast majority of these obese young people have food intakes which are not only of the same order but often less than those of normal weight. There is, however, no flouting of the laws of thermoâ€" dynamics. If we look at the other side of the balance sheetâ€"activity â€"we find that these obese youngâ€" sters differ from their nonâ€"obese classmates in that they are relaâ€" tively inactive. In a typical group reported by Johnson, active sports were practised less than oneâ€"third as much by the obese as by the nonâ€"obese. Overweight teenagers often have sedentary habits and are interested in reading, music, art or quiet games rather than vigorous â€" sports â€" and â€" athletics. Sometimes the sedentary habits are attributable to psychogenic factors. 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