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Childhood obesity- a bad sign of what might follow

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by Randima Attygalle

‘All work and no play makes Jack a dull boy’ calls for rephrasing today into ‘Bad food and screen time make Jack an obese boy’. Childhood obesity is increasing rapidly in Sri Lanka and the present COVID-19 pandemic is a double whammy, with children being home-bound with no physical activity. The increased screen time spent on virtual learning adds fuel to the fire.

“Although we did see more obese and overweight children in high income settings in the past, today the incidence of obesity is rising among the urban middle class,” observes the Consultant Paediatrician and Professor of Paediatrics from General Sir John Kotelawala Defence University, Prof. Ishani Rodrigo. She cites a recent survey among 5-18 year olds in urban Sri Lanka which showed an obesity prevalence of 10.3% and overweight prevalence of 11.3%. Studies in the Colombo, Gampaha and Jaffna Districts reflect a higher prevalence of childhood obesity says Dr. Rodrigo. “We are yet to unearth island-wide data on the problem,” she adds.

In 2019, according to the WHO, an estimated 38.2 million children worldwide, under the age of five years were overweight or obese. Once considered a high-income country problem, excess weight and obesity are now on the rise in low- and middle-income countries, particularly in urban settings. In Africa, the number of overweight children under five has increased by nearly 24% percent since 2000. Almost half of the children under five who were overweight or obese in 2019 lived in Asia.

The etiology of obesity is multi-factorial and complex. Although at a basic level it is about more ‘calories in’ than ‘calories out’, there is a genetic contribution as well, says the paediatrician. “Although pathological obesity is attributed to medical conditions such as Cushings Syndrome and hypothyroidism what is more often seen is simple obesity. It is often the food and lifestyle which contribute to it.”

Increased intake of food high in simple carbohydrates, sugars and fats, convenience food such as pastries and kottu high in energy, fast food, sweetened beverages, flavoured milk, fizzy drinks, large portion sizes and frequent snacking are among the major triggers of obesity in children. Poor intake of vegetables and fruit in the diet, less outdoor play, increased screen time, less household chores for children and dependence on electrical appliances as opposed to doing tasks manually have made the situation worse.

Food advertising aimed at children, enabling availability of sugary beverages at affordable prices and lack of healthy food choices in school canteens/tuck shops (the choices largely being starchy and sugary food) have also accelerated this national health dilemma. “In the UK, the school meal policy was revised, adopting the healthy school lunches which were promoted by the famous master chef Jamie Oliver. The country also imposed a sugar tax on beverages depending on the amount of sugar they contain,” explains Prof. Rodrigo who calls for a similar shift in the local policy. “Although the Ministry of Health had issues dietary guidelines, they have not yet filtered to communities and there are no national level programmes to have a dialogue with parents, teachers and school authorities on this national health crisis.”

COVID pandemic has also led to an alarming increase in the weight of children across all age groups. “Children have lost most opportunities for physical activities including walking to school, playing with friends and organized sports. With virtual classrooms replacing real classrooms, children spend a considerable time before screens. Most of the entertaining is also afforded by screens. With very little to do at home, children eat often to relieve their boredom and mothers too tend to make more treats at home and feed their children which could go against them.”

Once obesity is established, managing of it becomes very challenging, warns Dr. Rodrigo who urges parents to encourage healthy eating and living. “Children usually eat the family diet, hence if the family diet is rich in starchy, fatty and sugary food and low in vegetables and fruit, they will automatically follow this.”

The long term repercussions of childhood obesity are multiple: adult obesity, the increased risk of cardiovascular disease, hypertension, heart disease, strokes and orthopaedic complications including joint pains and early osteoarthritis, increased levels of cholesterol, Type 2 diabetes and fatty liver are among these. The condition can also trigger skin problems such as thickening and discolouration of skin and stretch marks and also cause breathing problems including obstructive sleep apnea (stopping breathing during sleep), obstruction to airway and snoring. Childhood obesity also increases risk of fractures and certain cancers in adulthood including endometrial, breast, ovarian, prostate, liver, gallbladder, kidney, and colon cancers.

Addressing childhood obesity requires a multidisciplinary approach with collective inputs of paediatricians, nutritionists, physical training instructors, psychologists etc. “Motivation of the child and family or motivational counseling is the key in intervention which if often very intensive,” remarks the Professor. Following the initial assessment involving physical markers and other necessary medical tests, the psychological assessment involving the child and his/her family would follow. “Family history of obesity, family perception and understanding of the problem and motivation to achieve a healthy weight is important in this process,” she notes. Regular monitoring of children and motivational therapy sessions help keep children and their families on track, she says.

The ‘Nutri-Fit Programme’ at the University Hospital of the Kotelawala Defence University manages overweight and obese children. Conducted through the Paediatric Clinic of the hospital, the programme emphasizes on becoming healthier and more fit rather than losing weight. “Weight loss inevitably happens as a result of this approach,” explains the professor who goes on to note that this facility is extended to healthy cooking demonstrations for children, exercise and yoga sessions.

Obese children need to be empowered to overcome psychological trauma the condition entails, remarks the Consultant. Destigmatizing obesity, motivational counseling, removing the guilt stigma, making them partners in achieving the target, emphasizing health rather than obesity, identifying their strengths and encouraging them and early involvement of a clinical psychologist in addressing these issues are among the tools of empowerment. Severe cases of obesity may need certain medications.



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Crafting catwalk elegance behind the scene

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By Zanita Careem

While the spotlight at Colombo Fashion Week shines brightly, dazzling couture and celebrated designers, the true heartbeat of the event often lies behind the curtains. Backstage is where creativity meets pressure, precision and passion, a world powered by hairstylists, makeup artists, dress designers, choroegraphers and production teams work tirelessly against the clock.

At Colombo Fashion Week, the spotlight may belong to designers, but just behind the runway lights, another story unfolds – one of precession, pace and transformative artistry.

At the heart of it all stands Ramani Fernando, the quiet force who has shaped the face of fashion in Sri Lanka for decades. Long before the first model takes her stride, Ramani Fernando and her team are already at work. Backstage is a flurry of motion, hair dryers humming, brushes sweeping, palettes opening and closing in rhythm. Yet amid the chaos there is a remarkable sense of order. That order is Ramani. For years, she has been the official hair and beauty partner of Colombo Fashion Week, curating looks that not only complement but elevate each designer’s vision. Whether it is sleek, pulled back aesthetic for a structured collection or wild textured volume for a more experimental line her work ensures that beauty becomes an extension of fashion.

The crew of CFW is more than a just a team comprising some of the country’s most skilled stylists and make up artistry. Many of them trained in her own academy, the crew operates under intense pressure with seamless co-ordination.

“A single show can demand dozens of looks in a matter of hours. Multiple designers each with a distinct creative direction, rely on the team to interpret and excute their vision and precision. Timing is everything. There are no second takes. Every strand of hour, every stroke of make up must be fearless before the model steps onto the runway. And yet what stands out is not finish , nor the speed, but the consistency said Ramani. Colombo Fashion Week has increasingly positioned itself on the global fashion map, and beauty plays a crucial role in that evolution. Each season, Ramani Fernando’s team introduces looks that are not only trends driven but often trend-setting within the local industry.

In the end, the curtain does not just hide preparation,it protects the chaos,creativity,and colloboration that make the final moment possible.

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Early diagnosis, better chances and stronger hope

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Senior Consultant Cancer Surgeon Dr Anuruddha Thewarapperuma

Senior Consultant Cancer Surgeon Dr Anuruddha Thewarapperuma on…


In a timely and though-provoking session held at Apeksha Hospital, Senior Consultant Cancer Surgeon Dr. Anuruddha Thewarapperuma addressed one of the most pressing health concerns facing modern society, the growing prevalence of cancers and the importance of early detection.

Speaking to the ‘ Sunday Island,’ Dr Anuruddha stressed that awareness and timely medical intervention continue to be the strongest weapon in the fight against cancer. In Sri Lanka many cancer patients still arrive at hospitals during the advanced stages of illness, but the role of awareness, early detection and compassionate medical care has never been more vital to most patients.

Speaking on the growing burden of cancer in Sr Lanka, Dr Anuruddha stressed that one of the biggest challenges we face is delayed diagnosis. Many patients first seek treatment from family doctors, or attempt to ignore symptoms, often believing they are a minor health issue. By the time they meet a specialist, the disease may already be in an advanced stage

Cancer is no longer a disease affecting the old, he explained. Today we see younger patients, as well, especially with breast cancer, colorectal cancer, and lung and oral cancer

Dr Thewarapperuma, who specialises in complex cancer surgeries, including breast, colorectal, pancreatic and lung cancers, highlighted that breast cancer remains one of the most common cancer among women in Sri Lanka. He urged women to undergo regular screenings and immediately seek medical advice if they notice unusual lumps, skin changes or discharges. Colorectal cancer, another rapidly rising concern, often begins with silent symptoms. He pointed out that warnings signs, such as changes in bowel habits, rectal bleeding, unexplained weight loss and persistent abdominal discomfort, should never be ignored. Lifestyle changes, unhealthy diets, and lack of excercise, are among the contributing factors behind the increasing numbers.

With Sri Lanka witnessing a steady rise in cases of breast cancer, colorectal lung and oral cancers, he noted many lives could be saved through routine screenings and greater public education. He said that we must not only be aware of medical facts but also on changing attitudes towards cancer.

He explained that fear, stigma and misinformation often prevent patients from seeking treatment early.

Cancer, detected early, can often be treated successfully, he emphasised, encouraging the public to pay attention to warning signs and prioritise regular health check-ups.

According to the veteran surgeon, the impact of modern lifestyles specially fast foods, smoking, dietary habits and environment influences are contributory factors. Many patients walk into my room frightened, not knowing what the future holds. Dr Thewarapperuma explained, some men and women worry about their children, some fear of losing thier identity, while others are terrified simply because of the word cancer itself. He stressed the emotional healing is just as important as medical treatment. Dr Thewarapperuma noted that not only the patient even families also experience emotional strain .

He said different cancers affect patients emotionally in different ways, yet fear and uncertainty remains common to all.

Speaking further on breast cancer, he said it remains one of the most common cancers affecting women worldwide and in Sri Lanka. Many women initially struggle with shock and insecurity. They are emotinally shattered, He maintained with early diagnosis and medical treatment many cancer patients go on to lead healthy and confident lives.

He always focussed on the fact that early detection and timely treatment are crucial in improving survival rates and ensuring better quality of life for the patient. Breast cancer can often be treated successfully if detected early, he noted. Women should never ignore changes in their breasts, even if there is no pain

He encouraged women to become familiar with their own bodies, through regular self examinations. Common warning signs are a lump, changes in breast shape or size,,nipple discharge, a lump under the arm are a few symptoms women should be aware of.

He noted awareness, education and regular screenings and mammograms continue to play a vital role in reducing risks and improving survival rates.

Dr Thewarapperum also highlighted the growing incidence of colon cancer which is becoming increasingly common in Sri Lanka, yet many people are unaware of its early warning signs. This cancer is common among middle aged and older adults.

Symptoms such as persistent abnominal pain, changes in bowel habits, unexplained weight loss, blood in stools and ongoing fatigue should never be ignored

According to the Senior Consultant, many patients delay in seeking medical attention; they panic only after the disease reaches an advanced stage.

Talking about oral cancers, it continues to be one of the most common cancers in Sri Lanka, largely due to lifestyle habits, such as smoking, betel chewing and excessive alcohol consumption.

Colon cancer, is more frequently diagnosed in individuals above the age of 50.

Nevertheless youngest individuals, with unhealthy lifestyle habits, are also increasingly at risk

Also speaking about lung cancers Dr Thewarapperuma said this cancer affects both men and women and remains one of the leading causes of cancer-related deaths.

He warned that even non-smokers are now at risk due to increasing exposure to harmful pollution.

According to him, many cancer patients seek medical attention, only at the advanced stage, because early symptoms are often overlooked by most people.

Despite these challenges, he expressed confidence in the advances made in cancer treatment in Sri lanka. Modern technology, improved surgical techniques,and multi disciplinary care have significantly improved patient outcomes and survival rates

However, delayed diagnosis among patients in Sr Lanka continues to remain one of the biggest challenges in cancer management.

Dr Anuruddha highlighted throughout our discussion the importance of early diagnosis significantly have higher success rates and better quality of life, after treatment.

Apeksha Hospital’s multi disciplinary approval to cancer management combining experienced consultants, advanced surgical procedures, diagnostic facilities and personalised patient care, has contributed positive treatment outcome across several common cancers including breast, colon, oral, lung and other cancers.

Dr Thewarapperuma explained that modern cancer care are not limited to surgery alone.

Timely screening, accurate diagnosis, coordinated specialist care and emotional support, all play a major role in successfull recovery.

“We at Apeksha Hospital continues to focus on patient centred treatments while creating awareness on prevention and early detection through educational programmes and medical discussions.

We remain committed to offer hope, confidence and quality healthcare to patients facing cancer diagnosis.

His message to the public was clear – awareness, early screening, and timely medical attention remains the strongest weapons in the fight against all kinds of cancer. He says cancer, when detected early, is no longer a battle that must be faced without hope and this disease is not the end of life either. Early detection saves lives and emotional strength gives patients the courage to continue their journey, said this well known Senior Consultant Cancer Surgeon. He is attached to several leading hospitals, including the istitute at Maharagama (Apeksha Hospital) and also Hemas and Asiri Surgical hospitals.

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A milestone of excellence

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From Left: Nawaz Rizmi (Assistant Manager – Operations), Sahan Madusanka (Group HR Manager), Sandra Krishanthy (Assistant Manager – Medical Operations), Dr Sarah Fazy (Managing Director & CEO), Dr Nalini Samararathna (Medical Officer), and Chamath Goonesinghe (Head of Marketing).

Dr Sarah Fazy, also known as Dr Cherry, recently marked a major professional milestone by recieving the ISO certification. It is more than a professional achievement – it is a statement of discipline, vision and modern excellence in aesthetic medicine.

360 Skin Clinic & 360 Aesthetics has achieved a significant milestone in its journey of clinical excellence and service innovation after being awarded the prestigious ISO 9001:2015 / SLS ISO 9001:2015 certification, reinforcing its position as one of Sri Lanka’s leading providers of cosmetic, aesthetic and wellness care.

Issued by the Sri Lanka Standards Institution (SLSI), the certificate of conformity recognises that 360 Wellness Centre (Pvt) Ltd., has successfully implemented a Quality Management System that meets the rigorous international standards of ISO 9001:2015, one of the world’s most respected benchmarks for quality assurance and continual improvement.

Founded by renowned cosmetic and aesthetic physician Dr Sarah Fazy, widely known as Dr Cherry, the 360 brand has built a reputation for combining medical expertise with personalised care, advanced technology and a strong commitment to client wellbeing. Over the years, the clinic has expanded its services while maintaining a steadfast focus on ethical practice, innovation and trusted results.

Commenting on the certification, Dr. Sarah Fazy, Founder of 360 Skin Clinic & 360 Aesthetics, said “This certification is a proud moment for our entire team and a reflection of the standards we strive to uphold every day. Quality care, patient safety and professional excellence have always been at the heart of our vision. Achieving ISO 9001:2015 recognition validates our commitment to delivering world-class services to every client who places their trust in us.”

Dr. Sarah Fazy receiving the ISO 9001:2015 certification

The achievement marks a new chapter for 360 Skin Clinic & 360 Aesthetics, ensuring that every treatment, consultation and customer interaction is guided by internationally recognised processes focused on consistency, safety, efficiency and patient satisfaction.

ISO 9001:2015 is a globally recognised framework developed by the International Organisation for Standardisation (ISO). It provides organisations with a structured model to enhance operational efficiency, maintain consistent service quality and continually improve customer experiences.

Dr. Sarah further stated, “At 360 Skin Clinic & 360 Aesthetics, we believe beauty and wellness should be approached with responsibility, precision and compassion. This milestone motivates us to continue raising the bar in aesthetic medicine and wellness care in Sri Lanka.”

For 360 Skin Clinic & 360 Aesthetics, the certification demonstrates its commitment to delivering dependable, high-quality services, maintaining robust quality control systems, continuously improving internal processes, ensuring transparency, accountability and professionalism, and prioritising patient safety and satisfaction.

The certification scope covers a broad portfolio of services, including medical and cosmetic skincare, haircare solutions, aesthetic consultations, facial treatments, cosmetic procedures, nail care, surgical enhancements and hair transplantation services.

This recognition provides customers with added confidence that they are receiving care aligned with internationally accepted standards, delivered by trained professionals using advanced techniques and modern technology.

Since its inception, 360 Skin Clinic has been driven by a mission to redefine beauty, wellness and self-care in Sri Lanka. What began as a visionary concept has evolved into a trusted brand supported by a multidisciplinary team of specialists dedicated to helping clients look and feel their best.

The clinic is known for conducting detailed consultations and personalised assessments to create bespoke treatment plans tailored to individual skincare and wellness goals. Its medical aesthetic team continues to invest in state-of-the-art technology and evidence-based treatments to remain at the forefront of the industry.

With the attainment of ISO 9001:2015 / SLS ISO 9001:2015 certification, 360 Skin Clinic & 360 Aesthetics strengthens its promise to deliver elevated care, trusted results and a standard of excellence clients can feel confident in.

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