You gotta love yourself before you can do anything effectively right is that the number-one thing when you have a patient come in who is obese off the bat what is the most consistent issue you’ve seen that’s non-medical? Yeah so no doubt about that with people that I deal with we’re talking about people who have a hundred pounds overweight those patients are all gonna have some issue whether it be social psychological emotional even economic issues getting a job being promoted they can be impacted because of the fact that their obesity is impacting their life so I see a lot of a depression I see a lot of anxiety I see a lot of panic attacks we see social issues marriages friendships things like that so yes all of those patients have to be adult with with their social and psychological issues. Well we did a pretty lengthy list of conditions that you can deal with if you are obese break it down for kids versus adults because you see people who are dealing with the weight issue their whole life but then is it true that the medical conditions don’t kick in until they’re older or what are we looking at? No we can see kids especially with the kids and the adolescents that we deal with we deal with you know we call kids 14 years and above and we can see diabetes and high blood pressure and those kids as well just related to obesity not the childhood diabetes that we see in young six year olds but obese related diabetes so there’s no doubt that an adolescent with obesity can have medical conditions there’s no doubt that an adolescent with obesity can have psychological or social condition we know very well the school yard is a very difficult place for those youngsters and bullying and and discrimination so yeah we see it now as you get older it gets worse because the medical conditions pile on and the medical issues get worse and the severity we’re talking about heart attacks at the age of 40 and 50 years old.