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April 27, 2012  Mexico City, Mexico - acanthosis nigricans. Jose Manuel Perea Rosas, a sixteen year old Mexican boy, attends a monthly consultation with doctors while being treated at the Federico Gomez children´s Hospital in Mexico City for symptoms related to severe morbid obesity. Jose Manuel weighs 333 pounds and is 162,5 centimeters high with a BMI 57,2. He has gained 32 pounds in 3 years since his first visit to the hospital in 2009 when he weighed 301 pounds and was 161,3 centimeters tall with a BMI 52. He says he has been larges since he was 4 years old, and kept on gaining weight. He has been diagnosed with morbid obesity, Metabolic Syndrome X, insulin resistance, acanthosis nigricans, systemic arterial hypertension, Ventricular hypertrophy,  fatty liver disease, chronic severe obstructive sleep apnea hypopnea, Cryptorchidism, bilateral genu valgum, instability of the Capsular ligaments and Palmoplantar keratodermas. Jose Manuel would like to get a bariatric surgery, but he must loose weight and get his BMI down to 45 before he can apply. Jose Manuel is a student from a family with financial difficulties living in Ecatepec de Morelos. The poor in Mexico have a difficult time accessing preventive health care and education about unhealthy food. Obesity is a massive epidemic affecting countries around the world. Mexico has one of the highest obesity rates in the world, and public health officials are increasingly alarmed by the rapid rise in child and youth obesity. Mexico holds the first place worldwide in childhood obesity. About one-third of children in Mexico are now classified as either overweight or obese. There is also a high prevalence of obesity among the poor in Mexico. Photo credit: Benedicte Desrus