Written By: Prerna Mittra | Updated : March 4, 2024 9:36 PM IST
Obesity is a complex condition and a single therapy may be insufficient for its management. It requires a comprehensive approach combining multiple therapies for long-term success. (Photo: Freepik)
World Obesity Day 2024: Obesity refers to an abnormal or excessive fat accumulation in the body that makes one overweight and presents a risk to health. According to the World Health Organization (WHO), a body mass index (BMI) over 25 is considered 'overweight', and over 30 is 'obese'. It states that from 1990 to 2022, the percentage of children and adolescents aged 5-19 years living with obesity increased four-fold from 2 per cent to 8 per cent globally, while the percentage of adults 18 years of age and older living with obesity more than doubled from 7 per cent to 16 per cent. On the occasion of World Obesity Day today, the Obesity and Metabolic Surgery Society of India (OSSI) Unveiled comprehensive guidelines for managing the condition. Compiled by Dr Aparna Govil Bhasker and approved by the immediate past president Dr Praveen Raj, president Dr Randeep Wadhawan and the executive committee of OSSI 2022-24, these guidelines address the rising concerns around obesity in India, and aim to mitigate the prevailing confusion in its management.
According to the National Family Health Survey (NFHS), between 2019 and 2021, approximately 6.4 per cent of women and 4.0 per cent of men aged 15-49 years in India have lived with obesity, which is linked to various adverse health conditions such as diabetes, hypertension, heart disease, sleep apnea, joint issues, cancers, reproductive disorders, etc.
According to OSSI, obesity is a complex condition and a single therapy may be insufficient for its management. It requires a comprehensive approach combining multiple therapies for long-term success. Healthy diet, exercise, behaviour modification, and psychological support are foundational for all obesity treatment methods, it states.
* Clinically-significant weight loss is defined as 5 per cent of the baseline weight. Weight loss outcomes after various therapies are listed as under:
* The results of any therapy for weight loss must be reviewed every 3 months, and where there is no benefit/progression even after 6 months, escalation of therapy to the next step is necessary.
* Treatment must be tailored to the individual and recommended as per their unique health profile.
* If the weight surpasses the recommended target range as per the height, individuals should seek guidance from primary healthcare practitioners, registered dieticians, nutritionists, or exercise specialists.
* Diet and lifestyle modification is recommended as a standalone treatment option for individuals with lower degrees of obesity (class 1/stage 0) or obesity-related health risks.
* Pharmacotherapy (anti-obesity/weight loss medications) or endoscopic bariatric procedures like intra-gastric balloon or endoscopic sleeve gastroplasty (ESG), along with diet and lifestyle modification can be advised as a primary treatment option for individuals who have not attained 5 per cent loss of their baseline weight despite undergoing 6 months of diet and lifestyle interventions, or are developing obesity-related comorbidities despite diet and lifestyle modification. It is also recommended for individuals who do not wish to/have access to/are medically unfit for bariatric/metabolic surgery, and for those high-risk patients in whom bariatric/metabolic surgery may not be feasible as a first-stage procedure.
* Per the OSSI guidelines, bariatric/metabolic surgery is recommended as a primary treatment option for obesity for patients with a BMI 35 Kg/m2, with/without the presence of any obesity-related comorbidity; patients with a BMI 30 Kg/m2, in the presence of 2 or more obesity-related comorbidities; for patients with a BMI 27.5 Kg/m2 with uncontrolled type 2 diabetes despite optimum medical management; patients with a waist circumference 80 cm in females and 90 cm in males along with type 2 diabetes and other obesity-related comorbidities; patients 18 years and up to 65 years of age. For patients < 18 years of age, a multidisciplinary team must be consulted before surgery. In the case of patients > 65 years, the benefits of surgery must outweigh its risks.
"These guidelines intend to help in officially recognising obesity as a disease rather than just a lifestyle issue. This recognition is vital in changing public perception and promoting a standardised and consistent medical approach to its management," Dr Randeep Wadhawan said, as quoted in a press release.
