New obesity guidelines target more than just BMI to guide treatment

According to a recent nationwide cross-sectional study, the prevalence of obesity in the country is 40.3%, with a higher incidence among women, urban populations, and individuals aged over 40 years.

Mumbai: Internationally-acclaimed experts have submitted new obesity guidelines based on associated conditions and not BMI alone. These new health parameters were recently published in the Journal of the Association of Physicians of India (JAPI).

The  study involved a group of endocrinologists, diabetologists, cardiologists, gynecologists and bariatric surgeons. 

Dr Shashank Shah, internationally acclaimed bariatric surgeon and former President Obesity and Metabolic Surgery Society of India (OSSI) and ex-President of All India Association for Advancing Research in Obesity (AIAARO), along with Prof. Dr Neeta Rohit Deshpande, endocrinologist and obesity physician, wrote the paper. 

The new guidelines need immediate action and implementation by all medical experts and associations of the medical fraternity ahead of the new year 2024. 

According to the guidelines, in India, a person is considered overweight when their BMI is between 23-25 kg/m2, while a person with a BMI over 25 k/m2 is considered obese.

However, the Indian population is prone to developing excess fat accumulation around the waist, especially around the internal organs such as the liver and the pancreas. This can be the starting point for metabolic diseases such as diabetes, also known as visceral obesity or abdominal obesity.

Obesity is the accumulation of excess body fat to the extent that it presents a health risk. According to a recent nationwide cross-sectional study that evaluated data from 100,531 adults in a randomized cluster sample across India, the prevalence of obesity in the country is 40.3%, with a higher incidence among women, urban populations, and individuals aged over 40 years. 

The highest incidence was reported in South India (46.51%) while the lowest was in East India (32.96%). It has been predicted that the prevalence of obesity will triple by 2040 among Indian adults aged 20 to 69 years, according to a press statement. 

“At the international level, these new guidelines have already been implemented and treatment of obesity is based on associated problems. India is known as the capital of diabetes, and it is one of the youngest nations in the world,“ said Dr Shah.

“Obesity and overweight have reached pandemic proportions across the globe today, and India is no exception. This condition is the mother of all metabolic diseases, including cancer, type 2 diabetes, hypertension, etc., and mechanical disorders such as arthritis of the knees, not to mention mental disorders such as anxiety and depression. The economic burden to the individual, community, and the country can be enormous,” Dr Shah added.

Body mass index (BMI) is the common measure used to define obesity. Physical inactivity and aging are significantly associated with obesity in India. Abdominal obesity in women typically develops during the third and fourth decades of life. Unfortunately, the Indian population that has abdominal obesity and metabolic syndrome is at a higher risk for cardiovascular disease, irrespective of their body mass index, informed Dr Shah.