India's obesity new guidelines

For decades, doctors have used body mass index (BMI) as a tool to measure obesity. Now experts have provided new guidelines for obesity treatment and diagnosis after 15 years.

Jan 15, 2025 - 17:00
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India's obesity new guidelines

For decades, doctors have used body mass index (BMI) as a tool to measure obesity. A person with their BMI over 30 is usually considered obese. Now experts have provided new guidelines for obesity treatment and diagnosis after 15 years.

Doctors have said that sometimes, people with excess body fat don't always have a BMI over 30, which means that their health risks can go unnoticed. Therefore, top experts from India have redefined obesity for Indians in a landmark study, addressing the unique health challenges faced by the population.

Experts, such as doctors, surgeons, physiotherapists, and nutritionists from the National Diabetes Obesity and Cholesterol Foundation (N-DOC), Fortis C-DOC Hospital, and the All India Institute of Medical Sciences (AIIMS), have provided guidelines for obesity treatment and diagnosis after 15 years, similar to the new definition released by The Lancet Diabetes and Endocrinology today.

Lancet researchers defined clinical obesity as a condition of illness that, akin to the notion of chronic disease in other medical specialties, directly results from the effect of excess adiposity on the function of organs and tissues.

Obesity means having too much body fat, which can harm your health. While obesity is defined by body fat, measuring it accurately often requires special machines like Bioelectrical Impedance or DEXA scans, which are expensive and not commonly available in clinics.

People with obesity store different amounts of fat, but where the fat is located in the body matters a lot. Research shows that too much fat around the belly is more dangerous and increases the risk of diseases compared to fat stored in other areas.

As per Indian doctors and researchers, new definition and guidelines for obesity were needed due to several factors--- The old 2009 guidelines relied solely on BMI (a weight-to-height ratio) to diagnose obesity. Research now shows BMI alone is not enough, especially for Indians. Studies reveal a strong link between belly fat, inflammation, and early health problems in Indians.

The new guidelines separate “harmless obesity” from obesity that causes health issues.

KEY CHANGES

Focus on Belly Fat: Abdominal fat is now a key factor in diagnosing obesity due to its link to insulin resistance and other conditions.

Health Problems Matter: The definition includes obesity-related issues like diabetes, heart disease, and joint pain.

Stage 1 Obesity: Increased adiposity (BMI > 23 kg/m²) without apparent effects on organ functions or routine daily activities. This stage of obesity, currently not causing any pathological problems (“Innocuous obesity”), could progress to Stage 2 obesity, which has an association with mechanical and disease-related problems.

Stage 2 Obesity: Advanced state of obesity with increased BMI of more than 23 kg/2, abdominal adiposity, excess Waist Circumference (WC), or Waist-to-Height Ratio (W-HtR). One of these impacts physical and organ functions: mechanical conditions (such as knee arthritis due to excess weight) or the presence of diseases associated with obesity (such as type 2 diabetes).

The above stage shows that obesity hinders the functions of organs of the body and makes individuals more symptomatic, requiring more intensive management. The guidelines were developed using the Delphi process, a method for building expert consensus. Five surveys were conducted from October 2022 to June 2023.

The new definition, introduced 15 years after the last update, offers a clear and practical framework to diagnose and manage obesity in India. By focusing on Indian-specific traits, it aims to curb the growing obesity epidemic and related conditions like diabetes.

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