Revamp Your Life: Embrace New Indian Strategies to Combat Obesity

New guidelines for diagnosing obesity have been presented by Indian physicians, addressing a significant crisis in India.

Published in Diabetes & Metabolic Syndrome: Clinical Research & Reviews, professionals from the National Diabetes Obesity and Cholesterol Foundation (N-DOC), Fortis C-DOC Hospital, and the All India Institute of Medical Sciences (AIIMS) have outlined lifestyle alterations aimed at combating obesity, which differ depending on its stage.

Obesity has been categorized into two stages: Stage 1 and Stage 2.

Stage 1: Characterized by excess body fat (BMI exceeding 23 kg/m2) without impacting organ functions or daily tasks, Stage 1 obesity does not yet cause health complications but may progress to Stage 2, which is associated with mechanical issues and diseases.

Stage 2: This advanced stage of obesity is recognized by a BMI above 23 kg/m2, increased abdominal fat, larger waist circumference, or a high waist-to-height ratio. This can hinder physical and organ functionalities, leading to problems such as arthritis in the knees due to excessive weight or obesity-related conditions like type 2 diabetes.

LIFESTYLE MODIFICATIONS AND CONTROLLING OBESITY

The assessment of obesity involves examining medical history, conducting a physical examination, and performing relevant tests to eliminate secondary causes and identify associated health issues.

STAGE 1 OBESITY

Lifestyle Modifications

In stage 1 obesity, placing emphasis on customized nutrition plans, regular exercise, and behavioral adjustments is critical. These measures are typically sufficient to reduce the likelihood of progressing to stage 2 obesity.

Medication may be necessary for individuals at risk for stage 2 obesity (for instance, those with a family history of diabetes or heart conditions), significant weight gain (10% or more) despite adhering to lifestyle changes, and those with a BMI of 27.5 kg/m2 or greater.

STAGE 2 OBESITY

For individuals with stage 2 obesity, steadfast and intensive lifestyle modifications are imperative.

Nutritional Management

• Decrease calorie consumption to create a negative energy balance. Balance macronutrients while reducing calorie intake. Consider low-carbohydrate and ketogenic diets as these are beneficial for immediate weight reduction, particularly in individuals accustomed to high-carbohydrate diets. Strive for a daily calorie deficit of approximately 500 kcal through diet and physical activity.
• Commit to long-term dietary changes to prevent weight regain. Prioritize protein intake and add more protein or supplements to assist in weight reduction and enhance nutrition.
• Low-carbohydrate diets promote fat metabolism by reducing carbohydrate consumption.
• Select dietary plans that are aligned with personal tastes, nutritional requirements, and sustainability.

Importance of Physical Activity

Engagement in physical activity assists in weight loss, preserves muscle mass, and enhances overall health. It is most effective when combined with dietary changes to maintain a negative energy balance.

• Aim for a minimum of 60 minutes of daily physical activity.
• Minimize sedentary lifestyles and include light-intensity exercises.
• Combine both aerobic and resistance training for optimal results.
• Customize exercise plans to suit individual needs and gradually elevate intensity.
• Conduct pre-exercise health assessments for individuals with existing medical conditions.

Pharmacological Intervention

• Set realistic goals for weight loss and recognize the possibility of plateaus during treatment.
• Prepare individuals for potential weight regain following the discontinuation of medications.
• Utilize medication in conjunction with lifestyle changes to achieve a 5-10% reduction in body weight over the course of 3-6 months.
• Avoid medications that encourage weight gain, and instead choose weight-neutral alternatives.

Medications for Non-Diabetic Patients

In India, approved options comprise orlistat and GLP-1 receptor agonists. Orlistat remains the most accessible anti-obesity medication.