MUMBAI: Seeking the integration of obesity prevention and management into India’ s national public health programmes, experts from the Obesity and Metabolic Surgery Society of India (OSSI) and the Endocrine Society of India (ESI) have recommended Obesity Management Protocols for the nation. They have also sought support and stigma-free obesity management care, clearer food labelling, healthier school environments and the pursuit of public awareness initiatives.
Not surprisingly, the role of dieticians has also evolved. Sound added that the BMC had taken 35 nutritionists on board at the primary healthcare level, who guide people at the city’s 185 public health centres on nutrition care.
A dietitian plays an important role in the dietary management of these conditions, particularly obesity, helping individuals adopt sustainable, evidence-based dietary and lifestyle changes,” said clinical nutritionist Ruby Sound, founder director, International Association of Dietitians for Metabolic Health and Nutrition. “Unlike earlier, when nutrition care was considered just a part of the treatment, today nutrition intervention is recognised as the first line of management for patients with obesity, diabetes, hypertension, heart ailments and other metabolic diseases.
In the latter, the fat content is generally subcutaneous or below the skin, which actually insulates the body. Indians generally have abdominal fat, which leads to serious health issues. Other studies have also painted a grim picture. “The risk does not begin with the first heart attack; it can accumulate silently for years. Underlining the importance of the intervention, the OSSI and the ESI have jointly developed an expert consensus on Obesity Management Protocols, in which they have recommended that the government facilitate healthcare for the obese.
“However, for the Indian population, we tend to be wary even if the BMI is 27, since Indians are different from the western population. The charter, developed from 55 recommendations from 78 experts, calls for a broader change in how India responds to obesity.
“Anyone who has a Body Mass Index (BMI) of over 30 is considered obese,” explained Dr Om Lakhani, executive committee member of the ESI. “Nearly four of every 10 Indian adults, as per the ICMR-INDIAB study, have abdominal obesity, which is particularly important, as abdominal fat is closely linked to insulin resistance and other cardiovascular risk factors,” explained Dr Aparna Govil Bhasker, a bariatric and metabolic surgeon.
Also, we tend to attract obesity-related ailments like diabetes, fatty liver and heart attacks almost a decade earlier than the western population.
In Mumbai, the BMC has responded to it, though at the treatment level. “Here, patients are diagnosed and medications too are prescribed depending on the scale of the issue. There are also nutritionists on board to advise and guide patients.”
“At the tertiary care civic hospitals level, diabetic care clinics have already been set up, which also look handle cases of obesity, since that is one of the primary sources of diabetes,” said Dr Nikhil Bhagwat, head of the endocrinology department in the BMC’s Nair Hospital.
