New Definition of obesity for Asian Indians living in India, has been Released after 15 years, in-step with Worldwide Release of New Definition by The Lancet Diabetes and Endocrinology

New Definition of obesity for Asian Indians living in India, has been Released after 15 years, in-step with Worldwide Release of New Definition by The Lancet Diabetes and Endocrinology 

National, 15 th January 2025: A landmark analysis conducted by National Diabetes Obesity and Cholesterol Foundation (N-DOC), Fortis C-DOC Hospital for Diabetes and Allied Sciences, and All India Institute of Medical Sciences (AIIMS) has redefined obesity for the Indian population. This new classification marks a significant step forward in addressing the unique health challenges posed by obesity in Asian Indians. Background The need for updated obesity guidelines stems from several critical factors: 1. Outdated BMI Criteria: The previous guidelines for obesity in Asian Indians, established in 2009 (lead author Prof. Anoop Misra), relied exclusively on Body Mass Index (BMI, a ratio of weight in kg/height in meter square) for diagnosis. Newer research highlights the shortcomings of using BMI alone to accurately diagnose obesity or related conditions, especially for the Asian Indians. 2. Emerging Health Data: Studies have shown a strong correlation between abdominal obesity in Asian Indians, resulting inflammation and the early onset of comorbid diseases, further emphasizing the need for a refined definition. 3. Separation of ‘Innocuous Obesity” from “Obesity with Consequences” Key Components of the New Guidelines 1. Focus on Abdominal Obesity: Abdominal fat, which is closely linked to insulin resistance and prevalent in Asian Indians, is now recognized as a key factor in the diagnosis. 2. Inclusion of Comorbid Diseases: The new definition integrates the presence of comorbidities—such as diabetes and cardiovascular disease—into the diagnostic process, ensuring that obesity-related health risks are better accounted for, and taken care of in management. 3. Inclusion of Mechanical Problems Associated with Obesity: For example, knee and hip osteoarthritis etc, or shortness of breath during daily activities, which produce poor quality of life. New Two-Stage Obesity Classification The revised guidelines introduce a two-stage classification system, addressing both generalized and abdominal obesity: The study introduces a two-stage classification of obesity. Initiation starting point for both is BMI more than 23 kg/m2 : • 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 association with mechanical and disease related problems. • Stage 2 Obesity: Advanced state of obesity with increased BMI more than 23 kg/2 , and o Abdominal adiposity; excess Waist Circumference (WC) or Waist-toHeight Ratio (W-HtR). o One of the following impacting physical and organ functions ▪ Mechanical conditions (e.g. knee arthritis due to excess weight) OR ▪ Presence of diseases associated with obesity (e.g. type 2 diabetes) The above stage (“Obesity with consequences”) reflects that obesity is hindering functions of organs of the body and making individual more symptomatic requiring more intensive management Tailored Weight Reduction Strategies, based on above classification, could be used in an effective and personalized manner by use of new guidelines. Study Methodology The study was conducted using the Delphi process, a structured communication technique, and involved experts in obesity and metabolic disorders: • A steering committee of five members oversaw the consensus-building process. • Five rounds of surveys were completed between October 2022 and June 2023. • Participants included a diverse group of physicians, surgeons, physiotherapists, and nutritionists. • The surveys utilized a 5-point Likert scale, with a 67% agreement threshold for consensus on key parameters such as obesity classification, diagnostic methods, and intervention guidelines. Expert Comments Dr. Anoop Misra, Padma Shri awardee and Executive Chairman & Director of Diabetes and Endocrinology at Fortis C-DOC Hospital, emphasized the importance of the findings: "Obesity rates in India are rising at an alarming pace, extending beyond urban areas. These guidelines are groundbreaking and easy to implement, providing stage-specific strategies for managing obesity-related conditions across India. These also allow application of weight loss therapies to be applied early and optimally" Dr. Naval Vikram, Professor of Medicine, AIIMS, New Delhi, added: "A distinct definition of obesity for Indians is crucial for the early detection of related diseases and the development of targeted management strategies. This study fills critical gaps in our understanding and offers a clear, rational approach to tackling obesity in the Indian population." Conclusion The newly revised definition (being unveiled 15 years after the last definition) and classification system aim to enhance the diagnosis, treatment, and rational management of obesity in India. By incorporating the specific characteristics of the Indian population, these guidelines offer a robust framework to combat the rising obesity, and linked epidemics diabetes and a number of related diseases. About Fortis C-DOC Hospital Diabetes, Endocrinology & Allied Multi Specialties: Fortis C-DOC Hospital is a 23-bed facility spread over an area of 20,000 square feet at Delhi’s Chirag Enclave. The hospital has been in operation since January 2012 and has emerged as one its kind hospital in North India providing comprehensive treatment, care and management for diabetes, metabolic diseases and endocrine disorders. The hospital is equipped with luxurious rooms, 2 operating suites, advanced centre for diabetic foot and wound care, scientific weight loss and weight management, bariatric and minimal access surgery, insulin pump, total knee /hip replacement surgery, diabetic eye lab and dialysis lab, round the clock diagnostic lab, radiology and pharmacy services. A dedicated team of top medical experts follow globally accepted protocols supported by state-of-the-art technology, with internationally acclaimed Padma awardee and Dr. B. C. Roy awardee--Prof. Anoop Misra, a diabetes expert and researcher. About Fortis Healthcare Limited Fortis Healthcare Limited – an IHH Healthcare Berhad Company – is a leading integrated healthcare services provider in India. It is one of the largest healthcare organizations in the country with 28 healthcare facilities, 4,500+ operational beds (including O&M facilities) and over 400 diagnostics centers (including JVs). Fortis is present in India, United Arab Emirates (UAE), Nepal & Sri Lanka. The Company is listed on the BSE Ltd and National Stock Exchange (NSE) of India. It draws strength from its partnership with global major and parent company - IHH, to build upon its culture of world-class patient care and superlative clinical excellence. Fortis employs ~23,000 people (including Agilus Diagnostics Limited) who share its vision of becoming the world’s most trusted healthcare network. Fortis offers a full spectrum of integrated healthcare services ranging from clinics to quaternary care facilities and a wide range of ancillary services.