India Revamps Obesity Guidelines After 15 Years: Here's What's New

India has finally introduced updated guidelines to address the country's unique health challenges, after relying on the body mass index (BMI) as a primary measure of obesity for over 15 years. The revised framework offers a more comprehensive approach to obesity diagnosis and treatment, and spearheaded by experts from the National Diabetes Obesity and Cholesterol Foundation (N-DOC), Fortis C-DOC Hospital, and the All India Institute of Medical Sciences (AIIMS).

These changes align with a recent study published by The Lancet Diabetes and Endocrinology journal which challenges the conventional approach of relying on BMI to diagnose obesity. It also emphasises the need for a tailored strategy for tackling obesity and related health risks among Indians.

A Shift From BMI: What Has Changed?

BMI, a widely used metric calculated as weight (in kilograms) divided by the square of height (in meters), has long served as the benchmark for diagnosing obesity. Individuals with a BMI over 30 were traditionally classified as obese. However, experts now argue that this approach oversimplifies the condition, as individuals with excess body fat don’t always have a BMI exceeding 30, leading to undetected risks.

The updated guidelines adopt a more nuanced perspective, focusing on body fat distribution and its impact on organ function, especially in the Indian context.  

Why Are The New Guidelines Essential?

The 2009 criteria relied heavily on BMI without considering the unique body compositions of Indians. Research shows that health risks may manifest in individuals with a BMI lower than 30, necessitating revised cut-offs for accurate diagnosis.

Also Read: Surgical Infection Rate Higher In India Than Many High-Income Countries, Reveals ICMR Study

Indian populations are predisposed to abdominal obesity, which significantly increases the risk of metabolic disorders such as insulin resistance, diabetes, and cardiovascular diseases. The new guidelines prioritise the measurement of waist circumference and waist-to-height ratio (W-HtR) to address this critical factor.

Indian populations are predisposed to abdominal obesity, which significantly increases the risk of metabolic disorders such as insulin resistance, diabetes, and cardiovascular diseases. The new guidelines prioritise the measurement of waist circumference and waist-to-height ratio (W-HtR) to address this critical factor.

Redefining Obesity

Obesity is no longer defined merely as excess weight but as a clinical condition characterized by harmful levels of adiposity that impair organ and tissue function. While traditional metrics like BMI remain useful, the updated approach emphasizes:  

• Distribution of fat, particularly around the abdomen.  
• Advanced diagnostic tools, such as bioelectrical impedance and DEXA scans, which provide a clearer picture of body fat composition.  
• A two-stage classification system for obesity; Stage 1 and Stage 2 obesity. Stage 1 Obesity is referred to as increased body fat without significant impact on organ function or daily activities (BMI > 23 kg/m²). Stage 2 Obesity is referred to as advanced obesity characterised by abdominal adiposity, high waist circumference, and organ impairment.

Also Read: Lancet Report Declares BMI an Incomplete Measure of Obesity, Urges Diagnostic Overhaul

Health Impacts Of Obesity

The revised guidelines highlight the range of health risks associated with obesity, including:

• Diabetes: Excess fat disrupts insulin function, increasing diabetes risk.
• Arthritis: Additional body weight strains joints, exacerbating arthritis symptoms.
• Cardiovascular Issues: Abdominal fat is a major contributor to heart disease.
• Cancer: Obesity is linked to certain types of cancer, particularly those affecting hormone-sensitive tissues.

Bottomline

With the updated guidelines, healthcare providers in India are better equipped to diagnose and manage obesity. By shifting focus from weight alone to a more comprehensive assessment of fat distribution and associated risks, these measures pave the way for early intervention and improved health outcomes.

For individuals, the guidelines emphasise the importance of regular monitoring, a balanced diet, and physical activity to mitigate the risks of obesity-related complications. The new framework is a landmark step in addressing India’s growing obesity epidemic and its ripple effects on public health.