The unveiling of the OSSI guidelines is not just a procedural update; it’s a response to an alarming trend. A 2023 study highlighted a staggering reality: over half of India’s adult population battles abdominal obesity, summing up to an estimated 350 million individuals. This condition is not merely about physical appearance; it’s a harbinger of chronic diseases such as diabetes, hypertension, and heart disease, which strain India’s health infrastructure and reduce the quality of life for millions.
The new guidelines introduced by the Obesity and Metabolic Surgery Society of India (OSSI) advocate for a holistic approach to obesity management. From diet and lifestyle modifications to advanced interventions like pharmacotherapy and bariatric/metabolic surgery, the guidelines cover the spectrum of treatment options available. The aim is to achieve clinically significant weight loss, defined as 5% of baseline weight, which can significantly reduce the risk of obesity-related health conditions. Furthermore, these guidelines emphasize the importance of tailoring treatment to individual health profiles and consulting healthcare professionals for guidance.
General Obesity Guidelines for Treatment:
1. Obesity is a complex condition and hence a single therapy may be insufficient for its management necessitating a comprehensive approach combining multiple therapies for long-term success.
2. A healthy diet, exercise, behavior modification, and psychological support are foundational for all obesity treatment methods.
3. Selection of treatment modality should prioritize maximal clinical benefit in terms of weight loss and overall quality of life while upholding organ function integrity.
4. Clinically significant weight loss is defined as ≥ 5% of the baseline weight. Weight loss outcomes after various therapies are listed below:
- Diet and lifestyle modification: 4 to 6% total body weight loss
- Anti-obesity mediations: 5 to 20% total body weight loss
- Endoscopic bariatric therapies: 13- 20% total body weight loss
- Bariatric and metabolic surgery: up to 40% or more total body weight loss
5. The results of any therapy for weight loss must be reviewed every 3 months and where there is no benefit/progression even after 6 months, escalation of therapy to the next step in treatment is necessary.
Bariatric/Metabolic Surgery Recommendations
As per the guidelines of OSSI, bariatric/metabolic surgery is recommended as a primary treatment option for obesity for:
- Patients with a BMI ≥ 35 Kg/m2, with/without the presence of any obesity-related co-morbidity.
- Patients with a BMI ≥ 30 Kg/m2, in the presence of 2 or more obesity-related co-morbidities.
- For patients with a BMI ≥ 27.5 Kg/m2, with uncontrolled type 2 diabetes despite optimum medical management.
- Patients with a waist circumference ≥ 80 cm in females and ≥ 90 cm in males along with type 2 diabetes and other obesity-related co-morbidities.
- Patients ≥ 18 years and up to 65 years of age. For patients < 18 years of age a multi-disciplinary team must be consulted before deciding on surgery. In the case of patients > 65 years, the benefits of surgery must outweigh the risks.
- All patients should be motivated to enter a long-term weight management program and should be committed to life-long follow which must be provided by the bariatric team.
As India takes a significant step towards addressing the obesity epidemic, the message is clear: understanding, compassion, and comprehensive care can turn the tide against this global health challenge.
Ref:
For more: