Background <p>Obesity in India is rising rapidly, with higher body fat at lower BMI and younger age compared to Western populations, leading to earlier onset of type 2 diabetes and cardiovascular disease in a resource-constrained health system. Protocols for obesity care therefore need to address region-specific challenges and ensure culturally acceptable, feasible treatment options.</p> Methods <p>The Obesity and Metabolic Surgery Society of India (OSSI) and the Endocrine Society of India (ESI) jointly developed India-specific obesity management protocols using a modified Delphi consensus. A protocol development team generated 73 statements based on literature review and expert experience. Seventy-eight experts (38 OSSI, 40 ESI) participated; 100% voted in round 1 and 90% attended an in-person round-2 meeting. Statements with more than 80% agreement were considered to have achieved consensus. After revision and deletion of redundant items, 55 statements across eight modules were finalized.</p> Results <p>Consensus agreement exceeding 80% was achieved for all 55 statements covering obesity recognition, prevention, treatment selection, monitoring and follow-up, lifestyle therapy, obesity management medications, metabolic and bariatric surgery, and palliative care. The panel strongly endorsed recognition of obesity as a chronic non-communicable disease, integration of obesity care into national health programs, equitable access to treatment, and a multimodal, stigma-free approach tailored to Indian BMI and anthropometric thresholds.</p> Conclusion <p>This first joint OSSI-ESI consensus provides India-specific guidance across the obesity care continuum. By integrating prevention, individualized therapy and multidisciplinary care, the recommendations aim to standardize clinical practice, inform policy and improve outcomes and quality of life for people living with obesity in India.</p>

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Expert Consensus on Obesity Management Protocols – A Joint Position Statement by Obesity and Metabolic Surgery Society of India (OSSI) and Endocrine Society of India (ESI)

  • Aparna Govil Bhasker,
  • Nitin Kapoor,
  • Sarfaraz Baig,
  • Chetan Parmar,
  • Shehla Shaikh,
  • Randeep Wadhawan,
  • Sumeet Shah,
  • Narendra Kotwal,
  • KVS Harikumar,
  • Sambit Das,
  • Abhamoni Baro,
  • Abhishek Katakwar,
  • A G Unnikrishnan,
  • Altamash Shaikh,
  • Ambrish Mithal,
  • Ana Soraya Monteiro,
  • Apoorv Shrivastava,
  • Aprajita Pradhan,
  • Arun Prasad,
  • Ashish Vashishtha,
  • Beatrice Anne,
  • Bindu Kulshreshtha,
  • Chitra Selvan,
  • Deep Goel,
  • Gagan Priya,
  • G S Jammu,
  • Hemant Phatale,
  • Indira Maisnam,
  • Jaideep Khare,
  • Kaushik Pandit,
  • Khushboo Agarwal,
  • Lakshmi Kona,
  • Kuldeepak S Kular,
  • Lakshmi Nagendra,
  • Lakshmi Nalini Kopalle,
  • Madhu Goel,
  • Mahendra Narwaria,
  • Manish Baijal,
  • Manish Khaitan,
  • Manish Motwani,
  • Mohammed Ismail,
  • Mohan T Shenoy,
  • Mohit Bhandari,
  • Muffazal Lakdawala,
  • Nandakishore Dukkipati,
  • Nishant Raizada,
  • Pawanindra Lal,
  • Poonam Shashank Shah,
  • Pradeep Chowbey,
  • Praveen Raj Palanivelu,
  • Prem Narayan,
  • R Bharath,
  • R Santosh,
  • Radhika Jindal,
  • Raj Palaniappan,
  • Rajesh Khullar,
  • Rajesh Rajput,
  • Rama Walia,
  • Ramen Goel,
  • Richa Jaiswal,
  • S V Madhu,
  • Sachin Mittal,
  • Sailesh Lodha,
  • Sandeep Aggarwal,
  • Sandeep Julka,
  • Sanjay Kalra,
  • Saptarshi Bhattacharya,
  • Sarita Bajaj,
  • Shashank Joshi,
  • Shashank Shah,
  • Shrihari Dhorepatil,
  • Sujoy Ghosh,
  • Sukhvinder Singh Saggu,
  • Sunil Kumar Kota,
  • Sunil Mishra,
  • Surendra Ugale,
  • Sushil Jindal,
  • Tejal Lathia,
  • Vikram Lotwala,
  • Vinay Khatri,
  • Vivek Bindal

摘要

Background

Obesity in India is rising rapidly, with higher body fat at lower BMI and younger age compared to Western populations, leading to earlier onset of type 2 diabetes and cardiovascular disease in a resource-constrained health system. Protocols for obesity care therefore need to address region-specific challenges and ensure culturally acceptable, feasible treatment options.

Methods

The Obesity and Metabolic Surgery Society of India (OSSI) and the Endocrine Society of India (ESI) jointly developed India-specific obesity management protocols using a modified Delphi consensus. A protocol development team generated 73 statements based on literature review and expert experience. Seventy-eight experts (38 OSSI, 40 ESI) participated; 100% voted in round 1 and 90% attended an in-person round-2 meeting. Statements with more than 80% agreement were considered to have achieved consensus. After revision and deletion of redundant items, 55 statements across eight modules were finalized.

Results

Consensus agreement exceeding 80% was achieved for all 55 statements covering obesity recognition, prevention, treatment selection, monitoring and follow-up, lifestyle therapy, obesity management medications, metabolic and bariatric surgery, and palliative care. The panel strongly endorsed recognition of obesity as a chronic non-communicable disease, integration of obesity care into national health programs, equitable access to treatment, and a multimodal, stigma-free approach tailored to Indian BMI and anthropometric thresholds.

Conclusion

This first joint OSSI-ESI consensus provides India-specific guidance across the obesity care continuum. By integrating prevention, individualized therapy and multidisciplinary care, the recommendations aim to standardize clinical practice, inform policy and improve outcomes and quality of life for people living with obesity in India.