K Srinivasan
In the middle of January, India revised the criteria for obesity shifting from the traditional Body Mass Index (BMI) formulae to waist circumference and the waist-to-height ratio. This new standard would translate into individuals being classified as obese despite having a normal BMI if their waist measurements surpass certain thresholds. So if waist measurements exceed 80 cm for women and 90 cm for men, it will be classified as abdominal obesity. These updated guidelines facilitate the early detection and management of obesity, while also distinguishing between benign and severe obesity that necessitates medical attention.
Experts from the National Diabetes Obesity and Cholesterol Foundation (NDOC), Fortis C-DOC Hospital, and the All India Institute of Medical Sciences (AIIMS), who authored the report and updated guidelines, have defined various metrics for diagnosing obesity. These metrics include Waist Circumference (WC), Waist-to-Height Ratio (W-HtR), abdominal adiposity (the accumulation of excess fat in the stomach and abdominal area), and Body Mass Index (BMI) as the key elements in its measurement.
Instead of calling someone ‘overweight’ (a term that has been eliminated), individuals will be classified for obesity – Grade I and II. The Indian. Standards were released following the publication of global obesity guidelines by Lancet Diabetes & Endocrinology, which advocated for a shift away from relying solely on body mass index (BMI) for diagnosing obesity.
Considering the Indian tendency towards abdominal obesity – a situation that hugely increases the possibility of cardiovascular diseases and diabetes – the latest updated guidelines emphasise the importance of measuring waist circumference and the waist-to-height ratio (W-HtR) to tackle this critical issue.
Business Today quoted, Dr Anoop Misra, Director of the Fortis CDOC Centre of Excellence for Diabetes, Metabolic Diseases, and Endocrinology in New Delhi (and one of the authors of the report), as saying.: “Obesity should not be reduced to excess weight alone; it affects the body on a systemic level. Current BMI-based assessments often fail to accurately reflect adiposity, either underestimating or overestimating it.”
Comprehensive approach
Dr Misra explained that the previous guidelines, published in 2009, relied solely on BMI, which overlooks critical factors. “Asian Indians, for example, tend to accumulate fat at lower BMI levels compared to Western populations, leading to conditions like Type 2 diabetes at an earlier stage,” he noted. As a result, the updated guidelines now advocate for a more comprehensive approach that includes waist circumference, waist-to-height ratio, comorbidities, and the impact of obesity on daily activities, in addition to BMI.
While the guidelines are good for classification, the fact is India has an epidemic of obese people. According to a recent blog by Sir Ganga Ram Hospital: ‘’ India has the third-highest percentage of obese persons in the world…Over the past 10 years, India’s obesity rate has almost tripled, impacting both the country’s urban and rural populations. A global crisis of obesity is affecting people of all ages.” Data indicates that obesity rates are high in India, coinciding with the nation’s fast economic expansion and changing lifestyle standards. More than 100 million people in India struggle with obesity. It is observed that abdominal obesity is highly prevalent.
Communication drive
According to the National Family Health Survey-5 (2019-21), 23 per cent of women and 22.1 per cent of men in India are overweight. Kerala, Tamil Nadu Punjab and Delhi have high incidence rates while Madhya Pradesh and Jharkhand have low prevalence.
The classification is only bound to exacerbate the problem. Considering that abdominal fat is going to be the key driver in classification, the epidemic is only likely to be turbocharged with the numbers skyrocketing. What one needs is a huge communication drive to educate people to exercise more, lead a healthy life and understand the dangers of having a tummy.
