Obesity Is More Than a Lifestyle Issue

Health experts are calling for a major shift in how India understands and manages obesity. A joint expert document prepared by the Obesity and Metabolic Surgery Society of India (OSSI) and the Endocrine Society of India (ESI) describes obesity as a chronic disease requiring timely recognition, scientific treatment and long term care.

The experts argue that simply telling people to “eat less and exercise more” oversimplifies a condition influenced by multiple biological and social factors.

Why Obesity Needs a Different Approach

Obesity is influenced by a complex combination of genetic, metabolic, endocrine, environmental, psychological, socioeconomic and lifestyle factors.

This means two people with similar body weights may have very different health risks and may respond differently to treatment.

The experts therefore emphasise moving away from blame and focusing instead on improving the person’s overall health and reducing obesity related complications.

BMI Alone May Not Tell the Full Story

One of the key recommendations is to avoid using BMI or body weight alone to determine the severity of obesity or decide on treatment.

The expert document points out that Indian populations can develop metabolic complications such as type 2 diabetes and cardiovascular disease at comparatively lower BMI levels and younger ages than many Western populations.

This makes assessment of overall metabolic health particularly important in Indian patients.

Lifestyle Changes Still Matter

The new approach does not dismiss healthy eating or physical activity.

Nutrition, exercise, sleep and behavioural changes remain important components of obesity management. However, experts stress that these measures should be individualised rather than treated as a universal solution.

The appropriate treatment strategy should depend on the person’s disease severity, health risks, medical history and response to earlier interventions.

Treatment Can Go Beyond Lifestyle Modification

For some patients, lifestyle interventions alone may not provide adequate improvement.

Depending on individual needs, the consensus recommends considering psychological support, obesity management medications, endoscopic therapies and metabolic or bariatric surgery.

These options should not be viewed as competing approaches. Instead, they can serve different roles at different stages of the disease and may be adjusted as a patient’s health needs change.

Early Treatment Could Prevent Complications

Experts describe obesity as a progressive and relapsing disease. Delaying appropriate treatment can allow obesity and its associated complications to worsen.

Early recognition and personalised intervention could therefore help patients address metabolic risks before they develop into more serious health problems.

Tackling Stigma Is Part of Treatment

The experts also highlight the psychological impact of obesity related stigma.

People living with obesity may experience guilt, shame and reluctance to seek medical help when their condition is viewed simply as a consequence of poor choices or insufficient willpower.

A more compassionate, stigma free approach could encourage people to seek timely professional care and remain engaged with long term treatment.

Prevention Needs a Wider Public Health Strategy

The consensus also calls for action beyond individual clinical care.

Experts recommend measures such as clearer food labelling, healthier school environments and stronger public awareness initiatives. These population level strategies can complement clinical treatment and help create environments that support healthier choices.

What This Means for India’s Healthcare System

Recognising obesity as a chronic disease could encourage healthcare providers to develop more structured obesity care pathways.

Doctors may increasingly need to assess not just weight, but also metabolic health, psychological wellbeing and associated conditions. Hospitals and clinics can potentially integrate multidisciplinary services involving physicians, endocrinologists, nutrition professionals, psychologists and bariatric specialists.