Obesity is a global health crisis affecting developing nations, including India. The management of obesity continues to evolve with newer drugs, metabolic and bariatric surgery and endoscopic interventions, requiring family physicians and specialists to adapt their clinical practice accordingly. There is an urgent need for a standardized algorithm to diagnose, stage, and treat obesity. The Endocrine Society of India (ESI) and the Obesity Surgeons Society of India (OSSI) appointed a steering committee to develop an evidence-based algorithm for managing patients with obesity in India. This was put to vote by 80 specialists (38 from OSSI and 42 from ESI) in a physical meeting. A proposed stage-wise algorithm based on Edmonton Obesity Staging System, Asian definition of obesity, and resources in India, received 100
INTRODUCTION:This study aimed to examine the impact of metabolic and bariatric surgery (MBS) on key micronutrients in patients with obesity over 10 years. PATIENTS AND METHODS:A retrospective chart review was carried out for individuals who had MBS from February 2013 to May 2022 at 11 centres. The micronutrient (iron, Vitamin B12, Vitamin D3 and calcium) levels were collected before surgery and up to 10 years afterwards. RESULTS:The data from 1675 individuals with a mean age of 43.09 ± 11.93 years were analysed. The study population comprised 34.81% of males and 65.19% of females. There was an increase in the serum iron levels over 1 year (P < 0.01), 3 years (P < 0.01), 5 years (P = 0.2175), 7 years (P < 0.01) and 10 years (P = 0.0998) after surgery. Similar results were observed for Vitamin B12 levels at 1 year (P < 0.01), 3 years (P < 0.01), 5 years (P = 0.3083), 7 years (P = 0.2817) and 10 years (P = 0.2645). Vitamin D3 levels increased at 1 year (P < 0.01), 3 years (P < 0.01), 5 years (P < 0.01), 7 years (P = 0.0069) and 10 years (P = 0.8179). However, calcium levels exhibited a downwards trend at 5 years (P = 0.0008) post-surgery. CONCLUSIONS:A high prevalence of micronutrient deficiency was observed amongst patients preoperatively, which improved following MBS.
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. 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
