Obes Surg. 2026 Aug 3. doi: 10.1007/s11695-026-08870-4. Online ahead of print.
ABSTRACT
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.
PMID:42545588 | DOI:10.1007/s11695-026-08870-4