Obesity in South Asia: Phenotype, Morbidities, and Mitigation
Purpose of Review
Obesity has increased in South Asian countries that are still grappling with undernutrition. In this review, we highlight the characteristics of obesity, its relation to morbidities, and its management in South Asians. A literature search was conducted using relevant search engines and based on key words focusing on obesity in South Asians.
The increasing trend in obesity prevalence is caused by imbalanced diets and physical inactivity. South Asians, in general, have higher body fat and lower skeletal muscle mass at the same or lower BMIs compared to white people (“high body fat-normal BMI-low muscle mass” phenotype). In addition, excess abdominal adiposity, typically seen in South Asians, and increased hepatic fat (non-alcoholic fatty liver disease) are associated with an increased risk for type 2 diabetes and cardiovascular disease. Challenges in treatment include lack of awareness regarding correct diets and non-compliance to diet and exercise regimens. Social and cultural issues limit physical activity in South Asian women. Finally, there is a lack of expert health professionals to deal with increased cases of obesity. Aggressive management of obesity is required in South Asians, with more intensive and earlier diet and exercise interventions (i.e., at lower BMI levels than internationally accepted). At a population level, there is no clear policy for tackling obesity in any South Asian country. Prevention strategies focusing on obesity in childhood and the creation of food and activity environments that encourage healthy lifestyles should be firmly applied.
Obesity in South Asians should be evaluated with ethnic-specific guidelines and prevention and management strategies should be applied early and aggressively.
KeywordsObesity Management Comorbidities Counseling South Asians Asian Indians Diet Physical activity Pharmacotherapy Bariatric surgery
Compliance with Ethical Standards
Conflict of Interest
Anoop Misra has received research funding from Herbalife International and has received compensation from Dr. Reddy’s Laboratories, Boehringer Ingelheim, AstraZeneca, Janssen, Sanofi-Aventis, and Lilly for service as a consultant. Ranil Jayawardena declares that he has no conflict of interest. Shajith Anoop declares that he has no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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