New Delhi: Amid the ongoing COVID-19 pandemic, All India Institute of Medical Sciences (AIIMS), Delhi in a study observed obesity and allied comorbidities pose an enormous healthcare burden that requires a lifestyle modification by counselling and support from the provider.
The study titled 'Practice-based recommendations Lifestyle-related advice in the management of obesity: A step-wise approach' stated that, "physicians' regular encounter with obese patients and involvement in all aspects of medical management such as assessment, counselling and management of multidisciplinary teams makes them important stakeholders. For better prevention and management of obesity practise based recommendation is required".
At the initial stages of management, lifestyle-related advice on diet and physical activity is recommended.
"Lifestyle intervention programs such as Diabetes Prevention Program (DPP) and Action for Health in Diabetes (Look AHEAD) target weight reduction of 5 per cent-10 per cent and correction in metabolic parameters such as glycosylated haemoglobin, blood pressure, and lipid profile."
Pharmacotherapy is introduced at body mass index (BMI) '>30 kg/m2 or BMI >27 kg/m2 with comorbidities', with an expected response of 5 per cent weight reduction in three months. The last stage is surgical intervention.
"A moderate calorie deficit diet of 1000-1200 kcal for women and 1500-1800 kcal for men is generally recommended for dietary management. Patients on very low calorie diets (<800 kcal) experience weight cycling, i.e., recurrent losing and gaining weight. The calculated calorie intake should be accurately balanced between different food groups" Dr Piyush Ranjan, Additional Professor Department of Medicine, AIIMS says.
The study added, "Long term effect of Covid 19 on lifestyle, the study suggests time to wake up to avoid chronic illness".
The study made the observation that physicians should classify patients with established coronary heart disease, diabetes and sleep apnea as a high risk group.
A history of multiple risk factors like hypertension, deranged lipid profile (high low-density lipoprotein and low high-density lipoproteins), impaired glucose fasting and family history of heart disease should be elicited.
"A deduction of 500-750 kcal from this intake should be initiated. In clinical practice, a standard diet of 1200-1500 kcal for females and 1500-1800 kcal for males is recommended. A progressive reduction of calories is suggested. This deficit will help in achieving about half kilogram per week of weight loss," the study reads.
While considering socialising and eating out a part of the lifestyle it says patients to avoid dishes with "cream, fried, mayonnaise, pesto, mozzarella, basted, casserole, refined flour and honey-mustard sauce etc."
The review is a consolidation of practical dietary approaches "which can be incorporated in standard obesity care by general practitioners".