Multimodal Approach to Obesity Management – Essentials to Setup Obesity Exemplars in India

This chapter examines the essential components required to establish effective obesity clinics and obesity exemplars in India within the context of the country’s distinct “thin–fat” phenotype, higher visceral adiposity, and elevated cardiometabolic risk at lower body mass index (BMI) thresholds. It highlights the limitations of BMI-centric assessment and supports an India-specific approach incorporating waist measures, early risk profiling, Edmonton Obesity Staging System, and complication-based stratification. The review integrates Indian epidemiologic data, Endocrine Society of India guidance, staging recommendations, and practical frameworks for obesity clinic development. It outlines a stepwise model for clinic establishment encompassing obesity education, selection of practice model, infrastructure and equipment readiness, multidisciplinary team development, structured obesity management programs, and continuous quality improvement. The chapter further describes the progression from preclinic to standard clinic, advanced clinic, and center of excellence, with emphasis on stigma-free care, standardized workflows, longitudinal follow-up, digital integration, and real-world evidence generation. Overall, it supports an India-adapted, Chronic Care Model for obesity management in which visceral adiposity awareness assessment, complication-centric staging, and scalable multidisciplinary clinic systems are central to improving long-term outcomes.