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Who are we?

What is Symbolic Care?

Symbolic care is your exclusive patient support program that assists you to follow your prescribed therapy correctly and stay consistent with your treatment plan.

How Symbolic Care Supports your journey?

Personalised Care: Individualized assistance on your prescribed therapy initiation and support to help you feel confident in your care plan.

Therapy Adherence: Simplified guidance to stay consistent with your therapy and feel confident in your care plan.

Understanding Obesity

What is Obesity?

Doctors use Body Mass Index (BMI) to check weight status. For Indians and other Asian populations, the risk of diabetes and heart disease starts at lower BMI values.

BMI Cut-offs for Indians (Asian Guidelines)

Normal weight18.5 to 22.9
OverweightBMI 23 or above
ObesityBMI 25 or above

These numbers are followed in India because Asians have higher body fat and more tummy fat at lower weight.

Is Obesity a Disease?

Yes. Obesity is now recognised by global medical bodies as a:

"Chronic, relapsing, neurohormonal medical condition."

  • Chronic: It lasts long-term, like diabetes or high BP.
  • Relapsing: Weight regain is common because the body tries to go back to old weight.
  • Neurohormonal: The brain and hormones control appetite, metabolism, and fat storage.

What Do Major Health Organizations Say?

  • World Health Organization (WHO): Obesity is a chronic disease. Asian BMI cut-offs should be used for risk assessment. Long-term care may include lifestyle changes, medicines, or surgery.
  • ICMR (Indian Council of Medical Research): Uses Overweight ≥23 and Obesity ≥25 for Indians. Advises medical evaluation for metabolic risks.
  • ADA (American Diabetes Association): Calls obesity a chronic, relapsing neurohormonal disease. Recommends stepwise treatment like diet, activity, counselling, and medications.

Factors causing Obesity

1. Genetics

  • Gain weight faster.
  • Store more fat around the stomach.
  • Have a slower metabolism.
  • Develop diabetes at lower weight.

Inheritance accounts for 40-70% of a person’s obesity risk.

2. Metabolic Adaptation

  • Lowers metabolism (burns fewer calories).
  • Increases hunger hormones (ghrelin).
  • Decreases fullness hormones (leptin).

This is why weight regain happens: it is biology, not lack of willpower.

Key Takeaways for Indians with Obesity

  • Obesity is defined at BMI ≥25 for Indians.
  • It is a medical condition, not a personal weakness.
  • Genes, hormones, and metabolism play a large role in weight gain.
  • WHO, ICMR, and ADA recommend long-term, scientific treatment.

What is the "Thin-Fat Indian" Phenotype?

Many Indians may look thin or normal weight from the outside but still have high body fat inside the body, especially around the stomach.

This pattern is called the Thin-Fat Indian Phenotype.

It means a person may have normal BMI but more total body fat, less muscle mass, and more fat stored around the tummy (visceral fat).

This hidden fat increases the chance of many chronic diseases like diabetes, high blood pressure, high cholesterol, and fatty liver.

Why Are Indians More Prone to This?

1. Naturally lower muscle mass

Indians generally have less muscle, which lowers metabolism.

2. Higher body fat at the same weight

Indians may have 3-5% more body fat than Europeans at the same BMI.

3. Effects of early childhood nutrition

Babies born small or undernourished tend to store fat easily as adults.

4. Lifestyle habits

Low physical activity plus a high-carb diet can lead to higher fat gain.

What is Central Obesity? (Stomach Fat)

Central obesity means too much fat around the waist and internal organs.

MenMore than 90 cm (35 inches)
WomenMore than 80 cm (31.5 inches)

Even if one’s body looks thin, a large waist increases health risk. Central obesity increases the risk of diabetes, high BP, heart disease, fatty liver, and PCOS in women, even at lower weight.

Nutritional Guidelines

Calorie Counter

Estimated calories: 130 kcal

These are simple estimates for patient education.

Nutrition guidance for patients on GLP-1 therapy

  • Keep meals regular and avoid long gaps that can increase hunger later.
  • Build meals around protein, vegetables, pulses, curd, eggs, or other lean options.
  • Choose smaller portions if appetite is low or if nausea is present.
  • Limit sugary drinks, frequent fried snacks, and ultra-processed foods.
  • Drink water steadily through the day instead of waiting until you feel very thirsty.

Key nutrition facts and practical dietary guidance

  • GLP-1 medicines reduce appetite and slow stomach emptying, so people often feel full sooner and may tolerate smaller portions better.
  • Eating too little for long periods is not the goal. Poor intake can raise the risk of dehydration, constipation, nutrient gaps, and unwanted muscle loss.
  • Protein remains important during weight loss because it helps preserve lean body mass, especially when combined with strength or resistance activity.
  • Fibre can help with fullness and constipation, but it should be increased gradually and taken with enough fluids to avoid worsening bloating or discomfort.
  • Common stomach-related side effects include nausea, vomiting, constipation, diarrhoea, and heartburn. These are often more noticeable early in treatment and after dose escalation.
  • If a patient cannot keep fluids down, feels light-headed, or has persistent vomiting, they should contact their clinician promptly rather than trying to push through symptoms.

This section is educational and should be tailored by the treating clinician based on diabetes status, kidney function, appetite, and tolerance.

Physical Exercise

What are calories?

Calories are a measure of energy. Food and drinks provide calories, and your body uses that energy to support basic functions such as breathing and circulation, as well as daily movement and exercise.

How do calories relate to weight loss?

When you are active, your body uses more energy, so you burn more calories. Over time, weight loss happens when the calories you burn are greater than the calories you take in. Exercise supports that process, while food intake still plays a major role in creating the overall calorie deficit.

Calorie Burner

Enter weight and duration to estimate calories burned.

This calculator gives a simple estimate. Actual calories burned vary with body size, effort, pace, and fitness level.

Physical exercise, resistance training, and key health facts

  • Start with walking or other low-impact movement most days of the week.
  • Add resistance or strength work to help protect muscle mass.
  • Increase time slowly so the routine feels sustainable.
  • Break long sitting periods with short movement breaks through the day.
  • If knee pain, breathlessness, or other symptoms are present, choose lower-impact options and seek medical advice when needed.

This section is educational and should be adapted to the patient’s age, mobility, cardiovascular risk, and medical conditions.

BMI

Calculate your BMI

Choose gender Select one
Your BMI --

Enter height and weight

Healthy weight range -- Estimated from BMI 18.5 to 22.9

What is BMI?

BMI is a simple screening tool based on height and weight. It helps identify weight-related risk, but it does not tell the full story on its own.

For Indian adults, BMI 23 and above suggests overweight risk and BMI 25 and above suggests obesity risk. Waist size adds important information because central obesity carries its own risks.

Other ways to check risk

  • Use a soft measuring tape around the waist after a normal breath out.
  • Measure around the midpoint between the lower ribs and the top of the hip.
  • A higher waist value can signal central obesity even when BMI looks lower.
Personal support

Trust Symbolic Care in your healthcare journey!

Speak with our care team for personal counselling and guidance on the next step.

FAQs

Questions patients often ask

Where should I begin?

Start with one change you can realistically continue, such as regular meals, a short daily walk, better sleep, or taking your treatment as advised. Small steps are easier to maintain than trying to change everything at once.

Do I need to do everything perfectly?

No. Progress usually comes from consistency, not perfection. Missing a walk, eating out once, or having a difficult day does not undo your effort. What matters is returning to your routine.

What if I have tried before and not seen lasting results?

That is common. Many people need support, structure, and time before they find an approach that works for them. A setback is not failure. It is often a sign that the plan needs to be more practical, more supportive, or better matched to your life.

Can small daily changes really make a difference?

Yes. Repeated everyday habits shape long-term progress. A little more movement, more regular meals, better hydration, and better sleep can add up over time and help you stay on track.

How do I stay motivated on difficult days?

Keep the goal simple. Focus on the next healthy choice instead of the whole journey. Some people find it helpful to track small wins, follow a routine, or speak regularly with a doctor, counsellor, or family member who can encourage them.

When should I speak to a doctor?

Speak to a doctor if weight is affecting your energy, confidence, mobility, sleep, blood sugar, blood pressure, or overall health, or if you feel unsure about what to do next. It is better to ask early than wait until problems become harder to manage.

Can my family help me in this journey?

Yes. Support from family can make healthy routines easier. Shared meals, walking together, encouragement, and a non-judgmental environment often help people stay consistent.

What should I remember most?

Be patient with yourself. Health improvement is usually gradual. A steady, realistic plan with ongoing support is often more effective than quick fixes.

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