Obesity is increasingly recognized as a chronic, relapsing disease with profound implications for cardiovascular health. In India, the prevalence of overweight and obesity is rising rapidly, contributing to an earlier onset of coronary artery disease (CAD), heart failure with preserved ejection fraction (HFpEF), and other cardiometabolic complications compared to Western populations. Effective management requires a combination of lifestyle, pharmacologic, and system-level strategies.

Recognition of obesity as a chronic disease is essential to shift clinical practice from episodic interventions to sustained, multidisciplinary care. Clinicians must integrate weight management into routine cardiovascular care, emphasizing early risk identification and individualized treatment plans. The current burden in India underscores the need for culturally adapted approaches that address dietary patterns, physical activity limitations, and socioeconomic determinants of health.

Standardized treatment algorithms are critical for improving outcomes. These should outline clear thresholds for initiating pharmacotherapy, selection of agents based on comorbidities, and integration with lifestyle interventions. Evidence-based anti-obesity medications, such as GLP-1 receptor agonists, dual/triple agonists, and emerging oral agents, can be safely incorporated into cardiovascular care, providing additional benefits beyond weight loss, including improvements in blood pressure, lipid profiles, and glycemic control.

Successful management also requires a multidisciplinary approach, involving endocrinologists, cardiologists, dietitians, and behavioral therapists. Patient education and regular follow-up are key to adherence and long-term success.

At the health system level, policy recommendations should support access to pharmacotherapy, development of obesity clinics, reimbursement for multidisciplinary care, and nationwide awareness programs. By integrating clinical, pharmacologic, and policy measures, Indian healthcare providers can more effectively address the dual challenges of obesity and cardiovascular disease, improving overall health outcomes and reducing the burden on healthcare systems.

What for Practice:

• Multidisciplinary approach (cardiology + endocrinology)
• Standardized treatment algorithms needed

Reference: Kalra S, Kesavadev J, Goel R, Lakdawala M, Agrawal V, Malhotra N, et al. Burden of Obesity in India: Need for Policy Changes to Attain Highest Possible Level of Health and Well Being. Clin Obes. 2026 Apr;16(2):e70072. doi:10.1111/cob.70072.