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Obesity Pillars Roundtable: Obesity and South Asians
Harold Edward Bays1, Amardeep Shrestha2, Varalakshmi Niranjan3
1Diplomate of American Board of Obesity Medicine, Medical Director/President Louisville Metabolic and Atherosclerosis Research Center, Clinical Associate Professor/University of Louisville Medical School, 3288 Illinois Avenue, Louisville, KY, 40213, USA.
Obesity Pillars
|November 22, 2023
Summary
Individuals from South Asia with obesity face higher risks of cardiovascular disease (CVD) due to unique metabolic and anatomical responses. This includes increased visceral fat and endocrine/immune issues, leading to more CVD risk factors.
Area of Science:
- Endocrinology
- Metabolic Syndrome
- Cardiovascular Disease
Background:
- South Asian populations with obesity exhibit heightened susceptibility to cardiovascular disease (CVD) risk factors and events.
- This increased risk is linked to adiposopathic responses, including abnormal endocrine and immune effects from adipocyte hypertrophy and visceral fat accumulation.
- Genetic, epigenetic, nutritional, and physical activity factors contribute to this predisposition in South Asians.
Purpose of the Study:
- To discuss the clinical management of obesity in patients of South Asian descent.
- To highlight the unique physiological characteristics contributing to CVD risk in this population.
- To emphasize a patient-centered approach in diagnosis and treatment.
Main Methods:
- A roundtable discussion format was employed.
- Four obesity specialists with expertise in managing South Asian patients participated.
- Clinical diagnostic and treatment strategies were discussed.
Main Results:
- Obesity in South Asians is associated with larger adipocytes, reduced functional adipocytes, and increased visceral adiposity.
- These factors contribute to endocrine and immune abnormalities, explaining elevated CVD risk.
- Specific CVD risk factors include metabolic syndrome (even at lower BMI), insulin resistance, type 2 diabetes, elevated lipoprotein (a), and specific dyslipidemia patterns.
Conclusions:
- Obesity in South Asians presents with distinct anatomical and metabolic features that increase cardiovascular risk.
- Understanding these unique aspects is crucial for effective clinical management.
- A patient-centered approach tailored to the South Asian population is recommended for diagnosis and treatment.
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