Obesity Treatment​ in Hyderabad, India

PACE Hospitals is recognized as the best hospital for obesity treatment in Hyderabad, offering expert care for patients with abdominal obesity, morbid obesity, childhood obesity, and truncal / central obesity. Our specialists focus on precise obesity diagnosis and treatment, ensuring personalized solutions for every individual.

As one of the leading obesity hospitals in Hyderabad, we provide advanced treatment plans including lifestyle modification, dietary counseling, medical management, and minimally invasive bariatric procedures when required. Each approach is designed to achieve safe weight reduction, improve overall health, and prevent obesity-related complications.

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Obesity Treatment

Why Choose PACE Hospitals for Obesity Treatment​?

Obesity is a multifactorial and complex health condition which requires a detailed and systemic approach to diagnosis. Diagnostic approaches are meant not only to establish the presence of obesity but also to identify and address underlying causes, measure the severity of the condition, and assess the health risks associated with it. The physician or endocrinologist considers the following before selecting the appropriate tests to diagnose obesity: 

• Medical history 
• Physical examination 

Medical history

A thorough medical history includes assessment of weight since childhood, previous weight loss attempts, dietary habits, physical activity levels, sleep patterns, and psychosocial factors. It is essential to review medications that may contribute to weight gain, such as corticosteroids, antipsychotics, or some antidepressants and screen for symptoms of secondary causes, such as hypothyroidism or Cushing's Syndrome. Family history of obesity, diabetes, cardiovascular disease, and metabolic syndrome needs to be documented. 

Physical examination

Physical examination focuses on measuring height, weight, body mass index (BMI), and waist circumference to assess central adiposity. Blood pressure, heart rate, and signs of obesity-related complications such as acanthosis nigricans, joint pain, or edema are evaluated. The distribution of body fat, specifically between central and peripheral obesity, provides additional information about metabolic risk.

Diagnostic Tests for Obesity

Based on the above information, a physician or endocrinologist advises the diagnostic tests to evaluate obesity and its related complications. The following are the tests that might be recommended to assess obesity:

Laboratory tests 

• Fasting blood glucose and HbA1c: These tests screen for impaired glucose metabolism and diabetes, a common complication of obesity. Fasting blood glucose measures blood sugar after an overnight fast, while HbA1c reflects average blood sugar levels over the past 2–3 months, this assists in the diagnosis and monitoring of diabetes. Collectively, offers a comprehensive view of both short-term and long-term diabetes control.

• Lipid profile: This panel assesses cholesterol fractions such as high-density lipoprotein (HDL) and low-density lipoprotein (LDL)and triglycerides, identifying dyslipidemia associated with obesity-related cardiovascular risk. Early detection enables timely management to reduce heart disease risk. Abnormal lipid levels often coexist with other metabolic issues, forming part of the metabolic syndrome.

• Liver function tests: In order to screen for nonalcoholic fatty liver disease (NAFLD), which is commonly identified in obese people because of the buildup of fat in the liver, these analyses of proteins and enzymes. Regular check-ups can assist with recognising liver dysfunction before it progresses to irreversible damage.

• Thyroid function tests: Measurement of thyroid hormones (TSH, free T4) helps rule out hypothyroidism, which is an endocrine disorder that contributes to weight gain and complicates obesity management because thyroid dysfunction is vital for metabolic function and treatment outcomes.

• Renal function tests and electrolytes: These tests assess the kidney function and the electrolyte balances; they have an impact since fat increases the risk of high blood pressure (Hypertension) and renal disease. Proper kidney function is critical for maintaining fluid balance and controlling blood pressure.

• Sleep studies (polysomnography): For individuals with suspected obstructive sleep apnea, characterised by repetitive airway obstruction during sleep, the sleep studies provide a definitive diagnosis. This condition is strongly linked to obesity and can worsen metabolic and cardiovascular status.

Imaging studies

• Computed Tomography (CT) scans: CT scans are the gold standard for measuring visceral fat in obesity investigations, as they provide comprehensive pictures that distinguish between bad visceral and subcutaneous fat. They offer automated, precise measurements of fat distribution, which is critical for determining metabolic risk. However, exposure to ionising radiation limits its frequent usage, particularly in youngsters and for routine screenings. Despite this, obese patients frequently require additional CT scans due to a higher incidence of linked health conditions. The technology is expensive and needs specialised analysis.

• Magnetic Resonance Imaging (MRI) scans: MRI provides good soft tissue contrast without using radiation, making it suitable for securely tracking changes in fat distribution over time. It may differentiate between different fat types and even quantify total body fat. Advances now enable faster, automated scans, making them more feasible for clinical research. However, MRI is more expensive, less accessible, and takes longer than CT. These elements limit their routine clinical application in obesity assessment.

• Dual-Energy CT (DECT) scan: DECT enhances image quality in obese patients by combining two X-ray energies, resulting in crisper images with less noise and more contrast. Studies suggest that it works effectively even in larger patients, with image quality unaffected by body size. DECT also permits enhanced material decomposition, which improves diagnostic accuracy. The cost and variety of systems further limit their widespread adoption.

• Abdominal ultrasound: This non-invasive imaging modality can detect fatty infiltration of the liver, helping confirm or exclude fatty liver disease in obese patients and guide further management.

Stages of Obesity

Obesity is recognised as a chronic, progressive, and relapsing disease that extends beyond simple measurements of body weight or BMI. Clinical staging systems, such as the American Association of Clinical Endocrinologists (AACE) Adiposity-Based Chronic Disease (ABCD) model, classify obesity based on the presence and severity of related complications. This approach allows healthcare professionals to individualise management strategies, focusing on the prevention, early detection, and treatment of obesity-related health issues rather than BMI alone. It includes the following:

Stage 1: Obesity without complications

Individuals have an elevated body mass index (BMI) but no detectable obesity related health issues or functional limitations.

At this stage, the focus is often on preventing future complications through lifestyle modifications such as diet, physical activity, and behavioural changes. Early intervention can be highly effective in halting disease progression.

Stage 2: Obesity with mild to moderate complications

Obesity is accompanied by early or moderate health issues such as prediabetes, borderline hypertension, dyslipidemia, mild sleep apnea, or osteoarthritis.

While the complications are manageable, they indicate the body is beginning to be affected. To prevent worsening health, treatment involves structured weight management strategies, which include medication or supervised programs.

Stage 3: Obesity with severe complications

This stage involves severe, often chronic conditions like uncontrolled type 2 diabetes, cardiovascular disease, severe sleep apnea, or advanced NAFLD/NASH.

At this point, obesity is directly contributing to significant organ damage or functional impairment. Intensive intervention, including medical therapy, possible bariatric surgery, and comprehensive multidisciplinary care, is typically required to manage both weight and comorbidities.

Obesity differential diagnosis

Endocrine and metabolic disorders encompass a broad spectrum of conditions that can present with overlapping clinical features, making accurate diagnosis essential for effective management. Below are the conditions that are included under the differential diagnosis of obesity: 

• Hypothyroidism: An endocrine disorder characterized by insufficient secretion of thyroid hormones, often resulting in weight gain, fatigue, and cold intolerance. Thyroid function tests, like thyroid-stimulating hormone (TSH) and free T4, are essential to confirm the diagnosis and help distinguish it from obesity caused by caloric excess.
• Cushing Syndrome: This condition involves chronic exposure to excess cortisol, which causes central obesity, facial rounding like moon face, and muscle wasting. Clinical signs such as purple striae and proximal muscle weakness, along with tests like 24-hour urinary cortisol or dexamethasone suppression, help clarify the cause.
• Polycystic ovary syndrome: A common endocrine disorder in women, marked by insulin resistance, hyperandrogenism, and ovulatory dysfunction. Weight gain in PCOS is often accompanied by acne, hirsutism, and menstrual irregularities, helping clinicians distinguish it from uncomplicated obesity.
• Genetic obesity syndromes: Conditions such as Prader-Willi, Bardet-Biedl, and leptin deficiency syndromes typically present with early-onset obesity, developmental delays, and abnormal appetite regulation. Genetic testing and associated phenotypic features support diagnosis.
• Lipodystrophy (generalised or partial): This disorder involves the loss or abnormal distribution of adipose tissue, frequently accompanied by severe insulin resistance and metabolic complications. Unlike obesity, fat is absent or displaced rather than excessive. Diagnosis is based on physical appearance, metabolic profile, and genetic or acquired etiology.
• Medication-induced weight gain: Certain medications, such as antipsychotics, corticosteroids, insulin, and some antidepressants, leads to weight gain as a side effect. A thorough medication history, especially correlated with the timeline of weight changes, often reveals the underlying cause.
• Hypothalamic obesity: Occurs following damage to the hypothalamus from tumors, trauma, or surgery, resulting in uncontrollable hunger known as hyperphagia and reduced energy expenditure. Rapid weight gain, resistance to lifestyle interventions, and a relevant medical history are key indicators.
• Depression and psychiatric disorders: Mood and behavioural disorders can affect body weight through altered appetite, decreased physical activity, and medication side effects. A psychiatric assessment is usually required to identify this underlying causes.
• Pseudohypoparathyroidism: A rare genetic disorder characterized by resistance to parathyroid hormone, often associated with short stature, developmental delays, and obesity. Diagnosis is supported by biochemical markers such as low calcium and high PTH levels.
• Acromegaly: While known for somatic overgrowth, such as enlarged hands, feet, and facial features. Acromegaly may also contribute to insulin resistance and altered body composition. Elevated growth hormone and IGF-1 levels confirm the diagnosis.
• Adipose dolorosa (dercum’s disease): A rare disorder marked by painful fatty deposits, primarily affecting obese, middle-aged women. The presence of pain in adipose tissue, fatigue, and depression sets this condition apart from standard obesity.
• Metabolic syndrome: A constellation of metabolic abnormalities including central obesity, dyslipidemia, hypertension, and insulin resistance. Diagnosis relies on meeting specific clinical and laboratory criteria, such as waist circumference, fasting glucose, triglycerides, and HDL levels.
• Fluid retention or ascites: Conditions like liver cirrhosis, heart failure, or nephrotic syndrome may cause fluid accumulation simulating weight gain. Physical examination, abdominal imaging, and ascitic fluid analysis help clarify the nature of the swelling.
• Fluid Retention or ascites: Conditions causing fluid accumulation can mimic weight gain. Differentiated by physical exam, imaging, and fluid analysis.

Obesity Treatment Goals

The goals of obesity treatment are to attain and maintain a healthier body weight, reduce obesity-related health risks, and improve quality of life. Specifically, the therapy aims to:

• Aim to avoid more weight gain.
• Reduce body weight by an initial target of about 5% to 10% from baseline, which can improve obesity-related complications and set the stage for further weight loss if needed.
• Maintain the obtained weight loss over the long term to avoid regaining weight.
• Improve physical activity and eating behaviours through dietary, behavioural, and sometimes medical or surgical interventions.

These goals focus on gradual, sustained progress tailored to the individual's health status and preferences, emphasising lifestyle changes combined with other therapies when appropriate.

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Since obesity is a chronic condition with complex causes and no definitive cure, the focus is on long-term management through lifestyle changes, medical interventions, and sometimes surgical procedures. Treatment strategies are personalized based on the individual's degree of obesity, associated health risks, and other personal factors. The approach generally includes:

• Nonpharmacological treatment 
• Pharmacological treatment 
• Surgical procedures 

Nonpharmacological management

• Dietary modifications
• Physical activity
• Behavioural therapy

• Dietary management: A calorie-reduced, balanced diet is recommended, emphasizing lean proteins, vegetables, healthy fats, fruits and whole grains. Reducing sugary drinks, processed foods, and high-fat foods is essential. Individualized meal planning with a registered dietitian improves adherence and outcomes.
  
• Physical activity: At least 150 minutes per week of moderate-intensity aerobic activity, such as brisk walking or cycling, is advised, along with muscle-strengthening activities on two or more days per week. Gradual increases in activity are encouraged.
  
• Behavioural therapy: Behavioural strategies such as self-monitoring, goal setting, problem-solving, and cognitive-behavioural therapy (CBT) help people to adopt and maintain healthy habits. Structured weight loss programs and support groups can enhance motivation and accountability.

Pharmacological treatment 

Pharmacotherapy for obesity is recommended when lifestyle interventions alone are inadequate, particularly for adults with a BMI of 30 kg/m² or ≥27 kg/m² with obesity-related complications. To achieve clinically significant and long-term weight loss, medications target many pathways such as appetite management, gut hormone modulation, and fat absorption. Therapy selection is based on efficacy, safety, and individual patient factors, and treatment includes: 

With medications: Medications that are considered for adults with a BMI ≥30 kg/m², or ≥27 kg/m² with at least one obesity-related complication, when lifestyle changes alone are insufficient. Medication categories used in long-term obesity management include:

• GLP-1 receptor agonists: These are also known as Gut hormone modulators, these medications mimic or enhance hormones in the gut that regulate appetite and satiety, leading to reduced hunger and increased feelings of fullness. They can provide significant weight reduction along with benefits for metabolic health. Gastrointestinal side effects are common.
• Combination agents: These combine medications with different mechanisms, often working on appetite signals in the brain and reducing food cravings. They offer increased weight loss compared to single agents and may impact both appetite and reward pathways.
• Lipase inhibitors: It is also called fat absorption inhibitors. These prevent the absorption of some of the dietary fat in the intestine, resulting in decreased calorie intake. They can be used long-term but may cause gastrointestinal side effects, especially if dietary fat intake is not reduced.

Surgical management

Bariatric surgery

Surgical intervention is the most effective long-term option for severe obesity (BMI ≥40 kg/m², or ≥35 kg/m² with comorbidities) when other treatments have not worked. Surgical options may include procedures that reduce stomach size or alter digestive pathways. Surgery can lead to significant and long-term weight loss and improvement in obesity-related diseases. Improvement in obesity-related diseases, but requires lifelong monitoring for nutritional deficiencies and surgical complications.

Supportive and adjunctive measures

• Psychological counselling: To address underlying psychological or emotional issues related to eating behaviours or self-image.
• Treatment of secondary obesity: Managing hormonal disorders, genetic conditions, or medication-induced weight gain as appropriate.
• Managing comorbidities: Regular evaluation and treatment of conditions commonly associated with obesity, such as elevated cholesterol, abnormal glucose tolerance, high blood pressure, sleep disorders, and mood disorders.

Prognosis of obesity

Prognosis varies based on the degree of obesity, associated health conditions, and the effectiveness of management strategies. Obesity is a chronic condition with complex causes and often requires long-term treatment. The overall prognosis can be favorable with sustained weight loss and lifestyle modifications. Still, without proper management, obesity is linked to increased risks of complications such as cardiovascular diseases, diabetes, and reduced quality of life.

Long-term outcomes show that overweight and obese individuals can have varied survival advantages in some contexts. Still, severe obesity, like BMI ≥35, is generally associated with higher risks of complications like heart failure and rehospitalization. Recurrence of obesity is common due to difficulty maintaining weight loss, and long-term adherence to lifestyle modifications is crucial.

Surgical intervention like bariatric surgery tends to have beneficial long-term outcomes compared to pharmacological treatment alone, especially for severe obesity. However, prognosis depends heavily on individual factors and timely, consistent management.

Thus, the prognosis of obesity includes:

• Potential for improvement and quality of life enhancement with effective long-term management.
• Risk of chronic comorbidities if obesity persists or worsens.
• Common challenge of weight regain and recurrence without sustained lifestyle changes.
• Surgical options offering better long-term outcomes in selected cases.

Frequently Asked Questions (FAQs) on Obesity Treatment

What is obesity?

The World Health Organisation (WHO) defines an adult obese individual as having a body mass index (BMI) of ≥30 kg/m², whereas an overweight individual is one with a BMI of ≥25 kg/m². Children's criteria are based on growth standards and reference charts. While BMI is the clinical standard, body fat percentage is considered a more direct, if less often utilized, indicator of obesity.

Can children be obese?

Yes, children can be obese. Childhood obesity has become increasingly common globally, including among children under five years old. Obese and overweight children are at greater risk of both physical health problems, such as hypertension, and mental health issues, including depression. Furthermore, children who are overweight or obese have a high chance of remaining obese into adulthood, which increases the risk of chronic diseases later in life.

How to prevent obesity?

Obesity can be prevented by maintaining a balanced diet high in healthy grains, fruits, vegetables, and lean proteins, avoiding high-calorie snacks, processed foods and sugary drinks. Engaging in regular physical activity, reducing sedentary behaviours like prolonged screen time, and ensuring adequate sleep are key lifestyle measures. Routine monitoring of weight and growth, especially in children, helps detect early signs of excess weight gain and allows for timely intervention.

Does obesity affect mental health?

Obesity in children and adolescents is related to a greater risk of mental health problems like anxiety and depression. Negative experiences, such as weight stigma and low self-esteem, can also lead to emotional distress. Addressing both physical and mental health is therefore essential in managing obesity.

How does obesity cause diabetes?

Obesity leads to diabetes by causing insulin resistance and impairing pancreatic β-cell function, resulting in reduced insulin production over time. Excess fat, especially in the abdomen and organs, causes inflammation, produces harmful lipids and cytokines, and disturbs normal metabolic signalling, all of which exacerbate insulin resistance and raises blood glucose levels. Type 2 diabetes develops as a result of these changes, especially when the pancreas fails to compensate for increasing insulin resistance.

What parts of the body does obesity affect?

Obesity can affect nearly every organ, increasing risk for arthritis, heart disease, diabetes, breathing problems, and some cancers. It also raises the likelihood of liver disease, skin conditions, and mental health issues like depression. Excess body fat impacts physical function, health, and overall quality of life.

How does obesity cause hypertension?

Obesity causes hypertension by overactivating the sympathetic nervous system and the renin-angiotensin-aldosterone system, releasing hormones that affect blood vessels, and promoting insulin resistance and inflammation. Excess fat around the kidneys can also compress them, leading to sodium retention and higher blood pressure.

Is obesity gender specific?

No, obesity is not exclusively gender-specific; it affects both men and women, but it is generally more common in women and often leads to more health problems in them. Differences are due to biological factors like hormones and genetics, as well as sociocultural and environmental influences. Gender-specific approaches can make prevention and treatment more effective.

Which superfood helps to control obesity?

Several superfoods can aid in obesity management by providing essential nutrients, fibre, and healthy fats that promote feelings of fullness and support metabolism. Oats and lentils, for instance, are high in fibre and protein, while berries and apples are high in antioxidants and provide satiety, and avocado contains heart-healthy fats and fibre. Fatty fish, such as salmon, eggs and chia seeds, are also beneficial because they regulate blood sugar and reduce cravings.