Executive summary of evidence and consensus-based clinical practice guideline for management of obesity and overweight in postpartum women: An AIIMS-DST initiative.

Sandhya Kamath, Gaurishankar Kaloiya, Anita Malhotra, Anoop Misra, Geetha Balsalkar, Manju Puri, Achla Batra, Jagmeet Madan, Anjali Dabral, Raman Kumar, S Shantha Kumari, Tanveer Kaur, Asmita Muthal Rathore, Archana Verma, Rakhi Singh, Kamlesh Tewary, Randeep Guleria, Archana Kumari, Ambuja Choranur, Neerja Bhatla, Piyush Ranjan, Divjyot Kaur, Upendra Baitha, K Aparna Sharma, Mangesh Tiwaskar, Anupam Prakash, Srikumar Venkataraman, Wareesha Anwar, Aruna Nigam, Siddharth Sarkar, Kiran Guleria, Shakun Tyagi, Naval K Vikram

Journal: Diabetes & metabolic syndrome 2022;16(3):102425

PMID: 35248972

Full Text on Elsevier Science View on PubMed

Abstract

INTRODUCTION

Postpartum obesity is a public health concern. There is a need to counsel women about their postpartum weight management, accounting for various barriers they face. Limited literature in the Indian context underscored the need to develop the clinical practice guideline to be used by healthcare providers in Indian healthcare settings.

METHODS

The guideline was formulated by following the standardised methodology proposed by the National Health and Medical Research Council. Various steps such as identification of the patient population, assembly of the guideline development groups, identification of the key clinical questions, guideline development methods, grading the quality of evidence and recommendations and guideline translation were carried out to develop and validate the clinical practice recommendations.

RESULTS

The evidence and consensus-based clinical practice guideline has been developed, providing recommendations for key topics of interest for first-line treatment of obesity (lifestyle-related management). Recommendations focus on screening and initiating discussion with overweight and obese postpartum women as well as those who had normal pre-pregnancy body mass index but have retained excessive weight in the postpartum period. Recommendations highlight the evaluation and management of dietary, physical activity and breastfeeding behaviour. Recommendations also account for behavioural modification techniques to improve adherence to the prescribed weight management advice. Duration and frequency of follow-ups as well as the advice to be disseminated have also been discussed in the recommendations.

CONCLUSION

The guideline provides clinical practice points that can be used by healthcare providers, postpartum women and policymakers for opportunistic screening and management of postpartum obesity.

Address: Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India.; Department of Medicine, All India Institute of Medical Sciences, New Delhi, India. Electronic address: [email protected].; Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.; Department of Home Science, University of Delhi, New Delhi, India.; Department of Obstetrics and Gynaecology, Seth G. S. Medical College, Mumbai, India.; Food and Nutrition, Department of Home Science, Vice-principal, Lakshmibai College, University of Delhi, New Delhi, India.; Department of Obstetrics and Gynaecology, LHMC and SSK Hospital, New Delhi, India.; President, Association of Obstetricians and Gynaecologists of Delhi (AOGD), Professor, Department of Obstetrics and Gynaecology, VMMC and Safdarjung Hospital, New Delhi, India.; Indian Dietetic Association, India.; Department of Obstetrics and Gynaecology, Maulana Azad Medical College, New Delhi, India.; Department of Obstetrics and Gynaecology, University College of Medical Sciences, New Delhi, India.; Department of Obstetrics and Gynaecology, VMMC and Safdarjung Hospital, New Delhi, India.; Department of Psychiatry and NDDTC, All India Institute of Medical Sciences, New Delhi, India.; Department of Obstetrics and Gynaecology, Hamdard Institute of Medical Sciences & Research, New Delhi, India.; Seth G S Medical College and KEM Hospital, Mumbai, LT Municipal Medical College and General Hospital, Mumbai, India.; The Federation of Obstetric and Gynaecological Societies of India, India.; Academy of Family Physicians of India, India.; President, Indian Menopause Society, Former Professor and Head, Department of Obstetrics and Gynaecology, Osmania Medical College, Hyderabad, India.; Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, New Delhi, India.; Department of Psychology, University of Delhi, New Delhi, India.; Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.; Department of Medicine, LHMC and SSK Hospital, New Delhi, India.; Association of the Physicians of India, India.; Endocrinology Committee, The Federation of Obstetric and Gynaecological Societies of India, India.; All India Institute of Medical Sciences, New Delhi, India.; Chairman, Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, Chairman, National Diabetes, Obesity and Cholesterol Foundation (N-DOC) and President, Diabetes Foundation (India), New Delhi, India.

DOI: 10.1016/j.dsx.2022.102425

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MeSH Terms: Consensus, Exercise, Female, Humans, Obesity, Overweight, Postpartum Period, Pregnancy