Understanding obesity among young adults in India: A focus group study.

INTRODUCTION: The study aims to understand the knowledge and awareness about risk factors and consequences of obesity, barriers and motivators to weight loss, and potential solutions for weight management among young adults (YAs) in India. METHOD: Six focus group discussions were conducted with an inductive approach among obese YAs (18-30 years) recruited through snowball and purposive sampling. The principle of maximum diversity was used to build a pool of varied and extensive information regarding obesity in YAs. The discussions were audio-recorded and transcribed verbatim using NVivo 1.0 by QSR International to generate codes, subthemes, and themes from the discussions. RESULT: Among the thirty recruited YAs (mean age 24.7 ± 2.84 years), nearly half were from a high-income group (56.6 %) and had postgraduate education (53.3 %). Key themes included the need for increased awareness about obesity risk factors and consequences across different societal levels. Physical appearance was the primary motivator for weight loss, followed by physical endurance and social support. Major barriers included lack of energy, time, motivation, lifestyle changes, easy access to unhealthy foods, work commitments, and workplace culture. A holistic approach involving dietary changes, physical activity, and educational and policy reforms was suggested as potential solutions. CONCLUSION: The challenges faced by YAs in developing countries regarding different aspects of the development and management of obesity are unique and different from the other population groups. Individualized weight management modules may be useful for managing obesity in this group.

Body mass index and cognitive functioning decline: Exploring the relationship.

BACKGROUND: Cognitive functions may play an important role in the management of obesity by promoting compliance towards lifestyle-related behaviours. This study aimed to identify cognitive deficits among adults and examine their association across different Body Mass Index (BMI) categories in an Indian setting. MATERIALS AND METHODS: The study is a cross-sectional survey of a sample attending a tertiary care hospital in northern India. The Montreal Cognitive Assessment (MoCA) scale was administered as part of an interview schedule to evaluate participants' cognitive performance across eight domains. The responses were analyzed to investigate the association between BMI and total MoCA scores, as well as domain-specific MoCA scores. RESULTS: Three hundred forty-nine participants, with a mean age of 36.9 ± 10.9 years and a BMI of 26.7 ± 4.6 kg/m2, were recruited. BMI was found to be significantly associated with the total MoCA score, indicating a negative relationship (P < 0.001). A significant negative association was found between six domain-specific scores, namely visuospatial, attention, language, abstraction, delayed recall (P < 0.001), orientation (P < 0.05), and BMI. CONCLUSION: An association between BMI and cognitive functioning (both overall and domain-specific) was observed, showing a dose-effect relationship. In these cases, visuospatial, attention, language, abstraction, delayed recall, and orientation were found to be affected.

A Cross-Sectional Survey of 505 Postpartum Women to Assess Lifestyle-Related Behaviour, Barriers, and Myths Affecting Postpartum Weight Retention and Its Management.

Background/Purpose: This study aims to assess lifestyle-related factors such as diet, physical activity and sleep along with common myths, beliefs, and barriers to a healthy lifestyle and resultant postpartum weight retention. It has also explored the association of the aforementioned factors with socio-demographic variables. Methods: A cross-sectional survey was conducted using a comprehensive pre-validated questionnaire on a convenience sample of postpartum women using a telephonic interview schedule. Results: A total of 505 postpartum women were recruited with median postpartum weight retention of 5 kg. More than half of the participants had incorrect dietary practices with less than one-tenth of women indulging in low/moderate-intensity physical activity. Postpartum women had poorer diet (p < 0.05) and sleep (p < 0.01) in the initial phase postpartum as compared to late postpartum. These women were also less physically active in the initial months and as the postpartum period progressed their physical activity also improved significantly (p < 0.001). Socio-demographic variables such as socio-economic status, education, and employment status were significantly associated with unhealthy lifestyle practices. Common barriers were lack of knowledge, time constraints, lack of childcare support and cultural myths and beliefs. Conclusion: The findings of the study will help in developing a comprehensive women-centric weight management module focusing on practical guidelines for lifestyle, breastfeeding and other confounding factors associated with postpartum weight management.

Postpartum weight retention and its association with socio-demographic and obstetrics correlates: A cross-sectional hospital-based preliminary survey in India.

BACKGROUND AND AIMS: Postpartum weight retention can predispose women to an elevated risk of obesity and associated complications. The study aims to assess the magnitude of postpartum weight retention and its association with socio-demographic and obstetrics correlates. METHODS: A cross-sectional survey was carried out in February and March 2022 via telephonic interviews. Convenience sampling technique was used for recruiting postpartum women in first three months, four to six months and beyond six months post-delivery (date of delivery January 2021 to January 2022). Chi2 test and regression analysis were employed to study the association of socio-demographic and obstetrics correlates with postpartum weight retention. RESULTS: The final sample comprised 505 postpartum women with a mean age of 29 ± 4 years. The mean postpartum weight retention was 4.96 ± 3.64 kg, 5.38 ± 3.93 kg and 5.80 ± 3.95 kg in the first three months, four to six months and beyond six months post-delivery respectively. In the first three months, socio-economic status and gestational weight gain were associated with weight retention (p < 0.05). In four-six months, type of family, education qualification, and gestational weight gain were associated with weight retention (p < 0.05). Beyond six months post-delivery, gestational weight gain was associated with postpartum weight retention (p < 0.05). CONCLUSION: The findings provide preliminary data on the magnitude of weight retention in Indian postpartum women. Postpartum women are at an increased risk of weight retention with the overall shift to a higher body mass index category as compared to the pre-pregnancy period. It is crucial to timely screen women at risk and implement weight management strategies.

Physical Activity, Yoga, and Exercise Prescription for Postpartum and Midlife Weight Management: A Practical Review for Clinicians.

This narrative review is aimed to practically review and evaluate the existing evidence and illuminate the effectiveness of physical activity, yoga, and exercise for postpartum and midlife weight management. A comprehensive review was conducted using electronic databases such as PubMed and google scholar using search terms physical activity, exercise, yoga, postpartum, midlife, weight loss, weight reduction, and all the probable terms. This helped in generating evidence-based information and formulating practical physical activity prescriptions to be used by obstetricians, general clinicians, nutritionists, and other allied healthcare personnel. Overweight and obesity in postpartum and midlife women present long-term health risks and complications. Indulging in optimum physical activity comprising exercise and yoga will help in weight management, increasing muscular strength, and endurance thus improving overall health and well-being. Supplementary Information: The online version contains supplementary material available at 10.1007/s13224-022-01627-w.

Development and Validation of a Questionnaire to Assess the Risk Factors, Facilitators, and Barriers to Postpartum Weight Management.

Background: Postpartum period is associated with significant weight retention and weight gain. The aim of this study was to develop and validate a comprehensive questionnaire to assess the risk factors, facilitators, and barriers to postpartum weight management. Methodology: The development and validation were done in five major steps by applying a mixed-method study design. Items were generated through literature review, focus group discussions, and in-depth interviews, followed by the assessment of content validity, face validity, construct validity, and reliability. Result: The final questionnaire comprises 36 items which are split into five major domains assessing perceptions related to body weight, eating behaviour, physical activity, sleep pattern, and beliefs/myths associated with postpartum period. The questionnaire has a satisfactory construct validity through factor analysis (65.12) and good internal consistency and reliability with a Cronbach's alpha of 0.79. Conclusion: This is a comprehensive tool to assess the risk factors, facilitators, and barriers to postpartum weight management and will aid in developing women centric strategies to curb the problem. Supplementary Information: The online version contains supplementary material available at 10.1007/s13224-022-01631-0.

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

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.