A recent conference of bariatric and metabolic surgeons in India led to the general concern that obesity is still not recognized as a disease in India, when it actually is the mother of most metabolic and lifestyle diseases.

The government and insurers have well laid out support system to treat diseases like diabetes, heart disease, blood pressure, joint replacement, and kidney failures but there is no cognisance of mother of all these diseases -- obesity. "Today obesity is not identified as a disease in India. Bariatric surgery is considered as a cosmetic surgery," said Arun Prasad, President, Obesity Surgery Society of India (OSSI) on 24^th March on the culmination of a 2-day conference of bariatric and metabolic surgeons.

"They will do heart surgery putting stents in a patient who has developed heart disease due to obesity, replace joints when a person is obese and his joints have stopped working, or do a kidney transplant on an obese-diabetic. But they fail to see obesity as a disease," he said. The force behind organising the 1^st World Consensus Meeting on Bariatric Metabolic Surgery Standardisation in New Delhi is OSSI executive member Mohit Bhandari, who runs a leading weight loss and diabetes surgery centre, Mohak Bariatric and Robotics, at Indore.

"The situation is very alarming because nobody realises that we are in an era of non-communicable diseases. At one end, we are dying of malnutrition, at the other we are dying because of obesity and diabetes. The government is not spending anything on obesity," he said. There are national communicable diseases programme for tuberculosis and malaria, but there is no programme for obesity, he said. Five per cent of India's population is obese and of them 2.5 per cent are morbidly obese. India is world's third most obese nation after US and China. In urban cities like Delhi, about 22 per cent women and about 18 per cent men are obese.

In childhood (0-16 years) obesity, 15 per cent of Indian children are obese, which is second largest in the world after China. A quarter of these obese children are likely to become diabetics when they grow up. As for the insurance coverage for obesity, Prasad said: "It is covered in most of the European and American countries, but not in our country. One or two insurance companies have come up with it but there should be a government policy which identifies obesity as a disease."