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Obesity and Undernutrition, Parameters, Causes, Socio-economic Factors

Context: Obesity and overweight are causing over 3.4 million deaths every year worldwide.

Obesity and Undernutrition

  • India faces a growing challenge of both obesity and undernutrition, co-existing within the population, as per a new Lancet study.
  • This phenomenon, known as the “double burden” of malnutrition, poses significant health risks.
About Obesity
  • Obesity is a chronic disease that occurs when the body stores excess calories as fat
  • It is caused by an imbalance of calories consumed and calories expended (when someone eats too many high-fat or high-sugar foods and doesn’t get enough physical activity).
  • Other factors: Certain medications, such as antidepressants, steroids and diabetes medications, Lack of sleep, Stress & Genetics.
  • A body mass index (BMI) of over 30 indicates obesity.
  • Potential Health Problems caused due to Obesity: Stroke, Type 2 diabetes, High blood pressure, High cholesterol, Sleep apnea, Certain cancers etc.
  • Government Efforts to Tackle Obesity:
    • Eat Right India: A campaign from the Food Safety and Standards Authority of India (FSSAI) that promotes healthy eating habits. The campaign has three pillars:
      • Eat Safe: Promotes safe and hygienic food.
      • Eat Healthy: Promotes diet diversification and fortification
      • Eat Sustainably: Promotes the conservation of water resources, eating local and seasonal foods.
    • Fit India Movement, POSHAN Abhiyan, Mid day Meal Scheme etc.

Parameters of Obesity and Undernutrition

  • Obesity: Defined by the World Health Organization (WHO) as an abnormal fat accumulation posing health risks.
    • Adults: BMI ≥ 30 kg/m2
    • Children/adolescents: BMI two standard deviations above the mean
  • Undernutrition: Encompasses various forms, including underweight.
    • Adults: BMI < 18 kg/m2
    • Children/adolescents: BMI two standard deviations below the mean

Facts about Obesity and Undernutrition

Obesity

  • Women: Increased from 1.2% (1990) to 9.8% (2022), with 44 million affected in 2022.
  • Men: Increased by 4.9% (1990-2022), with 26 million affected in 2022.
  • Children: Significant rise (3% in girls, 3.7% in boys) over 32 years.
  • 2022: 3.1% of girls and 3.9% of boys obese (compared to 0.2 million each in 1990; 7.3 million boys and 5.2 million girls in 2022).

Undernutrition

  • Despite the decline, prevalence remains high.
  • 2022: 13.7% of women and 12.5% of men were underweight.
  • Thinness (underweight in children):
    • Highest in the world for girls (20.3%) and second highest for boys (21.7%).

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Causes of Obesity and Undernutrition

  • Lack of access to affordable, nutritious food: Contributes to both undernutrition and obesity.
    • Undernutrition: Limited access to food itself.
    • Obesity: Increased access to processed, unhealthy foods high in fat, sugar, and salt.

Socio-economic Factors

  • Gender: Women have higher obesity rates due to:
    • Limited access to physical activity (walks, gyms).
    • Prioritising family nutrition over their own.
    • Less sleep (waking up early, sleeping late).
    • Central obesity (abdominal fat accumulation) might be as high as 40-50% in some regions.
  • Income: While traditionally associated with the rich, obesity is rising among the poor due to:
    • Affordability and convenience of junk food (e.g., samosas, pakoras) compared to fruits and vegetables.
  • Urban-rural divide: Obesity is more prevalent in urban areas.
  • Undernutrition: Persists in remote, rural areas of poorer states due to:
    • Limited food access, with some people having only one meal a day.

Health Impacts of Obesity and Undernutrition

  • Obesity: Increases risk of diabetes, hypertension, heart attacks, and strokes.
  • Undernutrition: Increases the risk of non-communicable diseases later in life:
    • “Catch-up growth” in adulthood may lead to bodies less able to adjust to increased nutrition, making them more susceptible to diseases like diabetes.
    • This phenomenon has been observed in famines, where the rate of diabetes increases significantly years later in those born during the famine.
Obesity Stats
  • Global:
    • 1 in 8 people is living with obesity.
    • 890 million adults and 160 million adolescents are affected by it.
    • 37 million children under 5 years old are overweight & 390 million children aged 5-19 years are overweight.
  • India:
    • 13% obesity rate, higher than other middle-income countries.
    • India ranks 3rd globally in obesity prevalence, after China and USA.
    • India ranks 2nd globally in obese children.

Solutions for Obesity and Undernutrition

  • The study emphasises addressing both obesity and undernutrition simultaneously.
  • Focus on programs promoting healthy nutrition:
    • Targeted cash transfers.
    • Food assistance (subsidies, vouchers for healthy foods).
    • Free healthy school meals.
    • Primary care-based nutritional interventions.
  • Ensure food security.
  • Support weight loss for those with obesity: Prevention and management are crucial due to the earlier onset of obesity, leading to longer exposure.
    • Making healthy food affordable and accessible is a key challenge.
  • Pharmacological treatment: While promising, the study suggests its limited impact due to high costs and lack of generalizable guidelines.

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