Why is India Staring at an Obesity Challenge?

Context: Recently, Prime Minister Narendra Modi, in his ‘Mann Ki Baat’ radio programme, highlighted the alarming increase in obesity in India.

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• He cited that 1 in 8 Indians is affected by obesity.
• Urged people to reduce oil consumption by 10% per month to promote a healthier lifestyle.

Obesity Challenge: The Scale of the Problem

Definition of Obesity: The World Health Organization (WHO) defines overweight and obesity as abnormal or excessive fat accumulation that poses a health risk.

Obesity Trends in India (NFHS Data)

The National Family Health Surveys (NFHS) data shows a steady rise in obesity:

• Women (Overweight/Obese):
  • 2015-16 (NFHS-4): 6%
  • 2019-21 (NFHS-5): 24%
• Men (Overweight/Obese):
  • 2015-16 (NFHS-4): 9%
  • 2019-21 (NFHS-5): 9%
• Urban obesity levels are significantly higher than rural areas.

Abdominal Obesity (Lancet Study, 2023)

A 2023 study in The Lancet Regional Health Southeast Asia analyzed NFHS-5 data and found:

• 40% of women had abdominal obesity.
• 12% of men had abdominal obesity.

Childhood Obesity

NFHS data shows an increase in overweight children under 5 years:

• 2015-16: 2.1%
• 2019-21: 3.4%
• Older children face even higher risks (World Obesity Atlas 2022 estimates for 2030):
  • 5 to 9-year-olds: 81% prevalence
  • 10 to 19-year-olds: 23% prevalence

Health Risks Associated with Obesity

Metabolic Syndrome

Indians are genetically predisposed to storing fat in the abdomen.

• Abdominal obesity contributes to metabolic syndrome, increasing risks of:
  • Type 2 diabetes
  • Heart disease
  • Stroke

Adult Health Risks

According to the WHO, obesity is a major risk factor for leading causes of poor health and early death, including:

• Several types of cancer
• Osteoarthritis

Diabetes

India has the highest number of diabetes cases in the world, with 101 million people suffering from diabetes.

Cancer

Indian Council of Medical Research (ICMR) – National Cancer Registry Programme projects:

• 2022: 14.6 lakh cases
• 2025: 15.7 lakh cases

Cardiovascular Diseases (CVDs)

• One of the leading causes of death and disability in India.
• Indians are affected by CVDs at least 10 years earlier than other populations.

Non-Communicable Diseases (NCDs)

60% of all deaths in India are now due to NCDs, which include obesity-related illnesses.

Childhood and Adolescent Health Risks

Childhood obesity can lead to:

• Higher risk of NCDs at an earlier age.
• Adverse psychosocial effects:
  • Lower school performance.
  • Lower quality of life.
  • Higher risk of stigma, discrimination, and bullying.
• Children with obesity are more likely to remain obese in adulthood.

Causes of Rising Obesity in India

Unhealthy Diet and Ultra-Processed Foods

Urban India has seen a rise in:

• Ultra-processed food consumption.
• Unhealthy eating habits (high in sugar, salt, and unhealthy fats).

Low Physical Activity Levels

A Lancet Global Health Study (2023) found that:

• Nearly 50% of Indians do not get sufficient physical activity.
• Indoor lifestyle: Increased use of digital devices and sedentary work culture.
• Outdoor conditions discourage activity:
  • No safe cycling lanes or pedestrian paths.
  • Shrinking green spaces.
  • Rising street crime deters walking in urban areas.

Air Pollution

Air pollution contributes to inflammation, leading to:

• Increased risk of cardio-metabolic diseases.
• Visceral fat accumulation (fat stored around organs).

Economic Barriers to Healthy Eating

• Low-income households rely on carbohydrate-heavy diets (rice & wheat).
• Protein & micronutrient-rich foods (fruits, vegetables, dairy, pulses, meat) are expensive.
• Rural obesity is rising and may soon overtake urban obesity.

Limitations in Measuring Obesity

• Traditional BMI Limitations: Body Mass Index (BMI) is the most commonly used metric but has limitations:
  • Does not differentiate between muscle mass and fat.
• Does not indicate fat distribution in the body.

Updated Obesity Diagnosis Guidelines

• Indian experts introduced a new obesity classification:
  • Stage 1: Increased fat accumulation but no impact on organs or daily life.
  • Stage 2: Fat accumulation impacts organ function and physical abilities.
• Recommended new measurement methods:
  • Waist circumference
  • Waist-to-height ratio
  • Body fat percentage

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