Context

• The prevalence of obesity varies widely across states, affecting both urban and rural populations.
• Additionally, the World Obesity Federation has identified India as having one of the highest annual increases in childhood obesity globally.
• The alarming rise in obesity has severe health implications, contributing to conditions like diabetes, hypertension, and cardiovascular diseases, as well as imposing a heavy economic burden on the country.
• Despite these concerns, obesity remains an under-addressed issue in India’s public health agenda, requiring urgent attention and policy-driven interventions.

Rising Prevalence of Obesity in India

• Recent data from the National Family Health Survey (NFHS-5, 2019-21) indicates that nearly one in four Indian adults is either overweight or obese.
• However, the prevalence of obesity varies significantly across states, regions, and demographic groups.
• In some states, obesity rates are as low as 8%, while in others, they exceed 50%.
• Both men and women in urban and rural settings are affected, although urban populations tend to have a higher prevalence due to lifestyle factors.
• The situation is even more alarming among children. The World Obesity Federation has identified India as having one of the steepest annual increases in childhood obesity worldwide.
• Over the past 15 years, the number of overweight and obese children in India has doubled, and in the last 30 years, it has tripled.
• This trend is concerning as childhood obesity often leads to obesity in adulthood, increasing the risk of chronic diseases at an earlier age.
• A nationwide study published in The Lancet Diabetes and Endocrinology (2023) estimated that among Indian adults aged 20 and above:
  • 35 crore people (one in three) have abdominal obesity
  • 25 crore people (one in four) have general obesity
  • 21 crore people (one in five) have high levels of blood cholesterol
• These figures indicate that obesity is not only a growing problem but also a complex health issue affecting multiple aspects of well-being, including cardiovascular health, metabolism, and overall quality of life.

Causes of the Obesity Epidemic in India

• Transition from Undernutrition to Overnutrition
  • Historically, India has battled malnutrition and undernutrition, with large sections of the population suffering from food scarcity.
  • However, in recent years, the country has transitioned from being a "calorie-deficient" to a "calorie-sufficient" nation, though food distribution remains inequitable.
  • While many still struggle with hunger and undernutrition, a significant portion of the population has easy access to calorie-dense foods, leading to a paradoxical rise in obesity alongside malnutrition.
• Poor Dietary Habits
  • The increased consumption of high-fat, salt, and sugar (HFSS) foods and ultra-processed foods (UPFs) is one of the primary drivers of obesity.
  • These foods, which include sugary beverages, fast food, packaged snacks, and processed meats, are often low in essential nutrients but high in calories.
  • The affordability and accessibility of such foods have led to an increase in unhealthy eating habits, especially among urban populations.
  • A significant challenge is that eating healthy is becoming more expensive than consuming junk food.
  • Fresh fruits, vegetables, and nutritious whole foods are often costlier than processed, packaged, and fried foods, making it difficult for many families to maintain a balanced diet.
• Sedentary Lifestyles and Lack of Physical Activity
  • Urbanisation has led to drastic changes in how people live and work.
  • Traditional lifestyles, which involved higher levels of physical activity, have been replaced by sedentary habits, especially in cities.
  • Long hours of screen time, desk jobs, reduced outdoor activities, and increased dependence on motorized transport have all contributed to lower levels of physical movement.
  • According to the World Health Organization (WHO), nearly 50% of Indians fail to meet the recommended levels of physical activity.
  • The lack of open spaces, parks, cycling tracks, and pedestrian-friendly infrastructure in cities has further discouraged physical movement.

Health and Economic Consequences of Obesity

• Increased Burden of Non-Communicable Diseases (NCDs)
  • Diabetes: India is home to over 100 million diabetics, with numbers rising due to obesity.
  • Cardiovascular Diseases: High cholesterol and obesity contribute to heart disease, the leading cause of death in India.
  • Hypertension: Obesity leads to high blood pressure, increasing the risk of strokes and kidney diseases.
  • Cancer: Certain types of cancer, including breast and colon cancer, are linked to obesity.
  • The increasing burden of obesity-related diseases places immense pressure on India’s healthcare system, requiring urgent intervention.
• Economic Costs of Obesity
  • The Global Obesity Observatory (2019) estimated that the economic cost of obesity in India was $28.95 billion (₹1,800 per capita), or 1.02% of GDP.
  • These costs are associated with:
    • Higher healthcare expenditures for obesity-related diseases
    • Lost productivity due to obesity-related illnesses
    • Reduced workforce efficiency and higher absenteeism
  • If left unchecked, the economic burden of obesity is projected to increase to ₹4,700 per capita by 2030 (1.57% of GDP).
  • This growing financial strain highlights the urgent need for policy-driven solutions to curb the obesity epidemic.

Policy and Programmatic Solutions to Tackle Obesity

• Public Awareness and Education
  • A structured public awareness campaign is needed to reframe obesity as a chronic disease that requires prevention and management.
  • Educating people about the link between obesity and conditions like diabetes, hypertension, and liver disorders is crucial.
• Promotion of Physical Activity
  • Urban planning must prioritise active lifestyles by incorporating bicycle lanes, public parks, and open gymnasiums to encourage physical activity.
  • Workplaces and schools should also facilitate exercise-friendly environments.
• Regulation of Processed and Unhealthy Foods
  • HFSS and UPF products should be taxed at higher rates, while subsidies should be provided for healthier food options like fruits and vegetables.
  • The food industry should be encouraged to adopt ethical marketing practices to reduce the appeal of unhealthy foods.
• Integration of Obesity Screening in Healthcare
  • Regular health check-ups should include measurements of weight, height, and waist circumference.
  • Discussions about maintaining a healthy weight should be a routine part of healthcare visits.
  • A simple guideline, such as maintaining a waist circumference below 80 cm for women and 90 cm for men, can help individuals track their health.
• Medical Interventions and Guidelines
  • The availability of anti-obesity medications is increasing, but there is a need for clear guidelines on their appropriate use.
  • Medical professionals must be trained to identify and treat obesity effectively.
• Workplace and Community Interventions
  • Workplaces should promote awareness campaigns, provide weighing scales, and encourage employees to maintain a healthy weight.
  • A culture of regular health monitoring should be embedded in corporate policies.

Conclusion

• The rising prevalence of overweight and obesity in India poses a serious threat to public health and economic stability.
• Tackling obesity requires a collective effort from individuals, healthcare professionals, policymakers, and businesses.
• A comprehensive strategy involving awareness, taxation, urban planning, healthcare screening, medical interventions, and school programs is essential.
• By taking immediate and coordinated action, India can build a healthier and more prosperous future, ensuring that its economic growth is not undermined by preventable health crises.