Obesity in India has become a widespread and urgent health issue, with rising household-level clustering and a strong link to cancer risk.

About Obesity

• According to the World Health Organization (WHO), obesity is defined as an abnormal or excessive fat accumulation that presents a risk to health.

• The commonly used metric to classify obesity is Body Mass Index (BMI), where a BMI of 30 or above is classified as obese
• BMI is a number calculated from weight and height. (BMI = weight (kg) / height (m²))
• A person is considered Normal when their BMI of 18.5 to 24.9 based on the World Health Organization (WHO) guidelines.
• Underweight refers to a BMI less than 18.5, indicating a body weight that is too low for good health.

Household-level obesity in India

• National prevalence: Nearly 20% of Indian households have all adult members overweight, and 10% have all adults obese.

• State-level clusters: States like Tamil Nadu and Punjab report two in five households with all adults obese.
• Urban concentration: Obesity clustering in urban households is double that of rural areas, showing the impact of urbanisation and lifestyle changes.
• Cycle of risk: Obese households often raise children in environments that normalise poor diets and sedentary habits, creating generational health risks.

Key Drivers of Rising Obesity in India

• Dietary shift: Greater consumption of processed, high-calorie foods
• Energy imbalance: Excess calorie intake vs. low physical activity
• Unhealthy diet: High in fats, sugars, and processed foods
• Physical inactivity: Sedentary lifestyle and limited movement in both urban and rural areas
• Obesogenic environment: Poor access to healthy food and active living spaces
• Behavioural factors: Stress, emotional eating, poor sleep
• Genetic factors: Inherited traits affecting metabolism and appetite
• Iatrogenic factors: Weight gain due to medical treatment or procedures

Implications of Obesity

Economic

• Dual challenges: India’s obesity epidemic coexists with undernutrition and other health system pressures. 
• Economic Burden: (According to Global Obesity Observatory)
  • By 2030, Obesity cost is projected to rise to ₹6.7 lakh crore (1.57% of GDP, ~₹4,700 per capita).
  • By 2060, the burden could reach ₹69.6 lakh crore (2.5% of GDP, ~₹44,200 per capita).
• Broader economic fallout: Includes loss of livelihood, opportunity costs, and emotional toll due to lack of societal support.

Health

• Cancer association: WHO’s International Agency for Research on Cancer (IARC) classifies excess body weight as a risk for at least 13 cancers, including colorectal, breast (postmenopausal), endometrial, pancreatic, and kidney.
• Increased risk with comorbidity: IARC’s 2023 study showed high BMI with cardiovascular disease raises cancer risk by 17%.
• US estimates: Excess body weight accounts for about 11% of cancers in women and 5% in men

Government of India’s Strategic Framework for Obesity Prevention

• National Programme for Prevention and Control of NCDs (NP-NCD): Addresses major NCDs linked to obesity: cardiovascular diseases (27%), cancers (9%), diabetes (3%), and more.
• Ministry of AYUSH: Promoting Traditional Health Systems
  • Specialized Ayurvedic Care: The All India Institute of Ayurveda )AIIA) offers obesity care using Panchakarma, dietary guidance, and yoga.
• Fit India Movement (2019): Promotes daily fitness through school certification and community campaigns. Initiatives like Fit India Sundays on Cycle and mass yoga sessions
• Eat Right India Movement: Promote safe, sustainable, and healthy food practices.
• ‘Aaj Se Thoda Kam’ Campaign by FSSAI: Urging consumers to gradually reduce their intake of fat, sugar, and salt.
• Regulating High Fat, Salt, and Sugar (HFSS) Foods: Mandatory front-of-pack labelling for foods high in fat, salt, and sugar to help consumers make informed food choices.
• Infrastructure expansion: Plan to establish Day Care Cancer Centres in all district hospitals by 2027; 200 centres expected by 2025–26,  which should integrate prevention efforts.

Recommendations

• Expand the National Programme for Prevention and Control of Non-Communicable Diseases to focus on high-risk households.
• Targeted focus areas: Southern states, urban zones, and affluent families need concentrated attention.
• Regulatory interventions: Global examples suggest benefits of taxing sugary drinks, front-of-pack nutrition labels, and restrictions on marketing ultra-processed foods. (E.g., Kerala’s 2016 fat tax)
• City planning: Build walkable, active urban neighbourhoods with access to fresh farm produce.
• Reduce sedentary habits: Design work and public spaces that promote movement over passive lifestyles.

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