A Lancet study predicts that by 2050, nearly a third of India’s population will be overweight or obese.

About Obesity

• Definition: The Obesity Medicine Association (OMA) defines obesity as a chronic, relapsing, multifactorial neurobehavioral disease characterized by excessive body fat, leading to adipose tissue dysfunction and negative health effects.
  • It is officially classified as a disease by the World Health Organization (WHO).

• Diagnosing Overweight and Obesity: BMI serves as an indicator of fatness, with additional measures like waist circumference aiding in a more accurate assessment of obesity.
  • Adults: Overweight is defined as a BMI of 25 or higher, while obesity is a BMI of 30 or more.
  • Morbid obesity exists when BMI is more than or equal to 35.
• Limitations of BMI: BMI does not distinguish between fat and muscle mass, making it an incomplete indicator of obesity.
  • It fails to reveal fat distribution, which is crucial for assessing health risks.

Reasons For New Obesity Guidelines For Indians

Indian doctors and researchers emphasized the need for updated obesity guidelines due to several key factors:

• Genetic Disposition: Indians are genetically more prone to abdominal fat accumulation, which significantly increases the risk of metabolic syndrome, type 2 diabetes, and heart disease.
• Limitations of BMI: The 2009 guidelines relied solely on BMI, but research shows it is insufficient, particularly for Indians.
  • Abdominal Obesity: Studies highlight a strong link between excess belly fat, inflammation, and early health risks in the Indian population.
• Better Risk Assessment: The new guidelines distinguish between obesity with significant health consequences and cases that pose minimal risk.

Key Findings of the Recent Lancet Study

• Global Trend: Global projections indicate that more than half of adults and a third of children and adolescents will be overweight or obese.
• India (2021): India led in the absolute number of overweight or obese young people in 2021, surpassing China and the U.S.
• Rising Obesity in Adolescents (15-24 years)
  • Young Men: 1990 – 0.4 Cr → 2021 – 1.68 Cr → 2050 – 2.27 Cr
  • Young Women: 1990 – 0.33 Cr → 2021 – 1.3 Cr → 2050 – 1.69 Cr
• Growing Childhood Obesity
  • Boys: 1990 – 0.46 Cr → 2021 – 1.3 Cr → 2050 – 1.6 Cr
  • Girls: 1990 – 0.45 Cr → 2021 – 1.24 Cr → 2050 – 1.44 Cr

Causes of the Obesity Epidemic

• Dietary Changes: Increased availability and consumption of ultra-processed food (UPF) and reduced physical activity (WHO: 50% of Indians do not meet recommended levels).
• Environmental & Urban Factors:
  • Shrinking green spaces and lack of safe pedestrian and cycling infrastructure.
  • Traffic congestion and safety concerns deter outdoor exercise.
  • Air pollution contributes to inflammation, increasing obesity risk.
• Lifestyles changes:: Urbanization and technological advancements have led to reduced physical activity and sedentary lifestyle. 
  • Desk jobs, reduced reliance on walking, and increased screen time contribute to lower energy expenditure.
  • There is an increasing trend of eating out, where oils used are refined and unhealthy.
• Socioeconomic Factors: While obesity is often associated with affluence, malnutrition and obesity coexist in India. 
  • Lower-income groups are vulnerable to obesity due to the affordability and accessibility of unhealthy food options.
  • 55% of Indians cannot afford a healthy diet, and 40% lack an adequate-nutrient diet (The State of Food Security and Nutrition in the World (SOFI) 2024 report).
• Psychological and Behavioral Factors: Stress, depression, and emotional eating often lead to excessive calorie intake and weight gain.
• Endocrine and Metabolic Factors: Conditions such as hypothyroidism and polycystic ovary syndrome (PCOS) contribute to obesity, particularly among women.

Reasons For Obesity Epidemic Being a Concern

• Societal Perception: Societal attitudes in India normalize overweight and obesity, treating them as personal issues rather than public health concerns.
• Economic impact:
  • In 2019, obesity cost India $28.95 billion (₹1,800 per capita, 1.02% of GDP).
  • By 2030, this is projected to increase to ₹4,700 per capita (1.57% of GDP).
• Global and National Burden: In 2021, half of the world’s obese and overweight adults lived in just eight countries, including India, highlighting its widespread impact.
• Double Burden of Disease: In low- and middle-income countries, obesity coexists with childhood malnutrition and infectious diseases, placing additional strain on healthcare systems.
• Serious Health Risks: Obesity is a major risk factor for noncommunicable diseases.
  • It significantly increases the risk of Type 2 diabetes, cardiovascular diseases (heart disease, stroke), and certain cancers (e.g., breast, colon, liver).
  • with 3.4 million deaths globally each year.

Government Initiatives for Public Health and Obesity Management

• Food Safety and Standards Authority of India (FSSAI’s) Eat Right India Movement: promotes safe, healthy, and sustainable food through hygiene certification, training, and food safety programs. 
  • It also raises consumer awareness via Eat Right Campus & Eat Right School programs, advocating mindful eating habits.
• Fit India Movement: Launched in 2019, the movement encourages citizens to incorporate fitness into their daily routines through school certification programs, community-driven activities, and mass fitness initiatives.
• POSHAN Abhiyaan: aims to improve nutrition for children, adolescent girls, pregnant women, and lactating mothers by integrating technology-driven monitoring, multi-sectoral collaboration, and awareness campaigns.
• ‘Aaj Se Thoda Kam’ Awareness Campaign: FSSAI launched the ‘Aaj Se Thoda Kam’ campaign to encourage the gradual reduction of fat, sugar, and salt in daily diets.
  • The initiative utilizes multimedia tools, including videos, banners, and digital platforms, to reach diverse audiences.
• National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD): the scheme aims to promote health through behaviour change by engaging communities, civil society, media, and development partners.
• RUCO Initiative: The RUCO (Repurpose Used Cooking Oil) initiative ensures the safe disposal of used cooking oil, preventing its reuse in food businesses and repurposing it for biodiesel production. 

Way Forward

• Recognition as NCD: Obesity must be officially recognized as a major non-communicable disease (NCD) and its prevention and management should be integrated into India’s public health policies.
• Public Awareness & Education: Example: A comprehensive National Obesity Programme should include awareness campaigns, school-based interventions, workplace wellness programmes, access to treatment, taxation on unhealthy foods and so on.
• Encouraging Physical Activity: Urban planning should prioritize bicycle lanes, parks, and public gyms while workplaces promote fitness initiatives and body composition analysis.
• Regulating Unhealthy Foods: Impose higher taxes on High-Fat Sugar Salt (HFSS) and ultra-processed foods, enforce ethical food marketing, and encourage healthy school canteens.
  • India’s Economic Survey 2024-25 suggests higher taxation on UPF to curb obesity.
• Routine Health Screening & Medical Interventions: Integrate BMI, waist circumference, and basic health literacy into regular check-ups.
  • Establishing a national registry to track obesity trends, outcomes, and interventions is important
• Making Healthy Food Affordable & Accessible: Promote affordable nutritious food through subsidies, online food delivery platforms, and Corporate social responsibility (CSR) funding from the food industry.

Conclusion

With sustained commitment, cross-sector collaboration, active citizen participation and  lifestyle changes, India can set a global example in tackling obesity and safeguarding future generations. 

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