Introduction

At present, India is facing a daunting obesity challenge which does not augur well for the future of the country. India is a fast-developing economy with a majority of a young population. The present-day youth is the hope for this economic revival of the country. If they become lethargic or lazy on account of obesity, this surging hope will be dashed to the ground. India needs healthy and physically fit young men and women to bear the brunt of mounting physical and mental pressure. In the last week of January 2025, the prime minister of India, Narendra Modi, said in his radio programme, “Mann Ki Baat” that there is an alarming increase in obesity in the country, particularly among children. He further highlighted that obesity affected one in eight Indians. He urged people to reduce oil consumption by 10% each month and stressed that to build a healthy nation, obesity needed to be addressed.1

Obesity as defined by W.H.O.

The World Health Organization has defined overweight and obesity as abnormal or excessive fat accumulation that presents a risk to health.2 The Lancet study uses Body Mass Index (BMI)-the ratio of a person's weight to their height squared-to determine obesity. Adults with a BMI of greater than 30 were considered obese, and those with BMI between 25 and 30 were deemed overweight. For children and young adolescents between the ages of 5 and 17 years, the researchers considered the weight-for-age and gender recommendations of the International Obesity Task Force.3

Extent of the Problem

According to the data provided by the National Family Health Surveys, obesity has been increasing across the country over the years:-

1. The percentage of obese women saw a rise of about 4% between the period 2015-16 to 2019-21, from 20.6% (NFHS-4) to 24% (NFHS-5), respectively.
2. The percentage of overweight/obese men increased from 18.9% to 22.9% during this period.
3. Urban numbers were significantly higher than rural numbers.
4. As per the research paper published in The Lancet Regional Health Southeast Asia, analysing the NFSH-5 data, the prevalence of abdominal obesity (assessed through waist circumference) in the country was found to be 40% in the women and 12% in men.
5. The childhood obesity showed concern in as much as the percentage of children under five, being overweight, rose from 2.1% to 3.4% from 2015-16 to 2019-21, as per NFHS data.
6. Among the children above five, the figures are higher. The World Obesity Atlas estimates that India will have a child obesity prevalence of 10.8% among 5 to 9-year-olds and 6.23% among 10 to 19-year-olds by 2030.4
7. According to another study, “With the global prevalence of obesity in children and adolescents having increased by 244% in the past 30 years and having a forecasted increase of 121% in the next 30 years, trends in adult obesity prevalence are unlikely to abate".5
8. The number of overweight/obese people is on the rise in India. According to the Lancet study, by 2050, India may even overtake China in certain categories. By then, India will have 450 million adults, close to 12% of the global overweight/obese population, who are overweight or obese, the second highest in the world, comprising 70 million children and adolescents. In the age group of 5-14 years, the number will be 36.9 million, the second highest in the world while in the age group of 15-24 years, the number will be 30.5 million, the highest in the world.6
9. There were nearly 211 crores overweight or obese people in the world in 2021, accounting for 45% of the global population. Out of these, around half of overweight and obese adults lived in eight countries-China (40.2 crore), India (18 crore), the US (17.2 crore), Brazil (8.8 crore), Russia (7.1 crore), Mexico (5.8 crore), Indonesia (5.2 crore), and Egypt (4.1 crore).7

The Key factors behind the growth of obesity

One of the major propagators of obesity is the shift towards consuming calorie-dense foods high in sugar, salt, and fats, according to the studies. It further says that in countries with high prevalence of obesity, traditional local food supply systems have been replaced by “big food distribution” that provides high-calorie foods with long shelf life.8 According to K. Srinath Reddy, distinguished professor of public health, Public Health Foundation of India, “Rising levels of obesity in urban India are due to a combination of multiple factors: unhealthy diets loaded with ultra-processed foods, lowered levels of physical activity and even air pollution which provokes inflammation that predisposes the body to cardio-metabolic diseases and visceral adiposity in the body".9

Another deterrent is the cost factor, says Vandana Prasad, a public health professional, which restrains the low-income group families to eat better instead of consuming carbohydrates like rice and wheat. Indian diets, especially among poor families, are deficient in iron and protein. Foods like fruits, vegetables, pulses, dairy and animal-based foods are costly and unaffordable for them. 10

In 2024, a study was published in The Lancet Global Health which said that almost half of all Indians are not sufficiently physically active. Dr. Srinath Reddy adds that “Even as indoor sedentariness is increasing due to the seated nature of office work and use of digital devices, outdoor conditions are not conducive to safe and pleasurable physical activity".11 Further, the safe cycling lanes and pedestrian paths are almost absent. The lanes are by and large, dimly lit. Green spaces for recreational physical activities are gradually shrinking. Last but not the least, the traffic density and rising street crime deter walkers in many urban zones.

The Health Risks

According to the World Health Organization (WHO), obesity in adults is a major risk factor. It is one of the prominent reasons for poor health and early death. These encompass cardiovascular disease, several common cancers, diabetes and osteoarthritis. In the case of the number of diabetic persons, India leads the world with an estimated 101 million. The incidence of cancer is also rising: from 14.6 lakh cancer cases in 2022, the projected number is likely to go up to 15.7 lakh in 2025, as per the Indian Council of Medical Research-National Registry Programme. Cardiovascular disease remains one of the leading causes of death and disability, reportedly affecting Indians at least 10 years earlier than in other countries.

In case of children, being overweight affects children's and adolescents’ immediate health and is associated with greater risk and earlier onset of various non-communicable diseases. It can also bring adverse psychological consequences that may affect school performance and quality of life, compounded by stigma, discrimination and bullying. The obese children are likely to grow as obese adults.12

The Remedial Measures

A. At the personal level:

1. One should start consuming predominantly plant-based, with plenty of fruit and vegetables, nuts and seeds, which amounts to an ideal diet.
2. Fibre-rich foods help reduce the scale and speed of sugar and fat absorption. They also enable the growth of friendly gut bacteria (microbiome) which counter obesity and prevent cardio-metabolic diseases. For non-vegetarians, fish is preferable to fowl and fowl to flesh, while maintaining a predominantly plant-based diet.13
3. Ultra-processed foods, which contain an overdose of sugar, salt, unhealthy trans fats or saturated fats should be avoided at all costs. Similarly, sugar-sweetened beverages need to be avoided. Water is undoubtedly the healthiest drink.
4. Physical activity helps in reducing body fat and increases insulin sensitivity of skeletal muscles and prevents diabetes. Dynamic exercises are good for reducing overall body fat. Weight-bearing or resistance exercises are good for reducing abdominal fat. Smoking should be avoided as it increases abdominal fat. 14

(B) At the government level

1.  Food and agricultural policies must encourage crop diversity which can prove to be beneficial in promoting dietary diversity. Fibre-rich, low glycemic foods like millets are more preferable to starchy cereals.
2. Public policy instruments must discourage the promotion and consumption of ultra-processed and sugar-sweetened soft drinks which induce both general and visceral obesity.
3. Regulatory measures must include restrictions on sugar, salt and fat content of manufactured food products.
4. It should be ensured that warning labels in front of the pack clearly caution consumers of high levels of any of the above-mentioned items.
5. Celebrity advertisements or misleading health claims should be banned.
6. Government should ensure safe pedestrian paths, protected cycling lanes, and green spaces for community recreation to encourage physical activity.

Conclusion

The growing obesity problem is a cause of great worry for the economic and social growth of India. An overweight or obese person can scarcely contribute to achieving developmental goals. The growing problem can still be nipped in the bud. But for this, along with policy interventions at the level of the government, the active involvement of the citizenry, including the corporate sector. An exhaustive awareness campaign is to be launched without any further delay to mobilise the youth and the veterans alike. Obesity can only be checked by adopting a holistic approach. Piecemeal efforts will not suffice anymore.

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Reference:

1. Zubeda Hamid, Why is India staring at an obesity challenge?, The Hindu, Feb 2, 2025.
2. Ibid.
3. Anonna Dutt, India's obesity problem, The Indian Express, Feb 10, 2025.
4. Ibid.
5. Anonna Dutt, India's obesity problem, The Indian Express, Feb 10, 2025.
6. Rhythma Kaul, Country to lead in overweight young people by 2050: Report, Hindustan Times, Feb 4, 2025.
7. Anonna Dutt, India's obesity problem, The Indian Express, Feb 10, 2025.
8. Anonna Dutt, India's obesity problem, The Indian Express, Feb 10, 2025.
9. Zubeda Hamid, Why is India staring at an obesity challenge?, The Hindu, Feb 2, 2025.
10. Ibid.
11. Ibid.
12. Ibid.
13. K. Srinath Reddy, Obesity surge needs multi-pronged action, Hindustan Times, Feb 18, 2025.
14. Ibid.