Obesity in India- Explained Pointwise

According to a new Lancet study, there has been a steady increase in obesity levels in India. The study has pointed to increase in obesity levels of both adults and children, over the last 32 years. India has become one of the countries with a high ‘double burden‘, with the increase in both malnutrition and the obesity levels.

What is obesity? What does the study reveal about the levels of obesity in India?

Obesity- According to the World Health Organisation (WHO), obesity is defined as an abnormal or excessive accumulation of fat that poses health risks.

How is obesity measured

1. Adults over the age of 20 years
Obese- Body Mass Index (BMI) of 30 kg/m2 or more.
Underweight- Body Mass Index (BMI) is less than 18 kg/m2.

NOTE- BMI is a person’s weight in kilograms divided by the square of height in meters.

2. School-aged children and adolescents between 5 and 19 years-
Obese- BMI is two standard deviations more than the mean.
Underweight- BMI is two standard deviations below the mean.

Data regarding obesity in India

1. More obese women as compared to men- Obesity in women has increased from 1.2% in 1990 to 9.8% in 2022. There are 44 million women living with obesity in 2022.

2. Increase in Men Obesity- Obesity in men has increased by 4.9% from 1990 to 2022. There are 26 million men living with obesity in 2022.

3. Significant Increase In Childhood Obesity- The number of obese boys has increased from 0.2 million in 1990 to 7.3 million in 2022. The number of obese girls has increased from 0.2 million in 1990 to 5.2 million in 2022.

Data regarding underweight in India

1. Underweight Men and Women- 13.7% of women and 12.5% of men were underweight.

2. Underweight Children- India has the highest number of underweight girls in the world. 20.3% of Indian girls are underweight. 21.7% of Indian boys are underweight, which is the second highest in the world.

What are the reasons behind the increasing obesity in India?

1. Unhealthy Lifestyle- Lack of healthy lifestyle is a major reason for increasing obesity rates in India. For ex- Lack of physical activities such as walks or gyms, lack of proper sleep. 

2. Lack of proper diet- Cheaper and easily available junk food has replaced the nutritious food in the dietary intakes of Indian population. For ex- According to recent Household Consumption Survey, Indians are spending less on cereals and pulses and more on beverages, refreshments and processed food.

3. Increased income and urbanization- Increased income levels have led to a rise in the consumption of foods high in fats, sugar and low physical activity.

4. Lack of awareness- There has been a general lack of awareness about healthy eating habits and the guidelines issued by FSSAI. Since Health is a state subject, there have been implementation challenges in ensuring proper implementation of FSSAI guidelines.

5. Growth of Ultra-processed food industry- Ultra processed food industry has boomed in India, leading to increased intake of trans fat in India. According to a joint study conducted by WHO and ICRIER, India’s ultra-processed food industry has grown at a CAGR of 13.37% in terms of retail sales value between 2011 and 2021.

6. Obesity no longer dependent on economic capacity- Obesity is no longer the disease of the rich in India. Eating junk food is cheaper and easier. For ex- The cost of samosas and pakoras available at roadside shacks is less than fruit and vegetables.

What are the negative impacts of Obesity in India?

1. Individual Health Implications- Overweight adults and children are at greater risk for non-communicable diseases such as diabetes and cardiovascular heart disease.

2. Improper development of Children in formative years- Obesity in children results in stunted physical and cognitive development.

3. Psychosocial Impact- Obese Individuals face psychosocial challenges like, body image issues and mental health concerns due to societal stigmas associated with weight.

4. Economic Burden- Obesity increases the economic burden due to productivity losses on account of decreased work efficiency and absenteeism.

5. Public Health Challenges- Obesity is a major reason behind the growth of Non-Communicable Diseases (NCDs), like diabetes, cancer, hypertension, cardiovascular diseases etc. This has increased strain on the fragile public healthcare system in India.

6. Social Inequality and Disparities- Obesity perpetuates a cycle of health challenges and economic disadvantages among the vulnerable sections, exacerbates existing socio-economic disparities. Women are disproportionately affected by obesity, facing challenges related to reproductive health, maternal health, and overall well-being.

What are the government initiatives to reduce the obesity burden?

The government has launched multiple initiatives which focusses on reducing obesity, and associated NCDs.

1. National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS)- It is being implemented under the National Health Mission. It aims to screen and ensure early interventions to check the obesity-related risk factors from becoming complicated.

2. Ayushman Bharat Health Wellness Centre scheme- Preventive aspect of hypertension and NCDs is being strengthened under Comprehensive Primary Health Care by promotion of wellness activities and targeted communication at the community level.

3. Eat Right Movement- The Eat Right India movement is an initiative of the Government of India and the Food Safety and Standards Authority of India (FSSAI) to transform the country’s food system in order to ensure safe, healthy and sustainable food for all Indians.

4. FSSAI limits for trans fats- FSSAI has issued guidelines limiting trans fatty acids in oils and fats to be not more than 2% by weight.

5. FSS (Labelling and Display) Regulations, 2020- It mandates that labels should mention food allergens, nutritional information including fat, trans fat, salt, sugar, added sugar etc.

What should be the way forward?

1. Awareness about the grave dangers of obesity- The medical community must create awareness about the NPCDCS guidelines, which recommend annual screening for excess weight in children as young as two to six years old.

2. Improving the access to nutrient rich food- The access of vulnerable sections to healthy nutrition must be enhanced by measures such as targeted cash transfers, vouchers for healthy foods, free healthy school meals, and primary care-based nutritional interventions.

3. Initiatives to reduce obesity among adults- Yoga days can be fixed in a week in offices, welfare societies. Also, under Swachh Bharat Abhiyan, cleaning of parks and other spaces can be promoted, so that adults can come for exercise.

4. Initiatives to reduce obesity among Children- Strict implementation of RTE act norms, by implementing mandatory minimum grounds size and other sports infrastructure in schools. Construction of parks and open spaces in colonies, so that children can play outside rather than remaining busy with indoor activity like video games, computer games.

5. Disincentivising the ultra-processed food industry- Higher taxes on unhealthy processed and junk food, and front-of-pack nutrition labelling to guide consumers must be implemented.