In the last two decades in India, a major epidemic infection has occurred that has not captured enough public attention – the challenge of overweight and obesity. The National Family Health Survey Round 5 (NFHS-5, 2019-21) suggests that every four men or women have almost one obesity. The ratio of people who suffer from overweight and obese, which are 8% to 50% in states, both in men and women and in rural and urban settings. The World Obesity Federation estimates that India’s annual growth in childhood obesity is one of the world’s most difficult. Excess weight and obesity in adults and children has doubled in the last 15 years and has been three times in the last three decades. A nationwide study by the Indian Council of Medical Research at Lancet Diabetes and Endocrinology (2023) had speculated that in India, one of adults over 20 years of age, one of the third (35 crore) has stomach obesity, every fourth person (in 25 crores) is generally obese and one of the fifth person.
The subject needs immediate attention
Being overweight and thick is often considered a personal issue. In addition, the general social attitude in India normalizes obesity or overweight. Over the last few decades, India has created another positive epidemiology innings: from being ‘food or calories lack’ to ‘food or calories enough (with uneven distribution) to become a nation. Nevertheless, the ‘State of Food Security and Nutrition in the World’ Report (2024), estimating that about 55% (78 crore) of India’s population could not tolerate a healthy diet and about 40% of people are less than a sufficient nutritious diet. In the last two decades, the easy and low-cost availability of high fats, salt, sugar (HFSS) and ultra-processed food (UPF) have complicated the challenge. Urbanization has led a sedentary lifestyle for many people. Recently, the World Health Organization (WHO) report states that 50% of Indians fail to meet recommended physical activity levels.
‘Thin Fat Indian’ is a scientifically valid hypothesis: Indians often have more fat in the body with a normal body mass index (BMI). The ‘normal soil hypothesis’ highlights obesity as a cause and risk factor for diabetes (one of each fourth Indian adult, or 25 million Indians, either diabetes or predeebitic). Overweight and obesity are associated with an estimated 3.4 million deaths in the world annually. This, Antar Alia, WHO and doctors from all over the world and professional union of the endocrinologist have admitted that obesity is both a risk factor/lifestyle challenge and a complex and chronic disease. The Global Obesity Observatory estimates that the annual economic cost of obesity and overweight in India in 2019 was $ 28.95 billion (00 1,800 per person), or 1.02% of India’s GDP. These costs are associated with health care expenses and lost productivity among others. Without adequate interventions, it is estimated that the economic burden is expected to increase to ₹ 4,700 per person to 2030 (or 1.57%of GDP). India’s Economic Survey 2024-25 pays attention to obesity as an emerging health challenge, recommending high taxation on UPF.
Nevertheless, unlike malnutrition, there are not enough programmatic initiatives to deal with obesity. However, the national government promotes ‘Khelo India’, ‘Fit India Movement’ or ‘Eat Right India’ campaigns, and has also been public discourses for lack of oil use in homes, these are the initiatives that have a lot of responsibility on the person, even most other stakeholders are less responsible.
Policy and programming solutions
A multi -layered approach is required to deal with obesity.
First, start a fine social dialogue, and a structured science communication and public awareness campaign to highlight that obesity is a disease with increasing burden and contributes to other diseases such as diabetes, high blood pressure, and liver disorders. Obesity requires prevention, care and management like any other health condition.
Second, regular regular physical activity should be done to promote and facilitate more. Believer with space for bicycle lane requires better urban planning and urban infrastructure development, free access to parks and other public places and open gymnasiums.
Third, HFSS and UPF products are prominent contributors to overweight and increasing burden of obesity. These foods need to be taxed at a high rate, which contains subsidy to ensure their easy and comprehensive availability with subsidies for healthy foods including fruits and vegetables and functions. The food industry must be volunteers to adopt moral practices in food marketing.
Fourth, ‘weight, height and waist circumference’ measurement should be an integral part of all health trips and preventive health check -up. Optimal weight should be discussed with health care providers in every engagement. People need to know the basic information such as what should be the optimal weight or waist circumference of someone. A very common but useful parameter to know someone’s ideal weight is the height in the centimeter minus 100 for men and minus 105 for women. The waist circumference of more than 80 cm in women and more than 90 cm in men is unhealthy.
Fifth, anti -obese drugs are being licensed in various settings. There is a need to develop and broadcast of clinical practice guidelines about ideal candidates for anti-observance drugs, which need to be used according to medical signals.
Sixth, each office and workplace need to increase awareness about ‘unhealthy weight’ in the workforce and easily provide weight scales. There should be a regular awareness campaign about obesity prevention. The body fat and composition analysis should be practiced regularly.
Seventh, schools and colleges should be engaged in sharing knowledge on healthy eating habits and healthy foods. The school canteen should serve healthy food. Siddha good practices like schools promoting health needs to be adopted in India. The learning of countries like Japan, where dietists are a part of every school network, should be detected.
Coordinated intervention
Eighth, obesity prevention requires many ministry’s busyness (health, finance, education, agriculture, urban planning and development) to work together. One of the learning from applying feeding and nutrition programs is that isolated intervention makes a limited difference. India’s nutrition should be rebuilt as ‘Supochan Abhiyan’, not only on feeding the nutrition intervention program, but also focusing on ‘Mindful Under-feeding’ and ‘Rightful Micronutrient Supplement’.
The ninth, research community, medical and public health professionals need to generate additional evidence including epidemiology data on overweight and obesity. This evidence needs to be easily communicated to the general public in the messages that come to understand. The professional union of doctors need to create the ability of health care providers in dealing with overweight and obesity.
Tenth, healthy food in India is becoming more expensive than eating junk food. Food industry, especially online food distribution platform, should facilitate healthy food. Corporate Social Responsibility Fund from the region should be kept to promote health lifestyle and eating habits.
Obesity is a public health challenge, waiting for overall, multi -layered and comprehensive interventions. Dealing of overweight and obesity is a sign for a healthy, economically rich and developed India.
Dr. Chandrakant Lahia is a practice doctor who has worked with the World Health Organization and other United Nations agencies for nearly 17 years. He is the author of ‘Obesity Care in India: A National White Paper’
Published – March 04, 2025 12:16 AM IST