Why is obesity growing in India? Experts list causes of the epidemic

Obesity is not just a cosmetic issue but a serious public health crisis that requires immediate attention.

Obesity is a major global health crisis, and India is now the third most obese country in the world, following the United States and China. According to the National Family Health Survey (NFHS-5) (2019-2021), over 135 million Indians are obese, with a higher prevalence among women at 24 percent compared to 22.9 percent in men. Alarmingly, childhood obesity is also on the rise, increasing from 2.1 percent in 2015-16 to 3.4 percent in 2019-2021, particularly in urban areas.

What defines obesity?
Obesity is typically measured using Body Mass Index (BMI), which is calculated by dividing a person’s weight in kilograms by the square of their height in metres. According to the World Health Organization (WHO), a BMI of less than 18.5 is considered underweight, while a BMI between 18.5 and 24.9 falls within the healthy weight range. Individuals with a BMI between 25 and 29.9 are classified as overweight, while those with a BMI of 30 or above are considered obese.

The classifications of obesity are further divided into categories, with Class 1 obesity ranging from a BMI of 30 to 34.9, Class 2 obesity from 35 to 39.9, and Class 3 obesity, also known as severe obesity, at a BMI of 40 or greater. However, Indian guidelines define obesity at a lower BMI threshold due to a genetic predisposition to metabolic diseases. In India, a BMI of 23 to 24.9 is considered overweight, while a BMI of 25 or higher is classified as obese.

Why is obesity increasing in India?
Dr Kiran Soni, Head of Nutrition & Health at Yatharth Hospital, Greater Noida, highlights several factors contributing to the rising obesity rates in India.

1. Sedentary lifestyle
The increasing urbanisation and modern work culture have resulted in a more sedentary lifestyle, where people spend long hours sitting in offices, commuting, or engaging in screen-based entertainment.

2. Unhealthy eating habits
The shift from traditional home-cooked meals to calorie-dense fast foods, refined sugars, and processed foods has worsened the situation, making unhealthy eating habits a major contributor to obesity.

3. Stress and sleep deprivation
High stress levels and poor sleep hygiene have led to hormonal imbalances, particularly an increase in cortisol, which contributes to weight gain.

4. Genetic and medical factors
Some individuals have a genetic predisposition to store fat more easily, making them more vulnerable to obesity. Certain medical conditions, such as hypothyroidism and insulin resistance, further increase the risk of excessive weight gain.

5. Socioeconomic and environmental factors
Higher incomes have led to greater affordability of high-calorie foods, while urbanization has reduced the need for manual labor. The lack of pedestrian-friendly infrastructure and accessible public spaces for physical activity have further contributed to a more sedentary lifestyle.

Health risks associated with obesity
Dr Sanjay Verma, Director of Minimal Access, GI, and Bariatric Surgery at Fortis Escorts, Okhla Road, New Delhi warns that obesity is not just about weight gain but also significantly increases the risk of life-threatening diseases. Individuals with obesity are at a much higher risk of developing type 2 diabetes, heart disease, and hypertension.

Excessive fat accumulation can also lead to fatty liver disease and cirrhosis, while added pressure on the joints increases the likelihood of developing arthritis. In addition to physical health problems, obesity has been linked to mental health issues such as depression and anxiety, as societal stigma and self-esteem challenges often affect individuals struggling with weight gain.

Obesity is typically measured using Body Mass Index (BMI), which is calculated by dividing a person’s weight in kilograms by the square of their height in metres.

How can obesity be controlled?
Experts emphasise that controlling obesity requires a multi-pronged approach that includes lifestyle changes, public health interventions, and medical treatments.

1. Healthy eating habits
Dr Mayank Madan, Director of Minimal Access and Bariatric Surgery at CK Birla Hospital, suggests that adopting healthy eating habits is crucial in preventing and managing obesity. A balanced diet that is rich in fiber, lean proteins, and healthy fats can help individuals maintain a healthy weight. Avoiding junk food, processed sugars, and high-calorie snacks is essential, while home-cooked meals with controlled portion sizes should be encouraged.

2. Regular physical activity
Engaging in regular physical activity is equally important in combating obesity. Individuals should aim for at least 150 minutes of moderate exercise per week, including activities such as walking, jogging, yoga, or strength training. For children, active playtime should be encouraged over excessive screen time to establish healthy habits from an early age.

3. Public health interventions
Public health interventions also play a key role in addressing the obesity epidemic. Government policies and awareness campaigns can help create a healthier environment by implementing taxes on sugary beverages and unhealthy foods, making physical education mandatory in schools, and improving food labeling to help consumers make informed choices.

4. Managing stress and sleep
Managing stress and ensuring adequate sleep are crucial for maintaining a healthy weight. High stress levels often lead to emotional eating and unhealthy lifestyle habits, while poor sleep disrupts metabolic functions. Maintaining a balanced work-life routine, practicing mindfulness techniques such as meditation, and ensuring seven to eight hours of quality sleep each night can contribute to better weight management.

5. Medical and surgical interventions
For individuals who struggle with severe obesity despite making lifestyle changes, medical and surgical interventions may be necessary. Dr. Verma explains that if a person’s BMI is above 35 and they are unable to lose weight through diet and exercise, bariatric surgery can offer a safe and permanent weight loss solution. Bariatric surgery is a proven medical intervention that can help individuals lose significant amounts of weight and reduce the risk of obesity-related health complications.