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Indians find themselves alongside the United States and China on the obesity spectrum, with approximately 80 million individuals classified as obese, according to a report by Lancet. Recently, Prime Minister Narendra Modi kicked off an anti-obesity initiative following a discussion of the topic on his monthly radio show, ‘Mann Ki Baat.’ He appointed ten prominent figures to lead this campaign. During his address on Sunday, PM Modi highlighted the pressing need to confront obesity and urged people to diminish their consumption of cooking oils. Additionally, he introduced a "challenge" encouraging individuals to reduce their oil intake by 10% while motivating ten others to join in. “For our nation to thrive with health and fitness, it is crucial that we unite in our efforts against obesity. This issue goes beyond personal health, becoming a matter of national importance,” he stated.

The ten individuals chosen by him to head the anti-obesity campaign include Jammu and Kashmir Chief Minister Omar Abdullah, industrialist Anand Mahindra, actor and politician Dinesh Lal Yadav ‘Nirahua’, shooting champion Manu Bhaker, weightlifting star Mirabai Chanu, Malayalam film legend Mohanlal, Infosys co-founder Nandan Nilekani, actor R Madhavan, singer Shreya Ghoshal, and philanthropist and MP Sudha Murty.

Child Obesity in India:

The study conducted by Lancet revealed a significant increase in obesity among Indian children aged 5 to 19, rising from 0.4 million in 1990 to 12.5 million in 2022. Among women over 20, obesity escalated dramatically, from 2.4 million in 1990 to 44 million in 2022. In terms of obesity prevalence, India ranks 182nd out of 197 countries for women and 180th for men in 2022. The country is positioned 174th globally for both genders, according to the report. The latest National Family Health Survey (NFHS-5), which was conducted between 2019 and 2021, the government's most thorough health and social indicators survey, indicated that 3.4% of children under the age of five are now overweight, an increase from 2.1% in 2015-16.

As per Unicef's World Obesity Atlas for 2022, it is anticipated that India will have over 27 million obese children by 2030, equating to one in ten children worldwide. The country ranks 99th among 183 nations regarding its ability to manage obesity, and the economic burden associated with excessive weight is projected to soar from $23 billion in 2019 to an astounding $479 billion by 2060. Dr. Arjan de Wagt, chief of nutrition at Unicef in India, pointed out to the BBC that in India, where 36% of children under five years are still experiencing stunting, “the progress we're achieving in fighting undernutrition is being counterbalanced by the rise of over-nutrition.” A survey by Max Healthcare in 2019 conducted in Delhi and surrounding areas found that at least 40% of children aged 5 to 9, teenagers aged 10 to 14, and adolescents aged 15 to 17 were either overweight or obese.

The Significance of Obesity as a Health Indicator:

The World Health Organization defines obesity as an abnormal or excessive fat accumulation that poses significant health hazards. A body mass index (BMI) greater than 25 indicates being overweight, while a BMI exceeding 30 classifies an individual as obese. Dr. Sanjay Verma, Director of Minimal Access, GI and Bariatric Surgery at Fortis Escorts on Okhla Road in New Delhi, highlighted the seriousness of the issue, stating, “India is currently facing a critical situation with obesity. In my clinical experience, approximately one in four or five patients is either clinically obese or overweight,” as reported by The Quint. In January, the Lancet Diabetes and Endocrinology Commission, supported by 75 medical organizations worldwide, proposed two methods for diagnosing obesity: clinical and pre-clinical obesity. According to the updated guidelines, pre-clinical obesity refers to a situation where there is a variable health risk associated with excess body fat, yet no evident health complications are present. The recommended care strategy should focus on reducing these risks. The Lancet commission emphasized this shift in perspective — recognizing obesity as a disease rather than merely a risk factor for other ailments — calls for heightened clarity in its diagnosis, as reported by Stat News, a site that focuses on health, science, and medicine.

Updated Guidelines for Obesity in India

Indian healthcare professionals and researchers have asserted the necessity of a new definition and updated guidelines for obesity, as the previous 2009 standards relied exclusively on BMI for diagnosis. Studies indicate that BMI is insufficient, particularly for the Indian population, in determining obesity levels. Research has identified a significant correlation between abdominal fat, inflammation, and early health issues among Indians.

Obesity can be categorized into two distinct stages:

Stage 1: This stage indicates increased fat accumulation (BMI > 23 kg/m²) that does not visibly impact organ function or daily activities. This form of obesity, often referred to as "Innocuous obesity," does not currently lead to any pathological issues but may escalate to Stage 2 obesity, which is associated with both mechanical complications and disease-related issues.

Stage 2: This advanced state of obesity arises when the BMI surpasses 23 kg/m², along with high abdominal fat, excessive waist circumference, or a concerning waist-to-height ratio. Such factors can affect physical and organ functions, leading to mechanical problems (like knee arthritis caused by excess weight) or the emergence of obesity-related diseases (including type 2 diabetes).

Factors Contributing to Higher Obesity Rates in Women

Dr. Pradeepa Guha, a study co-author and Head of Research Operations and Diabetes Complications at the Madras Diabetes Research Foundation, discussed key factors contributing to higher obesity rates among women, as reported by The Indian Express. She noted that many women find themselves overwhelmed with household and work responsibilities, leaving little time for exercise. Additionally, she pointed out that women in India often face challenges related to healthcare access and education, frequently prioritizing the nutritional needs of their families over their own. Furthermore, biological changes such as pregnancy and menopause also play a role in affecting women’s weight, according to the doctor.

Another medical professional, Dr. Sanjay Verma, who serves as the Director of Minimal Access, GI and Bariatric Surgery at Fortis Escorts, located on Okhla Road in New Delhi, stated, as reported by The Quint, that men often exhibit truncal obesity, a condition that may not be externally apparent but poses significant health risks. In this scenario, fat accumulates in the abdominal area.

Global Obesity Overview:

The World Health Organization (WHO) reported that in 2022, approximately 2.5 billion adults aged 18 and older were categorized as overweight, including over 890 million diagnosed with obesity. This figure reflects that 43% of adults, comprising 43% of men and 44% of women, fell into the overweight category, a rise from 25% in 1990. Notably, around 31% of the world's overweight population resides in the South-East Asia and African regions, as opposed to 67% located in the Americas. In 2022, about 16% of adults globally were classified as obese. Furthermore, an estimated 37 million children under five years old were recognized as overweight. Once viewed primarily as an issue for high-income nations, the prevalence of overweight individuals is increasingly noted in low- and middle-income countries.

Looking ahead, projections from the World Obesity Atlas 2024 suggest that nearly 3.3 billion adults may experience obesity by 2035, with young individuals between the ages of 5 and 19 anticipated to exceed 770 million by the same year. Estimates from the Global Burden of Disease study (IHME, 2024) indicate that around two-thirds of the annual 56 million deaths are attributable to non-communicable diseases (NCDs), contributing to 40% of NCD-related disability-adjusted life years (DALYs). In the United States, the National Institutes of Health reports that roughly 65% of adults and 15% of children and adolescents are currently classified as overweight or obese. The WHO highlighted that the U.S. ranked 15th in the world in 2022, with 42% of adults identified as obese.

Strategies for Preventing Obesity and Managing Diet:

Experts suggest that an effective approach to achieving a healthy weight includes a balanced diet along with a combination of cardiovascular exercise and strength training. Individuals are encouraged to focus on reducing or eliminating smoking, keeping track of dietary habits, refraining from excessive snacking, and avoiding binge eating. Dr. Pradeepa highlights the dangers of high sugar consumption through drinks such as soda and sweetened coffees. “For overall fitness and health, engaging in at least 60 minutes of physical activity daily is advisable. It is essential to limit the marketing of unhealthy food and beverages to children, impose restrictions on junk food advertising aimed at youths, implement clear nutritional labeling, and promote healthier choices in school cafeterias,” according to Dr. Pradeepa. Additionally, ensuring greater access to affordable, nutritious food is crucial. Experts also recommend encouraging children to participate in physical activities like outdoor games and sports, as well as completing household tasks after school, rather than allowing excessive screen time on phones, gadgets, or television.