The story so far: Earlier this week, Prime Minister Narendra Modi, in his ‘Mann Ki Baat’ radio programme highlighted the alarming increase in obesity in the country, particularly among children, and noted that obesity affected one in eight Indians. Mr. Modi urged people to reduce oil consumption by 10% each month and stressed that to build a fit and healthy nation, obesity needed to be addressed. Following this up with a social media post, Mr. Modi nominated a number of prominent personalities to spread awareness and strengthen the fight against obesity.
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What is the scale of the obesity problem in India?
Overweight and obesity are defined by the World Health Organization (WHO) as abnormal or excessive fat accumulation that presents a risk to health. Data from the National Family Health Surveys (NFHS) reveals that obesity has been increasing across India over the years. The percentage of women who were overweight/obese grew from 20.6% during NFHS-4 (2015-16) to 24% during NFHS-5 (2019-21). The percentage of overweight/obese men increased from 18.9% to 22.9% during this period. Urban numbers were significantly higher than rural numbers.
A 2023 research paper in The Lancet Regional Health Southeast Asia that analysed the NFHS-5 data, found the prevalence of abdominal obesity (assessed through waist circumference) in the country was 40% in women and 12% in men.
Childhood obesity is also an area of concern: the percentage of children under 5 who were overweight rose from 2.1% to 3.4% from 2015-16 to 2019-21, as per NFHS data. With older children the figures are higher: the World Obesity Atlas 2022 estimates that India will have a child obesity prevalence of 10.81% amongst 5 to 9-yearolds and 6.23% amongst 10 to 19-year-olds by 2030.
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What are the health risks associated with obesity?
Obesity is called the ‘mother of all diseases’. According to the WHO, obesity in adulthood is a major risk factor for the world’s leading causes of poor health and early death. These include: cardiovascular disease, several common cancers, diabetes and osteoarthritis.
India leads the world in the number of people with diabetes at an estimated 101 million. The burden of cancer is on the rise; from 14.6 lakh cancer cases in 2022, the number is projected to go up to 15.7 lakh in 2025, as per the Indian Council of Medical Research-National Cancer Registry Programme. Moreover, 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 fact, non-communicable diseases (NCDs) now account for about 60% of all deaths in India.
Being overweight in childhood and adolescence, the WHO says, affects children’s and adolescents’ immediate health and is associated with greater risk and earlier onset of various NCDs. It can also have adverse psychosocial consequences affecting school performance and quality of life, compounded by stigma, discrimination and bullying. Children with obesity are very likely to be adults with obesity, and are also at a higher risk of developing NCDs in adulthood.
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Why is obesity on the rise?
“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,” says K. Srinath Reddy, distinguished professor of public health, Public Health Foundation of India.
Cost is another factor. Low-income households, especially those that depend on the public distribution system, eat more carbohydrates through rice and wheat, says public health professional Vandana Prasad. “You can instruct people to eat better, but it is not possible if these foods are unaffordable. Indian diets, especially among poor families, are deficient in iron and proteins. Foods like fruits, vegetables, pulses, dairy and animal-based foods are all expensive. While at present obesity is still primarily an urban, middle class phenomenon in India, it is already rising among the rural poor, which may soon overtake other segments,” she adds
A study in The Lancet Global Health last year said almost half of all Indians are not sufficiently physically active. “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,” points out Dr. Reddy. The absence of safe cycling lanes and pedestrian paths are compounded by dimly-lit lanes; green spaces available for recreational physical activity are shrinking while traffic density and rising street crime deter walkers in many urban zones. “Unless clean, green and safe urban environments make it easy and enjoyable for regular physical activity, obesity levels will continue to rise in our cities and towns,” he cautions.
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Are we measuring obesity correctly?
While the usual metric to measure obesity is the Body Mass Index (BMI), there has been a growing debate about its limitations: BMI does not indicate how much of the weight is fat and where the fat is distributed in the body. Fat in the abdomen particularly — something that Indians are genetically predisposed to accumulating — contributes to metabolic syndrome, a group of risk factors that increases the chances of developing type 2 diabetes, stroke and heart disease.
This January, experts in India issued updated guidelines for obesity treatment and diagnosis that placed special emphasis on abdominal fat distribution. The classification introduces two stages in obesity — the first stage where there is increased adiposity without discernible effects on organ functions or daily activities and the second, where both physical and organ functions are impacted. It recommends the use of waist circumference or waist-to-height ratio and body fat measurements, alongside BMI, to diagnose obesity.
Published – March 02, 2025 12:11 am IST