The curse of the calories is truly upon us. Triglycerides and LDL cholesterol are the new-age demons feeding into our collective existential angst.
Modern lifestyle, marked by disproportionate gadget screen time, junk eating, changing work patterns, and lack of physical activity, is pushing us towards a major health crisis. Sedentary life is the new-age silent threat to public health, contributing significantly to the burden of chronic illnesses, including cardiovascular diseases, diabetes, dementia and cancer.
With one in every eight people being overweight, India is staring at an obesity epidemic. It needs to be tackled on a war footing. Prime Minister Narendra Modi’s recent announcement, nominating ten prominent personalities from diverse fields to promote awareness on the modern menace is a welcome development. It is time to wage a collective war against bulging waistlines. Roping in celebrities, including film stars, sports persons, business leaders and politicians, to raise awareness about the dangers of unhealthy eating and sedentary lifestyles is a laudable idea. They help in making social messaging more effective.
The Prime Minister has rightly emphasised the need to reduce oil consumption by 10% each month and to launch a joint fight against obesity to build a fit and healthy nation. Among those nominated by him are actors Mohanlal and R Madhavan, singer Shreya Ghoshal, Jammu and Kashmir Chief Minister Omar Abdullah, businessman Anand Mahindra, shooter Manu Bhaker, weightlifter Mirabai Chanu, Infosys co-founder Nandan Nilekani and philanthropist Sudha Murthy.
As per the 2019–2021 National Family Health Survey (NFHS-5), around 24% of women and 22.9% of men are obese in India. Persons with a body mass index (BMI) — ratio of a person’s weight and their height squared of more than 30 are considered to be obese. Those with a BMI of over 25 are considered to be overweight.
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Silent killer
Overweight and obesity are defined by the World Health Organisation (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 in the country was 40% in women and 12% in men. A shift in dietary choices and sedentary lifestyles are playing havoc with public health. According to a new global study, over 44 million women and 26 million men aged above 20 in India were found to be obese, compared to 2.4 million women and 1.1 million men in 1990.
No more an urban phenomenon
India ranks 182 among 197 countries for the prevalence of obesity in women and 180 for men in 2022. Child obesity is also a growing problem in India. More than 12 million children in the country, aged between five and 19, were grossly overweight in 2022, up from 0.4 million in 1990. These findings assume significance at a time when India already has a high burden of non-communicable diseases like heart disease, strokes, and diabetes.
The Covid-19 pandemic has further escalated the issue. The pandemic got people accustomed to staying at home, consuming more calories and moving less. Experts have been emphasising the links between these lifestyle-related diseases and obesity. Long thought to be an urban problem, obesity has become a health threat in rural parts of the country in the last decade. The World Obesity Atlas 2023 has warned that more than half of the world's population will be overweight or obese in another 12 years unless urgent action is taken to curb the growing epidemic.
In India, the overall impact of the health issues related to obesity on national GDP will be 1.8% by 2035. In fact, the country is facing a double whammy—malnutrition as well as obesity. Comprehensive national action plans are needed to prevent and treat obesity which is linked to several illnesses including type-II diabetes and some forms of cancer. It accounts for four million deaths annually with the global rates having tripled over the last five decades.
There is a need for targeted interventions at various levels including a massive drive to change dietary habits. Our traditional food was low on animal products, salt, refined oils, sugars and flours but we have now moved towards a diet that is high in energy but low in nutrients – refined carbohydrates, high fat, meat products, and processed foods. Consumption of added sugars plays a significant role in driving obesity, particularly when ingested through beverages like sodas, sweetened coffee, and tea.
Unfortunately, even the key nutrition-related policies like “Poshan 2.0” do not give adequate attention to unhealthy eating habits. Higher taxes on unhealthy food and incentives for healthy food, front-of-pack nutrition labelling to guide consumers are some of the measures needed to promote public awareness.
Way forward
A holistic health approach is needed to manage weight. Diet, exercise, and other lifestyle interventions become extremely important in people with pre-clinical obesity with the WHO recommending at least 150 minutes of moderate intensity physical activity or 75 minutes of vigorous intensity physical activity for adults every week.
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