NEW DELHI: Delhi, Kolkata and Chennai have emerged as hotspots for abdominal obesity in both men and women due to long hours in sedentary jobs, reliance on motorised transport, and easy access to packaged foods, which have created environments that promote weight gain, said a new nationwide study.
Published in Nature-Scientific Reports, the study, however, found that abdominal obesity is rising across the country, but not evenly. Instead, it follows a striking pattern shaped by geography and gender.
Based on data from over seven lakh people across 707 districts as per the National Family Health Survey 5 (2019-2021), the study also highlighted that more than half of women aged 15-49 (56.6%) and nearly half of men aged 15-54 (48.9%) in India has abdominal obesity, indicating an alarming trend with far reaching implications as non-communicable diseases such as diabetes and cardiovascular conditions are rising.
Led by the researchers from Health Systems Transformation Platform, New Delhi, an institution established by the Tata Trusts, the study also uncovered striking geographic disparities.
While northern states, including Punjab, Haryana, Delhi, Uttarakhand and Jammu and Kashmir, have a high prevalence of abdominal obesity among both men and women, the picture is totally different in central India. In districts across Madhya Pradesh, Chhattisgarh, Rajasthan, and parts of Maharashtra, relatively lower levels of abdominal obesity are reported.
But this advantage may not last, the study said, adding that as towns expand and lifestyles change, these areas could soon follow the same trajectory as the north.
The reason for abdominal weight among both men and women in northern states is basically because diets are increasingly rich in fats and refined carbohydrates. At the same time, physical labour has declined sharply, replaced by mechanisation and desk-based work. In some communities, a larger body size is still seen as a sign of prosperity - further reinforcing the trend.
Eastern India presents a mixed picture. States such as Bihar and Jharkhand continue to show lower prevalence, largely due to persistent poverty and undernutrition.
This is also beginning to change. Urban pockets in West Bengal and Odisha are already showing rising levels of abdominal obesity, pointing to shifting diets and lifestyles.
“This coexistence of undernutrition and obesity - often within the same region - is becoming one of India’s biggest public health challenges,” the researchers said.
The analysis also revealed distinct gender patterns across regions.
While the southern states like Kerala, Tamil Nadu and Andhra Pradesh show higher prevalence of abdominal obesity among women, across all age groups, certain districts in Telangana and Uttar Pradesh report higher rates among men, mainly linked to lifestyle changes among men with less physically demanding jobs, increased consumption of processed foods, and sedentary habits.
Researchers said that despite lower levels of behavioural risk factors such as tobacco and alcohol use, women exhibit a higher prevalence of abdominal obesity.
It cited biological factors, including hormonal changes and pregnancy-related weight gain, as well as social constraints that may limit physical activity and shape dietary practices among women for their weight gain.
Also, women often have fewer opportunities for physical activity, especially in urban and semi-urban settings. “Household responsibilities, safety concerns, and cultural norms can limit mobility; combined with changing diets, this creates a higher risk,” it added.
The researchers measured abdominal obesity using the waist-to-hip ratio, which is a more precise indicator of harmful fat distribution than conventional measures like Body Mass Index (BMI). Unlike general obesity, abdominal fat is closely linked to increased cardiometabolic risk, making it a more dangerous but often overlooked health indicator.
The study said that the rise in obesity in India is largely due to urban life fundamentally altering how people eat, work, and move. At the same time, many cities lack adequate spaces for walking, exercise, or recreation.
It pointed out a shifting social pattern. Obesity in India was traditionally more common among wealthier groups, particularly men. But this is changing mainly because cheap, calorie-dense foods are becoming widely available, spreading to lower-income populations too.
The researchers said that India’s expanding waistline is not just about lifestyle - it is about inequality, environment, and transition. “It reflects how rapidly the country is changing, and how uneven that change has been. If India is to tackle this growing crisis, it must start by recognising a simple truth: obesity is not the same everywhere, and it does not affect everyone equally. Understanding these differences is the first step toward addressing them.”
“By focusing on abdominal obesity, a more accurate predictor of future disease risk, it provides critical insights for early intervention. As the country grapples with the dual burden of malnutrition, the findings serve as a stark reminder that without proactive and targeted policy action, the consequences for population health could be profound,” the study added.