A report published by Lancet has depicted an alarming picture of the state of obesity in India—about 21.8 crore men and 23.1 crore women, or a third of India’s population, are likely to be overweight or obese by 2050.
In India, people with a body mass index (BMI) of above or equal to 25 are categorised as obese or overweight. According to the World Health Organization, those with a BMI of 25 or more are considered overweight, and those with 30 or more as obese. The BMI is a measure of a person’s body fat based on their height and weight, and is calculated by dividing a person’s weight in kilograms, by the square of their height in meters (kg/m²).
India ranked third in the world with an estimated 4.5 crore people categorised as obese in 2023. The top rank was held by the US, with an estimated 7.94 crore obese people, followed by China with 5.73 crore. However, the proportion of obese people to the total population in India and China being 7.2 percent and 8.2 percent, respectively, are much lower than that for the US (42.9 percent). In many developed and developing countries, the obesity rate is around 30 percent or more.
Global data shows that between 1990 to 2022, the overall percentage of adults above 18 years with obesity has more than doubled from 7 percent to 16 percent, while for children and adolescents aged 5 to 18 years, this proportion rose from 2 percent to 8 percent. These rates vary widely across countries and regions.
Results of India’s National Family Health Survey (NFHS) reveal an upward trend in the prevalence of obesity among Indian men and women. Between NFHS-4 and NFHS-5 rounds, corresponding to the periods 2015-16 and 2019-21, the proportion of overweight or obese persons among Indian men and women increased from 18.6 percent and 20.7 percent respectively; during 2015-16 and 2019-21, to about 22.9 percent and 24 percent respectively.
Over these two periods, the percentage of obese children in India (under five years) rose from 2.1 percent to 3.4 percent. The obesity rate was higher among urban Indians than rural Indians. Abdominal obesity was higher among Indian women as compared to Indian men.
A study led by Sakshi Singh of Lucknow’s King George’s Medical University noted that male children in India were at a higher risk of developing obesity compared to female children. Further, children studying in private schools were at a higher risk, compared to those studying in government schools. Children of working women faced a higher risk of obesity, as compared to children of non-working women.
Genetics; sedentary lifestyle, including consumption of high-fat and high-sugar foods; lack of physical activity; socio-economic and other factors account for this rising trend in obesity. Obesity increases the risk of cardiovascular diseases, diabetes, musculoskeletal disorders and certain types of cancers. The International Diabetes Federation projects that by 2050, India will be home to the second-largest number of diabetic (15.6 crore) people in the world.
This rising trend in obesity is a matter of concern for the government and households, hence, a larger share of government and household budget must be allocated for healthcare expenditures. The economic costs of obesity, in terms of health care costs and lost productivity, are immense. As per a 2023 report in the British Medical Journal, the global burden of overweight and obesity is expected to reach $4.2 trillion by 2035. Obesity costs the US healthcare system about $172 billion per year, whereas for the UK National Health Services it costs around £6.5 billion a year.
According to Global Obesity Observatory, the economic cost of obesity in India in 2019 was estimated at $28.95 billion (about ₹2.5 lakh crore), which is about 1.02 percent of India’s GDP. It is expected to rise to $81.53 billion (about ₹7 lakh crore) by 2030 which is about 1.57 percent of India’s projected GDP. Without intervention, these costs for India may reach $838.6 billion (about ₹69.6 lakh crore) by 2060.
National Sample Survey’s Consumer Expenditure Survey data reveals that not only undernutrition, but also overnutrition has been a serious problem in India. While undernutrition has received considerable attention in policy interventions in India, overnutrition has largely been neglected. Liberalisation of the Indian economy has led to consumption of more processed foods, meats and junk food, which have aggravated obesity in India.
Unlike in schools abroad, where participation in sports and gymnastics are compulsory, it is optional in India. Sports and gymnastics must be made compulsory in our schools. It is not enough that we practice yoga only on International Yoga Day, but also do it on a regular basis to improve health and well-being.
Awareness campaigns to encourage people to be fit, and shift to sustainable and healthier diets need to be accelerated. Although the government has implemented initiatives such as Fit India movement, Poshan Abhiyan, Khelo India to fester fitness and healthier lifestyle, these have had no visible impacts so far. It is laudable that the Union health ministry has taken cognisance of the matter and started acting.
K N Ninan | Former Professor, ISEC, Bengaluru and Lead Author, GEO-7, UNEP Nairobi
(Views are personal)
(ninankn@yahoo.co.in)