As obesity cases rise, focus grows on preventive steps
Last week, PM Narendra Modi called for urgent action to combat India’s growing obesity epidemic, emphasising the need to reduce oil consumption by 10 per cent
India is witnessing a concerning rise in non-communicable diseases (NCDs) and obesity, with recent interventions from the highest levels of government highlighting the urgency of addressing these health challenges — a position experts also backed.
Last week, Prime Minister Narendra Modi called for urgent action to combat India’s growing obesity epidemic, emphasising the need to reduce oil consumption by 10 per cent during his address at the 38th National Games opening ceremony on Thursday.
The prime minister’s concerns were echoed a day later when finance minister Nirmala Sitharaman presented the economic survey 2024-25 in Parliament, highlighting the health risks posed by ultra-processed foods. The survey revealed that nearly 9.6 per cent of rural and 10.64 per cent of urban food budgets are spent on beverages, refreshments and processed foods.
“There is enough research to show that the shift in dietary practices from unprocessed to semi-processed and to ultra-processed food items exposes an individual to a wide range of adverse health outcomes ranging from obesity, chronic inflammatory disorders, cardiovascular diseases, and mental disorders,” the survey stated.
Defining obesity
The push for dietary reform coincides with significant changes in how obesity is diagnosed globally. The Lancet Diabetes & Endocrinology recently published findings that challenge the traditional Body Mass Index (BMI) measurement, established in 1832, as the sole indicator of obesity.
Professor Francesco Rubino, chair of the commission at King’s College London, explained the complexities of obesity diagnosis in a statement: “Considering obesity only as a risk factor, and never a disease, can unfairly deny access to time-sensitive care among people who are experiencing ill health due to obesity alone. On the other hand, a blanket definition of obesity as a disease can result in overdiagnosis and unwarranted use of medications and surgical procedures, with potential harm to the individual and staggering costs for society.”
India’s approach to obesity diagnosis has seen multiple revisions over the years. In 2009, the country introduced modified BMI thresholds specifically for Asian Indians, recognising their tendency to develop health complications at lower BMI levels than Western populations. These guidelines set overweight at 23-24.9 kg/m² and obesity at >25 kg/m², significantly lower than Western standards of 25 and 30 kg/m² respectively.
Dr Anoop Misra of Fortis-C-DOC Centre of Excellence explained the significance of the latest guidelines: “The revised obesity diagnosis framework marks a significant advance for India’s healthcare system, where metabolic disease burden is rapidly rising. South Asian populations present a unique challenge, as they accumulate harmful abdominal fat at BMI levels considered ‘normal’ by traditional standards.”
He added that the new approach would improve treatment precision: “The proposed comprehensive assessment approach, incorporating waist circumference, body composition, and associated health conditions, enables more accurate risk stratification and helps deliver more targeted and appropriate treatment intensities.”
Indians’ dietary choices
Dr SK Sarin, director of the Institute of Liver and Biliary Sciences, emphasised the fundamentals of healthy eating in his book “Own Your Body A Doctor’s Life Saving Tips”: “Eating substantial natural, uncooked food is the key to good health. Broad principles of food intake that everyone must know-- how much to eat, what to eat, and when to eat.”
He particularly warned about processed sugars: “Fructose is the major culprit... Fructose intake slowly increased overtime, but in the past few decades the intake has dramatically increased. Manufactured food often contains fructose-glucose syrup... Colas, tonic waters and sodas often carry high fructose... fructose intake increases liver fat synthesis and reduces its clearance. The result is more fat in the liver and high triglycerides in the blood.”
While presenting the Union Budget on Saturday, Sitharaman noted increasing public awareness about nutrition: “It is encouraging that our people are increasingly becoming aware of their nutritional needs. It is a sign of a society becoming healthier. With rising income levels, the consumption of vegetables, fruits and shree-anna is increasing significantly.”
As the obesity crisis grows, attention has turned to new pharmaceutical interventions. Dr Nikhil Tandon, head of endocrinology at AIIMS-Delhi, cautioned against unsupervised use of emerging anti-obesity drugs: “At the moment they are our best bet but these must be taken under strict medical supervision. There are clear recommendations for who they work and for who they don’t, especially when talking about weightloss in non-diabetics. The percentage of people who can tolerate maximum dose is not 100%.”
During the release of World Obesity Atlas 2022, World Obesity Federation CEO Johanna Ralston emphasised the need for immediate action while maintaining optimism: “Now is the time for joined up, decisive and people centred action to turn the tide on obesity. It is clear we will not meet the 2025 UN targets to halt the rise of obesity, however we do have reasons to be optimistic. Every year we are increasing our scientific understanding of obesity, more people than ever are demanding action in their communities... means we should remain hopeful.”