Tackling obesity: India's growing public health challenge

According to a report by the WHO and Imperial College London, 100 million people globally are obese. Obesity is rapidly becoming a global health crisis, affecting millions of adults and children alike. Recent research has shown a dramatic increase in obesity rates worldwide in both developing and developed countries. 

This alarming rise is a concern for individual health and poses a substantial burden on healthcare systems and economies. Obesity is a disease that can occur due to dietary choices, lifestyle, and socioeconomic factors. 

This article delves into the latest findings on obesity rates. It explores the underlying causes and highlights the importance of comprehensive strategies to combat this issue. We aim to shed light on the urgent need for action to prevent and manage obesity.

Key evidence of reference here.

Image: The Indian Express

Major findings of the Lancet report on obesity:

• The study revealed the global rate of obesity among children and adolescents (5–19) grew four times, and the adult obesity rates have more than doubled between 1990 and 2022. 
• In 2022, 44 million women and 26 million men were suffering from obesity in India.
• Even if stunting remains on the decline in India, obesity—which is also a type of malnutrition—poses a threat.
• More women are obese than men globally, including in India.   

What is obesity?

According to the WHO, obesity is a chronic, complex disease defined by excessive fat deposits that can impair health. 

Overweight, or obesity, depends on a person's height, weight, and body mass index (BMI). For adults, the WHO defines:

• A person is overweight when their BMI is greater than or equal to 25
• A person is obese if their BMI is greater than or equal to 30.

Obesity and malnutrition: 

WHO defines malnutrition in all its forms, including: undernutrition (wasting, stunting, and underweight), inadequate vitamins or minerals, overweight, obesity, and diet-related noncommunicable diseases.

Thus, malnutrition consists of two components: underweight, or thinness, and obesity. The study examined these two characteristics of malnutrition. Discovering that despite India's position as one of the world's most malnourished and thinnest nations, the country's obesity prevalence has been rapidly rising between 1990 and 2022. 

Reasons behind obesity: 

• Dietary choices: People have moved from traditional food to fast food. Our traditional food was low in animal products, salt, refined oils, sugars, and flour. Whereas, fast/junk food is high in energy but low in nutrients—it contains refined carbohydrates, high fat, meat products, and processed foods. 
• Sedentary Lifestyle: The National Nutrition Monitoring Bureau's diet and nutrition surveys in rural areas carried out in different periods (decadal surveys) have shown that sedentary activity had significantly increased from 34 percent in 1975-79 to 74 percent by 2012. This could be a major contributing factor to the high prevalence of obesity in India. In addition, more use of mobile devices and tablets and fewer outdoor activities such as playing have had a potential effect on obesity among children.
• Women are more prone to obesity: Women tend to live in more traditional environments and are overburdened. They are unable to find time for exercise and have less access to wholesome food options and obesity-related education. Biological factors, such as menopause and pregnancy, also have a unique impact on women's weight. Women also get less sleep, which impacts their health.
• Unhealthy food options are more affordable: They are easily accessible than nutritious food options. Thus, obesity rates have climbed in lower incomes families of Tamil Nadu, Punjab, and Goa.

Effects of obesity: 

• Obesity and undernutrition are likely to increase the burden of noncommunicable diseases in the country.
• Hypertension, diabetes (especially Type 2), heart attacks, strokes, cancer, and liver damage are among the disorders that are anticipated to rise due to an increase in obesity.
• Obesity in parents increases the chances of the offspring suffering from obesity and related health issues.
• Obesity has the potential to lower life quality in general.
• People who once enjoyed physical activities might not be able to do so. They may also avoid public spaces. Individuals with obesity may also face discrimination. 
• Other life-related issues are: depression, disability, shame and guilt, social isolation and lower work achievement.

How can we tackle obesity?

The underweight-to-obesity transition can happen quickly, making situations even worse. Hence, obesity and underweight shouldn't be viewed in isolation.

The main focus must be on programs that promote healthy eating. Examples include:

• Targeted cash transfers
• Primary care-based nutritional interventions
• Free healthy school meals
• Food assistance in the form of vouchers or subsidies for nutritious items.

Reducing the consumption of processed foods and harmful fats while increasing physical activity will greatly reduce the risk of obesity. A diet low in sugary drinks and heavy in fruits and vegetables is essential for this. 

Supporting weight loss in obese individuals is also critically needed. However, prevention and management can be difficult. Since age of onset of obesity has decreased and exposure to obesity had increased. 

Thus, Lancet’s new study emphasizes the significance of controlling and preventing obesity from childhood to adulthood through nutrition, exercise, and appropriate medical care. 

Projects to make healthy meals affordable and accessible, particularly for low-income populations, should be promoted.

Research and development on obesity should be conducted separately for each group. As there are no universal clinical recommendations for treating obesity. It differs across institutions and nations.

Certain groups are completely deprived of opportunities to exercise and have restricted access to healthy diets. The government must create public areas where people can walk and exercise to reduce these disparities. 

Finally, evidence-based policies will also be necessary to help in this endeavor. Notably, the commercial sector must cooperate and take responsibility for the health effects of their products.

Conclusion: 

Obesity among children, adolescents, and adults is extremely alarming. A number of potential interventions could be implemented, including encouraging healthy diets and lifestyles, controlling the marketing and distribution of unhealthy foods and drinks, taxing sugar-filled beverages and junk food, subsidizing healthy foods, establishing secure and convenient areas for physical activity, diagnosing and treating obesity and its complications, and educating and increasing public awareness.

Governments and communities must work together to reduce obesity in order to fulfill the global targets set by the WHO and national public health authorities.

(Akrati is a researcher in public policy and social sector.)