Experts are now calling for urgent, multi-sectoral action to address what they describe as a chronic disease threatening India’s future.
Published Mar 05, 2025 | 3:49 PM ⚊ Updated Mar 05, 2025 | 3:49 PM
Obesity. (Supplied)
Synopsis: Childhood obesity in India has surged by 126 percent in 15 years, with adult obesity rates nearly doubling, costing the country $28.9 billion in 2019. Contributing factors include urbanization, sedentary lifestyles, and unhealthy diets. Experts call for urgent action to address this public health crisis, highlighting gaps in treatment, public awareness, and socioeconomic disparities that hinder access to care.
Childhood obesity in India has skyrocketed by 126 percent over the past 15 years, jumping from 1.5 percent in 2005-06 to 3.4 percent in 2019-21, according to the latest National Family Health Survey (NFHS-5).
This alarming trend, highlighted in the newly released National White Paper Obesity Care in India by the Foundation for People-centric Health Systems (FPHS), underscores a burgeoning public health crisis that extends far beyond children, with adult obesity rates nearly doubling and economic costs soaring to $28.9 billion in 2019.
The paper suggests that while most obesity estimates focus on adults, national-level data for children and adolescents remain limited. “This is concerning because global obesity rates are projected to increase most rapidly among these groups, rising from 10 to 20 percent in boys and from 8 to 18 percent in girls between 2020 and 2035,” said the paper.
The Comprehensive National Nutrition Survey (CNNS) 2018-19 provided an in-depth analysis of childhood nutrition across India, assessing pre-schoolers (0–4 years), school-aged children (5–9 years), and teenagers (10–19 years). With a total sample size of 112,245 participants, the study found that the prevalence of overweight and obesity in these groups stood at 2.69 percent, 4.18 percent, and 4.99 percent, respectively.
The paper further noted, “Additionally, research highlights that even Asian Indian children with normal weight are at heightened risk for cardiometabolic issues, with these risks being significantly higher among overweight children.”
Experts are now calling for urgent, multi-sectoral action to address what they describe as a chronic disease threatening India’s future.
“Overweight and obesity are driven by multiple factors such as urbanization, sedentary lifestyles, and changing dietary patterns. The time for action is now; inaction will have grave consequences, placing an increased burden on our health systems and hindering the nation’s economic development,” said Dr Chandrakant Lahariya, Founder and Director of Foundation for People-centric Health Systems.
The white paper revealed that 24 percent of women and 22.9 percent of men are obese, a sharp rise from two decades ago. Urban areas report prevalence rates between 13 and 50 percent, while rural regions range from 8 to 38 percent, signalling that obesity is no longer an urban-only issue.
According to data from the National Family Health Survey (NFHS-5), the prevalence of obesity among males aged 18–69 increased from 18.9 percent in NFHS-4 (2015–16) to 22.9 percent in NFHS-5. Among women, the proportion rose from 20.6 percent to 24 percent. The trend is also concerning for children, as the percentage of overweight children increased from 2.1 percent in NFHS4 to 3.4 percent in NFHS-5.
The paper highlighted that the rapid rise in overweight and obesity rates among adults in India, is largely driven by lifestyle shifts, work culture transitions, substance use, reduced physical activity, and unhealthy eating habits. Key contributors to this trend include age, urban residency, higher wealth index, access to clean fuel and sanitation facilities, and poor dietary patterns.
“Ethnicity and socioeconomic status also significantly influence Body Mass Index (BMI) in both men and women. Individuals with mixed ancestry from high-risk groups tend to exhibit intermediate obesity risks, while certain ethnic groups are more predisposed to obesity-related health complications. For example, Indian males have a higher likelihood of being overweight compared to White British males,” reads the paper.
Studies also revealed regional variations in obesity among South Indians, North Indians, and Northeast Indians, with differences in obesity’s impact on cardio-respiratory health. These disparities in adiposity and metabolic risks among mixed-ethnicity individuals are influenced by both genetic and environmental factors.
Additionally, differences in energy intake, physical activity, and body composition—such as fat vs. muscle and abdominal visceral vs. subcutaneous fat—vary among ethnic groups due to genetic predispositions.
The 2014 INDIA-ICMR study reported alarmingly high levels of physical inactivity in India, with a 54.5 percent prevalence. Urban areas recorded a 60 percent inactivity rate, compared to 50 percent in rural areas, with women being less active than men.
The paper read: “Urbanization has significantly increased the risk of obesity by encouraging sedentary lifestyles and reducing physical activity. City life often involves long commutes, desk jobs, and limited access to recreational spaces, leaving little room for exercise or active living. Moreover, urban areas are dominated by fast food outlets and processed food options, leading to unhealthy eating habits.”
It further pointed out that the convenience of modern technology, from online shopping to digital entertainment, further reduces physical activity. Combined, these factors create an environment that promotes weight gain, making urbanization and sedentary behaviours major contributors to the rising prevalence of obesity.
The financial toll is staggering. In 2019, obesity cost India $28.9 billion—roughly 1% of GDP—due to healthcare expenses and lost productivity. Without intervention, this could balloon to $440 billion by 2060, a 19-fold increase.
The white paper reframes obesity as a chronic disease, not a personal failing, linked to Type 2 Diabetes, cardiovascular diseases, hypertension, certain cancers, and metabolic disorders.
The paper further noted that Indians also face heightened risks due to the “Thin-Fat Indian” phenotype, where even those with lower BMIs carry excess fat, amplifying complications. Among the elderly, sarcopenic obesity—obesity coupled with muscle loss—is also reported to be rising.
Despite the crisis, India lacks a dedicated obesity management strategy. Programs like Ayushman Bharat, Fit India Movement, and Eat Right India promote wellness but fall short of targeted obesity care.
The report highlighted a lack of standardized treatment protocols, limited training for healthcare providers, and inadequate insurance coverage for interventions like bariatric surgery.
Public awareness is low, as many Indians do not recognize obesity as a disease, viewing it instead as a personal failure or lifestyle choice.
Stigma and cultural perceptions discourage early medical intervention, particularly among women, who face higher prevalence yet reduced access to care—which delays treatment.
Apart from the above issues, limited access to obesity care due to socioeconomic disparities further compounds the problem.
(Edited by Sumavarsha)
