South Asians are vulnerable due to higher visceral fat for the same BMI compared to Western populations, increasing the risk of metabolic and cardiovascular diseases even at lower weights.
Published Jan 21, 2026 | 7:00 AM ⚊ Updated Jan 21, 2026 | 7:00 AM
Obesity. (Supplied)
Synopsis: Obesity has become a major public health challenge in India. Experts warned that obesity is a multi-system disease, driving chronic conditions ranging from fatty liver and heart disease to kidney dysfunction and cognitive decline.
In India, obesity is no longer a cosmetic concern — it has quietly become a major public health challenge. According to the National Family Health Survey (NFHS‑5, 2019–21), about 24 percent of women and 23 percent of men aged 15–49 are overweight or obese, while 3.4 percent of children under five are overweight.
“Obesity is not just about weight. It affects nearly every organ system and silently increases the risk of serious chronic diseases,” Dr Vikram Patil, senior consultant cardiologist at Kauvery Hospital in Bengaluru, told South First.
Experts warned that obesity is a multi-system disease, driving chronic conditions ranging from fatty liver and heart disease to kidney dysfunction and cognitive decline.
The rise of obesity in India is fueled by urbanisation, sedentary lifestyles, and dietary changes. Mechanisation and convenience-oriented living have reduced physical activity, while the intake of refined carbohydrates, ultra-processed foods, and alcohol has skyrocketed.
“Even in villages, the diet hasn’t changed much over generations, but the physical activity has reduced drastically. This imbalance between energy intake and expenditure is a key reason why obesity is rising,” Dr Dinesh Ramaswamy, Senior Surgical Gastroenterologist, SIMS Hospital, Chennai, told South First.
South Asians are particularly vulnerable due to higher visceral fat for the same BMI compared to Western populations, increasing the risk of metabolic and cardiovascular diseases even at lower weights.
“Visceral fat accumulates around organs like the liver, kidneys, and heart, which is why younger individuals can develop hypertension and other complications even with mild obesity,” added Dr Patil.
Government data support these observations: NFHS‑5 highlights that overweight and obesity are increasing among adults and children, emphasising the need for early intervention and public awareness.
Obesity is a major driver of metabolic liver disease, including MASLD (Metabolic Dysfunction Associated Liver Disease).
“Both obesity and fatty liver have a common origin. Excess energy intake without adequate physical activity leads to fat deposition, not just under the skin but in organs like the liver,” explained Dr Ramaswamy.
According to Dr Ramaswamy, liver disease in obese individuals progresses gradually. It starts with fatty liver, where excess fat accumulates in liver cells without causing immediate symptoms.
Over time, this can develop into NASH (non-alcoholic steatohepatitis), marked by inflammation, and then into fibrosis, where liver tissue begins to scar. Early-stage fibrosis can often be reversed with weight loss, dietary changes, and management of conditions like diabetes.
However, once fibrosis advances to cirrhosis, the damage becomes irreversible. Dr Ramaswamy also pointed out that hormonal imbalances, such as insulin resistance, diabetes, and hypothyroidism, accelerate fat deposition, increasing the risk of inflammation and long-term liver damage.
This highlights the importance of early detection and lifestyle interventions to prevent serious liver disease in obese individuals.
“Even a brisk 30-minute walk daily, combined with dietary adjustments, can significantly reduce liver fat and lower the risk of progression to cirrhosis,” he says. Lifestyle factors like alcohol intake and ultra-processed foods further exacerbate the condition.
Treatment focuses on weight loss, dietary changes, increased physical activity, and management of comorbidities, making early detection crucial.
Obesity profoundly affects cardiovascular health. “Obesity leads to endothelial dysfunction, hormonal changes, and sympathetic nervous system activation, which narrow blood vessels and cause resistant hypertension,” explained Dr Patil.
Over time, functional changes become structural: Arteries stiffen, and hypertension can become chronic. The accumulation of visceral fat around vital organs increases the risk of early-onset hypertension and cardiac events.
“Obesity often coexists with dyslipidemia and diabetes, and together these conditions damage the blood vessels, increasing the risk of heart attacks,” added Dr Patil.
Fortunately, early intervention can reverse many effects. “Weight reduction of 5–10 percent can lower blood pressure by 5–10 mmHg, and in some morbidly obese patients, bariatric surgery can reverse hypertension completely,” said Dr Patil. Obesity is now considered a cardiovascular risk equivalent, comparable to smoking, yet it often remains under-recognised.
Obesity extends its effects to the kidneys and brain, creating long-term risks. Nephrologists report that obesity increases the risk of chronic kidney disease (CKD) by causing hypertension, diabetes, and metabolic stress.
Early screening for proteinuria and kidney function is essential to prevent irreversible damage. From a neurological perspective, midlife obesity significantly raises the risk of dementia, Alzheimer’s disease, and cognitive decline.
Speaking to South First, Dr Sudhir Kumar, Senior Consultant Neurologist, Apollo Hospitals, Hyderabad, explained, “Even in people without diabetes, obesity and insulin resistance independently raise the risk of dementia. Brain imaging shows atrophy and other structural changes in obese individuals.”
“Obesity also reduces the clearance of amyloid deposits, contributing to Alzheimer’s pathology. Hypertension and small vessel disease further increase the risk of vascular dementia,” said Dr Karthikeyan S, Neurologist at MGM Hospitals, Chennai.
Early intervention is crucial: losing just 5–10 percent of body weight improves glycemic control, lowers blood pressure, reduces fatty liver, and protects brain health.
Obesity is a multi-system disease. Its effects on the liver, heart, kidneys, and brain are interconnected through shared pathways: Insulin resistance, chronic inflammation, vascular damage, and hormonal changes. Many patients remain asymptomatic for years, making early detection and intervention essential.
“Obesity is not just a number on the scale — it drives diseases silently across multiple organs. Early action, even modest weight loss, can prevent serious complications,” emphasised Dr Ramaswamy.
Prevention focuses on lifestyle modifications: A balanced diet, regular physical activity, limiting processed foods and alcohol, and controlling comorbidities like diabetes and hypertension.
Government programmes like the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) promote screening, awareness, and preventive care, but societal recognition of obesity as a disease remains limited.
Obesity in India has reached epidemic proportions, affecting nearly a quarter of adults and increasingly impacting children. Beyond appearance, it is a systemic disease driving fatty liver, heart disease, kidney dysfunction, and cognitive decline.
Experts agree that early intervention — through diet, exercise, and lifestyle changes — is key. Even a 5–10 percent reduction in body weight can significantly reduce the risk across multiple organ systems.
Tackling obesity requires a combined effort from individuals, healthcare providers, and policymakers.
As India grapples with a growing burden of non-communicable diseases, obesity prevention and early management remain among the most effective ways to protect long-term health.
(Edited by Muhammed Fazil.)
