Tackling obesity

The book calls for urgent steps to deal with India’s most recent, and wholly preventable, health crisis.

IT is ironic that India, which has been fighting undernutrition for decades, is now also facing an epidemic of obesity, cutting across classes, regions and age groups. Unlike other diseases and disorders, obesity is still not recognised by the government and society as a threat to public health.

At a time when consumerism and consumption have reached new heights thanks to new technology and the rise in incomes, this book by Dr Kamal Mahawar, a bariatric surgeon based in the U.K., has come as a wake-up call to rally people for a collective fight against the obesity crisis.

A slim volume of about 270 pages, the book highlights the root causes of the epidemic, the social and cultural context in which it develops and the steps that need to be taken urgently.

Dr Mahawar writes with a rare felicity to highlight the harm caused by lifestyle changes and the need to undo it by acting swiftly. He warns the reader that about 5 per cent of the country’s population now officially suffers from obesity and that a “much larger pool of overweight individuals” is rapidly heading towards it. Obesity and associated diseases such as diabetes, high blood pressure and heart disease pose a threat to public health like never before.

The author’s focus, except for a chapter devoted to treatment and surgery, is on prevention, and he spares no effort to goad readers into walking the talk and taking the necessary action to burn extra calories and trim excess fat. Health is not seen in isolation but as a problem that has to be tackled keeping in mind social issues, technological changes, lifestyle adoption, cultural legacies and general awareness of best practices.

The book is divided into 12 chapters, followed by an appendix and bibliography. Each chapter offers, in bite-sized chunks, a diagnosis and a cure for a particular issue, along with takeaways of key points.

In the first chapter, titled “The Epidemic”, the author offers a broad outline of the severity of the crisis and how it is panning out in India in a manner similar to what happened in developed countries, where obesity first emerged as an affliction of the rich and well-heeled and spread to the middle classes. In the subsequent chapters, he explores the link between obesity and diabetes, delineates how fat deposition affects virtually every organ of the body and how those who are overweight are at a higher risk of developing a variety of diseases.

However, his tone is not always alarmist; along with the diagnosis, he also assures readers that weight loss will “improve all of these conditions and even reverse many of them in the early stages”. A separate chapter is devoted to calories and calorie counting and the multitude of diet plans and regimens that have sprung up in recent times targeting the health-conscious sections of society.

The most important, and impressive, chapter is the one on childhood obesity. Inculcating best practices in eating in children prepares them for a lifetime of correct food choices and healthy living. The chapter deals with the need to discourage children from consuming processed foods and soft drinks, as also the role that schools can play in guiding students towards a healthy lifestyle.

Through the chapters on hunger and satiety, healthy cooking, healthy eating and lifestyle and physical activity, Dr Mahawar underscores the need to eat the right type of foods, avoid overeating and burn excess calories. “Diabesity” is a new term he has coined to explain the connection between diabetes and obesity. It deals extensively with the cause and the effect of this problem and shows how dietary patterns play a crucial role in managing diabetes. For extreme cases, pill therapy or surgical treatment is unavoidable, he says, and devotes a few pages to available options.

The last two chapters urge policymakers and others who can influence society to recognise obesity as a disease and take concrete steps to overhaul the entire ecosystem. Apart from individual responsibility, the author stresses the role of parents, teachers, employers, doctors, the food industry and the government in tackling this crisis.