Obesity epidemic

In the paradox that India is, malnutrition among the poorest is matched by obesity among the wealthiest.

HYDERABAD, 21/08/2011: The mushrooming obesity clinics are taking people for a ride and in the process inflicting psychological damage among obese persons. Photo: K. Ramesh Babu

India is growing fat. Malnutrition and stunted growth owing to lack of sanitation may be the country’s peculiar problems if a recent UNICEF report is to be believed, but, according to a report published recently in Lancet, India is the third most obese country in the world, after the China and United States. Using data that covered 188 nations from 1980 to 2013, its researchers have found that 3.7 per cent of men and 4.2 per cent of women in India are obese.

Overweight and obesity may have once been a high-income country problem, but today it is on the rise in low- and middle-income countries, particularly in their urban areas. In these countries, the prevalence of childhood overweight and obesity in preschool children is over 30 per cent. In 2012, more than 40 million children under the age of five worldwide were found overweight or obese. Of these children, more than 30 million live in developing countries and 10 million in developed countries.

Overweight and obesity are defined as abnormal or excessive fat accumulation that could impair health. A body mass index (BMI) greater than or equal to 25 is overweight, while a BMI greater than or equal to 30 is obesity, by World Health Organisation (WHO) standards.

India’s particular problem is that urban Indians have shifted from their traditional diet of coarse grains and millets to refined wheat and rice as the staple cereal, leading to a substantial reduction in the fibre content and possibly micronutrients in the diet, says The Lancet report. The affluent among them are consuming more fats, oils, sugars, and Western-style fast foods. A sedentary lifestyle and lack of physical activity compound the problem.

Doctors in India agree that obesity is a growing public health concern as it is a major risk factor for heart disease, diabetes, arthritis and certain cancers. According to a 2009 study in The Lancet, moderate obesity (BMI 30-35) cuts life expectancy by two to four years and severe obesity (BMI 40-45) by an entire decade. The WHO has warned India that its number of people with diabetes could increase from 19 million today to 60 million by 2025.

However, awareness is spreading in India over the rising obesity levels. A new study by the Centre for Science and Environment has recommended a ban on junk food in schools and on their premises and also regulation of advertisements promoting its consumption. Celebrity endorsements and prime-time airing of advertisements influence the young and the old alike, leading to a “fat” explosion.

Solutions may vary from regulation of advertisements to high taxation of sugar-sweetened beverages. Mexico — where 70 per cent of adults and 30 per cent of children are overweight — is now leading the battle against obesity and junk food. Last September, it imposed a 10 per cent tax per litre on sugar-sweetened beverages to shed its record as the world’s largest consumer of sugary drinks. In July, it imposed restrictions on television advertising for high-calorie foods and soft drinks.

Government intervention can play a role in reducing the obesity epidemic in India too.