New Delhi: A global study reveals that in 2022, 82.5 million Indians were classified as obese. Conducted by the NCD Risk Factor Collaboration (NCD-RisC) in association with the World Health Organization (WHO), the study highlights that approximately 9.8 percent (or 44 million) of Indian women, and 5.4 percent (or 26 million) of Indian men, fell in the obese category in the same year.
This was in contrast with 1.2 percent of women and 0.5 percent of men classified as obese in 1990, the study, published in The Lancet Thursday, showed.
NCD-RisC is a network of health scientists around the world that provides rigorous and timely data on major risk factors for non-communicable diseases. More than 1,500 researchers who participated in the study analysed the weight and height measurements of over 220 million people aged five or older (63 million people aged five to 19 years, and 158 million aged 20 years or older) from more than 190 countries. Researchers looked at body mass index (BMI) to understand how the number of obese and underweight people have changed worldwide from 1990 to 2022.
The study defines obesity as a BMI of 30 kg/m² or higher for adults and “a BMI of more than two standard deviations above the median of the WHO growth reference for children and adolescents”. The WHO growth reference for children and adolescents is the standard devised by the WHO to measure weight and height of people from 0-20 years.
The study showed that globally, an estimated nearly 880 million adults were living with obesity in 2022 (504 million women, and 374 million men) — 4.5 times the 195 million recorded in 1990 (128 million women and 67 million men). Combined with the 159 million children living with obesity in 2022, this is a total of over 1 billion people affected by obesity that year.
Statistics from India show that 3.9 percent (about 7.3 million) boys aged 5-19 years were obese in 2022, in comparison to 3.1 percent (5.2 million) of girls in the same age category. This is compared to 0.1 percent of girls and 0.2 percent of boys with obesity in the country in 1990.
The prevalence of obesity in India ranked 19th lowest (or 182nd highest) in the world for women and 21st lowest (or 180th highest) in the world for men in 2022.
“This new study highlights the importance of preventing and managing obesity from early life to adulthood, through diet, physical activity, and adequate care, as needed,” WHO Director-General Tedros Adhanom Ghebreyesus said in a statement.
“Getting back on track to meet the global targets for curbing obesity will take the work of governments and communities, supported by evidence-based policies from WHO and national public health agencies. Importantly, it requires the cooperation of the private sector, which must be accountable for the health impacts of their products,” he said.
Commenting on the obesity findings from India in the analysis, Dr R. Hemalatha, director of the Indian Council of Medical-National Institute of Nutrition (ICMR-NIN), told ThePrint that the findings on obesity from India could just be reflecting the “tip of the iceberg”.
“The country is grappling with a far greater challenge of overweight and abdominal obesity, which are big contributors to the alarmingly rising NCD (non-communicable diseases) burden,” she said.
The findings also reveal that in India, the underweight rate decreased from 41.7 percent in 1990 to 13.7 percent in 2022 for women and 39.8 percent to 12.5 percent for men. On the other hand, 20.3 percent of girls and 21.7 percent of boys are considered ‘thin’.
The study considers a BMI of less than 18.5 kg/m² underweight and less than two standard deviations below the median of the WHO growth reference as thin.
According to the study, the prevalence of underweight in India ranked 13th highest in the world for women and 26th highest in the world for men in 2022.
Nutrition expert Seema Gulati pointed out that the findings shed light on significant shifts in India’s obesity and underweight rates over the past few decades and offer valuable insights into the country’s evolving health landscape.
“The stark increase in obesity rates, particularly among women, underscores the pressing need for targeted interventions to address this emerging health concern. Concurrently, the decline in underweight prevalence signifies improvements in certain aspects of nutrition and healthcare accessibility,” Gulati, the head of a nutrition research group at the Delhi-based non-profit National Diabetes, Obesity, and Cholesterol Foundation, added.
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Triple burden of obesity, abdominal obesity & being underweight
Statistics from the Union Ministry of Health and Family Welfare’s National Family Health Survey 5 (NFHS-5), conducted between 2019 and 2021, had put the number of obese or overweight women at 24 percent and men at 22.9 percent — higher than the figures shown in the new study.
However, NFHS had measured obesity and overweight as a BMI of 25 and over in adults as compared to the 30 kg/m² or higher that in the study.
Meanwhile, Hemalatha stressed that the new analysis does not touch upon the grave problem of abdominal obesity in India — a health challenge unique to South Asians.
Based on NFHS data, a study published in The Lancet last year had said that overall 40 percent of women and 12 percent of men are abdominally obese in the country — meaning women with a waist circumference of over 80 cm and over 94 cm in men.
“Abdominal obesity is a strong predictor of cardiovascular diseases, type-2 diabetes, and other metabolic disorders, and many people who have healthy BMI also happen to have abdominal obesity,” Hemalatha said.
Easy accessibility to high-calorie and refined food, even in non-urban areas, and lack of physical activities contribute to this epidemic and need to be tackled at the individual level, she said, calling for a policy intervention that introduces higher taxes for refined and packaged foods while offering tax incentives to healthier options.
“Also, it will help to introduce front-of-pack labeling indicating which products contain added sugars, total fats, saturated fats, trans fats, and sodium. This can help make buyers choose better,” Hemlatha said.
Arun Gupta, convenor of Nutrition Advocacy in Public Interest — a national think tank on nutrition — meanwhile pointed out that the results from the latest study show that India has the highest percentage of underweight women, girls, and boys in South Asia.
Overall 196 million Indians have been classified as underweight or thin. “It’s a shame that India lags behind its immediate neighbors (in underweight population) and still believes it will be a global guru if its human development is below par,” Gupta said.
Gulati also highlighted that the persistent high prevalence of underweight, especially among women, indicates ongoing challenges in ensuring equitable access to adequate nutrition and healthcare services.
These findings emphasise the need for comprehensive public health strategies tailored to India’s unique socio-economic and cultural context, he said.
However, both problems have solutions, said Gulati: “As our latest Household Consumption Expenditure Survey reveals that 20-27 percent of food expenses are on beverages or processed food products or food orders, a check on the beverage and ultra-processed food products consumption is possible through regulation on marketing and labeling. For underweight men and women and children, food assessment for diversity and quantity can provide answers to help them with incentives or control of food prices.”
(Edited by Uttara Ramaswamy)
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