Editorial: Obesity is the new enemy

Instead of treating obesity as an individual’s problem, intervention strategies must consider the family as a unit and promote healthy lifestyles

India is a picture of unique paradoxes where malnutrition and obesity co-exist as serious public health problems. While millions of children go to sleep on empty stomachs despite the country boasting surplus food production, a shift in dietary choices and sedentary lifestyles is pushing millions, particularly in urban areas, towards obesity. Once seen as a problem of the affluent, obesity has now transcended economic and social barriers at an alarming rate. Studies show that nearly 20 per cent of Indian households now have all adult members classified as overweight, while 10 per cent have all adults classified as obese. In States like Tamil Nadu and Punjab, two out of every five households have all adults classified as obese. Urban areas have a higher prevalence of obesity, demonstrating how prosperity and urbanisation are transforming India’s health landscape. A multi-pronged, nationwide drive must be initiated to promote public awareness about the urgent need for a healthy lifestyle, regular exercise, and dietary changes. Obesity and overweight are the most important risk factors responsible for diabetes, and the disease burden can be prevented or delayed by lifestyle changes, including adopting a healthy diet and doing regular physical activity. India’s obesity crisis is not a distant threat — it is a present reality. There is growing evidence linking obesity to cancer. The World Health Organisation’s International Agency for Research on Cancer (IARC) has classified excess body weight as a significant risk for cancer. Obesity is directly associated with at least 13 types of cancer, including colorectal, breast, kidney, liver, pancreatic, ovarian, thyroid, meningioma, gastric cardia, and gallbladder.

An IARC study, published in 2023, the largest of its kind, showed that having a high Body Mass Index (BMI) increases cancer risk by 17 per cent for people who also have cardiovascular diseases. Instead of treating obesity as an individual’s problem, intervention strategies must consider the family as a unit and promote healthy lifestyles. Families must be encouraged to opt for healthier ingredients, prepare meals at home using fresh vegetables, leafy greens, whole grains and fruits, and engage in physical activities as a unit. Such intervention can dramatically transform household practices, reversing altered metabolic pathways and cardio-metabolic risk factors in a matter of days and weeks. What is alarming in the Indian context is that obesity among children is also rising. A recent study by the All India Institute of Medical Sciences (AIIMS) found alarming levels of obesity among schoolchildren in the national capital. The data reveal a disturbing socio-economic trend: over 24 per cent of private school students were classified as obese, compared to 4.5 per cent in government schools. This could significantly increase the risk of early-onset cardiovascular diseases, musculoskeletal disorders, and Type 2 diabetes. This problem is not just confined to Delhi but represents a nationwide trend. If left unchecked, this could take the form of an epidemic.

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