PM Modi wants a fitter India, but are we ready to give up our guilty pleasures?

Prime Minister Narendra Modi has warned of India’s growing obesity crisis, urging citizens to cut edible oil consumption by 10% and adopt a more active lifestyle. Citing a Lancet study, he cautioned that if current trends continue, 44 crore Indians could be obese by 2050, placing immense strain on the healthcare system. His appeal highlights obesity’s links to diabetes, heart disease, and rising medical costs.A Lancet study released ahead of World Obesity Day (March 4) reinforces these concerns. It reveals that nearly eight crore Indians, including one crore children and adolescents, are obese. Between 1990 and 2022, obesity among women rose by 9% (4.4 crore women), while among men, it increased by 5% (2.6 crore men). The most at-risk group may be India’s youth, with 70 lakh boys and 50 lakh girls (ages 5-19) affected.India’s obesity crisis exists alongside undernutrition, creating a paradoxical malnutrition challenge, especially in urban areas. The World Health Organization (WHO) estimates that by 2030, obesity-related healthcare costs in India could exceed $50 billion, driven by diabetes, cardiovascular diseases, and obesity-related cancers.PM Modi sounds alarm on India’s obesity crisisModi’s remarks emphasize the need for immediate action, a concern echoed by health experts. His push for lifestyle changes and dietary shifts aligns with research warning that India’s healthcare system may struggle with a rising obese population.With one in eight people worldwide—about one billion individuals—now obese, it is among the biggest public health challenges of the 21st century.Modi has specifically called for reducing edible oil consumption and promoting physical activity to combat lifestyle diseases. Without policy changes and large-scale health interventions, India faces an explosion of obesity-driven complications, including diabetes, heart disease, and metabolic disorders. His emphasis on dietary modifications aligns with research linking excess fat intake to India’s obesity epidemic.The urban lifestyle dilemmaThe shift from traditional diets to processed, calorie-dense foods has played a pivotal role in India’s obesity epidemic. “We've moved away from home-cooked meals rich in fibre and nutrients to fast food and sugary drinks,” observes Dr Aparna Govil Bhasker, consultant bariatric and laparoscopic surgeon at MetaHeal Center, Mumbai. “This trend is especially concerning among children and adolescents, who often adopt the dietary habits of adults.”Beyond diet, urbanisation has fuelled a sedentary lifestyle. Long work hours, increased screen time, and reliance on motorised transport have significantly reduced physical activity. “Lack of pedestrian-friendly infrastructure and pollution discourage outdoor exercise, exacerbating the issue,” adds Dr Hrishikesh Salgaonkar, consultant-bariatric and minimally invasive surgery at Fortis Hospital, Mulund.While lifestyle choices are a major contributor, genetics also play a critical role in obesity rates among Indians. “Studies indicate that 40-70% of obesity can be attributed to heredity,” says Dr Bhasker. “South Asians have a higher predisposition to abdominal obesity and metabolic disorders, even at lower BMI levels.”One key genetic factor is the ‘thrifty gene hypothesis’, which suggests that South Asians have evolved to store fat more efficiently due to historical food scarcity. This makes them particularly vulnerable to modern-day high-calorie diets and sedentary lifestyles.Additionally, studies show that South Asians have a higher propensity for visceral fat accumulation — fat that surrounds internal organs — leading to an elevated risk of insulin resistance, diabetes, and cardiovascular diseases at a lower BMI than Western populations.Moreover, recent genetic research has identified specific gene variants, such as FTO and MC4R, which are strongly associated with obesity in the Indian population. These genes influence appetite regulation, energy metabolism, and fat storage. Understanding these genetic predispositions is crucial for developing personalized medical treatments and preventive strategies tailored to the Indian demographic.medium nocaption119014416Redefining obesity for IndiansGlobally, overweight is defined as a Body Mass Index (BMI) of 25 kg/m² or above, and obesity as 30 kg/m² or above. However, India has revised these cutoffs to reflect its unique metabolic risks: overweight begins at a BMI of 23 kg/m², and obesity at 27.5 kg/m². “Indians have higher body fat percentages and greater risks of diabetes and heart disease at lower BMI levels,” explains Dr Aasim Maldar, consultant endocrinologist at PD Hinduja Hospital.But experts warn that BMI alone is an outdated metric. “Anthropometric measurements like waist circumference, waist-to-height ratio, and body fat percentage are better indicators of obesity-related risks,” says Dr Shashank Shah, founder of Laparo Obeso Centre. “A more holistic approach that considers metabolic diseases, cholesterol levels, and joint-related issues is critical.”Childhood obesityPerhaps the most alarming statistic from The Lancet study is the sharp rise in childhood obesity. By 2050, projections indicate that 16.4 million boys and 14.4 million girls aged 5-14, along with 22.7 million young men and 16.9 million young women aged 15-24, will be obese.UNICEF’s latest report suggests that childhood obesity rates in India have doubled in the last decade, with nearly 14 million children under 18 at risk of developing metabolic disorders.“This means an entire generation is at risk of developing chronic diseases like diabetes, heart disease, and liver conditions before they even reach middle age,” warns Dr Bhasker. “It’s a looming economic crisis as well, as the healthcare costs of treating these conditions will place an unprecedented burden on our system.”Healthcare system can’t handle the weightThe rise in obesity-related illnesses is already straining India’s healthcare infrastructure at an alarming rate. “There has been a four-to-five-fold increase in obesity-related cases in outpatient departments (OPDs) across the country,” says Dr Sanjay Khare, visiting chief & director of bariatric medicine at Apollo Hospitals, Navi Mumbai. “A decade ago, obesity was mostly an underlying factor in diabetes and hypertension cases. Today, we see direct obesity consultations skyrocketing.”According to the Indian Medical Association (IMA), obesity-related cases accounted for 15-20% of endocrinology OPD visits in 2013. Today, that number has climbed to 30–35% in urban centers. The Economic Times recently reported that obesity-related absenteeism and productivity losses in India's corporate sector cost businesses over ₹1.2 lakh crore annually.Hospitals are also witnessing a sharp rise in bariatric surgeries and obesity-related emergency admissions. The National Health Profile report states that over 30% of intensive care unit (ICU) admissions in urban hospitals are linked to obesity-related complications, including heart attacks, strokes and respiratory issues like sleep apnea.Additionally, there is a growing shortage of specialized healthcare professionals trained in obesity management. According to the Indian Council of Medical Research (ICMR), India currently has only one obesity specialist per 60,000 people, far below the global average. This shortage is further compounded by a lack of structured obesity management programs in medical colleges and hospitals.“The burden on the healthcare system is immense,” notes Dr Maldar. “We urgently need national-level intervention, including training programs for healthcare providers and the integration of obesity management into primary care services. Without immediate action, India's healthcare infrastructure will be unable to cope with the rising tide of obesity-related diseases.”medium nocaption119014443What can help fight the bulge?In response to the crisis, pharmaceutical companies are developing new obesity treatments. GLP-1 receptor agonists like semaglutide, which have revolutionised weight loss management in the West, are expected to be available in India soon. “These drugs have demonstrated weight loss of 10-20% total body weight in clinical trials,” says Dr Bhasker. “However, they come with potential side effects, including digestive disturbances and long-term safety concerns.”Indian pharmaceutical giants like Eli Lilly and Sun Pharma are working on next-generation weight-loss medications, such as Tirzepatide and Utreglutide, which are expected to launch within the next five years. Meanwhile, demand for bariatric surgery is soaring. “Innovations like Endoscopic Sleeve Gastroplasty [ESG] are making weight-loss surgery more accessible and less invasive,” says Dr Salgaonkar.Beyond medical interventions, experts advocate for traditional Indian practices such as yoga. “Studies have shown that yoga significantly reduces BMI, waist circumference, and body fat percentage,” notes Dr Muffazal Lakdawala, director of general and minimal access surgery at HN Reliance Foundation Hospital. “When combined with lifestyle modifications, it can be an effective tool for weight management.”Policymakers are also being urged to take decisive action. The health ministry is considering a 10% tax on sugary drinks and ultra-processed foods, similar to global models in Mexico and the UK. “India must adopt bold measures,” argued Dr Lakdawala. “Mexico successfully implemented a soda tax, leading to a measurable decline in consumption. India should follow suit. Subsidising healthier food options and banning junk food advertising targeted at children are also essential.”A warningIndia’s obesity crisis is no longer a distant threat — it is here, and it is accelerating. “If we don’t act now, we risk an entire generation being crippled by metabolic diseases,” warns Dr Bhasker.With obesity rates climbing, chronic disease burdens increasing, and a healthcare system under mounting stress, India must respond with an aggressive, multi-pronged strategy — one that combines medical advancements, public health interventions, and policy reforms. The time to act is now.