OBESITY IN INDIA

India is getting FAT

CONTENTS
● DEFINITION
● CLASSIFICATION
● EPIDEMIOLOGY
● HAZARDS
● PREVENTION & CONTROL
DEFINITION

● Abnormal growth of adipose tissue

○ Hypertrophic (↑ size)
○ Hyperplastic (↑ number)
● It can be
○ android type (apple type) or
○ gynoid (pear type)
MORE COMMON
IN INDIA AND
MORE
DANGEROUS
Classification

According to WHO,

● Grade 1 (overweight) - BMI of 25-29.9 kg/m2

● Grade 2 (obesity) - BMI of 30-39.9 kg/m2
● Grade 3 (severe or morbid obesity) - BMI ≥40 kg/m2

➔ BMI or Quetelet index is the most commonly used method to define obesity
➔ BMI = Wt. in kg / (Ht. in m)2
● For children under 5 years of age:
○ overweight is weight-for-height greater than 2 standard deviations above WHO
Child Growth Standards median; and
○ obesity is weight-for-height greater than 3 standard deviations above the WHO
Child Growth Standards median.
● Children aged between 5–19 years
○ overweight is BMI-for-age greater than 1 standard deviation above the WHO
Growth Reference median; and
○ obesity is greater than 2 standard deviations above the WHO Growth Reference
median.
In India
● WHO BMI criteria resulted in underestimation of burden of Obesity
● Heights and weights differ in different ethnic groups
● Many studies suggest the BMI of
○ ≥ 23 kg/m2 → overweight
○ ≥ 25 kg/m2 → obesity

Or
○ WC>90 cm in men and >80 cm in women
EPIDEMIOLOGY
● Worldwide obesity has nearly tripled since 1975.
● More than 1 billion people worldwide are obese
○ 650 million adults,
○ 340 million adolescents and
○ 39 million children
● Majority of overweight or obese children live in developing countries
● Most of the world's population live in countries where overweight and obesity
kills more people than underweight.
● 39 million children under the age of 5 were overweight or obese in 2020.
● Over 340 million children and adolescents aged 5-19 were overweight or
obese in 2016.
Double burden of malnutrition

● Many low- and middle-income countries are now facing a "double

burden" of malnutrition.
● the problems of infectious diseases and undernutrition - rapid
upsurge in noncommunicable disease risk factors such as obesity
and overweight, particularly in urban settings.
INDIAN SCENARIO
● In 2016 put 135 million Indians as overweight or obese
● Nearly 23% of men and 24% of women were found to have a body mass
index (BMI) of 25 or more
● 3.4% of children under five are now overweight.
● Abdominal obesity was found in about 51% with higher rates in women
(women: 56%; men: 35%)
Causative factors

● Multifactorial
○ Level of activity
○ Metabolic factors
○ Dietary habits
○ Genetic factors
○ Smoking cessation
○ Endocrine factors
○ Pregnancy and menopause
○ Race, sex, and age factors
○ Psychological factors
○ Ethnic and cultural factors
○ History of gestational diabetes
○ Socio-cultural factors and
○ Lactation history in mothers
urbanization
HAZARDS
● Cardiovascular diseases (mainly hypertension, heart disease and stroke)
● Diabetes;
● Gall bladder and other metabolic diseases
● Musculoskeletal disorders (especially osteoarthritis – a highly disabling
degenerative disease of the joints);
● Sleep apnea and breathing problems
● Cancers (including endometrial, breast, ovarian, prostate, liver, gallbladder,
kidney, and colon).
● Low quality of life

The risk for these noncommunicable diseases increases, with increases in BMI.
PREVENTION AND CONTROL

● Primary
○ Population strategy
○ High risk strategy
● Secondary
● Tertiary
Steps in prevention

● Understanding the increasing burden

● Act ASAP
● Deploy Programmes that prevent and treat
● Prevention starts very early - from WOMB
World Obesity Day 2022 – Accelerating action to stop
obesity - March 4
● to act early, ideally even before a baby is conceived.
● Good nutrition in pregnancy
● exclusive breastfeeding until the age of 6 months and continued
breastfeeding until 2 years and beyond
● to create a better food environment
● restricting the marketing to children of food and drinks high in fats, sugar and
salt,
● taxing sugary drinks
● providing better access to affordable, healthy food
 ACTIONS BEHAVIOURS

INCREASE
● COMMUNITY INFORMATION ● Consumption of fruit & vegetables
● HEALTHY FOOD ● Moderate to vigorous physical
● ACTIVE LIFESTYLES activity
● SPORT & RECREATION ● Walking & incidental activity
INFRASTRUCTURE DECREASE
● PREVENTION & EARLY ● Consumption of energy dense
INTERVENTION SERVICES nutrient poor foods
● Consumption of sugar sweetened
beverages
● Sedentary small screen
behaviours
SURGICAL INTERVENTION
● Bariatric surgery is currently the only modality that provides a significant,
sustained weight loss for morbidly obese patients and improvement in
obesity-related comorbidities.
● Many procedures have been introduced but each carries high risk and high
surgical morbidity.
● Hence these procedures are reserved for Morbid obese resistant patients with
comorbidities.
INDIA It’s time to stop Walking and Start Running.