The steady weight gain among Indians sits heavy on the country’s public and private health services. Last week, a report by National Family Health Survey 6 (NFHS-6) for 2023-24 says more Indians aged 15-49 years are obese than ever before. As per the latest report, 30.7% (up from 24% recorded in NFHS-5 in 2019-2021) of women and 27.3% (up from 22.9%) men in India are now obese. This couldn’t have come at a worse time for a country that is facing multiple headwinds on several fronts ranging from education to economy.
With more than 100 million confirmed diabetics and pre-diabetics and millions more living undiagnosed and undetected cases, the rapidly growing obesity numbers are adding to India’s well documented diabetes epidemic. Weight gain affects overall health in several ways leading to multiple diseases including Type 2 diabetes due to insulin resistance. Some other common health risks of weight gain include high blood pressure and heart disease, increased chances of suffering a stroke, fatty liver disease, high cholesterol and metabolic syndrome, sleep apnea and breathing problems, joint pain and osteoarthritis (especially in knees and back) and hormonal imbalance and fertility problems. Weight gain also impacts mental health leading to low confidence, anxiety, and depression.
“Weight gain and obesity negatively affect nearly every major organ system. It leads to reduced energy levels and poorer quality of life. Even moderate but continuous weight gain over many years can increase these risks substantially,” says Dr. (Prof.) Amit Javed principal director and head of department for gastrointestinal oncology, laparoscopic gastrointestinal, bariatric and minimally invasive surgery, Fortis Memorial Research Institute, Gurugram.
Brand new problem
The laundry list of health problems for people who gain excessive weight doesn’t end there. Latest research by a team from Swedish university presented at the European Congress on Obesity in Istanbul in mid-May found that those who gain weight in adulthood face up to five times higher risk of developing multiple cancers. The researchers tracked more than 600,000 individuals (250,000 men and about 380,000 women) between the ages of 17 and 60 over several years. They noted each participant’s weight four times and also tracked their cancer diagnoses up until 2023. The team found that cancer risk was directly proportional to heavier starting weight as well as greater the weight gained in adulthood, greater was the risk of developing cancer. They also found that obesity can cause 13 different kinds of cancer while it was further linked to eight more types of cancer.
Weight gain during adulthood is being increasingly linked to a higher risk of several cancers, including breast, colorectal, endometrial, pancreatic, and liver cancers, notes Dr. Imran Nisar Shaikh, consultant for medical oncology, Kokilaben Dhirubhai Ambani Hospital, Mumbai. “Excess body fat promotes chronic inflammation, hormonal imbalance, and insulin resistance, all of which can create conditions that support cancer development. This is not just a concern for older adults. Weight gain that begins in the late 20s or 30s and continues through middle age can significantly raise long-term health risks,” explains Shaikh, urging adults across all age groups in the country to keep a closer eye on their weight and overall metabolic health.
According to the Swedish research types of cancer associated with weight gain differed for men and women. Men who are overweight before the age of 30 face five times higher risk of liver cancer, 58% increased risk of colon cancer and double the risk of pancreatic and kidney cancer compared to those who don’t put excess weight. Obese women under 30 years of age have a four-and-a-half times higher risk of endometrial cancer, double the risk of kidney cancer, 76% increased risk of meningioma and 67% higher risk of pancreatic cancer compared to those who aren’t obese.
Women who gain weight at later stages of their life face higher risk of endometrial cancer, postmenopausal breast cancer, meningioma and colon cancer. Weight gain beginning in early adulthood and continuing through middle age appears especially harmful because the body remains exposed to these metabolic stresses for a longer duration, reasons Javed. “Clinically detectable cancers tend to emerge after 40 years of age, but the metabolic damage accumulates silently over the decades prior to this point. This means people should focus on preventing gradual yearly weight gain early in life,” adds Javed.
What’s making India obese?
Going by the findings in NFHS-6 — India’s latest and most comprehensive health report — obesity is no longer a big city problem but a nationwide one. India is now seeing obesity and lifestyle diseases rise not only in metro cities but also in smaller towns, says Javed echoing the findings of NFHS-6. Both Javed and Shaikh agree that India’s growing obesity problem is driven by lifestyle, dietary and environmental changes. “Urbanisation has brought with it more sedentary routines, desk-based jobs, less physical activity, and more screen time, which have significantly lowered daily calorie expenditure. Easy availability of processed foods, sugary drinks, late-night eating and high-calorie food deliveries have changed how Indians eat. Chronic stress, poor sleep, long work hours, and erratic schedules also lead to hormonal changes that make weight gain more likely,” says Shaikh.
With more and more people adopting urban lifestyle patterns such as increased dependence on cars, bikes elevators, and screen-based entertainment reduces everyday movement. Javed also contends that many Indians stop playing sports and exercising after graduating from college or getting married. This reduced physical exercise and movement is a direct cause of weight gain in adulthood. He also holds alcohol consumption as one of the primary reasons for India’s obesity crisis. “Social drinking and weekend binge eating contribute heavily to excess calories. Apart from these factors hormonal and medical issues including thyroid disorders, PMOS, diabetes medications, antidepressants, and ageing-related metabolic slowdown can also cause weight gain,” adds Javed.
The fix
Anyone who has tried to lose weight quickly realises that gaining weight was the easiest part of the deal while shedding it requires tackling multiple aspects of one’s life and lifestyle. Cult fitness expert Indira Chavva says it’s better to address the root cause of weight gain rather than fixating on just one thing such as your BMI, food or exercise. She suggests start with identifying the stress in your life and then you put in place food, exercise and an active lifestyle. Indeed, you will need to focus on these if you want to see sustained results on the weighing scale and the measuring tape.
According to Javed the best way to address weight gain is right at the very start: prevent gradual weight gain before it becomes obesity. “Ideally, healthy habits should begin in the 20s or early 30s, but it is beneficial to start at any age,” he says.
However, if you have already missed this opportunity, Shaikh says building sustainable habits early, rather than turning to crash diets or short-term fixes is the most effective approach. “A balanced diet built around whole foods, adequate protein, fibre, fruits, and vegetables, paired with regular physical activity, goes a long way. Aiming for at least 150 minutes of moderate exercise a week, along with some strength training to maintain muscle mass, is a good baseline. Sleep, stress management, hydration, and routine health check-ups matter just as much. Even small, consistent changes to daily habits can make a real difference in reducing long-term risks tied to obesity, metabolic disease, and cancer,” says Shaikh.
Because most of the time the weight gain is due to sedentary lifestyle, unhealthy eating habits and stress. But we tend to address only one of the above like food, exercise or rigorous and unrealistic weight management goals in short span of time. So it’s better we address the stress part first and slowly cater to food and exercise or leading an active lifestyle.
However, for the severely obese (BMI greater than 32.5 in Asians), bariatric surgery and the new age weight loss drugs remain the most effective evidence-based interventions in consultation with a medical professional.
Shrenik Avlani is a writer and editor and the co-author of The Shivfit Way, a book on functional fitness.