India plans to introduce waist-to-hip ratio (WHR) tracking across public hospitals as part of a nationwide strategy to curb obesity, marking a shift away from relying primarily on Body Mass Index (BMI), according to two government officials aware of the plans.
The nationwide exercise, led by the Union Ministry of Health and Family Welfare, will focus on measuring abdominal fat—considered a stronger predictor of metabolic diseases than overall body weight—and is expected to begin across government hospitals, the officials said.
The move follows findings from the Lancet Commission on Obesity, that BMI often misclassifies health risks in South Asians, who are genetically predisposed to accumulating harmful visceral fat despite having a normal body weight. By measuring fat distribution through WHR, the government believes it can identify people at higher risk of diabetes and cardiovascular disease far earlier than BMI alone.
Queries emailed to the health and family welfare ministry spokesperson on 9 July 2026 remained unanswered till press time.
Why it matters
Visceral fat is considered a key driver of non-communicable diseases (NCDs) such as type 2 diabetes, early-onset hypertension and cardiovascular disorders.
With one in five urban adults now overweight or obese, according to the ICMR-INDIAB national study, the government's new approach forms part of its broader strategy to prevent India from becoming home to the world's second-largest obese population by 2050, after China.
Obesity has emerged as a major public health challenge for India, increasing the risk of diabetes, hypertension, heart disease and mental health disorders, while also imposing a significant economic burden through higher healthcare costs and reduced productivity.
A Lancet study projects the number of overweight and obese adults in India to rise from 180 million in 2021 to 449 million by 2050. By mid-century, the crisis is expected to include around 218 million men, 231 million women and more than 30 million children aged 5-14 years.
Grassroots rollout
To ensure nationwide coverage, the government has roped in nearly 1 million Accredited Social Health Activist (ASHA) workers.
Equipped with specialized measuring tapes and digital tracking logs, ASHA workers will also serve as community counsellors, educating households about portion control, reducing consumption of ultra-processed foods and increasing physical activity.
"We are seeing a rise in central obesity among the Indian population. By implementing waist-to-hip ratio tracking directly in government hospitals, we can intercept metabolic issues before they turn into chronic conditions," said the first government official cited above, requesting anonymity.
"This is no longer just an adult problem; our front-line workers are being trained to spot early markers of obesity in children right at the doorstep. ASHA workers will assist in mapping high-risk clusters so that local administrations can execute targeted nutritional interventions," added the first official.
Officials said screening will cover adults visiting outpatient departments and lifestyle disease clinics at public hospitals, while ASHA workers will conduct community-level tracking during household visits. The programme aims to make obesity screening a routine component of local health records, covering adults and monitoring obesity indicators among children.
Mint had earlier reported on the government's plan to roll out a nationwide obesity screening programme for schoolchildren using waist-to-hip ratio measurements.
While the policy framework has been finalized, pilot screening blocks and ground-level infrastructure are currently being operationalized across selected states, according to the official.
Prime Minister Narendra Modi had, in January 2025, urged citizens to adopt healthier lifestyles and called for a 10% reduction in edible oil consumption.
Expert views
Public health experts offered mixed views on the proposed shift.
Dr Aashish Chaudhry, managing director, Aakash Healthcare, said:
“While BMI remains a tool for assessing obesity, Waist-to-Hip Ratio (WHR) identifies visceral or abdominal fat, which is closely associated with heart disease, diabetes, fatty liver, hypertension, cancers, and metabolic disorders.”
“If WHR screening is implemented and followed by public health interventions promoting healthy eating, physical activity, and lifestyle modification, it can become a strategy to reduce obesity-related diseases and improve long-term health.”
While experts agree WHR is a better indicator of abdominal obesity because it captures fat accumulation around internal organs—something BMI cannot distinguish—they also point to practical challenges in measuring it on a large scale.
"(Prof) Dr K Srinath Reddy, former president at the Public Health Foundation of India (PHFI), said:
"Waist to Height Ratio (WHtR) has been regarded as a good measure of abdominal obesity or visceral adiposity. Since fat deposits around abdominal organs are associated with high levels of inflammation in body tissues, they have a better correlation with cardio-metabolic diseases than body mass index (BMI) which also does not differentiate between body fat mass, muscle mass, bone weight and weight of body fluids. Measurement of abdominal obesity is especially important in Indians, due to its high prevalence in South Asians."
He added:
“It is not always easy and practically unfeasible to measure hip circumference in clothed persons, particularly for women in rural communities. In recent years WHtR has been recognised as a good measure of abdominal obesity. Many international agencies (such as National Institute for Clinical Excellence (NICE) in the UK) have adopted it in preference to BMI. A WHtR of more than 0.5 spells a high risk of diabetes and heart disease. WHtR was first validated in children and later in adults, in different parts of the world. As an easy to measure index, it would be more feasible for use by frontline workers in primary care. It will also be easy for even lay persons in the community to use as a serial self measured index of risk reduction over time, if they are made aware of it.”
Meanwhile, following the patent expiry of Semaglutide on 20 March this year, domestic pharmaceutical companies launched generic versions, significantly expanding access across India.
However, public health concerns remain. India recently issued an urgent safety advisory for all GLP-1 receptor agonists, calling for stricter monitoring of adverse effects, as previously reported by Mint.