Obesity as a Roadblock to Development

In consonance with changing lifestyles previously associated with economically developed nations, obesity has proven to be a public health challenge of epidemic proportions. Globally, obesity figures have tripled since 1975. A 2016 study found that 1.9 billion people over the age of 18 were overweight, of whom, at least 650 million were diagnosed as obese. Nor is obesity a phenomenon unique to developed economies as previously thought. Today, a majority of the world’s population lives in countries where this condition results in more deaths than caused by being underweight. In 2016, 41 million children under the age of 5 were reported to be overweight or obese and 340 million children between the age group of 5 to 19 years were reported to be suffering from the same medical condition.

In India, the prevalence of generalized obesity was 135 million, abdominal obesity, 153 million and combined obesity, 107 million according to a 2015 study by ICMR – INDIAB. There are many facets to being overweight or obese impacting the economic, social and medical status of a nation. Women are increasingly being observed to be obese in India. In terms of health expenditure on obesity-related problems alone, households are caused severe losses in terms of their ability to meet minimum conditions for quality of life. A cohort study in a sample population in the national capital territory of Delhi found that average monthly expenditure could go up to INR 224 per month compared to INR 68 for normal weight women on account of obesity.

A person is said to be overweight or obese when there is an excessive or abnormal accumulation of fat in the body that affects health. The Body Mass Index, which is defined as a person’s weight in kilograms divided by the square of his height in meters, is commonly used to measure excess weight or obesity. By WHO standards, a BMI over 25 is indicative of being overweight while a BMI over 30 indicates obesity.

In a nation that has traditionally focused on poverty, hunger and malnutrition as public health imperatives, perhaps, the time has come to adopt national health policies with changing times. Obesity is as much a threat to national disease burdens as any other medical condition. Cardiovascular disease and diabetes – both having significant economic portents - have established co-morbidities with obesity as do osteoarthritis and several cancers.

It has been argued that resilience to recessionary trends in India as compared to that suffered by other major economies, is the very reason why obesity is an increasing menace to wellness indicators in India. Obesity is caused by both increased intake of energy-rich foods high in fat content and increasing physical inactivity owing to sedentary work cultures, evolving modes of transportation and rising urbanization.

Another root cause of the rise of obesity is the lack of policies to support health, agriculture, transport, urban planning, the environment, food processing, distribution and marketing, and education. Obesity continues to be fully preventable, however. Conducive environments and greater awareness among communities are central to shaping people’s choices. Healthier foods and active lifestyles, as choices, need to be made more accessible, available and affordable. The availability of safe and dedicated cycling lanes, for example, works to reduce not only traffic congestion but also keeps the public driven to seek healthy lifestyles. School curriculums could include compulsory playtime and activities that involve workouts. Workplaces could include timeouts for exercise, meditation, and relaxation to help work-life balance. Parks and recreational centers could have greater facilities for strenuous activity. Penalizing the deliberate use of excessive fats and sugars could be required if current trends continue.

By Dr Pankaj Gupta, President, IIHMR University, Jaipur