WHO defined obesity and overweight as ‘the abnormal or excessive fat accumulation that may impair health’. The Obesity Medical Association also defined obesity as, ‘a chronic, relapsing, multifactorial, neurobehavioral disease, wherein an increase in body fat promotes adipose tissue dysfunction and abnormal fat mass physical forces, resulting in adverse metabolic, biomechanical, and psychosocial health consequence’. Obesity is usually the result of an imbalance between calories consumed and calories expended.
According to the guidelines set by the World Health Organization (WHO), a healthy BMI (Body Mass Index) range is between 18.5 kg/m2 and 24.9 kg/m2, which is applicable worldwide regardless of nationality. However, for Asian countries such as India, where obesity is more prevalent, a narrower range of 18.5-22.9 kg/m2 has been recommended. A BMI value of 25 or higher indicates overweight, while a BMI of 30 or higher indicates obesity. The widespread prevalence of obesity worldwide has led to the coining of the term “globesity.”(Mukhra et al., n.d.)
The rates of obesity and overweight have tripled since 1975(WHO). Shockingly, in 2016 alone, over 1.9 billion adults aged 18 and above were classified as overweight, with more than 650 million of those individuals being classified as obese. Nearly 40% of adults aged 18 and over (split almost evenly between men and women) were considered overweight in 2016, while obesity affected roughly 13% of the world’s adult population (with women being slightly more affected than men). Unfortunately, the problem is not just limited to adults, with an estimated 38.2 million children under the age of 5 classified as overweight or obese in 2019.(Obesity and Overweight, n.d.)
Obesity is no longer just a problem in high-income countries, as it has now become an increasingly prevalent issue in low- and middle-income nations, particularly in urban areas. Currently, at least 2.8 million individuals die each year due to being overweight or obese, and this has reached epidemic proportions worldwide. More people across the globe are overweight or obese than underweight.
India is ranked third in the world for having the highest number of obese people, which has significantly increased the burden of non-communicable diseases (NCDs). The rate of overweight and obesity in India has been rising at a faster pace compared to the global average. The prevalence of overweight and obesity increased among women from 1998 to 2015, with overweight prevalence rising from 8.4% to 15.5%, and obesity prevalence rising from 2.2% to 5.1%. (NFHS-2 to 4) In NFHS-5 the prevalence of obesity or overweight in India is 24.0% in women and 22.9% in men, with a significant increase in urban settings i.e. 33.2% in women and 29.8% in men. The prevalence is higher in Manipur as compared with India, with 34.1% in women and 30.3% in men, with higher prevalence in urban settings i.e. 39.0% in women and 33.4% in men. In Karnataka, the prevalence is almost the same as that of Manipur with 30.1% in women and 30.9% in men, but higher in urban settings, i.e. 37.1% in women and 39.4% in men. (NFHS-5) In a study done by Luhar et al. in 2020, the prevalence of obesity and overweight in India is expected to triple by 2040, with a greater increase in rural areas than in urban areas, especially among older age groups. (Luhar et al., 2020)
The fundamental cause of obesity and overweight is an energy imbalance between calories consumed and calories expended. There has been a rise in the consumption of energy-dense foods that are high in fat and sugars, along with an increase in physical inactivity across the globe. This can be attributed to the sedentary nature of work, changes in modes of transportation, and urbanization. Other risk factors for obesity include poor-quality sleep, high levels of stress, underlying health conditions such as metabolic syndrome, genetics, and medication-induced weight gain caused by antidepressants, antipsychotics, and other drugs. Changes in dietary and physical activity patterns often occur due to environmental and societal changes that come with development. The absence of supportive policies in areas such as health, agriculture, transport, urban planning, environment, food processing, distribution, marketing, and education can further aggravate the situation. (Overweight and Obesity – Causes and Risk Factors | NHLBI, NIH, n.d.)
People who are overweight or obese are at increased risk of many serious diseases and health conditions. These include cardiovascular disease, stroke, type 2 diabetes, hypertension, musculoskeletal disorder, and certain types of cancers like endometrial, osteoarthritis, breast, ovarian, prostrate, liver, gallbladder, kidney and colon. With the increase in BMI, there is a risk of an increase in these noncommunicable diseases.(CDC, 2022) Childhood obesity is linked to a greater likelihood of being obese later in life, premature death, and disability during adulthood. Besides the increased future risks, overweight children may also experience breathing problems, a higher risk of fractures, hypertension, early signs of heart disease, insulin resistance, and psychological effects. (Childhood Obesity – Symptoms and Causes, n.d.)
Obesity and being overweight can increase the risk of developing several non-communicable diseases. Fortunately, both of these conditions can be prevented with a healthy lifestyle. These interventions should start even before conception and continue into early childhood. They involve ensuring appropriate weight gain during pregnancy and practicing exclusive breastfeeding for at least the first 6 months post-birth, and up to 24 months or beyond. Promoting healthy behaviors among children, regardless of their current weight status, means emphasizing balanced nutrition, regular physical activity, managing sedentary activities, and ensuring adequate sleep. Limiting screen time, particularly among children, is crucial to encourage physical activity and reduce sedentary behavior. It is essential to restrict the consumption of sugar-sweetened beverages and energy-dense foods while advocating for other nutritious eating habits.
Embracing a healthy lifestyle characterized by a balanced diet, regular physical activity, sufficient sleep, abstaining from tobacco and alcohol, and practicing emotional self-regulation is fundamental. Moreover, moderating energy intake from total fats and sugars while increasing the consumption of fruits, vegetables, legumes, whole grains, and nuts is crucial. Making physical activity a regular part of our daily routine can benefit our overall well-being and assist in maintaining a healthy weight. (Obesity and Overweight, n.d.)
References:
References:
CDC. (2022, September 24). Effects of Overweight and Obesity. Centers for Disease Control and Prevention. https://www.cdc.gov/healthyweight/effects/index.html
Childhood obesity—Symptoms and causes. (n.d.). Mayo Clinic. Retrieved April 12, 2024, from https://www.mayoclinic.org/diseases-conditions/childhood-obesity/symptoms-causes/syc-20354827
Luhar, S., Timæus, I. M., Jones, R., Cunningham, S., Patel, S. A., Kinra, S., Clarke, L., & Houben, R. (2020). Forecasting the prevalence of overweight and obesity in India to 2040. PLoS ONE, 15(2), e0229438. https://doi.org/10.1371/journal.pone.0229438
Mukhra, R., Kaur, T., Krishan, K., & Kanchan, T. (n.d.). Overweight and Obesity: A major concern for health in India.
Obesity and overweight. (n.d.). Retrieved January 3, 2024, from https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
Overweight and Obesity—Causes and Risk Factors | NHLBI, NIH. (n.d.). Retrieved April 13, 2024, from https://www.nhlbi.nih.gov/health/overweight-and-obesity/causes
Speakman SR. Obesity. Part one–The greatest health threat facing mankind. Biologist 2003; 50:11–4
About the Author: Adahrii Payini is MPH Scholar at Edward & Cynthia Institute of Public Health – Advanced Technical Cooperation Center with Yenepoya ( DU).
Disclaimer: Views expressed are the author’s own. Edward & Cynthia Institute of Public Health or Yenepoya (Deemed to be University) are not responsible for contents or opinions reflected in this article.
