Why in the News?

A report by The Lancet Diabetes and Endocrinology Commission emphasized body fat distribution, beyond Body Mass Index (BMI), as a vital health and disease risk indicator. In this response, India has revised its obesity guidelines after 15 years.

What is the present status of Obesity?

• Rising Obesity Rates: The obesity rate in India has significantly increased, with approximately 9.8% of women and 5.4% of men classified as obese as of 2022, compared to just 1.2% for women and 0.5% for men in 19901. This translates to around eight crore individuals being classified as obese, including one crore children aged 5 to 19 years1.
• Economic Impact and Healthcare Costs: It is projected that India will spend about $13 million annually on treating obesity-related illnesses by 2025 as per the World Obesity Federation. The rising prevalence of obesity is associated with various non-communicable diseases, including diabetes and cardiovascular issues.
• Changing Demographics: The prevalence of obesity is expected to continue rising, with forecasts suggesting that by 2040, around 30.5% of men and 27.4% of women will be either overweight or obese.

What are the initiatives taken by the government? 

• National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS): This program aims to screen individuals for obesity-related risk factors and ensure early intervention to prevent complications associated with obesity. It is part of the broader National Health Mission.
• Eat Right India Movement: Launched by the Food Safety and Standards Authority of India (FSSAI), this initiative focuses on transforming the food system to promote safe, healthy, and sustainable food for all citizens. It includes awareness campaigns about nutrition and healthy eating habits.
• Ayushman Bharat Health Wellness Centres: These centres strengthen preventive healthcare by promoting wellness activities and targeted communication at the community level, addressing non-communicable diseases (NCDs) including obesity.
• Regulatory Measures: The FSSAI has set guidelines to limit trans fats in food products to no more than 2% by weight and has introduced labelling regulations that require nutritional information on food packaging, helping consumers make informed dietary choices.

What are the new guidelines?  

• Terminology Update: The term “overweight” has been removed, categorizing obesity into Grade I (BMI >23 kg/m² without health issues) and Grade II (BMI >23 kg/m² with associated health limitations) to emphasize nuanced stages of obesity.
• Focus on Abdominal Obesity: Waist circumference (>90 cm for men, >80 cm for women) and waist-to-height ratio are prioritized as critical measures for assessing health risks in Asian Indians

Why has it been revised after 15 years?

• Rising Prevalence of Obesity: The prevalence of obesity in India has doubled over the past two decades, with significant increases observed in both adults and children. This alarming trend necessitated a reevaluation of existing guidelines to address the growing public health crisis effectively.
• Limitations of Previous Guidelines: The previous guidelines, established in 2009, relied solely on Body Mass Index (BMI) for diagnosing obesity.
  • This approach was found inadequate as it did not consider critical factors such as abdominal fat distribution and the unique metabolic responses of Asian Indians, who tend to develop obesity-related health issues at lower BMI thresholds compared to Western populations.
• Global Framework Alignment: The revised guidelines align with global recommendations from The Lancet Diabetes & Endocrinology Commission, which advocates for a broader understanding of obesity as a chronic disease rather than merely excess weight. T

What are the health issues that can develop due to obesity?

• Cardiovascular Diseases: Obesity significantly increases the risk of developing heart disease and stroke. It contributes to high blood pressure and unhealthy cholesterol levels, which are critical risk factors for cardiovascular conditions.
• Type 2 Diabetes: Excess body weight can disrupt the body’s ability to use insulin effectively, leading to insulin resistance and a higher likelihood of developing type 2 diabetes. This chronic condition is closely linked to obesity and can result in severe health complications if not managed properly.
• Certain Cancers: Obesity is associated with an elevated risk of various cancers, including breast, colon, endometrial, and liver cancers. The increased body fat may influence hormone levels and inflammation, contributing to cancer development.

Way forward: 

• Comprehensive Public Health Strategies: Strengthen preventive measures through awareness campaigns, promote healthy lifestyles, regulate unhealthy food products, and expand screening programs under initiatives like NPCDCS and Ayushman Bharat.
• Collaborative Policy Reforms: Enhance inter-sectoral collaboration to address urbanization, sedentary lifestyles, and dietary patterns while aligning with global obesity management frameworks for effective, long-term solutions.

Mains PYQ:

Q  Public health system has limitations in providing universal health coverage. Do you think that private sector can help in bridging the gap? What other viable alternatives do you suggest? (UPSC IAS/2015)

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