Obesity: India’s Silent Tsunami – A Call For Preventive Reforms Across Institutions

India faces a growing burden of obesity, with 24% of women and 22.9% of men now overweight or obese, reveals National Family Health Survey (NFHS-5) [1], doubling since 1980[2]. Childhood obesity has more than doubled in many metros. The World Health Organization warns that over 163 million Indians could be obese by 2030 [3].

As a gastroenterologist, I have witnessed the rise in fatty liver disease, diabetes, and cardiovascular conditions due to excessive weight gain. Obesity fuels non-communicable diseases, claiming 47% of lives in India, according to the Indian Council of Medical Research (ICMR) [4]. The ICMR-INDIAB study [5] reports a weighted prevalence of generalised obesity at 28.6% and abdominal obesity at 39.5% among adults.

A Lancet study [6] highlights the elevated risk of type 2 diabetes among Indians with a BMI above 25. The economic cost is alarming, with obesity-related healthcare expenses projected to reach $13 billion annually by 2025, as per World Health Federation [7]. Bold, systemic action is necessary to prevent this growing burden. We must act early, wisely, and together to address this national imperative.

As a gastroenterologist witnessing the downstream effects of obesity daily, I urge policymakers, educators, employers, and healthcare providers to confront this epidemic head-on. The time for half-measures is over.

If obesity begins with what we eat, then the canteens of our schools, corporate offices, and government hospitals are ground zero. These institutions feed millions daily, yet too often, they serve up a steady diet of junk—high in sugar, salt, and unhealthy fats. It’s time to rewrite the menu.

1. School canteens: The first line of defence

A Public Health Foundation of India study [8] found that 60% of urban school canteens sell predominantly unhealthy snacks, contributing to childhood obesity.

To combat this, India needs a national policy regulating school canteen menus, focusing on fresh fruits and vegetables, whole grains, non-fried snacks, and banning soft drinks and junk food near schools.

Global examples like Chile and the UK have shown success in reducing childhood obesity rates through stringent school food regulations. India can emulate these models by introducing 'Healthy School Meal Guidelines', similar to the mid-day meal initiative, to promote healthy eating habits from a young age.

2. Corporate workspaces: A breeding ground for metabolic disorders

Indian corporate settings often promote sedentary lifestyles and unhealthy eating habits, increasing obesity-related disorders. Regulatory frameworks should require corporate canteens to display calorie counts, offer healthier options, and limit processed meals.

Employers should be incentivized to promote healthy living, as studies show healthier employees lead to greater productivity and reduced absenteeism.

A Business Group on Health report [9] found wellness-focused companies enjoy 25% less absenteeism and 15% higher productivity, proving that health is good business.

3. Government Hospitals: Leading by Example

Government hospitals, paradoxically, often serve unhealthy food in canteens and nearby kiosks. To transform public health, change must begin from within.

Hospitals should mandate healthy meals, ban junk food nearby, and introduce obesity counselling in OPDs, becoming beacons of preventive care and integrating brief nutrition counselling into patient visits.

4. The role of government doctors: From curative to preventive

India's healthcare system is overwhelmed due to a focus on treatment over prevention. Empowering government doctors to prioritize preventive health screening can be revolutionary. This includes annual BMI, blood sugar, and cholesterol checks at PHCs, health talks, and early NCD detection.

The NPCDCS [10] endorses preventive screenings, but execution lags. Bolstering this framework with a focus on obesity could save lives and resources, requiring a paradigm shift from reactive to proactive public health approach.

5. MBBS curriculum: Time for academic reforms

India's MBBS curriculum needs reform to prioritize preventive medicine, given NCDs account for 65% of deaths, reveals (WHO).

A standalone module on obesity, metabolic syndromes, preventive diagnostics, nutrition counselling, and community medicine would equip future doctors to tackle 21st-century challenges.

This academic shift would enable physicians to focus on prevention, treating patients before it's too late, and addressing the growing burden of lifestyle-related diseases in India.

A national health emergency in slow motion

Obesity may not spread like a virus, but its impact is no less catastrophic. It silently increases the risk of heart disease, cancer, liver failure, diabetes, joint problems, depression, and even premature death. We must stop viewing obesity as a matter of personal responsibility alone — it is a systemic failure that demands systemic solutions.

A cross-sectoral strategy — involving schools, offices, hospitals, curriculum-makers, and public policy thinkers — is the only way forward. India is on the verge of becoming the obesity capital of the world if it doesn’t act now.

The time to intervene is not tomorrow. Not next year. But today. Let us build a healthier, lighter, and brighter India. “Prevention is not a choice — it’s our only chance.”