Global Obesity Epidemic (Lancet)

Global Obesity Epidemic (Lancet)

NEWS: A pair of studies published in The Lancet have projected that by 2050, over half of all adults (380 crore people) and one-third of all children and adolescents (74.6 crore people) worldwide will be overweight or obese. These studies provide crucial insights into the rising prevalence of obesity and overweight individuals globally, including forecasts till 2050.

 

WHAT’S IN THE NEWS?

  1. Global Overweight and Obesity Trends:
    • As of 2021, approximately 211 crore (2.11 billion) people, which accounts for 45% of the global population, were classified as overweight or obese.
  2. Countries with the Highest Obese Populations:
    • Half of the global obesity cases are concentrated in just eight countries, with the highest numbers recorded in:
      • China: 40.2 crore (402 million)
      • India: 18 crore (180 million)
      • USA: 17.2 crore (172 million)
      • Brazil: 8.8 crore (88 million)
      • Russia: 7.1 crore (71 million)
      • Mexico: 5.8 crore (58 million)
      • Indonesia: 5.2 crore (52 million)
      • Egypt: 4.1 crore (41 million)

 

Obesity in India: Alarming Trends

  1. Adults (25+ years):
    • The number of overweight and obese adults in India has increased significantly since 1990.
    • By 2050, India is projected to have the second-largest obese and overweight adult population globally.
  2. Older Adolescents (15-24 years):
    • In 2021, India overtook China as the country with the highest number of overweight and obese adolescents.
    • This trend is expected to continue rising in the coming decades.
  3. Children (5-14 years):
    • Currently, India ranks second only to China in terms of overweight and obese children.
    • By 2050, India is expected to narrow the gap, with obesity levels in China stabilizing while they continue to rise in India.

 

NFHS-5 Statistics on India’s Obesity (2019-21)

  1. Overall Obesity Rates:
    • 24% of Indian women and 23% of Indian men are classified as overweight or obese.
  2. High-Risk Waist-to-Hip Ratio:
    • 56.7% of Indian women and 47.7% of Indian men have a high-risk waist-to-hip ratio, increasing their susceptibility to metabolic diseases.
  3. Obesity in Age Group 15-49 Years:
    • 6.4% of women and 4.0% of men in this age group are classified as obese.
  4. Rising Childhood Obesity:
    • The percentage of children under 5 years who are overweight (weight-for-height) has increased from 2.1% in NFHS-4 (2015-16) to 3.4% in NFHS-5 (2019-21) at the national level.

 

Impacts of Rising Obesity Levels

  1. Long-Term Obesity Cycle:
    • Overweight and obese children are at a higher risk of becoming obese adults, perpetuating the obesity cycle across generations.
  2. Early Onset of Diseases:
    • Obesity significantly increases the risk of Type 2 diabetes, cardiovascular diseases, hypertension, stroke, and certain cancers at an earlier age.
  3. Rising Healthcare Burden:
    • Higher obesity levels increase demand for medical treatments and surgeries, leading to a surge in healthcare costs.
  4. Aging Population at Risk:
    • By 2050, 25% of obese individuals will be aged 65 and above, placing greater strain on healthcare and elderly care systems.
  5. Coexistence of Undernutrition and Obesity:
    • Many low- and middle-income countries (LMICs), including India, face a double burden of malnutrition, where undernutrition coexists with rising obesity rates in different population segments.

 

Causes of the Obesity Epidemic

  1. Shift in Dietary Patterns:
    • Increased consumption of calorie-dense foods high in sugar, salt, unhealthy fats, and refined carbohydrates.
  2. Rise of Ultra-Processed Foods:
    • The rapid expansion of multinational food corporations has led to the proliferation of packaged and processed foods, replacing traditional diets.
  3. Weak Regulatory Frameworks:
    • Many developing nations, including India, lack stringent policies to regulate fast food, junk food advertisements, and misleading nutrition claims.
  4. Market Trends and Processed Food Consumption:
    • Between 2009 and 2019, the highest increase in ultra-processed food consumption was recorded in:
      • Cameroon
      • India
      • Vietnam

 

Potential Solutions to Address the Obesity Epidemic

  1. Protect Local Food Systems:
    • Strengthening traditional food markets and encouraging the consumption of locally sourced foods over imported processed foods.
  2. Public Health Policies:
    • Implementing national obesity prevention programs, promoting nutritional awareness, and taxing unhealthy foods to discourage their consumption.
  3. Clinical Interventions:
    • Increasing investment in obesity management, prevention, and treatment, including bariatric surgeries and lifestyle interventions.
    • Exploring next-generation obesity drugs to aid in weight management.

 

How is Obesity Measured?

  1. Traditional BMI Classification (WHO Standards):
    • Underweight: BMI < 18.5
    • Normal weight: BMI 18.5 - 24.9
    • Overweight: BMI 25 - 29.9
    • Obese: BMI > 30
  2. Issues with BMI-Based Classification:
    • Limitations in assessing body fat distribution:
      • Some lean individuals (especially in India) with a normal BMI may still have excess abdominal fat, leading to obesity-related health risks despite appearing "healthy" by BMI standards.
      • Some individuals with high muscle mass may have a BMI over 30 but still be metabolically healthy, leading to potential misclassification.
  3. New Lancet Proposal (2024):
    • Clinical Obesity:
      • Diagnosis based on BMI, waist circumference, muscle mass, and overall body function rather than just BMI alone.
    • Pre-Clinical Obesity:
      • A new category for individuals with high BMI but no immediate metabolic health issues, highlighting those at risk of developing obesity-related diseases in the future.

 

Conclusion

  • Obesity has emerged as a significant public health crisis worldwide, with India witnessing a steep rise across all age groups.
  • Changing dietary habits, increasing urbanization, and weak regulatory policies have contributed to this epidemic.
  • Multi-sectoral interventions involving public health policies, education, food regulation, and clinical treatments are necessary to mitigate the long-term impact of obesity on healthcare systems and overall well-being.

 

Body Mass Index (BMI)

  • Body Mass Index (BMI), previously known as the Quetelet index, is a simple way to check if an adult has a healthy weight.
    • It is calculated by dividing a person's weight in kilograms by their height in meters squared (kg/m²).
    • To find BMI, take a person’s weight (kg) and divide it by their height (m) squared.
  • Healthy BMI Range: A normal BMI falls between 18.5 and 24.9, based on the World Health Organization (WHO) guidelines.
  • Government interventions to promote healthy lifestyle
  • The Government of India has launched several initiatives to promote healthier lifestyles, better nutrition, and physical activity.
    • Fit India Movement
    • National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD) 
    • POSHAN Abhiyaan
    • Eat Right India
    • Khelo India
    • National Health Mission
    • FSSAI’s ‘Aaj Se Thoda Kam’ Campaign
    • FSSAI's RUCO (Repurpose Used Cooking Oil) initiative
    • Regulating High Fat, Salt, and Sugar (HFSS) Foods

 

Source: https://indianexpress.com/article/explained/explained-health/lancet-studies-obesity-overweight-9872323/