Obesity and Undernutrition, Parameters, Causes, Socio-economic Factors

Combating the double burden of malnutrition in India requires a multi-pronged approach. Know here all about Obesity and Undernutrition, Parameters, Causes and Health Impacts.

Table of Contents

Context: Obesity and overweight are causing over 3.4 million deaths every year worldwide.

Obesity and Undernutrition

India faces a growing challenge of both obesity and undernutrition, co-existing within the population, as per a new Lancet study.
This phenomenon, known as the “double burden” of malnutrition, poses significant health risks.

About Obesity

Obesity is a chronic disease that occurs when the body stores excess calories as fat
It is caused by an imbalance of calories consumed and calories expended (when someone eats too many high-fat or high-sugar foods and doesn’t get enough physical activity).
Other factors: Certain medications, such as antidepressants, steroids and diabetes medications, Lack of sleep, Stress & Genetics.
A body mass index (BMI) of over 30 indicates obesity.
Potential Health Problems caused due to Obesity: Stroke, Type 2 diabetes, High blood pressure, High cholesterol, Sleep apnea, Certain cancers etc.
Government Efforts to Tackle Obesity:
- Eat Right India: A campaign from the Food Safety and Standards Authority of India (FSSAI) that promotes healthy eating habits. The campaign has three pillars:
  - Eat Safe: Promotes safe and hygienic food.
  - Eat Healthy: Promotes diet diversification and fortification
  - Eat Sustainably: Promotes the conservation of water resources, eating local and seasonal foods.
- Fit India Movement, POSHAN Abhiyan, Mid day Meal Scheme etc.

Parameters of Obesity and Undernutrition

Obesity: Defined by the World Health Organization (WHO) as an abnormal fat accumulation posing health risks.
- Adults: BMI ≥ 30 kg/m2
- Children/adolescents: BMI two standard deviations above the mean
Undernutrition: Encompasses various forms, including underweight.
- Adults: BMI < 18 kg/m2
- Children/adolescents: BMI two standard deviations below the mean

Facts about Obesity and Undernutrition

Obesity

Women: Increased from 1.2% (1990) to 9.8% (2022), with 44 million affected in 2022.
Men: Increased by 4.9% (1990-2022), with 26 million affected in 2022.
Children: Significant rise (3% in girls, 3.7% in boys) over 32 years.
2022: 3.1% of girls and 3.9% of boys obese (compared to 0.2 million each in 1990; 7.3 million boys and 5.2 million girls in 2022).

Undernutrition

Despite the decline, prevalence remains high.
2022: 13.7% of women and 12.5% of men were underweight.
Thinness (underweight in children):
- Highest in the world for girls (20.3%) and second highest for boys (21.7%).

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Causes of Obesity and Undernutrition

Lack of access to affordable, nutritious food: Contributes to both undernutrition and obesity.
- Undernutrition: Limited access to food itself.
- Obesity: Increased access to processed, unhealthy foods high in fat, sugar, and salt.

Socio-economic Factors

Gender: Women have higher obesity rates due to:
- Limited access to physical activity (walks, gyms).
- Prioritising family nutrition over their own.
- Less sleep (waking up early, sleeping late).
- Central obesity (abdominal fat accumulation) might be as high as 40-50% in some regions.
Income: While traditionally associated with the rich, obesity is rising among the poor due to:
- Affordability and convenience of junk food (e.g., samosas, pakoras) compared to fruits and vegetables.
Urban-rural divide: Obesity is more prevalent in urban areas.
Undernutrition: Persists in remote, rural areas of poorer states due to:
- Limited food access, with some people having only one meal a day.

Health Impacts of Obesity and Undernutrition

Obesity: Increases risk of diabetes, hypertension, heart attacks, and strokes.
Undernutrition: Increases the risk of non-communicable diseases later in life:
- “Catch-up growth” in adulthood may lead to bodies less able to adjust to increased nutrition, making them more susceptible to diseases like diabetes.
- This phenomenon has been observed in famines, where the rate of diabetes increases significantly years later in those born during the famine.

Obesity Stats

Global:
- 1 in 8 people is living with obesity.
- 890 million adults and 160 million adolescents are affected by it.
- 37 million children under 5 years old are overweight & 390 million children aged 5-19 years are overweight.
India:
- 13% obesity rate, higher than other middle-income countries.
- India ranks 3rd globally in obesity prevalence, after China and USA.
- India ranks 2nd globally in obese children.

Solutions for Obesity and Undernutrition

The study emphasises addressing both obesity and undernutrition simultaneously.
Focus on programs promoting healthy nutrition:
- Targeted cash transfers.
- Food assistance (subsidies, vouchers for healthy foods).
- Free healthy school meals.
- Primary care-based nutritional interventions.
Ensure food security.
Support weight loss for those with obesity: Prevention and management are crucial due to the earlier onset of obesity, leading to longer exposure.
- Making healthy food affordable and accessible is a key challenge.
Pharmacological treatment: While promising, the study suggests its limited impact due to high costs and lack of generalizable guidelines.