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

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.

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.

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.

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