Obesity Problem In India

Obesity problem in India was bad enough, but it just got larger. According to Dr Ramen Goel,of the All India Association for Advancing Research (AIAARO) in Obesity, about 15% more Indians now have the dubious distinction of being considered overweight or obese. This is the upshot of new scientific definitions of obesity for Indians announced by Dr. Anoop Misra and Dr Makkar at the Asia-Oceana Conference on Obesity organized for the first time in India recently by the AIAARO. The findings were a part of a Consensus Statement published in February 2009 issue of the Journal of the Association of Physicians of India (JAPI). The statement was published by a prestigious consensus group of medical professionals representing numerous medical disciplines from reputed medical institutions, hospitals, government-funded medical research institutions and policy making bodies. Several years of excellent research provided the basis for redefining obesity for Indians. Current definitions for obesity and for predicting associated adverse health effects are largely adapted from the criteria developed in the Western countries for the Caucasian population.

Increased body fat, is associated with many health conditions associated with obesity such as diabetes and high blood pressure. Particularly, central fat – the fat deposited around waist and the internal organs such as intestines and liver is the worse offender. Higher body fat or the central fat dramatically increases obesity-related health risks. Body mass index (BMI) is a convenient surrogate marker for estimating body fat content. BMI is calculated by dividing your weight in kg twice by your height in meters. Western standards consider a BMI of 20 – 24.9 as “normal”, 25 – 29.9 as overweight and 30 and above as obesity. Overweight and obesity cut-off points indicate a sharp increase in obesity-related health risks.

However, research showed a peculiar phenomenon. At similar BMI, Asian Indians have much greater central or total body fat compared to Caucasians, indicating that Asian Indians are more predisposed to health risks at a BMI that may be considered normal for Caucasians. Moreover, Asians with body fat and central fat distribution similar to that of Caucasians had greater health risks compared to Caucasians. Thus, Indians appear to get obesity-related diseases at a lower body fat level compared to Caucasians. This contributed to reconsidering the validity of the cut-off points for Asian Indians. Those with BMI between 23 – 25 will now be considered overweight and above 25 will be considered obese.

Similarly, new lowered cut-off points suggest that Indian men with waist circumference above 78 and women above 72 cm should be alerted against further weight gain and active treatment be initiated for weight management for waist circumferences above 90 and 80 cms for Indian men and women, respectively. Redefining overweight or obesity has more than academic significance. By recognizing possible health risks in a population segment hitherto considered “normal”, more Indians are likely to receive medical attention needed for prevention and treatment of obesity-related conditions. The new consensus guidelines also make specific treatment recommendations for Indians including physical activity, and for initiating drugs or surgical therapy. Overall, the recognition of a peculiar health situations in Indians, which is different from that of the West is a very welcome sign and is hoped to lead to appropriate corrective actions in this country.