Nina* is a 33-year-old communication professional from Mumbai who has been dealing with obesity for the past five years. While she recalls growing up as a ‘plump’ child, she says that during her childhood and teenage days, she was never unhealthy or obese. “I stayed at home and my mother ensured that I ate all right things,” she says. However, things went south a few years back, when she was diagnosed with acute clinical depression. “At that time, I started neglecting my general health and well-being,” she says. Even though Nina tried losing that extra weight multiple times, the lockdown made things extremely difficult for her. Nina is not alone.

In a reply to a question in the Lok Sabha on February 4, the Ministry of Health and Family Welfare had presented the numbers from a 2015-16 study conducted by the now-defunct National Nutrition Monitoring Bureau. It said almost half (44 per cent) of the urban women in India are either overweight or obese. The study surveyed 13,718 people aged between five and nine; 11,575 people between the ages 10 and 13; 11,462 between 14 and 17 and 1,23,281 adults living in urban areas in 16 States and UTs. It noted that in contrast to women, only 33.8 per cent of urban adult men are overweight or obese.  The numbers were small among children. For instance, only 8.1 per cent of boys and 7.2 per cent of girls, aged between five and nine were obese. Another observation was that, while the percentage of obese boys is higher than that of girls, upon reaching adulthood, more women are obese or overweight, compared to men.

Which State has the highest number?

The survey covered 13 States — Maharashtra, Gujarat, Kerala, Tamil Nadu, Karnataka, Andhra Pradesh, Odisha, West Bengal, Madhya Pradesh, Uttar Pradesh, Assam, Bihar and Rajasthan and two Union Territories — Puducherry and Andaman and Nicobar Islands --and the NCT of Delhi. The results showed that 59.7 per cent of the urban women in Puducherry were overweight or obese. The proportion is 54.1 in neighbouring Tamil Nadu, 52.3 per cent in Delhi and 52.2 per cent in Gujarat. The proportion is the lowest in Uttar Pradesh, where only 29.7 per cent of urban adult women fell in the overweight/obese category. The survey said 42.6 per cent of Rajasthan’s urban men are obese. They are closely followed by the urban men of Puducherry, where 42.5 per cent are obese. Only 21.1 per cent of West Bengal’s urban men are obese.

The cause

A study titled A comparison of the Indian diet with the EAT-Lancet reference diet, published in BMC Public Health says: “Indian diets, across States and income groups, are unhealthy. Indians also consume excess amounts of cereals and not enough proteins, fruits, and vegetables.” Veena Shatrugna, former deputy director of National Institute of Nutrition, agrees. She explained how excess consumption of cereals is creating an unhealthy population in the country. “Less than 60 per cent of your calories must come from cereals. If you eat 100 grams of cereal, you must have at least 20 grams of pulses for protein in the diet to be of good quality. You must consume pulses amounting to a fifth of the amount of cereals you consume,” she said, adding, “Your diet must also include protective foods like fruits, green leafy and root vegetables, eggs, flesh food, milk products and oils. Unless you have enough vitamins and minerals from the above foods, the rice you eat does not get completely metabolised. Instead, it gets converted to fats.” Shatrugna says that excessive cereal consumption happens among Indians because of the way in which the government distributes its food. “Every time there is a crisis, the government distributes large quantities of cereals. They have done a great job of it, but people have brought into the idea that rice and wheat are the only food they require. To be healthy, an adult must consume 400-500 grams of fruits and vegetables per person per day,” she says. In the absence of protective foods, the cereal calories go to make adults obese, however, these calories get used up when children run around and play, but also contribute to height increases.

Looking at the rural population The share of obese people is much less in rural India, according to an NNMB study from FY2011-12. The study that surveyed 10 States/UTs said that only 11.8 per cent of the adults are overweight or obese. While 13.5 per cent of rural women were obese, 10 per cent of men were obese too. Shatrugna says that this could be because of decreased food intake accompanied by an increase in physical activity among the rural population. In contrast, there is a marked decrease in physical activity levels in the urban population..

Neha*, another resident of Mumbai, agrees. The 35-year-old has been overweight for a while now and says that multiple factors have hindered her journey towards losing weight. She says that while gyms have caused health issues for her, she also found it difficult to spot a park or a space to jog. “Mumbai footpaths are either encroached by hawkers or are unwalkable due to garbage being dumped,” she says. “The pandemic put an end to almost all my efforts and I gained another 5kg. I shed 3kgs recently by jogging inside my society, but gained those 3kgs when I caught Covid,” she says. *Names changed on request

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