Obesity in India has a worrying address — the home.

Across the country, especially in the well-to-do urban households, entire families are sharing more than a common living area. They’re sharing bad food habits, sedentary lifestyles and a growing risk of lifestyle diseases — and now, their waistlines show it.

A new study analysing NFHS-5 (National Family Health Survey) data found that 20 per cent of households across India have all adults classified as overweight and 10 per cent had all adults obese. In States such as Tamil Nadu and Punjab, the figure climbs alarmingly high — nearly 40 per cent of homes have every adult classified as obese. And over 30 per cent of households in Manipur, Kerala, Arunachal Pradesh and Sikkim had all adults overweight. The study covered 6,36,699 households and 7,61,885 individuals.

So in India, obesity has become a family problem, not an individual one. This is because we are all used to eating a big serving of carbohydrates on our plates, says Sujatha Sasikumar, a Chennai-based registered dietician. “With a predominantly carb-dominant diet, you feel hungry more frequently, so you eat more, and often. This is the crux of weight gain,” explains Sujatha.

As India gets more urbanised, ‘modern’ and wealthy — families overeat and eat the wrong things at the wrong time, with little or no movement — a recipe for obesity. “We have access to a lot of food… all our social gatherings… revolve around food… Obesity is more among the privileged because it is a condition of over nutrition. We eat more than what we require and more calories than we can burn,” says Sujatha.

Dr Prashant Kumar Singh, an ICMR Scientist, and the lead author of the above mentioned study, sees this as part of a broader “nutrition transition.” He points out that, “States from southern India, being more economically developed, have undergone faster nutritional transitions from the traditional to processed foods and refined grains.” The phenomenon of nutrition transition is characterised by the adoption of urban lifestyles, unhealthy dietary habits, limited physical activity and increased use of tobacco and alcohol — significantly contributing to the rapid escalation of obesity rates, the study reported.

This coexistence of undernutrition (from processed / refined foods) and obesity within the same household is also worrying – as obesity is a health concern leading to diabetes, hypertension, heart diseases, stroke, etc. Even more troubling is the clustering – it is not behavioural, it’s generational. “These characteristics may be passed down to younger generations, creating another group at high risk for overweight and obesity,” he says.

A heavy blend
# 20% of Indian households had all adults overweight; 10% had all adults obese
# Over 30% of households in Manipur, Kerala, Arunachal Pradesh, and Sikkim had all adults overweight
# In Tamil Nadu and Punjab, 40% of households had all adults obese
# Among the richest households, 25% had all adults overweight; 17.3% had all adults obese
# In Urban households, 14.3–15% had all adults obese, while in rural households, it is 7.1–7.4%
# Among social groups, Scheduled Tribes: Only 4.2% of households had all members obese. ‘Forward’ other caste groups: Highest proportion at 12.2%
Source: ‘Family Matters’: A multilevel analysis of household-level clustering of overweight and obesity among adults in India, published in Public Health

Obesity clusters

The study observed that affluent populations have adopted more sedentary lifestyles, and entire households often share similar activity levels, which is leading to families becoming obesity clusters. Among the richest quintile, 24 per cent of households had all members overweight and 17 per cent had all members obese — nearly six times higher than the poorest households, Dr Prashant said.

“Nobody eats to become obese. They are eating excess of something and little of something... which is not satiating their hunger,” says Sujatha, calling for good food practices and exercise.

The silver lining is, families can also be the solution to the problem at hand. “Even if one person in the family starts changing their behaviour, it slowly starts to change the family too... because usually we don’t cook separately for separate family members. So, the common food plan helps to spark the change,” says Sujatha. Dr Prashant believes that the policy must now shift from treating obesity as an individual issue to a household one. He calls for implementing family-targeted screening in high-risk southern states, followed by family-focused interventions — nutrition counselling and meal planning support. He also suggests roping in schools as a bridge to families, besides including family nutrition and lifestyle education in school curricula.

Studies are also highlighting a growing incidence of overweight and obesity in rural India, sometimes worryingly outpacing that in urban areas, the ICMR’s research paper published in Public Health noted.

Dr Prashanth advocates for policy intervention — a “progressive taxation on unhealthy foods,” along the lines of a tax of sugar-sweetened beverages — while providing subsidies for healthy foods. People should move away from ultra-processed foods to traditional food practices, he says, towards a sustainable, evidence-based solution for obesity instead of running after ‘band-aid solutions’ to prevent recurrence.

“Even if the government rolls out great policies, nothing will change unless individuals step up,” says Sujatha. Experts have long been calling for bringing nutrition labelling to the front of the package.

Clear labels could help people make informed choices — something bold and unmissable, like the health warnings on cigarette packets, they say. A huge caution label flagging obesity, diabetes and blood pressure concerns on the front of packaged food, if it contained the “deadly trio” of refined carbs, fat and sugar, say public health experts, parking a thought for the FSSAI (Food Safety and Standards Authority of India).

And then comes political action. If gutka could be banned, perhaps States can look at ultra-processed foods, they ask. And since health is a State subject, maybe some States could take the lead to protect its people from not just tobacco or liquor but also the silent, slow, crushing weight of their own dinner plates.

Published on June 29, 2025