Obesity

Obesity is a long-term condition where excess body fat raises the risk of type 2 diabetes, heart disease, stroke, fatty liver, arthritis, sleep apnoea, and several cancers. It is a disease — not a character flaw — and it can be treated.

How it's measured in India

• BMI (weight ÷ height²): Indians and other South Asians have higher body fat and diabetes risk at lower BMI. Use Asian cut-offs: overweight ≥ 23, obese ≥ 25 (not the global 25 / 30).
• Waist circumference: central fat is the bigger problem. Men ≥ 90 cm, women ≥ 80 cm = abdominal obesity — this is common even in people who look "thin".
• A normal-BMI person with a large waist ("thin-fat" pattern) is still at high metabolic risk — don't wait for the scale to tell you.

What drives it

• Rapid diet shift — more refined rice/wheat, sugar, fried snacks, ultra-processed food, sweetened tea.
• Sedentary work, long screen time, little walking or outdoor play.
• Poor sleep, chronic stress, irregular meals.
• Genetics play a role but environment is what's changed in one generation.

Health risks

• Type 2 diabetes (Indians develop it ~10 years earlier than Europeans).
• High blood pressure, heart attack, stroke.
• Fatty liver disease, gallstones.
• Knee and hip arthritis.
• Obstructive sleep apnoea.
• Infertility, PCOS, pregnancy complications.
• Breast, colon, uterine, kidney, pancreatic cancers.

What helps

• Losing 5–10% of body weight meaningfully improves blood sugar, BP, lipids — full "normal BMI" is not required.
• Shift carbohydrates to whole grains and millets (ragi, jowar, bajra) instead of white rice and maida.
• Cut sugar-sweetened drinks, deep-fried snacks, bakery items, sweets, packaged namkeens.
• Plate pattern: ½ vegetables and dal, ¼ whole-grain, ¼ protein (eggs, fish, chicken, paneer, soya, sprouts).
• 150 minutes a week of brisk walking or equivalent, plus two sessions of strength work. Any movement beats none.
• Sleep 7–8 hours; treat snoring/daytime sleepiness (sleep apnoea is undiagnosed in most).

When medical treatment helps

• If lifestyle change isn't enough, prescription weight-loss medicines (including newer GLP-1 class) are increasingly available in India — only under a doctor, not from online sellers.
• Bariatric surgery is an established option at BMI ≥ 37.5, or ≥ 32.5 with serious diabetes/BP; available at many major Indian hospitals. It is not "cheating" — for severe obesity it is often the most effective treatment.
• Avoid unregulated "fat cutter" ayurvedic powders, slimming teas, and weight-loss clinics that promise 10 kg in a month — several have been linked to steroid and hormone contamination.

See a doctor

• BMI ≥ 23 (Asian cut-off) or waist above the cut-offs, especially with family history of diabetes, high BP, or fatty liver.
• Rapid weight gain without diet change — may indicate thyroid, PCOS, Cushing's, or medication effect.
• Snoring with daytime sleepiness, breathlessness on exertion, knee pain, periods becoming irregular.