A Big Fat Crisis – Let’s talk about Obesity I

It is quite counterintuitive, as the world often associates India with malnutrition. But the obesity rates in India are on the rise. Recent data state that more than 135 million Indians are clinically obese. And it is not just a cosmetic concern. Being obese is a severe medical condition. A recent report from World Health Organization states that worldwide obesity has tripled since 1975. It is the primary reason behind the risk of other illnesses and health problems, such as cardiovascular diseases, diabetes, high blood pressure, and certain cancers. Obesity is the reason behind various underlying chronic diseases and vice versa.

But how did we get here? Experts have quoted several factors that link to the obesity epidemic, like unhealthy food habits, sedentary lifestyles, lack of healthcare services, and inadequate financial support.

The Indian middle-class has developed financially in recent years, a sign of economic progress. Yet, more facility and abundance only make it more important to watch what we eat. And to maintain activity round the clock.

However, the topic of obesity is not all doom and gloom- there are many aspects to this complex problem, and solutions are within reach too. Even a modest weight loss can improve or prevent health problems. To shed light on the matter, we spoke to the renowned dietician Dr. Swathi Sreekanta, who joined us on World Obesity Day. Here’s an insightful Q&A with the expert to show us a way out of this prevalent crisis.

The word ‘obesity’ is commonly used, and we increasingly see it being used trivially. However, it is a severe medical condition. Can you please explain what obesity is in medical terms?

‘Fat’ is probably the layman’s way of putting it. But obesity is a non-communicable disease that requires a clinical diagnosis. In medical terms, every person has a factor, a Body Mass Index, also known as BMI. This is a ratio found using the person’s weight and height. Anyone who ranges between 19.9 – 24.9 is considered normal. Over 25-30 is overweight, and beyond 30 is classified as obese. Furthermore, grades 1, 2, and 3 measure its severity.

But considering the Asian body type, the measure might be slightly different from the European standards. We are not remarkably tall, to begin with, compared with Europeans. Off late, 23 is considered normal, and over 23 can be the category of overweight. Coming back to the term ‘obesity’ – it is a clinical term we use to diagnose someone overweight. And might need much more attention than someone whose weight is only slightly higher.

Apart from the BMI, the other indices for a healthy weight would be the waist-to-hip ratio. This can give us a more profound idea of where exactly one falters. It also helps to assess the type of body and the shape of one’s body.

It is often assumed that only putting on weight is an early sign, but what are the early signs of obesity?

Pain in the knees or your back: Sometimes, the slightest weight gain would show by way of pain in the knees or back. The immediate sign is that you would feel a lot heavier.

Clothes don’t fit anymore: Even though the whole concept of having the right size of jeans or blouse might seem very cosmetic at the outset, it is something that we should monitor every couple of months. Also, keep looking at whether your clothes fit the right way or become tight or loose.

Changes in the sleep pattern or skin: Other signs may include finding it hard to fall asleep, snoring, or changes in skin color. The higher fat deposit can form skin folds in joint areas of the body. If there is a folding of the skin, you might find some fungal infection there. You might notice some darkening of the skin at the nape of your neck – when you’re gaining a lot of weight. There is also some insulin resistance, hence the changes in your skin’s complexion.

Apart from that, changes in blood pressure, and varicose veins, are also signs of gaining weight, but those appear later.

One’s body weight depends on many factors, including genes, diseases, and lifestyle. What are some of the risk factors for obesity?

When somebody is on the heavier side, they tend to blame it on their genes. While genetic factors might come into play, weight is something we can control much more than we would like to admit. Once we see visible signs of becoming overweight, we should take action to stop it before it can reach the stage of severe obesity. Some conditions can cause you to gain weight without your involvement, like if you’re taking medications like steroids or if you’ve had surgery and your movement is limited. It is common for women to put on weight after pregnancy, and a thyroid imbalance or PCOS can also cause weight gain.

But unless you have a condition, it is often a function of how proactive you are – you are your best judge, so look and act accordingly. You can save from the obesity crisis just by being mindful. Keeping an eye on weight gain can save you from high medical costs.

Obesity has proven to be fatal in many Western countries. In India, we, too, are moving towards an increasingly sedentary lifestyle. How will increased cases of obesity in the country affect our population?

Obesity can be a symptom of and a cause of many noncommunicable diseases. It can’t be spread in a community through physical contact and invokes less fear than infectious diseases. But despite that, this noncommunicable disorder requires more urgent attention, as it afflicts populations at large and is the leading cause of developing diabetes, hypertension, heart diseases, and some types of cancers.

There are many other reasons why obesity is worrying. It is, for starters, self-limiting – when you gain weight, you find it challenging to get around and stop doing things you’d typically do. On gaining weight, one may be unable to do a particular sport because it impacts their knees or back. These changes occur far before obesity starts causing severe diseases, and gaining weight is a slow, incremental process that gets difficult to eliminate with time. Awareness is necessary – obesity is just a sign, and it is like a wake-up call. People need to act on weight gain and not let it lead to obesity.

We might also need to question our attitude around body weight – in India, looking healthy has always been a sign of prosperity, whether it be an adult or a child. Like you see people when they see a child, say, “why isn’t she chubby?”. We must challenge these beliefs because the world has changed considerably since the advent of the internet and smartphones, and childhood obesity can be a rising concern in our nation in the coming years.

I am glad there are forums like yours that are trying to make World Obesity Day popular so that people know that it is a widespread problem, but also that there is enough help out there, and they should reach out. Obesity causes populations to have poor mental health, leading to a lack of productivity and thereby affecting them. When healthy individuals perform their best, there is growth in the country. But an obese population weighs itself down.

Like what you’re reading? Head on to A Big Fat Crisis – Let’s talk about Obesity II to read the rest.