India’s big battle of the bulge

In these hectic days, where social media has become the country’s principal pre-occupation, the time for physical exercise is shockingly scanty. 

No surprise then that there is an outbreak of lifestyle diseases such as heart ailments, diabetes and obesity that plague the country’s middle-aged population across the economic divide, a trend that was once only the prerogative of the rich and super-rich.

Oscar Wilde’s epigrammatic expression of treating all trivial things very seriously and all serious things of life with sincere and studied triviality, applies to India of today more than anywhere else.

In the ongoing Parliament session, when a question was asked in the Lok Sabha by BJP MP, Rathva Gitaben Vajesingbhai, as to whether the incidence of obesity is increasing among not only among the middle-aged, but also the youth in urban areas, the minister of state of health and family welfare, Ashwini Kumar Choubey, revealed some eye-popping details. 

Citing the Indian Council of Medical Research (ICMR) report on the health of the nation’s states, he said that the contribution of high body mass index (BMI) in total disability-adjusted life year (DALY) of India has increased from 0.8% in 1990 to 3.6% in 2016.

As per the National Family Health Survey (NHFS)-4 (2015-16), there has been a spurt in obesity in both males (from 9.3% to 18.6%) and females (from 12.6% to 20.7%) in the age group 15-49 years in comparison to NFHS-3.

Three years since then, the situation on the ground appears grim as the age-group caught in the obesity syndrome ranges between 15 to 49, the most active and productive years in the life of an individual.   

Questions have been asked as to whether being obese is one’s fate or a genetic defect or eating disorder triggered by binge hogging and irregular work schedule or inability to maintain work-life balance through healthy habits. 

Whatever the reason, the result is often fatal if the root cause is not diagnosed quickly and remedial measures put in place before it develops into a complicated chain reaction that affects the functioning of a human being’s vital organs and the physical system.

A practicing bariatric surgeon in the United Kingdom, Dr Kamal Mahawar, who has done a dissertation on “Fight With Fat”, recently told this author that India is the third most obese country in the world with 3.8% of Indian men and 4.2% of Indian women wrestling with over-weight issues that affect their physical and psychical wellness. 

He blames the entry and entrenchment of fast-food outlets — both desi and videshi — as responsible for the swell in obesity numbers across the country and suggests that fast food products churned out by multinationals and the processed food industry, be taxed heavily.  

For the desi shops, dishing out such ready-to-eat heavily-layered masala food items, Mahawar advocates food labeling with mandatory display of calorie count as well as carbohydrate, fat and protein ingredients in granular detail, so that consumers have an informed option before going on a binge on unwholesome food stuff that becomes addictive over time. 

Ramming home some native wisdom and home truths on desirable dietary habits, the doctor contends that raw food typically releases calories slowly into the system, while processed and cooked food leads to abrupt surges in the release and absorption of calories by the body. Fending off the obesity epidemic is feasible, if one does not ignore traditional Indian culinary practices and consumption patterns, which has benefitted the human system. 

Be that as it may, the bugle on bulge and the battle ahead to fight the fat as raised by Dr Mahawar and the concerned MP in the country’s Parliament have not come a day too soon. India’s goal of reaching the $5-trillion dollar economy mark before long would sound like a pipe dream if the dietary habits of its productive and robust population do not change for the better to raise the total productivity of the economy. 

No doubt, the Modi-2 government has its tasks cut out in this battle of the bulge. It has already set in motion the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Strokes (NPCDCS), which is implemented for interventions up to district level under the National Health Mission (NHM). 

NPCDCS stresses on awareness creation for behaviour and lifestyle changes, alongside early diagnosis, treatment and follow-up of non-communicable diseases, including cardiovascular diseases and diabetes, for which obesity constitutes a major risk factor. 

Considering the staggering shortfall in infrastructure and human resources, including the number of doctors for taking up primary health needs of the vast population and perennially under-funding in rural health infrastructure, the awareness campaign to take the fight against fat is faced with stark ground realities. 

With diabetes and obesity melding in a seamless manner, Dr Mahawar cautions against the outbreak of ‘diabesity’ to focus attention on the dismal lack of support system for innumerable poor patients who suffer from these twin ailments. 

It is time the authorities woke up to the menace of obesity, not only in urban but also in rural areas, so that preventive and curative measures could be initiated on a war-footing to ensure India’s tryst with a mega-sized economy tag.

Author is a senior journalist based in New Delhi