Health and Me

Dr. Amit Bansal

Why Obesity In India Must Be Treated As A Chronic Disease

India is undergoing a steady but serious public health shift. For decades, <span>obesity</span> was long dismissed as a matter of personal discipline, a “lifestyle choice,” to be managed by sheer willpower. 

However, it has emerged as a progressive, chronic disease with complex biological roots that demand sustained medical care, which is no longer confined to urban centers. It now affects smaller towns and rural communities alike. The National Family Health Survey (NFHS-5) reports that nearly one in four Indian adults is overweight or obese.

The situation in children is even more alarming, as UNICEF estimates that by 2030, India could have more than 27 million children and adolescents aged 5-19 years living with obesity, which would account for 11 percent of the world’s burden and put millions at risk of early metabolic disease.

Yet obesity continues to be viewed largely as a <span>lifestyle</span> lapse rather than a chronic, relapsing condition shaped by genetics, environment, and metabolic dysfunction. Like <span><a href="https://www.healthandme.com/health/diabetes">diabetes</a></span> or <span><a href="https://www.healthandme.com/health/hypertension">hypertension</a></span>, it progresses over time and requires structured, long-term medical management.

<h2>The Pediatric Crisis And The Looming Public Health Debt</h2>

The clearest sign of how serious this problem has become is visible among children. Recent findings published in The Lancet estimate that more than 12.5 million Indian children are living with obesity. This is not a distant warning; it is unfolding in clinics across the country. 

Longer <span>screen time</span>, easy access to high-calorie packaged food, shrinking playgrounds, and limited physical activity have steadily altered childhood routines. As a result, pediatricians are diagnosing Type 2 diabetes, fatty liver disease, and hypertension in teenagers, conditions that were once largely confined to middle age.

When excess weight and metabolic imbalance begin in adolescence, the health impact stretches across decades. These children are likely to carry obesity into adulthood, along with a higher risk of <span>heart disease</span>, kidney disorders, and other chronic illnesses. 

The burden is not just medical; it affects education, productivity, and long-term quality of life. Tackling this trend demands more than occasional awareness drives. It calls for consistent screening, early counselling, family-based lifestyle changes, and structured metabolic monitoring from a young age.

<h2>The GLP-1 Revolution And The Medical Oversight</h2>

The rise of GLP-1 receptor agonists has reshaped the discussion around obesity treatment in India. After the January 2026 patent expiry of semaglutide, more affordable generics have widened access, particularly for middle-income patients. 

Clinically, these medications have clear advantages, as they decrease appetite, enhance insulin sensitivity, and have demonstrated durable <span>weight loss</span> and cardiovascular risk reduction in large international trials published in The New England Journal of Medicine.

However, increased availability has also fueled cosmetic and unsupervised use. GLP-1 therapies were developed to treat metabolic disease, not for short-term aesthetic goals. They act on hormonal pathways that regulate hunger and glucose metabolism, making them potent medical agents. 

Without proper evaluation, dose monitoring, and long-term planning, patients may experience gastrointestinal side effects, muscle loss, or weight regain after discontinuation.

In a country like India, where obesity often coexists with advanced diabetes and heart disease risk, these medications must remain part of a structured, physician-led plan. They are an important therapeutic option, but not a substitute for sustained lifestyle and metabolic care.

<h2>The Inevitable Link to Non-Communicable Diseases</h2>

Obesity should be recognized as a chronic disease, as it is the underlying cause for most of the non-communicable diseases in India. According to the Global Burden of Disease report, ischemic heart disease is one of the top causes of death in India, and obesity is a direct contributor to this.

Visceral fat is associated with systemic inflammation, insulin resistance, abnormal lipid levels, and hypertension, which are the major pathways that cause heart attacks, strokes, and kidney diseases. 

Visceral fat is also associated with an increased risk of colon cancer and post-menopausal breast cancer, which are being increasingly noticed in young Indians.

Adding to the complexity is the Indian “thin-fat” phenotype, in which individuals with a normal BMI can have high internal fat. Thus, in the treatment of obesity, one has to treat the metabolic problem rather than just the appearance alone. 

Recognizing it as a chronic disease shifts focus toward early detection, sustained therapy, and long-term follow-up, which are essential steps to reduce premature cardiovascular deaths in India’s working-age population.

<h2>A Path Towards Holistic Intervention</h2>

Managing a chronic disease is not just about a prescription; it is about an ecosystem of care." A truly effective solution would have to be multi-modal, which means combining precision nutrition that takes into account the Indian eating habits, as calorie restriction alone would not be effective because it does not address the hormonal regulation, behavioral patterns, psychological triggers, or the metabolic imbalance.

An effective approach combines medical nutrition therapy, supervised physical activity, behavioral counselling, pharmacotherapy when indicated, and metabolic or bariatric surgery for eligible patients. Surgical intervention, supported by long-term data, not only reduces weight but also induces remission of Type 2 diabetes in a significant proportion of patients.

The goal is to transition from "weight loss" to "metabolic restoration." By treating obesity with the same clinical rigor as any other chronic disease, the healthcare industry can finally move beyond the scale and begin saving lives through comprehensive, science-based intervention.

Health Conditions A-Z

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obesity

weight loss

semaglutide weight loss

childhood obesity

heart disease

hypertension

metabolic health

diabetes

lifestyle

screen time

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India is undergoing a steady but serious public health shift. For decades, obesity was long dismissed as a matter of personal discipline, a “lifestyle choice,” to be managed by sheer willpower. However, it has emerged as a progressive, chronic disease with complex biological roots that demand sustained medical care, which is no longer confined to urban centers. It now affects smaller towns and rural communities alike. The National Family Health Survey (NFHS-5) reports that nearly one in four Indian adults is overweight or obese. The situation in children is even more alarming, as UNICEF estimates that by 2030, India could have more than 27 million children and adolescents aged 5-19 years living with obesity, which would account for 11 percent of the world’s burden and put millions at risk of early metabolic disease. Yet obesity continues to be viewed largely as a lifestyle lapse rather than a chronic, relapsing condition shaped by genetics, environment, and metabolic dysfunction. Like diabetes or hypertension, it progresses over time and requires structured, long-term medical management. The Pediatric Crisis And The Looming Public Health DebtThe clearest sign of how serious this problem has become is visible among children. Recent findings published in The Lancet estimate that more than 12.5 million Indian children are living with obesity. This is not a distant warning; it is unfolding in clinics across the country. Longer screen time, easy access to high-calorie packaged food, shrinking playgrounds, and limited physical activity have steadily altered childhood routines. As a result, pediatricians are diagnosing Type 2 diabetes, fatty liver disease, and hypertension in teenagers, conditions that were once largely confined to middle age. When excess weight and metabolic imbalance begin in adolescence, the health impact stretches across decades. These children are likely to carry obesity into adulthood, along with a higher risk of heart disease, kidney disorders, and other chronic illnesses. The burden is not just medical; it affects education, productivity, and long-term quality of life. Tackling this trend demands more than occasional awareness drives. It calls for consistent screening, early counselling, family-based lifestyle changes, and structured metabolic monitoring from a young age.The GLP-1 Revolution And The Medical OversightThe rise of GLP-1 receptor agonists has reshaped the discussion around obesity treatment in India. After the January 2026 patent expiry of semaglutide, more affordable generics have widened access, particularly for middle-income patients. Clinically, these medications have clear advantages, as they decrease appetite, enhance insulin sensitivity, and have demonstrated durable weight loss and cardiovascular risk reduction in large international trials published in The New England Journal of Medicine. However, increased availability has also fueled cosmetic and unsupervised use. GLP-1 therapies were developed to treat metabolic disease, not for short-term aesthetic goals. They act on hormonal pathways that regulate hunger and glucose metabolism, making them potent medical agents. Without proper evaluation, dose monitoring, and long-term planning, patients may experience gastrointestinal side effects, muscle loss, or weight regain after discontinuation. In a country like India, where obesity often coexists with advanced diabetes and heart disease risk, these medications must remain part of a structured, physician-led plan. They are an important therapeutic option, but not a substitute for sustained lifestyle and metabolic care. The Inevitable Link to Non-Communicable Diseases Obesity should be recognized as a chronic disease, as it is the underlying cause for most of the non-communicable diseases in India. According to the Global Burden of Disease report, ischemic heart disease is one of the top causes of death in India, and obesity is a direct contributor to this. Visceral fat is associated with systemic inflammation, insulin resistance, abnormal lipid levels, and hypertension, which are the major pathways that cause heart attacks, strokes, and kidney diseases. Visceral fat is also associated with an increased risk of colon cancer and post-menopausal breast cancer, which are being increasingly noticed in young Indians. Adding to the complexity is the Indian “thin-fat” phenotype, in which individuals with a normal BMI can have high internal fat. Thus, in the treatment of obesity, one has to treat the metabolic problem rather than just the appearance alone. Recognizing it as a chronic disease shifts focus toward early detection, sustained therapy, and long-term follow-up, which are essential steps to reduce premature cardiovascular deaths in India’s working-age population. A Path Towards Holistic InterventionManaging a chronic disease is not just about a prescription; it is about an ecosystem of care." A truly effective solution would have to be multi-modal, which means combining precision nutrition that takes into account the Indian eating habits, as calorie restriction alone would not be effective because it does not address the hormonal regulation, behavioral patterns, psychological triggers, or the metabolic imbalance. An effective approach combines medical nutrition therapy, supervised physical activity, behavioral counselling, pharmacotherapy when indicated, and metabolic or bariatric surgery for eligible patients. Surgical intervention, supported by long-term data, not only reduces weight but also induces remission of Type 2 diabetes in a significant proportion of patients. The goal is to transition from "weight loss" to "metabolic restoration." By treating obesity with the same clinical rigor as any other chronic disease, the healthcare industry can finally move beyond the scale and begin saving lives through comprehensive, science-based intervention.