• Overview
  • Obesity prevalence
  • Population breakdowns
  • Drivers
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Obesity prevalence

Adults, 2015-2016

Survey type:Measured
Age:15-49
Sample size:754,697
Area covered:National
References:National Family Health Survey (NFHS-4) / DHS 2015-2016. Available at: https://dhsprogram.com/pubs/pdf/FR339/FR339.pdf (Accessed 6 March 2019).
Notes:WHO cut-offs used.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 2014-2015

Survey type:Measured
Age:18-69
Sample size:5032
Area covered:National
References:Tripathy JP, Thakur JS, Jeet G, Chawla S, Jain S, Prasad R. Urban rural differences in diet, physical activity and obesity in India: are we witnessing the great Indian equalisation? Results from a cross-sectional STEPS survey. BMC Public Health. 2016;16:816. doi:10.1186/s12889-016-3489-8.
Notes:WHO cut-offs displayed. Asian cut-offs also available.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 2005-2006

Survey type:Measured
Age:15-49
Sample size:181912
Area covered:National
References:National Family Health Survey (NFHS-3) 2005–06. International Institute for Population Sciences (IIPS) and Macro International. 2007.
Notes:Demographic Health Survey data includes ever married women aged 15-49 years only and may include males aged 15-59.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 1991-1995

Survey type:Measured
Age:35-64
Sample size:5537
References:Reddy KS, Prabhakaran D, Shah P, Shah B. Differences in body mass index and waist:hip ratios in North Indian rural and urban populations. Obesity Reviews, 2002;3:197-202
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 1988-1990

Survey type:Measured
Age:18+
Sample size:21361
References:Naidu AN, Rao NP. Body mass index: a measure of the nutritional status in Indian populations. European Journal of Clincial Nutrition 1994;48 (suppl 3):S131-S140
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 1974-1979

Survey type:Measured
Age:18+
Sample size:39143
References:Naidu AN, Rao NP. Body mass index: a measure of the nutritional status in Indian populations. European Journal of Clincial Nutrition 1994;48 (suppl 3):S131-S140
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Children, 2016-2018

Survey type:Measured
Age:5-9
Sample size:112316 (0-19 years)
Area covered:National
References:Ministry of Health and Family Welfare (MoHFW), Government of India, UNICEF and Population Council. 2019. Comprehensive National Nutrition Survey (CNNS) National Report. New Delhi.
Notes:Overweight BMI-for-age ≥ 1SD ≤ 2SD Obesity BMI-for-age ≥ 2SD
Cutoffs:WHO

Children, 2016-2018

Survey type:Measured
Age:10-19
Sample size:112316 (0-19 years)
Area covered:National
References:Ministry of Health and Family Welfare (MoHFW), Government of India, UNICEF and Population Council. 2019. Comprehensive National Nutrition Survey (CNNS) National Report. New Delhi.
Notes:Overweight BMI-for-age ≥ 1SD ≤ 2SD Obesity BMI-for-age ≥ 2SD
Cutoffs:WHO

Children, 2011-2012

Survey type:Measured
Age:10-19
Sample size:1900
Area covered:Urban only
References:Rohilla R, Rajput M, Rohilla J, Malik M, Garg D, Verma M. Prevalence and correlates of overweight/obesity among adolescents in an Urban City of North India. J Family Med Prim Care [serial online] 2014 [cited 2019 Oct 29];3:404-8. Available from: http://www.jfmpc.com/text.asp?2014/3/4/404/148127
Cutoffs:IOTF

Children, 2007

Survey type:Self-reported
Age:13-15
Sample size:8130
Area covered:Central Board of Secondary Education
References:Global School-based Student Health Survey, India (CBSE) 2007. https://www.who.int/ncds/surveillance/gshs/2007_India_CBSE_fact_sheet.pdf?ua=1 (last accessed 24.11.20)
Cutoffs:WHO

Children, 2007-2008

Survey type:Measured
Age:2-17
Sample size:20243
Area covered:National
References:V.V Khadilkar, A.V.Khadilkar, T.J.Cole, S.A.Chiplonkar and Deepa Pandit. 2010. Overweight and obesity prevalence and body mass index trends in Indian children. International Journal of Pediatric Obesity, Early Online, 1 - 9.
Notes:Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000 May 6;320(7244):1240-3.
Cutoffs:IOTF

Children, 2006

Survey type:Measured
Age:5-18
Sample size:21485
Area covered:Subnational
References:Data presented in Wang Y, Chen HJ, Shaikh S, Mathur P. Is obesity becoming a public health problem in India? Examine the shift from under- to overnutrition problems over time. Obesity Reviews 2009;10:456-474, data originally derived from Marwaha RK, Tandon N, Singh Y, Aggarwal R, Grewal K, Mani K. A study of growth parameters and prevalence of overweight and obesity in school children from Delhi. Indian Pediatr 2006; 43: 943–952.
Notes:IOTF International Cut off Used. Reference: Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000 May 6;320(7244):1240-3.
Cutoffs:IOTF

Children, 2002-2003

Survey type:Measured
Age:5-17
Sample size:2539
Area covered:Regional
References:Unpublished work
Notes:IOTF Cut off. Reference: Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: International survey. BMJ. 2000 May 6;320(7244):1240-3.
Cutoffs:IOTF

Overweight/obesity by education

Men, 2015-2016

Survey type:Measured
Age:15-49
Sample size:754,697
Area covered:National
References:National Family Health Survey (NFHS-4). Available at: https://dhsprogram.com/pubs/pdf/FR339/FR339.pdf (Accessed 6 March 2019).
Notes:WHO cut-offs used.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 2015-2016

Survey type:Measured
Age:15-49
Sample size:754,697
Area covered:National
References:National Family Health Survey (NFHS-4). Available at: https://dhsprogram.com/pubs/pdf/FR339/FR339.pdf (Accessed 6 March 2019).
Notes:WHO cut-offs used.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 2008-2010

Survey type:Measured
Age:20+
Sample size:13789
Area covered:National
References:Pradeepa R, Anjana RM, Joshi SR, et al. Prevalence of generalized & abdominal obesity in urban & rural India- the ICMR - INDIAB Study (Phase-I) [ICMR - INDIAB-3]. The Indian Journal of Medical Research. 2015;142(2):139-150. doi:10.4103/0971-5916.164234.
Notes:Prevalence of overweight and obesity by education. Generalized obesity (GO) was defined as a BMI ≥ 25 kg/m2 for both genders (based on the World Health Organization Asia Pacific Guidelines).
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Children, 2016-2018

Survey type:Measured
Age:5-9
Sample size:112316
Area covered:National
References:Ministry of Health and Family Welfare (MoHFW), Government of India, UNICEF and Population Council. 2019. Comprehensive National Nutrition Survey (CNNS) National Report. New Delhi.
Notes:Overweight BMI-for-age ≥ 1SD ≤ 2SD Obesity BMI-for-age ≥ 2SD
Cutoffs:Other

Children, 2016-2018

Survey type:Measured
Age:10-19
Sample size:112316 (0-19 years)
Area covered:National
References:Ministry of Health and Family Welfare (MoHFW), Government of India, UNICEF and Population Council. 2019. Comprehensive National Nutrition Survey (CNNS) National Report. New Delhi.
Notes:Overweight BMI-for-age ≥ 1SD ≤ 2SD Obesity BMI-for-age ≥ 2SD
Cutoffs:WHO

Children, 2013

Survey type:Measured
Age:14-16
Sample size:1079
Area covered:Surat city, Gujarat
References:Gamit SS, Moitra M, Verma MR. Prevalence of obesity and overweight in school going adolescents of Surat city, Gujarat, India.International Journal of Medical Science and Public Health 2015:Vol 4;42-47
Notes:Prevalence of overweight and obesity by Father's education. Students who had body mass index (BMI) of >85th and <95th percentile of reference population were classified as overweight and BMI of >95th percentile of reference population were classified as obese.
Cutoffs:WHO

Overweight/obesity by age

Adults, 2015-2016

Survey type:Measured
Sample size:754,697
Area covered:National
References:National Family Health Survey (NFHS-4). Available at: https://dhsprogram.com/pubs/pdf/FR339/FR339.pdf (Accessed 6 March 2019).
Notes:WHO cut-offs used.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Overweight/obesity by region

Men, 2015-2016

Survey type:Measured
Age:15-49
Sample size:803,211
Area covered:National
References:National Family Health Survey - 4 (2015-16) Available at: http://rchiips.org/nfhs/pdf/NFHS4/India.pdf
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 2015-2016

Survey type:Measured
Age:15-49
Sample size:803,211
Area covered:National
References:National Family Health Survey - 4 (2015-16) Available at: http://rchiips.org/nfhs/pdf/NFHS4/India.pdf
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 2008-2010

Survey type:Measured
Age:20+
Sample size:12634
Area covered:National
References:Pradeepa R, Anjana RM, Joshi SR, et al. Prevalence of generalized & abdominal obesity in urban & rural India- the ICMR - INDIAB Study (Phase-I) [ICMR - INDIAB-3]. The Indian Journal of Medical Research. 2015;142(2):139-150. doi:10.4103/0971-5916.164234.
Notes:Prevalence of overweight and obesity by region. Generalized obesity (GO) was defined as a BMI ≥ 25 kg/m2 for both genders (based on the World Health Organization Asia Pacific Guidelines).
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Children, 2016-2018

Survey type:Measured
Age:10-19
Sample size:112316 (0-19 years)
Area covered:National
References:Ministry of Health and Family Welfare (MoHFW), Government of India, UNICEF and Population Council. 2019. Comprehensive National Nutrition Survey (CNNS) National Report. New Delhi.
Notes:Overweight BMI-for-age ≥ 1SD ≤ 2SD Obesity BMI-for-age ≥ 2SD
Cutoffs:WHO

Children, 2016-2018

Survey type:Measured
Age:5-9
Sample size:112316 (0-19 years)
Area covered:National
References:Ministry of Health and Family Welfare (MoHFW), Government of India, UNICEF and Population Council. 2019. Comprehensive National Nutrition Survey (CNNS) National Report. New Delhi.
Notes:Overweight BMI-for-age ≥ 1SD ≤ 2SD Obesity BMI-for-age ≥ 2SD
Cutoffs:WHO

Overweight/obesity by socio-economic group

Men, 2015-2016

Survey type:Measured
Age:15-49
Sample size:754,697
Area covered:National
References:National Family Health Survey (NFHS-4). Available at: https://dhsprogram.com/pubs/pdf/FR339/FR339.pdf (Accessed 6 March 2019).
Notes:WHO cut-offs used.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 2015-2016

Survey type:Measured
Age:15-49
Sample size:754,697
Area covered:National
References:National Family Health Survey (NFHS-4). Available at: https://dhsprogram.com/pubs/pdf/FR339/FR339.pdf (Accessed 6 March 2019).
Notes:WHO cut-offs used.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 2008-2010

Survey type:Measured
Age:20+
Sample size:12783
Area covered:National
References:Pradeepa R, Anjana RM, Joshi SR, et al. Prevalence of generalized & abdominal obesity in urban & rural India- the ICMR - INDIAB Study (Phase-I) [ICMR - INDIAB-3]. The Indian Journal of Medical Research. 2015;142(2):139-150. doi:10.4103/0971-5916.164234.
Notes:Prevalence of overweight and obesity by occupation. Generalized obesity (GO) was defined as a BMI ≥ 25 kg/m2 for both genders (based on the World Health Organization Asia Pacific Guidelines).
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 2008-2010

Survey type:Measured
Age:20+
Sample size:12634
Area covered:National
References:Pradeepa R, Anjana RM, Joshi SR, et al. Prevalence of generalized & abdominal obesity in urban & rural India- the ICMR - INDIAB Study (Phase-I) [ICMR - INDIAB-3]. The Indian Journal of Medical Research. 2015;142(2):139-150. doi:10.4103/0971-5916.164234.
Notes:Prevalence of overweight and obesity by income. Generalized obesity (GO) was defined as a BMI ≥ 25 kg/m2 for both genders (based on the World Health Organization Asia Pacific Guidelines).
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Children, 2016-2018

Survey type:Measured
Age:5-9
Sample size:112316
Area covered:National
References:Ministry of Health and Family Welfare (MoHFW), Government of India, UNICEF and Population Council. 2019. Comprehensive National Nutrition Survey (CNNS) National Report. New Delhi.
Notes:Overweight BMI-for-age ≥ 1SD ≤ 2SD Obesity BMI-for-age ≥ 2SD
Cutoffs:WHO

Children, 2016-2018

Survey type:Measured
Age:10-19
Sample size:112316 (0-19 years)
Area covered:National
References:Ministry of Health and Family Welfare (MoHFW), Government of India, UNICEF and Population Council. 2019. Comprehensive National Nutrition Survey (CNNS) National Report. New Delhi.
Notes:Overweight BMI-for-age ≥ 1SD ≤ 2SD Obesity BMI-for-age ≥ 2SD
Cutoffs:WHO

Children, 2013

Survey type:Measured
Age:14-16
Sample size:1079
Area covered:Surat city, Gujarat
References:Goyal RK1, Shah VN, Saboo BD, Phatak SR, Shah NN, Gohel MC, Raval PB, and Patel SS. Prevalence of overweight and obesity in Indian adolescent school going children: its relationship with socioeconomic status and associated lifestyle factors. J Assoc Physicians India. 2010 Mar;58:151-8.
Notes:Prevalence of overweight and obesity by Father's occupation. Students who had body mass index (BMI) of >85th and <95th percentile of reference population were classified as overweight and BMI of >95th percentile of reference population were classified as obese.
Cutoffs:WHO

Insufficient physical activity

Adults, 2016

References:Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1.9 million participants. Lancet 2018 http://dx.doi.org/10.1016/S2214-109X(18)30357-7

Men, 2016

References:Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1.9 million participants. Lancet 2018 http://dx.doi.org/10.1016/S2214-109X(18)30357-7

Women, 2016

References:Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1.9 million participants. Lancet 2018 http://dx.doi.org/10.1016/S2214-109X(18)30357-7

Children, 2010

Age:11-17
References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A893?lang=en
Notes:% of school going adolescents not meeting WHO recommendations on Physical Activity for Health, i.e. doing less than 60 minutes of moderate- to vigorous-intensity physical activity daily.
Definitions:% Adolescents insufficiently active (age standardised estimate)

Boys, 2010

Age:11-17
References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A893?lang=en
Notes:% of school going adolescents not meeting WHO recommendations on Physical Activity for Health, i.e. doing less than 60 minutes of moderate- to vigorous-intensity physical activity daily.
Definitions:% Adolescents insufficiently active (age standardised estimate)

Girls, 2010

Age:11-17
References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A893?lang=en
Notes:% of school going adolescents not meeting WHO recommendations on Physical Activity for Health, i.e. doing less than 60 minutes of moderate- to vigorous-intensity physical activity daily.
Definitions:% Adolescents insufficiently active (age standardised estimate)

Estimated per-capita fruit intake

Adults, 2017

Survey type:Measured
Age:25+
References:Global Burden of Disease, the Institute for Health Metrics and Evaluation http://ghdx.healthdata.org/
Definitions:Estimated per-capita fruit intake (g/day)

Estimated per-capita processed meat intake

Adults, 2017

Survey type:Measured
Age:25+
References:Global Burden of Disease, the Institute for Health Metrics and Evaluation http://ghdx.healthdata.org/
Definitions:Estimated per-capita processed meat intake (g per day)

Estimated per-capita whole grains intake

Adults, 2017

Survey type:Measured
Age:25+
References:Global Burden of Disease, the Institute for Health Metrics and Evaluation http://ghdx.healthdata.org/
Definitions:Estimated per-capita whole grains intake (g/day)

Mental health - depression disorders

Adults, 2015

References:Prevalence data from Global Burden of Disease study 2015 (http://ghdx.healthdata.org) published in: Depression and Other Common Mental Disorders: Global Health Estimates. Geneva:World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO.
Definitions:% of population with depression disorders

Mental health - anxiety disorders

Adults, 2015

References:Prevalence data from Global Burden of Disease study 2015 (http://ghdx.healthdata.org) published in: Depression and Other Common Mental Disorders: Global Health Estimates. Geneva:World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO.
Definitions:% of population with anxiety disorders

Oesophageal cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, oesophagus, adults ages 20+. ASR (World) per 100,000

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, oesophagus, adults ages 20+. ASR (World) per 100,000

Breast cancer

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, breast, females, ages 20+. ASR (World) per 100,000

Colorectal cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, colorectum, adults, ages 20+. ASR (World) per 100,000

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, colorectum, adults, ages 20+. ASR (World) per 100,000

Pancreatic cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, pancreas, adults, ages 20+. ASR (World) per 100,000

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, pancreas, adults, ages 20+. ASR (World) per 100,000

Gallbladder cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, gallbladder, adults, ages 20+. ASR (World) per 100,000

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, gallbladder, adults, ages 20+. ASR (World) per 100,000

Kidney cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, kidney, adults, ages 20+. ASR (World) per 100,000

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, kidney, adults, ages 20+. ASR (World) per 100,000

Cancer of the uterus

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, cervix uteri, females, ages 20+. ASR (World) per 100,000

Raised blood pressure

Adults, 2015

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A875?lang=en
Definitions:Age Standardised estimated % Raised blood pressure 2015 (SBP>=140 OR DBP>=90).

Men, 2015

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A875?lang=en
Definitions:Age Standardised estimated % Raised blood pressure 2015 (SBP>=140 OR DBP>=90).

Women, 2015

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A875?lang=en
Definitions:Age Standardised estimated % Raised blood pressure 2015 (SBP>=140 OR DBP>=90).

Raised cholesterol

Adults, 2008

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A885
Definitions:% Raised total cholesterol (>= 5.0 mmol/L) (age-standardized estimate).

Men, 2008

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A885
Definitions:% Raised total cholesterol (>= 5.0 mmol/L) (age-standardized estimate).

Women, 2008

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A885
Definitions:% Raised total cholesterol (>= 5.0 mmol/L) (age-standardized estimate).

Raised fasting blood glucose

Men, 2014

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A869?lang=en
Definitions:Age Standardised % raised fasting blood glucose (>= 7.0 mmol/L or on medication).

Women, 2014

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A869?lang=en
Definitions:Age Standardised % raised fasting blood glucose (>= 7.0 mmol/L or on medication).

Diabetes prevalence

Adults, 2017

References:Reproduced with kind permission of IDF, International Diabetes Federation. IDF Diabetes Atlas, 8th edition. Brussels, Belgium: International Diabetes Federation, 2017. http://www.diabetesatlas.org
Definitions:Diabetes age-adjusted comparative prevalence (%).

Health systems

Economic classification: Lower Middle Income

Health systems summary

India has a mixed and complex health care system that has undergone significant reform in recent years. In 2014, the government announced plans for a nationwide universal health care system and in 2018, the Ayushman Bharat scheme was announced. Ayushman Bharat consists of 2 main elements: a National Health Protection Scheme that focuses on secondary and tertiary care for low-income and vulnerable families and Health and Wellness centres that deliver primary care. Other schemes in India (many of which are mandatory health insurance programmes) include the Employee State Insurance Scheme for factory workers, the Central Government Health Scheme for civil servants and two further schemes for rail and defence employees.

Historically, India has had poor health coverage and as a result, poor financial protection for most of the population. In 2015, out of pocket spending made up approximately 62.6% of total health expenditure. The impact of recent reforms remains to be seen, but India’s health system remains challenged by tackling both infectious disease and malnutrition in the context of rising non-communicable diseases and low financial investment.

Indicators

Where is the country’s government in the journey towards defining ‘Obesity as a disease’?No
Where is the country’s healthcare provider in the journey towards defining ‘Obesity as a disease’?No
Is there specialist training available dedicated to the training of health professionals to prevent, diagnose, treat and manage obesity?No
Have any taxes or subsidies been put in place to protect/assist/inform the population around obesity?Yes
Are there adequate numbers of trained health professionals in specialties relevant to obesity in urban areas?No
Are there adequate numbers of trained health professionals in specialties relevant to obesity in rural areas?No
Are there any obesity-specific recommendations or guidelines published for adults?Yes
Are there any obesity-specific recommendations or guidelines published for children?No
In practice, how is obesity treatment largely funded?Out of pocket

Perceived barriers to treatment

  • Lack of training for healthcare professionals
  • High cost of out of pocket payments
  • Poor health literacy and behaviour
  • Obesity not recognised as a disease
  • Lack of political will, interest and action

Summary of stakeholder feedback

It was said that health can be a low priority in India, with the majority of attention given to diseases common to the rural population, undernutrition and infectious disease. Stakeholders felt that neither the government nor the insurers classify obesity as a disease, and instead, obesity is subsumed under the nutrition agenda. This is reflected by the fact that governmental financial investment into obesity is limited (although its political investment extends to a sugar tax). At best, most felt that obesity is considered as just a risk factor for other diseases.

Stakeholders felt that because healthcare professionals do not financially benefit from treating obesity (as treatment is not typically reimbursed by insurers), many are not proactive with offering treatment and advice. The exception to this is bariatric treatment for which both training and guidelines exist - although, it was suggested that this exception may be financially motivated. Otherwise, it was said that people only tended to enter the system when they had medical complications and/or obesity-related illnesses and injuries rather than just treatment for the obesity itself. Low health-seeking behaviour was considered to be the result of high out of pocket expenses. Once in the system, it was reported that people fell out because of the fractured health system and poor outcomes in weight loss.

While there is a non –communicable disease strategy (and an accompanying implementation guide), stakeholders reported that there is no real focus on obesity within it. Various medical bodies have clinical guidelines for the treatment of obesity but as these do not have obvious backing from the government, it was suggested that uptake of these guidelines is poor. There is no specialist obesity training in India.

Based on interviews/survey returns from 12 stakeholders

Last updated: June 2020

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Categories:Evidence of Community Interventions/Campaign
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Organisation:Fit India
Find out more:fitindia.gov.in

Food Safety and Standards (Safe Food and balanced diets for Children in School) Regulations, 2020

Ten-point Charter for Food Supplied to School Children

Categories:Evidence of Nutritional or Health Strategy/ Guidelines/Policy/Action plan
Year(s):2020 (ongoing)
Target age group:Children
Organisation:Food Safety and Standards Authority of India
Linked document:Download linked document

Plans to introduce traffic light labelling scheme for foods sold in schools

The Food Safety Standards Authority of India (FSSAI) wants to introduce a traffic light labelling scheme for foods sold in school canteens and vending machines, in a bid to curb consumption of sugary drinks, heavily processed foods and confectionery.

Categories (partial):Labelling Regulation/Guidelines
Year(s):2019 (ongoing)
Target age group:Children
Organisation:Food Safety Standards Authority of India
Find out more:www.fssai.gov.in
Linked document:Download linked document

ICMR Guidelines for the management of Type 2 Diabetes

Categories:Evidence of Management/treatment guidelines
Year(s):2018 (ongoing)
Target age group:Adults
Organisation:ICMR
Linked document:Download linked document

Goods and Service Tax on Sweetened beverages

28% tax on All goods [including aerated waters], containing added sugar or other sweetening matter or flavoured

Categories:Taxation/Subsidies on Food or Beverages or law relating to public health
Year(s):2017 (ongoing)
Target age group:Adults and children
Organisation:Indian Government
Find out more:cbic-gst.gov.in

Management of Obesity in Asian Indians

This review outlines outlines approaches to obesity management in ‘real life mode’ and in context to Asian Indian patients.

Categories:Evidence of Management/treatment guidelines
Year(s):2017 (ongoing)
Target age group:Adults
Organisation:Behl S & Misra A
Linked document:Download linked document
References:Behl S, Misra A (2017). Management of Obesity in Asian Indians. Indian Heart Journal;69:539-544

National Action Plan and Monitoring Framework for Prevention and Control of NCDs in India

The National Action Plan and Monitoring Framework was developed as a consequence of World Health Organization’s comprehensive Global Monitoring Framework for Prevention and Control of Non-communicable diseases (2013-2020) by setting 9 voluntary targets and 25 voluntary indicators for 2025. India, as a WHO member state, with all the national stakeholders, evaluated the existing NCD surveillance system leading to the establishment of an advisory group that developed National Action Plan and Monitoring Framework for Prevention of NCDs in 2013. This framework has resulted in setting of 10 targets and 21 indicators for 2025 to track the progress of actions designed to prevent and control NCDs in India.

Categories:Evidence of NCD strategy
Year(s):2017-2022
Target age group:Adults and children
Linked document:Download linked document
References:National Action Plan and Monitoring Framework for Prevention and Control of NCDs in India. (2013). [online] 2012-2013 Biennial Workplan. Government of India. Available at: http://www.searo.who.int/india/topics/cardiovascular_diseases/National_Action_Plan_and_Monitoring_Framework_Prevention_NCDs.pdf

SANKALP: Disha swastha bharat ki (commitment to reduce the noncommunicable diseases in India)

The SANKALP document is a blueprint designed for the country to achieve its goals and targets under the National Action Plan and Monitoring Framework to prevent Non-Communicable Diseases. It defines an evidence based action plan that can be adopted by the government as well as the private sector by focusing on three key areas: Policy and Surveillance, Strengthening of Healthcare Systems and Healthcare Financing.

Categories:Evidence of NCD strategy
Year(s):2015 (ongoing)
Target age group:Adults and children
Organisation:Strategic Partnership Group, Asia and Partnership to Fight Chronic Disease
Find out more:www.fightchronicdisease.org
Linked document:Download linked document
References:SANKALP: Disha Swastha Bharat Ki (Commitment to reduce the noncommunicable diseases in India). (2015). Strategic Partnership Group, Asia and Partnership to Fight Chronic Disease, pp.1-48.

Consensus Physical Activity Guidelines for Asians Indians

The consensus physical activity guidelines for Asian Indians are a result of the absence of physical activity guidelines specifically for Asian Indians. The genesis of their development lies in the fact that the international physical activity guidelines have been developed based on the data available for the Caucasians. With Asian Indians predisposed to non-communicable diseases at a much early age compared to the Caucasians, the consensus group on physical activity across India formulated these guidelines. These focus on exercise prescription for Indian adults, adolescents and children.

Categories:Evidence of Physical Activity Guidelines/Policy
Year(s):2012 (ongoing)
Target age group:Adults and children
Organisation:Physical Activity Consensus Group
Linked document:Download linked document
References:Misra, A., Nigam, P., Hills, A., Chadha, D., Sharma, V., Deepak, K., Vikram, N., Joshi, S., Chauhan, A., Khanna, K., Sharma, R., Mittal, K., Passi, S., Seth, V., Puri, S., Devi, R., Dubey, A. and Gupta, for the Physical Activity Co, S. (2012). Consensus Physical Activity Guidelines for Asian Indians. Diabetes Technology & Therapeutics, 14(1), pp.83-98.

Consensus dietary guidelines for healthy living and prevention of obesity, the metabolic syndrome, diabetes, and related disorders in Asian Indians.

The consensus dietary guidelines for healthy living and prevention of obesity and other related disorders were developed considering the emergence of diet related non-communicable diseases in the country. These guidelines are applicable to Asian Indians in any geographical setting but are most applicable to individuals residing in the urban and semi urban areas. They focus on reduction in the intake of carbohydrates, preferential intake of complex carbohydrates and low glycemic index foods, higher intake of fibre, lower intake of saturated fats, optimal ratio of essential fatty acids, reduction in trans fatty acids, slightly higher protein intake, lower intake of salt, and restricted intake of sugar.

Categories:Evidence of Nutritional or Health Strategy/ Guidelines/Policy/Action plan
Categories (partial):Evidence of Management/treatment guidelines
Year(s):2011 (ongoing)
Target age group:Adults
Organisation:National Dietary Guidelines Consensus Group
Linked document:Download linked document
References:Misra, A., Sharma, R., Gulati, S., Joshi, S., Sharma, V., Ghafoorunissa, Ibrahim, A., Joshi, S., Laxmaiah, A., Kurpad, A., Raj, R., Mohan, V., Chandalia, H., Krishnaswamy, K., Boindala, S., Gopalan, S., Bhattiprolu, S., Modi, S., Vikram, N., Makkar, B., Mathur, M., Dey, S., Vasudevan, S., Gupta, S., Puri, S., Joshi, P., Khanna, K., Mathur, P., Krishnaswamy, S., Madan, J., Karmarkar, M., Seth, V., Passi, S., Chadha, D. and Bhardwaj for the National Dietary G, S. (2011). Consensus Dietary Guidelines for Healthy Living and Prevention of Obesity, the Metabolic Syndrome, Diabetes, and Related Disorders in Asian Indians. Diabetes Technology & Therapeutics, 13(6), pp.683-694.

Consensus Statement for Diagnosis of Obesity, Abdominal Obesity and the Metabolic Syndrome for Asian Indians and Recommendations for Physical Activity, Medical and Surgical Management

This consensus statement was developed to revise the guidelines for diagnosis of obesity, abdominal obesity, the metabolic syndrome, physical activity, and drug therapy and bariatric surgery for obesity for Asian Indians. These revised guidelines were formulated as the existing cut offs for overweight and obesity among Asian Indians was not appropriate as they are predisposed to developing obesity and its co-morbidities at lower cut offs. These guidelines are an evidence based outcome to be used countrywide to control the ever increasing burden of cardiovascular disease and type 2 diabetes.

Categories:Evidence of Management/treatment guidelines
Year(s):2009 (ongoing)
Target age group:Adults
Organisation:Consensus group on Obesity and Metabolic Syndrome
Linked document:Download linked document
References:Misra, A., Chowbey, P., Makkar, B., Vikram, N., Wasir, J., Chadha, D., Joshi, S., Sadikot, S., Gupta, R., Gulati, S., Munjal, Y. and For consensus group, (2009). Consensus Statement for Diagnosis of Obesity, Abdominal Obesity and the Metabolic Syndrome for Asian Indians and Recommendations for Physical Activity, Medical and Surgical Management. Journal of the Association of Physicians in India, 57, pp.163-170.

No actions could be found for the above criteria.

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