Editorial 1: India’s burden of rising obesity, the hefty cost to pay

Context

The general societal attitude in the country which normalises overweight or obesity must change; holistic interventions are needed to ensure a healthy nation.

Introduction

In the last two decades in India, a major epidemiological transition has happened that has not captured sufficient public attention — the challenge of overweight and obesity. The National Family Health Survey round 5 (NFHS-5, 2019-21) suggests that nearly one in every four men or women is obese. The proportion of those who are overweight and obese ranges from 8% to 50% across States, in both men and women, and in rural and urban settings.

India's Rising Obesity Crisis

• Childhood Obesity in India: The World Obesity Federation estimates that India’s annual increase in childhood obesity is one of the world’s steepest.
• Increase in Overweight and Obesity: Overweight and obesity in adults and children have doubled in the last 15 years… Overweight and obesity in adults and children have tripled in the last three decades.
• Findings from Nationwide Study (ICMR – The Lancet Diabetes and Endocrinology, 2023): Amongst adults over 20 years of age in India… One in every third person (35 crore) has abdominal obesity… One in every fourth person (25 crore) has generalised obesity… One in every fifth person (21 crore) has high levels of blood cholesterol.

Why the subject needs urgent attention

• Personal and societal perception: Being overweight and obese is often considered a personal issue… The general societal attitude in India normalises obesity or being overweight.
• Epidemiological shift: Over the past few decades, India has transitioned from being ‘food or calorie deficient’ to becoming ‘food or calorie sufficient’ (with inequitable distribution).
• Food security and nutrition report (2024): Estimated that around 55% (78 crore) of India’s population could not afford a healthy diet… Nearly 40% of people fall short of an adequate-nutrient diet.
• HFSS and UPF consumption: In the last two decades, the easy and low-cost availability of high fat, salt, sugar (HFSS) and ultra-processed food (UPF) has worsened the issue.
• Urbanisation and sedentary lifestyle: A WHO report states that 50% of Indians fail to meet recommended physical activity levels.
• The ‘thin fat Indian’ hypothesis: Indians with normal BMI often have higher body fat.
• Common soil hypothesis: Obesity is a cause and risk factor for diabetes… One in every fourth Indian adult (25 crore) is either diabetic or prediabetic.
• Global health impact: Overweight and obesity contribute to an estimated 3.4 million deaths annuallyworldwide.
• Obesity as a disease: WHO and professional associations recognize obesity as both a lifestyle challenge and a chronic disease.
• Economic burden of obesity (2019): The global obesity observatory estimated the annual economic cost of obesity in India at $28.95 billion (₹1,800 per capita), or 1.02% of GDP.
• Projected economic burden (2030): Expected to rise to ₹4,700 per capita (or 1.57% of GDP) without sufficient interventions.
• India’s economic survey 2024-25: Recognised obesity as an emerging health challenge… Recommended higher taxation on UPF.
• Lack of programmatic initiatives: Unlike undernutrition, there are not enough programmatic measures to address obesity.
• Government initiatives: Campaigns such as ‘Khelo India’, ‘Fit India Movement’, and ‘Eat Right India’ exist, but they place too much responsibility on individuals, while other stakeholders' roles are underplayed.

Policy and programmatic solutions

• Multipronged approach needed: Tackling obesity requires multiple strategies.
• Societal dialogue and awareness: A structured science communication and public awareness campaign is needed to highlight obesity as a disease that contributes to diabetes, hypertension, and liver disorders… Obesity needs prevention, care, and management like any other health condition.
• Promotion of physical activity: Better urban planning and infrastructure development should include bicycle lanes, free access to parks, public spaces, and open gymnasiums to facilitate regular physical activity.
• Regulating HFSS and UPF products: Higher taxation on HFSS and UPF products… Subsidies for healthier food like fruits and vegetables… Food industry should adopt ethical marketing practices.
• Health monitoring and preventive care: Weight, height, and waist circumference measurements should be integral to all health visits… Discussions about optimal weight should be routine in health-care check-ups… Ideal weight formula: Height (cm) minus 100 for males, minus 105 for females… Unhealthy waist circumference: More than 80 cm in women and 90 cm in men.
• Guidelines for anti-obesity medicines: Licensed anti-obesity medicines are emerging… Need for clinical guidelines to identify ideal candidates for these medicines, ensuring medical supervision.
• Workplace initiatives: Workplaces should raise awareness about unhealthy weight… Weighing scales should be easily available… Regular awareness campaigns and routine body fat analysis should be implemented.
• Schools and colleges' role: Knowledge sharing on healthy eating and diets should be promoted… School canteens should serve healthy food… Health-promoting school practices should be adopted… Learnings from Japan, where dietitians are part of every school network, should be explored.

Coordinated interventions

• Inter-ministerial collaboration: Obesity prevention requires multiple ministries (health, finance, education, agriculture, urban planning, and development) to work together… Isolated interventions have limited impact… India’s nutrition intervention programme should be reimagined as ‘Suposhan Abhiyan’, focusing not just on feeding but also on ‘mindful under-feeding’ and ‘rightful micronutrient supplementation’.
• Research and evidence generation: The research community, medical and public health professionals need to generate additional evidence on overweight and obesity… This evidence should be communicated in simple messages for the general public… Professional medical associations should train health-care providers to tackle obesity.
• Making healthy eating affordable: Healthy food is becoming more expensive than junk food… The food industry, especially online food delivery platforms, must encourage healthy eating… Corporate social responsibility (CSR) funds from this sector should be allocated to promote healthy lifestyles and eating habits.

Conclusion

Obesity is a public health challenge, waiting for holistic, multipronged and comprehensive interventions. Tackling overweight and obesity is a sine qua non for a healthy, economically prosperous and developed India.

Editorial 2: Battle for growth

Context

Increase in government spending, private consumption bode well.

Introduction

India’s economic trajectory in Q3FY25 saw a 6.2% real GDP growth rate, marking an improvement from the previous quarter’s 5.6% but remaining the slowest since Q4FY23. While the primary sector contributed significantly, manufacturing and services slowed. Global trade uncertainties, including U.S. tariffs, pose risks. Inflation moderation boosted consumption, but concerns over NSO’s data revisions highlight the need for transparency in economic assessments.

India’s economic trajectory in Q3FY25

• GDP growth rate: There was a significant uptick in India’s economic trajectory in the December quarter of this financial year (Q3FY25), registering a 6.2% real GDP growth rate, compared with a low revised estimate of 5.6% (5.4%)in the previous quarter.
  1. To be sure, this growth rate was the slowest since Q4FY23, except for the previous quarter’s 5.6%.
• Challenges in achieving full-year target: The 6.2% growth rate also suggests that the government’s full-year growth target of 6.5% is virtually unattainable.
  1. Global headwinds of tariffs that could lead to imported inflation, amid tepid performance by the manufacturing and services sector domestically.

Sector-wise growth trends

• Primary sector: The bulk of Q3FY25 growth has been bolstered by the primary sector, with a value-add of 5.2%, up from 1.8% in the same quarter last year.
• Manufacturing (Secondary sector): Growth slowed to 4.8%, compared with 12.4% last year.
• Services (Tertiary sector): Growth slowed to 7.4%, compared with 8.3% last year.

Chief Economic Adviser’s perspective

• Growth target concerns:While Chief Economic Adviser V. Anantha Nageswaran acknowledged that a growth rate of 7.6% in the current quarter is ambitious amid global economic uncertainties,
  1.  his suggestion that this growth is attainable sounds rather optimistic, unless the Maha Kumbh propelled a consumption spike that was able to buttress the current quarter’s growth numbers.

Impact of global trade uncertainties

• Vulnerability to trade policies: India’s manufacturing and services sectors remain vulnerable to global trade uncertainties,
  1.  such as the U.S.’s 25% import tariff on steel, and an equal percentage proposed on pharmaceuticals.
• Pharma sector concerns: About a third (31%) of India’s pharma exports totaling $8.7 billion were to the U.S. in FY24.
  1. News of the proposed tariffs has sent shock waves, with some firms suggesting a pivot to producing in the U.S.,
  2. which could potentially lead to a trade revenue loss for India.

Positive economic indicators

• Government spending growth: The uptick of 8.3% (2.3%) in government spending has been noted.
• Private consumption expenditure: Growth of 6.9% (5.7%) has been bolstered by a moderation in inflation.

Inflation projections and RBI estimates

• RBI projections for FY25: The RBI has projected inflation to
  1. average 4.8% in FY25,
  2. estimating that this would ease further to 4.2% in FY26,
  3.  indicating a possible alignment with the RBI’s medium-term target of 4%.

Concerns over NSO data revisions

• Unclear methodology changes: However, these current estimates have come into question as the National Statistical Office (NSO) indicated that it has attempted a tweaking of its methodology,
  1. factoring in “industry-wise/institution-wise detailed information,”
  2. but not quite elaborating on what material influence this has had on the quality and quantity of the data collected.
• Sectoral variations and data updates: The NSO went on to say that the “overall as well as sectoral variations in advanced estimates is –
  1. attributed to a revision of benchmark estimates and additional or updated data available on various indicators.”
• Need for transparency: The NSO must clarify this revision in methodology to enable a more informed analysis of the data that it provides.

Conclusion

India’s economic outlook presents both opportunities and challenges. While Q3FY25 showed modest growth, concerns over manufacturing slowdowns, global trade risks, and data transparency persist. Inflation control and rising consumption offer positives, but uncertainties in achieving the 6.5% growth target remain. Strengthening domestic sectors, improving policy clarity, and ensuring accurate economic assessments will be key to sustained growth. Addressing structural issues will determine long-term economic resilience.