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Obesity in Indian Girls and Women



obese indian womenDuring my current visit to New Delhi, it is hard to overlook the substantial increase in the prevalence of obesity in Indian men and women. While this may not be the phenotype that immediately comes to mind when thinking of India, there is no doubt that obesity prevalence is continuing to rise at an alarming rate.

Recent evidence for this comes from a study published by Chopra and colleagues from New Delhi, published in a recent issue of the European Journal of Clinical Nutrition.

In this systematic review of obesity in Indian girls and women were found to have consistently higher obesity rates than Indian boys or men.

Interestingly enough, abdominal obesity, sometimes referred to as ‘male-pattern’ obesity is in fact more common in Indian women than in men.

Not surprisingly, this increased rate of obesity is reflected in an increasing prevalence of type 2 diabetes that was reported to be as high as 14% in the 2001 National Urban Diabetes Survey.

Clustering of cardiovascular disease risk factors was further increased in post-menopausal women, not least due to a number of factors that may be of particular relevance in Indian women including sedentariness and overly caloric diets.

How exactly these increasing rates of obesity can be addressed remains anyones guess. While it is easy to see the proliferation of “slimming-centres” and “spas” at every corner, as in the West, these centres often provide little long-term help and of course generally do not cater to the folks, who would likely benefit the most.

Needless to say, the medical system in India, is as overwhelmed and insufficiently prepared to address obesity, as we are in the West.

Clearly a challenge if I ever saw one.

AMS
New Delhi, India

10 Comments

  1. Your global view gives you an interesting perspective. I would be interested to know if a rise of obesity in any particular country correlated with the use of the pill as the dominant birth control method. (Comparing it with countries where the pill is not the dominant form of birth control.) I’m thinking about tainted drinking water from birth control effluent. I wouldn’t be surprised to see a relationship between birth control effluent, early onset puberty and obesity. The former being the cause of the latter two. Sadly, in the developed world, many people are quick to blame obesity (assumed to be caused by gluttony and laziness) for early onset puberty and not look for a third factor that may be causal. Sigh.

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  2. Got to say that I did not know much about obesity in India. Quite interesting abstract on the European Journal of Clinical Nutrition.

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  3. There are 2 primary hormones controlling fat deposition-estrogens and insulin. Hormones controlling energy expenditure are produced by the thyroid and adrenal glands. The closer we get to the Equator, the less need for a hormone that produces heat-thyroid hormone. This equation puts dark skinned women at higher risk for most previously western medical conditions. In the past,we’d see these conditions develop in 2nd generation immigrants to the U. S. Now,we have exported the toxic foods that abort American lives to India,Africa,China,Mexico and other third world countries. For some reason,Indians develop obesity related metabolic conditions at a lower BMI than caucasians.

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  4. Ever since I first found out that you were to speak at the Hindustan Leadership Summit, I must confess to being rather curious as to your speech to the delegates. What will you find most pertinent to share with such a distinguished group? I know what I would wish to hear from you at this event and I thought I might share my thoughts with you here on your blog. I would want for you to treat India much as you treat your patients; with respect and understanding as well insight and honesty. I would wish for you to diagnose the current state of obesity in India and look for a trajectory of this disease and what it could mean to India in the future. I would envision a speech in which you carefully lay out the socioeconomic implications of obesity and explain why certain social and economic realities (time constraints and economic mobility) make India especially susceptible at this point in history to this growing epidemic. I would also hope that you would address the possible ways to slow the spread of obesity in India. That you would remind the delegates of uniquely Indian cultural traditions that actually work in India’s favor. You might not be able to tell them how to conquer obesity, but you can give them hope that it can be slowed down, managed, and addressed as any disease should be using the medical model. In the end, I would hope that you will leave them with a new perspective on the importance of social and economic imperatives in curbing the obesity epidemic and with some real optimism and hope that with a better perspective, much can be done to prevent the increase in trajectory of obesity in India. I am certain that you will leave them better equipped to understand what is happening and why it is happening and this will lead to better policy and planning on their part. I would never presume to tell you what you should say on this topic, but these thoughts are my hopes and wishes for your speech. I am certain that whatever you say, it will be important and helpful and delivered with empathy and charisma. I only wish I would hear it.

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    • I am sure all of these aspects will come up in the discussion – as you say, it is imperative that we use a medical lens to understand the biological reality of obesity and not look for quick-fix solutions or have unrealistic expectations regarding the impact of public health policies (which may take decades to bear fruit).
      a

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  5. Dear Dr Sharma,
    As you rightly pointed out, the steep rise in obesity in Indian women is overwhelming. What’s even more shocking is that most of these women do not even realize that they are obese!! Out centre did a survey of 3000 adolescent children for the prevalence of overweight and obesity and it is pretty high. The biggest hurdle in tackling this is that Indian women do not think they need medical help for this condition and instead, flock to non medical setups such as Ayurvedic spas, gym instructors, beauty salons and the like.

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  6. Fascinated by Doc. Roby Mitchell’s mention of heat-thyroid hormone. I work in Nicaragua and had never heard of those ideas before.

    Any good references on this that you could recommend?

    Gracias!

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  7. Just remember, Dr. Sharma, it might take decades to bear fruit, but there will never be fruit in the future unless fruit trees are planted now. We do today what will benefit or hurt the next generation; it might not have an immediate impact but that does not mean it is any less profound. Public policy matters, perhaps not to any one particular individual right now, but very much to the future generation. I started thinking in decades, and even generations when I became a mother. Somehow, planting fruit trees become a great deal more important. Regardless, I wish you a terrific Summit and am sure you will find the right words to change, educate and move this issue forward. I was never in doubt that we, in the obesity related community, are well represented in Hindustan.

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