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Obesity is a state of abnormal accumulation of fat in the body which may impair health. WHO defines any adult with a body mass index (BMI) of 30 or more as obese.  It further states that by 2016, 13% of the world’s population was obese and that worldwide obesity has tripled since 1975. The USA, China and India are the three countries which lead worldwide in cases of obesity among their populations.

Obesity comes with a host of health problems especially non-communicable diseases such as cardiovascular diseases (heart diseases and stroke), diabetes, musculoskeletal disorders and some cancers (Story, Hauck, Broussard, White, Resnick, & Blum, 2017). The risk to getting obesity related diseases increases with an increase in a person’s BMI. The high prevalence of obesity in first-world, a middle-income and poor country has prompted the WHO to declare obesity as a world epidemic in 1997, putting in place worldwide guidelines on how countries should tackle obesity in their respective jurisdictions (Newman, Sontag, & Salvato, 2016).

In India which is the world’s second most populated country, obesity has been increasing in recent years as the country’s economic fortunes keep on improving (Kaur, Rao, Radhakrishnan, & Rajasekar, 2016). 135 million people are reported to be affected by obesity in the country with its prevalence varying due to age, gender, socio-economic status, geographical environment among others (Saraswathi, Najafi, & Gangadhar, 2017). The prevalence is higher in women than in men with regions (states) that have a high socio-economic status having more cases than poor states (Ebrahim, Kinra, Bowen, & Andersen, 2016).

In developing countries and those with diverse economic status among the population such as India, there are cases of obesity and malnutrition among people in the same household with scenes of an obese mother feeding her malnourished child been common in the country (Gilberts, Arnold, & Grobbee, 2017). Even though obesity cases have been concentrated in the urban areas, there has been a recent spike in cases of obese people in the rural areas as well. This essay seeks to discuss the increasing cases of obesity and weight control in rural India, causes of the increase, its implications on the government, what the government is doing to curb the increase, what other countries with similar issues have done to curb the increase of obese cases and recommendations of what more needs to be done by stakeholders in order to arrest the situation completely (Mathew, Gajalakshmi, Rajad, & Kanimozhi, 2015).

Health outcomes of an obese population

Epidemiological studies have shown that obesity is directly associated with cardiovascular diseases, diabetes, high blood pressure and some cancers (Balagopal, Kamalamma, & Patel, 2018). In rural India, cases of abdominal obesity are very common which have led to increased cases of diseases such as diabetes, heart diseases. This has added an extra burden to the government which is also fighting to eradicate cases of malnutrition which are still prevalent in many parts of the country (Kalra & Unnikrishnan, 2017).


Studies show that the living conditions of Indians in rural areas have improved significantly over the last two decades. An increase in the economic fortunes of rural folks means they can now access transport facilities, medical care, educational status, changed food habits and other facilities which come with increased income in families (Kaur, Rao, Radhakrishnan, & Rajasekar, 2016). This has led to change in lifestyle from physically oriented recreational, transport and other activities to less-physical ones thus leading to significant increase in BMI and abdominal obesity. Overweight figures in rural India have risen from 2% in 1989 to 17.1% at present (Little, Humphries, Patel, & Dewey, 2016).

Obesity in rural areas is more prevalent among women than men with 40% of reproductive-age women been overweight. Children from rural areas are also more likely to be obese than in urban areas with those from families of lower income bracket been twice likely to become obese than those from higher income families (Tripathy, Thakur, Jeet, & Chawla, 2016). It is estimated that by 2025, there will be a total of 25million obese children in India.

Causes of increased obesity in Rural India

The increased cases of obesity in rural India can be attributed to several factors all of which are tied to the improved economic status of the country as a whole and that of its citizens (Gupta, Kapil, Khandelwal, & Khenduja, 2017). An increase in economic fortunes means access to urbanized facilities and amenities even in rural areas which in turn prompts a change in lifestyle. Rural people are abandoning a lifestyle which involves more physical activities and adopting an urbanized lifestyle which involves decreased physical activities (Siddiquee, Bhowmik, & Moreira, 2015). Adults are taking the bus or driving to various areas for work or to run errands while children are spending more time watching television and playing video games and less time playing cricket, soccer and hockey (Cruz, Davis, FitzGerald, Canaca, & Keane, 2016).  

Another cause of increase in overweight cases among the poor is what is referred to as thrifty phenotype, a postulate which avers that adults who were malnourished during fetus stage and during the first two years of infancy suffer from inability to properly oxidize fat at adulthood (Meshram, Rao, Rao, & Laxmaia, 2017). Other factors fueling the increase in obese cases in rural areas are similar to those of urban areas; increased uptake of sugary foods and foods filled with trans-fats and less uptake of unprocessed, raw foods, fruits and vegetables. Aggressive advertising tactics from manufacturers of these foods contribute in fueling the increase in intake especially in rural areas where majority of the people are still ignorant of the dangers of obesity to their health (Bhargava, Kandpal, & Aggarwal, 2017).

Government Policies towards preventing and containing obesity increase

The Indian government has been pre-occupied with preventing and containing cases of mal-nutrition among its citizens as opposed to taking a pro active approach towards preventing the increasing cases of obesity (Gilberts, Arnold, & Grobbee, 2017). However, the recent spike in obesity numbers has prompted the government to start initiating programs and policies to curb the increase. These include: –

  • The ministry of health and family welfare has reduced the diagnostic cut-off for Indian BMIs from 25 to 23 and the standard waist circumference to 90cm in men and 80cm in women (Gupta, Kapil, Khandelwal, & Khenduja, 2017).  This review is aimed at recognizing that native Indians genetically have more cholesterol and less muscle content than their Caucasian and black counterparts.
  • The government initiated the integrated National Program for Prevention and Control of Diabetes Cardiovascular Disease and Stroke (NPCDCS) which focusses on early detection and management, health promotion and prevention, increasing infrastructural capacity and other areas meant to educate, create awareness, prevent and manage the above diseases (Bhargava, Kandpal, & Aggarwal, 2017).
  • The department of health’s research and planning commission created a five year plan which recognizes obesity and Non Communicable Diseases (NCD) as an increasing challenge to the country and has undertaken initiatives of research aimed at identifying measures to control and manage NCDs (Mathew, Gajalakshmi, Rajad, & Kanimozhi, 2015).
  • The government has established a website on child obesity to offer information and online consultations to both parents and their children about any obesity related issue and advice on the way forward (Cruz, Davis, FitzGerald, Canaca, & Keane, 2016). The website has a chat function where parents can communicate with specialists, get free advice and book appointments for further medical attention. The hospital will attend to various dietary issues that lead to obesity and offer solutions towards the same (Gupta, Kapil, Khandelwal, & Khenduja, 2017).

Implications of non-action on obesity

Research has established that 50% of children who are obese grow up to be obese adults. This means half of all obese Indian children will become obese adults. Obesity in adults who have transitioned from obese childhood is very hard to manage (Mathew, Gajalakshmi, Rajad, & Kanimozhi, 2015).  Obesity prevalence is expected to triple among adults by 2040. Most of this increase is expected to happen among rural population and older Indians.

Such a sharp increase will present a serious challenge to the government in mitigating the increase of non-communicable diseases associated with obesity. An increase in these diseases (cardiovascular diseases, diabetes, some cancers etc.) will stretch the government’s financial ability to manage, control and treat these diseases (Kaur, Rao, Radhakrishnan, & Rajasekar, 2016).

Increased number of sick people also means a less productive population which results in a weaker economy. Families will also spend a lot of money seeking treatment for the sick which will turn to less income for households (Bhargava, Kandpal, & Aggarwal, 2017).    

Summary and implications of the research findings

The research above indicates that as the economy of India is getting better, the incomes of its citizens, including those in rural areas has also increased. This has prompted them to adopt urbanized lifestyles which include less physical activity and more consumption of junk foods (Gupta, Kapil, Khandelwal, & Khenduja, 2017). These two are the main contributory factors of obesity. The number of obese people in rural India has increased significantly and is almost matching that of urban dwellers (Balagopal, Kamalamma, & Patel, 2018).

The government on its part is partaking in some initiatives to prevent this increase but has not allocated enough financial and human resources to adequately address all areas of concern. There is a need of a more pro-active and multi- level approach towards initiating solutions to prevent, manage and control the increase of cases of obesity (Gupta, Kapil, Khandelwal, & Khenduja, 2017). All stakeholders in the health and public sector should be involved in undertaking these initiatives.

Failure to take immediate actions will lead to a dangerous spike in the number of obese cases among the rural population due to the increased urbanization of rural areas and better economic prospects of rural Indians (Gupta, Kapil, Khandelwal, & Khenduja, 2017).

Other countries which have run successful anti-obesity campaigns


In the USA which has the world’s third largest obesity cases, there have been several initiatives taken by both the federal government, state governments, charities and interested individuals (Kaur, Rao, Radhakrishnan, & Rajasekar, 2016).

The government has initiated policies such as development of national clinical guidelines, labelling of nutritional content on food packages, labeling of calorie content on restaurant menus and government efforts to increase access to funds for cheaper fruits and vegetables (Gilberts, Arnold, & Grobbee, 2017).

On individual level, personalities also known as obesity champions have initiated anti-obesity drives targeting school going children. These include former first lady Michelle Obama who made reduction of childhood obesity a primary objective of her stint in the White House. She designed and pushed the let’s move campaign which saw (Gupta, Kapil, Khandelwal, & Khenduja, 2017). Another anti-obesity champion was the former governor and presidential candidate Mike Huckabee who after suffering and recovering from type 2 diabetes partnered with churches and engineered removal of junk foods vending machines from schools and required every school cafeteria to only serve healthy foods (Little, Humphries, Patel, & Dewey, 2016).

Federal and state health authorities have also been running themed campaigns like the 5-2-1 campaign which targets parents to serve their children with a minimum of five servings of fruits and vegetables, get a maximum of two hours of television time and a minimum of one hour of exercise time per day (Bhargava, Kandpal, & Aggarwal, 2017).


Thirty years ago, Finland was one of the world’s unhealthiest nations. Its citizens used to eat poor diets and were very inactive partly due to the cold climate of the country (Bhargava, Kandpal, & Aggarwal, 2017). Consequently, the country had the highest number of cardiovascular prevalence in Europe before it embarked on a campaign which aimed at encouraging people to live more active lifestyles. The measures they took in the campaign include: –

  • Government established free exercise facilities and pools where people could access and utilize and free scheduled bus transportation to these facilities (Cruz, Davis, FitzGerald, Canaca, & Keane, 2016).
  • Distribution of free cleats to adults to fit in the bottom of their shoes to facilitate them to walk on icy roads. This was aimed at encouraging people to walk instead of driving.
  • Inter-city prize winning competitions in various sports, weight and cholesterol reduction (Gupta, Kapil, Khandelwal, & Khenduja, 2017).

The campaign was a huge success and helped the country to become one of the fittest countries on earth with its obesity figures dropping to insignificant numbers.

Proposed policies and programs to prevent the increase in obesity cases

Any policies and programs for prevention of increase in obese cases should be based on the factors that are stated in the first and second portions of this essay. They have to consider the various causes of increase in obese cases in rural India and what the government and other stakeholders have done in policy formulation (Mathew, Gajalakshmi, Rajad, & Kanimozhi, 2015). From these two, a policy and programs list which covers all areas of the condition from causes, creating awareness, managing and controlling the condition can be drawn. Here is a list of initiatives which need to be undertaken: –

  1. Thorough studies to get the exact depth of the problem – Studies in various areas of the obesity issue that are specific to the Indian population should be conducted. The country should stop relying on western based figures for indices like BMI (Meshram, Rao, Rao, & Laxmaia, 2017). After the indices used to determine who is and who is not obese are established, prevalence numbers can be freshly tabulated in order to get an idea about the depth of the problem before embarking on measures to prevent obesity prevalence (Tripathy, Thakur, Jeet, & Chawla, 2016).
  2.  A prevention regime that fuses both science technology with India’s traditional base – This is a wide area which includes fusing scientifically proven methods of prevention with traditional Indian way of life which is familiar hence more likely to be embraced by all citizens. Some of these measures include: –
  3. Encouraging rural Indians to start walking while attending to their duties and chores. This is an activity which they used to partake 20 years ago before the advent of motorbikes and vehicles.
  4. Encourage them to go back to consuming traditional Indian foods most of which are unprocessed hence free from cholesterol and processed sugars.
  5. Undertake an awareness campaign targeting rural folks many of whom are still ignorant on the issue of obesity. Educate them on the need to maintain and preserve a healthy lifestyle and make healthy choices. Obesity should be introduced as a school topic in junior primary and continually be taught up-to high school level. This will instill a sense of obesity awareness in children as they grow up and help them in preventing occurrences of the problem amongst them.
  6. The government should step in and curb the spread of fast food vendors especially western fast food multinationals (Kaur, Rao, Radhakrishnan, & Rajasekar, 2016). This can be done through increasing taxes and operating licenses for such vendors requiring them to put stickers indicating that their products are likely causes of obesity. Sale of junk food in schools and areas in the vicinity of learning institutions should also be stopped and school canteens should be required to only prepare healthy meals (Bhargava, Kandpal, & Aggarwal, 2017).
  7. The government can partner with other stakeholders and interested parties in establishing and running campaigns to encourage people to live a junk free and exercise filled lifestyles (Balagopal, Kamalamma, & Patel, 2018). Obese people can also be educated on how to seek help from professionals. Obesity centers should be established in hospitals and obese people encouraged coming out and seeking help to contain and eliminate their condition. Stakeholder such as Bollywood celebrities can be incorporated in awareness and educational as well as help seeking campaigns in partnership with the government and health industry players (Kaur, Rao, Radhakrishnan, & Rajasekar, 2016).


The numbers of obesity cases in rural India have been increasing due to increased income of India’s rural population. There is a need by both the government and other stakeholders to increase financial and human resources in order to adequately curtail the spiking cases. Such initiatives should focus on creating awareness to the rural population on the dangers and the diseases associated with obesity and educating them on the need to go back to their active lifestyles and eat healthy foods.

Any initiatives aimed at preventing the obesity problem need to encompass the need for a new set of indices to determine what constitutes as an obese case in India and then a new tabulation done to establish new numbers. Preventive and control measures should be easily understandable and manageable to the rural population to avoid the details been lost in translation. They should infuse the scientifically proven measures infused with the traditional Indian lifestyle so as to maintain familiarity.

The government should also undertake measures to prevent the uncontrolled sale of junk foods to the population and especially to school going children. Schools and other learning institutions should also be instructed to only serve healthy meals to learners. Lastly, the government in conjunction with stakeholders can establish obesity educational, management and control centers where people can visit and get assistance.


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