Data Munching | A global study on being underweight and obese is a mixed bag for Indians

In India and globally, indices of malnutrition show remarkable improvement. But the country needs to do a lot better in ensuring nutritional intake for all

A study published in the medical journal, Lancet, last week pointed out that more than a billion people across the world are now living in obesity, and that the prevalence of obesity in 2022 was four times that of 1990. These trends, when seen together with the declining prevalence of people who are underweight since 1990, make obesity the most common form of malnutrition in most countries.

In total, an estimated nearly 880 million adults were living with obesity in 2022 (Getty Images/iStockphoto)

In total, an estimated nearly 880 million adults were living with obesity in 2022 (504 million women and 374 million men), four and a half times the 195 million recorded in 1990 (128 million women and 67 million men). Combined with the 159 million children living with obesity in 2022, this is a total of over one billion people affected by obesity in 2022. Despite global population growth, 183 million women and 164 million men were affected by underweight in 2022, 45 million and 48 million fewer, respectively, than in 1990.

A detailed look at the numbers given in the report presents a clearer picture of obesity and malnutrition in India.

But first, let’s take a look at what the report and its headline findings are.

How have obesity and being underweight changed in the past three decades?

The study was conducted by the NCD Risk Factor Collaboration (NCD-RisC), in collaboration with the World Health Organization (WHO). Under it, more than 1,500 researchers across 190 countries in the world analysed the weight and height measurements from more than 220 million people aged five years or older (63 million people aged five to 19 years, and 158 million aged 20 years or older), representing in more than 190 countries.

The study focused on gathering data on body mass index (BMI) to understand how obesity and underweight have changed from 1990 to 2022. Adults were classed as being affected by obesity if they had a BMI greater than or equal to 30kg/m2 and classed as underweight if their BMI was below 18.5kg/m2. Among school-aged children (aged five to nine years) and adolescents (aged 10-19 years), BMI is used to define obesity and being underweight depending on age and sex because there is a significant increase in height and weight during childhood and adolescence.

And what about Indians?

Among Indians, the larger trend was in line with the global findings: the number (as well as the rate of) underweight people declined fast, while a clear rising trend was noted in terms of overweightedness.

As of 2022, a total of 196 million people across the country were underweight (44 million women, 26 million men, 5.2 million girls and 7.3 million boys), according to the report. Boys and girls are classified as those between the ages of 5 years and 19 years, according to the report.

The number of those affected by obesity in 2022 was 82.5 million (44 million women, 26 million men, 5.2 million girls and 7.3 million boys), compared to 31 million in 1990.

In adult women, obesity rates increased more than eight times during the analysis period, from 1.2% in 1990 to 9.8% in 2022 (the global average for this period changed from 8.8% to 18.5%, a two-fold increase). Among men, obesity rates saw a whopping 11 times increase, from 0.5% in 1990 to 5.4% in 2022 (the global average in this period went from 4.8% to 14%, a three-fold increase).

The obesity rate in India increased from 0.1% in 1990 to 3.1% in 2022 for girls and 0.1% to 3.9% in 2022 for boys.

Obesity rates in India

In terms of rank, however, India performed rather well in terms of obesity. Of the 190 countries analysed, India was on the 182nd spot in terms of obesity among women, and the 180th spot for obesity among men. It was on the 172nd spot in terms of obesity among girls, and 174th for obesity among boys.

Underweightedness has declined among Indians

A larger deviation in trend was noted in terms of underweightedness. In 2022, 13.7% of women were underweight, a massive decrease of 28 percentage points from what it was in 1990. Similarly, around 12.5% of men were underweight in 2022, a decrease of 27.3 percentage points from 1990. For girls, this proportion changed from 27.3% in 1990 to 20.3% in 2022 (a decrease of 7.0 percentage points), while for boys it dropped from 45.2% in 1990 to 21.7% in 2022 (a massive fall of 23.5 percentage points).

This meant India was the country that saw the second-highest decrease in the prevalence of thinness among women and girls, while it was the nation that saw the highest change in thinness among men and boys.

Underweight rates in India

While the massive change in the rate of underweight people may be a good sign, there is still a long way to go. In terms of global ranking, however, India fared quite poorly. Of the 190 countries analysed, India ranked 13th in terms of the proportion of underweight women, while it held the 26th rank in terms of underweight men. While this is bad in itself, India held the first spot globally in terms of the proportion of girls who were thin. For boys, India was second (behind only Niger) in terms of thinness.

What does this say about nutrition?

In all age groups, the combined burden of both forms of malnutrition increased in most countries between 1990 and 2022, driven by increasing obesity rates. However, the double burden of malnutrition (obesity and underweight together) declined in many countries in South and Southeast Asia, and in some countries in Africa for men, where the rate of underweight fell steeply.

Senior author Professor Majid Ezzati, of Imperial College London, said: “It is very concerning that the epidemic of obesity that was evident among adults in much of the world in 1990 is now mirrored in school-aged children and adolescents. At the same time, hundreds of millions are still affected by undernutrition, particularly in some of the poorest parts of the world. To successfully tackle both forms of malnutrition it is vital we significantly improve the availability and affordability of healthy, nutritious foods.”

Jamie Mullick, HT News Editor, analyses a data set to put forth an in-depth analysis of news that matters