Every year, World Obesity Day serves as a stark reminder of the growing global health crisis posed by obesity. This year, observed on March 4, 2025, the theme “Transforming Systems, Healthier Lives” underscores the urgent need for systemic changes in combating this complex disease.
The term ‘Obesity’ originates from the Latin word Obesus, meaning “having eaten until full”. However, modern medicine has redefined it as Adiposity-Based Chronic Disease (ABCD), recognising its persistent and progressive nature. The global burden of obesity is staggering with projections estimating that by 2035, one in four individuals worldwide will be obese. The 2025 Obesity Atlas, released by the World Obesity Federation, highlights a 115% increase in obesity rates between 2010 and 2025, affecting both developed and low- to middle-income countries.
India is no exception. Currently, 180 million Indians are obese, and projections suggest that by 2050, this number will rise to 440 million. This alarming trend demands immediate intervention at both governmental and societal levels.
Understanding obesity: Types and Causes
Obesity is not a uniform condition; it presents in different forms:
Normal weight obesity: High body fat despite normal BMI.
Metabolically obese, normal weight: Individuals with normal weight but metabolic abnormalities.
Metabolically healthy, obese: Obese individuals without metabolic disorders.
Metabolically unhealthy and obese : Obese individuals with multiple health risks.
The root causes of obesity are multifactorial
Dietary habits: Excess calorie intake, fast food consumption, alcohol, sugary items, and frequent dining out.
Sedentary lifestyle: Long hours of inactivity, reduced walking, and lack of exercise.
Environmental factors: Aggressive food advertising, limited access to affordable healthy foods.
Genetics: Metabolic rate, fat storage capacity, and appetite regulation.
Medication-related obesity: Certain antidepressants, antipsychotics, and anti-diabetic drugs contribute to weight gain.
Psychological stress: Depression, emotional eating, and poor sleep patterns. Ethnicity and gut microbiome alterations also play significant roles.
The health impact of obesity
Obesity is often termed the “Mother of All Diseases” due to its extensive health repercussions, which include cardiovascular diseases with increased risk of heart disease, hypertension, and stroke.
Obese people are also at high risk for type II Diabetes, characterised by insulin resistance, hyperinsulinemia, and metabolic syndrome is the other
Non-alcoholic fatty liver disease, gallstones caused by increased cholesterol excretion in bile, sleep Apnea & Pickwick syndrome, which causes obstructive breathing issues leading to right-sided heart failure are all common in people with obesity.
The excess weight is also hard on the joints, causing degenerative joint disease (Osteoarthritis).
Obesity increases the risk of developing cancer: In men – oesophagus, thyroid, colon, kidney; in women – endometrium, gallbladder, breast, oesophagus. Being overweight means the body is in a constant state of inflammation due to elevated inflammatory markers such as CRP and TNF.
A Lancet study, funded by the Gates Foundation, predicts that by 2050, half of the world’s population and one-third of children will be obese. This is not just a health issue—it is a monumental societal failure.
Obesity in children: A growing concern
In the 1980s and 1990s, children increasingly spent more time in front of screens—TVs, computers, and gaming consoles—while consuming aerated drinks and fast foods, earning them the label “couch potatoes”.
Parents and grandparents must take note: children must be encouraged to play outdoors, limit screen time, and adopt nutritious diets. The foundation of a healthy lifestyle begins in childhood, making early intervention crucial.
The economic and social burden of obesity
In the USA, 38% of men and 41% of women are obese or overweight. The economic burden of obesity includes rising healthcare costs, decreased productivity, and increased mortality rates. Poor health coverage, cheap junk food, and costly healthy food exacerbate the crisis, especially in sub-Saharan Africa, where obesity rates have surged by 250%.
New approaches to measuring and treating obesity
Traditional BMI (Body Mass Index) is now supplemented by waist circumference and waist-to-hip ratio for more accurate assessments. However, while weight-loss drugs from Eli Lilly and Novo Nordisk show promise, they remain expensive and offer no long-term benefits, as weight rebounds upon discontinuation. These drugs also pose significant risks, including stomach paralysis, kidney disease, pancreatic inflammation, bowel obstruction, increased heart rate, vision changes, fatigue, nausea, and diarrhoea.
A call to action: Prevention is the best cure
Obesity and overweight must be addressed NOW. It requires collective action from governments, healthcare professionals, the media, legal experts, paramedics, and the public.
Key preventive measures include
Nutritional awareness: Encouraging home-cooked, balanced meals over processed foods.
Active lifestyles: Promoting daily exercise, reducing sedentary habits.
Policy interventions: Restricting junk food advertising, subsidizing healthy food options
Education: Schools must incorporate health education and physical activities into curriculums
Mental health support: Addressing emotional eating, stress, and sleep hygiene
With China, India, the USA, Brazil, and Nigeria among the most affected nations, tackling obesity requires a global strategy. If left unaddressed, obesity will continue to burden healthcare systems, shorten life expectancy, and reduce overall quality of life.
The time to act is now—for a healthier future for ourselves and for generations to come.
(The author is a Professor of Pathology, Former HOD and Former Dean, Goa University, and President, Asian Society of Cytopathology)