Pot belly: Status symbol to sign of India's obesity problem

The Indian population is faced with a new epidemic and serious health threat - obesity. Obesity is when a person's body mass index is greater than or equal to 30.

The Lancet, an accredited medical journal, in a recent study stated India will have 450 million obese persons, the largest obese population in the world, by 2050. In 2021 India had the second-highest overweight adults with 180 million individuals, behind China.

India's weight woes are centered on pot belly or abdominal obesity - accumulation of excess fat around the stomach -  according to a report by BBC. This form of obesity is known to cause chronic conditions such as Type 2 diabetes and heart disease.

40 per cent of women and 20 per cent of men in India have abdominal obesity as per the data from National Family and Health Survey (NFHS-5). For the first time the NFHS measured waist and hip sizes as part of their study.

Indian guidelines define abdominal obesity as a waist over 90 cm for men and 80 cm for women. NFHS-5 data shows that one in two women between the ages of 30 to 49 show signs of a pot belly. Urban populations are more affected by abdominal obesity with high waist circumference and waist-to-hip ratios. However, there is also a notable rise in rural areas and lower and middle socioeconomic sections of society.

While it is a growing health concern, Indian pot bellies for long have been seen as a badge of prosperity and indulgence. In a rural setup it is a symbol of healthy eating. In movies, the pot belly has been used to depicy a lazy official or corrupt politician -- thus normalising it.

While India now grapples with a pot belly problem, some other cultures in the world continue to worship the pot belly to date -- case in point -- the Bodi tribe of Ethiopia where the man with the largest belly is celebrated.

Obesity can lead to a number of health issues, insulin resistance being a major concern according to the BBC report. Insulin resistance is a condition where the body stops responding to the hormone which helps regulate blood sugar - insulin. Fat around the abdomen disrupts how the body fat uses insulin, making it harder to control blood sugar.

Compared to Caucasians, South Asians, including Indians tend to have more body fat at the same body mass index.

According to the report, studies have shown larger, less efficient abdominal fat cells are unable to store fat under the skin. This leads to the excess fat spilling into vital organs like the liver and pancreas that regulate metabolism, increasing the risk of diabetes and heart disease.

Several genetic studies have attempted to explain the biological reason behind fat distribution patterns. Evolution lies at the centre of one theory. Indians, who for centuries were subjected to famines and chronic food shortages, saw their bodies adapting to survive in conditions of extreme scarcity. Abdomen became the storage site. With food no longer being scarce, the storage around the belly continued to grow.

The Indian Obesity Commission created a two-stage clinical system that considers fat distribution, related diseases and physical function to assess how fat leads to early health risks.

Stage one includes high BMI without abdominal obesity, metabolic disease, or physical dysfunction which can be fixed by lifestyle changes like diet, exercise, and sometimes medication.

The second stage includes abdominal obesity compounded by health issues like diabetes, knee pain or palpitations pointing to higher risk and calls for more intensive management.

According to the report Indian physicians believe the rise of abdominal obesity is due to lifestyle changes - more junk food, takeaways, instant meals and greasy home cooking. Drastic lifestyle changes need to be made with around 250–300 minutes of weekly exercise, studies have shown.