Changing mindsets and narratives around obesity for a healthier future

The Hindu

18-06-2025

A 42-year-old schoolteacher once told me she had tried everything: eating less, walking daily and yet, saw no change on the weighing scale. Like millions across India, she blamed herself, believing her weight to be a personal failure rather than a medical issue. She is not alone. In India, obesity is still seen as more a cosmetic concern than a medical one. People suffering from obesity are told to eat less, move more, and try harder. What they are rarely told is that obesity is a chronic disease that involves genetics, hormones, mental health, and the environment. And like any disease, it requires real treatment, not judgement.
Obesity on the rise
Globally, obesity is on the rise, and it is projected that without immediate action, around a third (746 million) of the world's children and adolescents will be overweight or obese by 2050. Despite the numbers, public perception hasn't caught up with medical science. We continue to treat obesity as a character flaw rather than a condition that deserves clinical attention. That mindset is dangerous: it is time to change how we talk about obesity and treat it like the chronic disease it is.
Also Read: Why obesity in children is a growing concern in India
India is also facing an obesity epidemic. The National Family Health Survey (NFHS-5) classified 24% of women and 23% of men as overweight/obesity, a sharp rise from previous years. This trend shows no sign of slowing down. More than 440 million Indians are projected to be overweight or obese by 2050. Moreover, obesity is no longer confined to urban elites. It is growing rapidly in rural areas and lower-income populations, driven by urbanisation, increased access to processed foods, sedentary jobs, and lifestyle changes.
This epidemic is not just about body size. It is about the surging rates of non-communicable diseases (NCDs) like diabetes, cardiovascular disease, and hypertension, which now account for 63% of all deaths in India.i
Why mindset matters
Obesity management is not just about calorie measurements. It involves complex interactions between genetics, hormones, brain chemistry, environment, and behavior. People living with obesity often find that their bodies resist weight loss, not because of a lack of discipline, but because their biology fights it. The challenge can be almost insurmountable and is further impeded by complications brought on by the disease. Only 20% of individuals with obesity can maintain their weight loss, long-term.
Despite this, the dominant narrative in India takes a simplistic and judgemental perception. It equates weight gain with laziness, and weight loss with virtue, and this stigma shows up in every societal conversation. Many still see obesity as a sign of prosperity, a harmless cosmetic issue, or, conversely, a moral failing. This mindset creates several problems including preventing people from seeking professional help and ignoring the complex interplay of biology when it comes to weight.
Obesity and mental health are also deeply interconnected, often creating a vicious cycle that is overlooked. Individuals living with obesity frequently face stigma, discrimination, and negative body image perceptions, all of which can lead to low self-esteem, anxiety, and depression. The emotional distress caused by societal judgment can, in turn, contribute to unhealthy eating patterns, reduced motivation for physical activity, and social withdrawal. Moreover, mental health conditions like depression may also influence biological factors such as hormone levels and metabolism, further complicating weight management. Addressing obesity, therefore, requires a compassionate, holistic approach that considers both physical and mental well-being, rather than focusing solely on weight loss.
Changing the narrative
Changing the narrative means recognising obesity as a chronic disease influenced by factors beyond individual willpower. It requires empathy, science-based understanding, and collective action. Databases must include a fuller picture of the individual's health-care status. Furthermore, there is substantial scope for stratification of clinical obesity into different subtypes, potentially based on their clinical presentation or pathophysiology
By embracing a more empathetic, science-based approach, and implementing comprehensive public health strategies, India can hope to stem the tide of this growing epidemic and ensure a healthier future for its citizens.
(Dr. Ramen Goel is director, bariatric & metabolic surgery, Wockhardt Group of Hospitals, Mumbai. [e-mail])