ICMR study finds one in four Indian married couples is obese: Why shared habits are pushing young Indians over the curve

Indian Express

16-07-2025

When they had married, Mumbai-based Sulabha and Jatin Deshpande had varied tastes in food and lifestyle — she liked home-cooked, mostly vegetarian food. He liked Mediterranean-style salads. She was an early riser, he was a late sleeper. But as they settled into their marriage and the stress of commute and a hectic work life got to them, they chose common ground — click-a-meal on weekdays, fast food, binges, late night presentations on laptops and lounge leisure on weekends. They negotiated the two most important markers of a fit body — sleep and physical activity. Both are now grossly overweight at 33.
From shared meals to mimicking habits, married couples are unwittingly triggering each other's weight gain, according to a new ICMR (Indian Council for Medical Research)-led study. As a result, at least one in four Indian married couples is now overweight or obese. Alarming rates of obesity were observed in couples under 30, compelling study authors to make a strong case for implementing couple-based interventions in urban, wealthy, media-exposed households and couples in states like Kerala, Manipur, Delhi and Goa and the Union Territory of Jammu and Kashmir.
That's because the highest couple obesity rates are in Kerala (51.3 per cent), Jammu and Kashmir (48.5 per cent), Manipur (47.9 per cent), Delhi (47.1 per cent), Goa (45 per cent), Tamil Nadu (42.7 per cent) and Punjab (42.5 per cent).
Why is this study significant?
The study was conducted by researchers from ICMR-National Institute of Cancer Prevention and Research, TERI School of Advanced Studies and other institutions. Researchers analysed data from 52,737 married couples across India – from the National Family Health Survey (NFHS-5 2019-21), making it the largest study in the country. They found that 27.4 per cent of couples exhibit concordance in their obesity status, with significantly higher rates among urban, affluent, and media-exposed households. Published in 'Current Developments in Nutrition', the study represents the first nationwide examination of spousal weight concordance in India.
In the study, couples with a body mass index (BMI, which is obtained by dividing a person's weight in kilograms by the square of their height in metres) equal to 23 were categorised as overweight or obese. Findings showed that nearly half (47.6 per cent) of the couples in the richest wealth quintile showed similar overweight/obesity profiles compared to just 10.2 per cent in the poorest quintile.
The urban-rural divide
Urban couples had higher rates of concordance (38.4 per cent) compared to rural couples (22.1 per cent). The risk of uniform habits was 4.3 times higher among the wealthiest couples compared to the poorest.
According to Dr Shalini Singh, senior author from ICMR-National Institute of Cancer Prevention, what makes this study particularly significant is how it reveals the geographic and demographic patterns of India's obesity epidemic through the lens of married couples. 'The stark contrasts – from Kerala's 51.3 per cent couple obesity to the much lower rates in eastern states – mirror India's uneven development trajectory. Our research demonstrates that marriage and a shared living environment can be powerful vectors for both the spread of obesity and, potentially, its prevention. This calls for a paradigm shift from individual-focussed interventions to household and community-based approaches that recognise obesity as a socially transmitted condition,' says Dr Singh.
How two different people end up having similar health profiles
Married couples are typically not genetically related, yet show similarity in health conditions, be it obesity, hypertension and smoking habits. 'This happens because of a shared lifestyle, diet, socio-economic status, environmental exposure and even emotional aspects,' says Dr Prashant Kumar Singh, lead author and corresponding author from ICMR-National Institute of Cancer Prevention and Research.
The commonest shared behavioural and lifestyle factors have been television watching (32.8 per cent of couples), newspaper reading (39.6 per cent concordance), reduced time for physical activities and dependence on processed and ultra-processed foods. Family structure and living arrangements also had an impact on aligning couple behaviour, according to Dr Singh. Nuclear families show 28.9 per cent versus 25.9 per cent concordance in joint families. Nuclear families end up consuming processed and ultra processed foods while joint families, which benefit from shared responsibilities and
support systems, have healthier eating habits and more active lifestyles.
Overweight couples with similar education levels comprise 31.4 per cent of the pie, educational similarity between spouses clearly aligning habits in food consumption and physical activity.
Alarming pattern among under-30 couples
Dr Singh says the findings are deeply concerning, given the significant similar obesity patterns among couples under 30 years of age. Kerala shows the highest concordance among young couples at 42.8 per cent, Goa is at 37 per cent, Jammu and Kashmir is at 31.6 per cent and Tamil Nadu is at 29.6 per cent. 'These figures suggest that obesity-related metabolic dysfunction is beginning much earlier in life. This predisposes young couples to diabetes, cardiovascular disease and other chronic conditions in their most productive years. The 4.3-fold higher risk among wealthy couples compared to the poorest reveals how India's nutrition transition is paradoxically creating new health burdens alongside economic prosperity. We urgently need couple-based interventions that target a shared lifestyle environment, particularly in urban, affluent communities where processed food consumption and sedentary lifestyles are becoming normalized,' says Dr Singh.
What about other states?
The moderate concordance states include Andhra Pradesh, Haryana, Himachal Pradesh, Telangana and Uttarakhand, all in the 25-35 per cent range, while the lower concordance states were the eastern and northeastern states, generally showing 19-22 per cent concordance.
Anuradha Mascarenhas is a journalist with The Indian Express and is based in Pune. A senior editor, Anuradha writes on health, research developments in the field of science and environment and takes keen interest in covering women's issues. With a career spanning over 25 years, Anuradha has also led teams and often coordinated the edition.
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