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From Awareness To Action: What 2025 Taught Us About Preventing Obesity and Lifestyle Diseases
Obesity and lifestyle diseases have been rising in India for many years, but the scale of the problem has become impossible to ignore. By 2025, that illusion clearly broke. The numbers became harder to dismiss, diagnoses started appearing earlier, and the impact began showing up not just in hospitals, but in everyday life.
We spoke to Dr Ashish Gautam, Principal Director, Robotic and Laparoscopic Surgery, Max Super Speciality Hospital, Patparganj, New Delhi, who explained why awareness alone hasn't been enough, how treatment options have evolved, and why the focus now needs to move firmly from recognition to sustained action.
NFHS-5 (2019-21) showed that nearly one in four adults is obese, with state-wise numbers ranging from 8-50%. This trend cuts across gender and geography, affecting people in both rural and urban areas. The World Obesity Federation also notes that childhood obesity is increasing at one of the fastest rates globally, placing India among the countries most at risk.
A 2023 nationwide study by the Indian Council of Medical Research, published in The Lancet Diabetes and Endocrinology, reinforced the size of the challenge: 35 crore adults have abdominal obesity, 25 crore have general obesity, and 21 crore have high cholesterol. Overweight and obesity have doubled in the last 15 years and tripled in the last three decades. These are not small shifts. They represent a population moving steadily toward long-term metabolic disease.
What 2025 Revealed About Everyday Habits
The last two decades changed food availability, meal patterns, and movement patterns across India. The country moved from calorie deficiency to calorie sufficiency, yet this did not lead to healthier eating. According to The State of Food Security and Nutrition in the World 2024, 55% of Indians cannot afford a healthy diet, and nearly 40% consume diets lacking adequate nutrients. This means calorie intake may be enough, but food quality is not.
Easy access to ultra-processed foods and products high in sugar, salt, and fat has reshaped eating habits. These foods are cheap, convenient, and widely marketed. Combined with longer hours spent sitting, long commutes, and reduced physical activity, the environment itself nudges people toward higher weight. A recent World Health Organization report found that half of all Indians fall short of recommended physical activity levels.
The pattern is seen in children as well. More than 14.4 million children in India are obese, the second-highest number in the world after China, as reported in the GBD Obesity Collaborators' study in The New England Journal of Medicine. Children today spend more time on screens, have less access to safe play areas, and consume more energy-dense packaged foods. Paediatric obesity is no longer rare. It is becoming a routine diagnosis in clinics.
Why Abdominal Fat Matters More
"Excess weight is not the only concern. Where the fat accumulates has a strong link to disease risk. Abdominal or visceral fat increases the chances of type 2 diabetes, high blood pressure, heart disease, sleep apnoea, fatty liver disease, and certain cancers. This form of fat triggers inflammation and metabolic dysfunction earlier and more aggressively than lower-body fat," explained Dr Gautam.
Central obesity is now widespread across Indian adults, as shown in the ICMR study. This is one reason lifestyle diseases are appearing at younger ages. Many adults in their 30s and 40s are being diagnosed with conditions that were once common only in older age.
Patterns Strengthened During the Pandemic
The COVID-19 years changed eating and activity habits. Restrictions reduced movement, limited access to fresh food, and increased reliance on packaged items. Screen time rose sharply for children and adults. These patterns did not fully reverse after restrictions were lifted. Many retained the same eating and activity routines, contributing to further weight gain.
Awareness Helped, But Action Was Limited
"People are now talking more openly about obesity, diabetes, blood pressure, and high cholesterol. But this rise in awareness does not translate into healthier daily choices. Unhealthy options are still cheaper and more accessible. Safe places for exercise are still missing in many areas. Nutritious food remains unaffordable for a large share of households. Ultra-processed foods continue to be marketed aggressively," added Dr Gautam.
Information alone cannot change behaviour when the surroundings push people the other way. This remains one of the clearest lessons from recent years.
How Treatment Approaches Evolved
"Lifestyle advice continues to be the foundation of treatment. Diet patterns focusing on whole foods, reduced sugars, and adequate protein showed good results. Regular movement, walking, strength training, and household activity remain key to prevention. However, 2025 also highlighted that a large group of individuals require additional support," said Dr Gautam.
Bariatric Surgery Became More Accessible
"For individuals with severe obesity and related health problems, bariatric surgery continued to show strong results. Those with a BMI above 32 when conditions like diabetes or sleep apnoea were present, or above 35 when obesity was severe, remained eligible. Robotic-assisted procedures offered better precision, lower blood loss, and faster recovery, making treatment safer and easier to tolerate," explained Dr Gautam.
Long-term evidence has shown clear benefits. The ARMMS-T2D study, published in JAMA, followed patients for 12 years and found that they maintained about 20% weight loss over time, along with better blood sugar levels and fewer medicines. The results stay stable because surgery changes gut hormones and improves insulin response. Many patients described feeling more energetic, moving more comfortably, and experiencing better sleep and reduced joint pain.
What 2025 Demonstrated About Prevention
The year highlighted the need for simple but consistent measures. Here are some listed by the expert:
- Regular movement throughout the day rather than only structured workouts.
- Access to affordable, nutrient-dense food rather than only packaged, calorie-heavy options.
- Safe public spaces for walking, cycling, and children's play.
- Clear front-of-pack labels so families can choose wisely.
- Reduced marketing of high-sugar, high-fat products to children.
- Early screening at schools and primary health centres to pick up weight changes sooner.
- The most effective changes were those built into daily routines, not those requiring major motivation or cost.
Childhood Obesity Demands Immediate Attention
"2025 showed that childhood obesity cannot be seen as a temporary phase. Without intervention, these children are far more likely to develop diabetes, fatty liver, and hypertension at a young age. They also face mental health challenges such as low self-esteem and mood disorders," said Dr Gautam.
Schools, anganwadis, and community groups play a significant role. When mid-day meals, school canteens, physical education periods, and local play areas improve, children respond quickly. Small shifts in school routines led to measurable differences in several districts.
A National Response Is Needed
India now requires a coordinated obesity prevention plan. Fragmented steps will not reduce the rising burden. Such a plan must include:
- Affordable access to healthy foods
- Clear standards for processed foods
- Limits on sugar, salt, and trans fats
- Public spaces that support daily movement
- Community-based programs for early detection
- School guidelines that promote healthy eating and regular activity
- Medical pathways for people who already have severe obesity or complications
Bottomline
Dr Gautam concluded, "Obesity affects productivity, daily movement, and life expectancy. It increases the load on healthcare systems and pushes many families into long-term medical expenses. Addressing it needs public health measures, clinical care, and community support working together."
Disclaimer: The information provided in this article is for general informational and educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or a qualified healthcare provider with any questions you may have regarding a medical condition.
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