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4th March 2024 (14 Topics)

Double Burden of Health in India


India has seen a steady increase in obesity levels — not only in adults but children too — over the last 32 years. At the same time, the prevalence of undernutrition has also remained high in the country. As a result, India has become one of the countries with a high “double burden,” according to a new Lancet study, which examined the trends of malnutrition across the world over the last 32 years.

1: Dimension: Reason behind the double burden

  • There is a lack of access to affordable and nutritious food for the prominence of undernutrition and obesity.
  • While lack of access to food can lead to undernutrition, increased access to processed foods high in fats, salt, and sugar has driven up obesity.
  • Why women are prone to putting on weight: Because most of them do not haveaccess to or time for physical activities such as walks or gyms. They are also likely to put the nutrition of the family above theirs. They are also likely to have fewer hours of proper sleep, waking up first and going to bed last”.
  • Eating junk food is cheaper and easier. While it is not nutritious, it is tastier. This has led to an increase in obesity even among the poor, especially in states that are better off such as Tamil Nadu, Punjab, and Goa.

2: Dimension: Rural-Urban Divide

  • While obesity is affecting more people, there continues to be a rural-urban divide when it comes to obesity.
  • An analysis of the NFHS-5 data shows that the prevalence of obesity was 31.7% in urban women and 19% in rural women. It was 28.6% among urban men and 18.8% among rural men.
  • Undernutrition persists in extremely remote and rural parts of poorer states where access to any kind of food is low in states like Bihar, Jharkhand, or Odisha, where people might be eating just one meal a day.

3: Dimension: Impact

  • An increase in obesity, especially in children, is likely to lead to an increase in diseases such as diabetes, hypertension, heart attacks, and strokes.
  • Undernutrition is likely to increase the burden of non-communicable diseases. 

4: Dimension: Required Measures

  • Obesity and underweight should not be considered in isolation because the underweight-obesity transition can occur rapidly, leaving their combined burden unchanged or higher.
  • The government need to focus on programmes that enhance healthy nutrition, such as targeted cash transfers, food assistance as subsidies or vouchers for healthy foods, free healthy school meals, and primary care-based nutritional interventions.

Data Box


  • Obesity in women has spiked in the past three decades — it increased from 1.2% in 1990 to 9.8% in 2022, according to the study.
    • There were 44 million women living with obesity in 2022.
  • Obesity in men increased by 4.9 percentage points during the same period, with 26 million men living with obesity in 2022.
  • Childhood obesity has also recorded a significant increase. There has been a spike of 3 percentage points in girls and 3.7 percentage points in boys over the 32 years that the study examined.
    • In other words, while 0.2 million boys and 0.2 million girls were obese in 1990, 7.3 million boys and 5.2 million girls were obese in 2022.

Underweight and thinness

  • Despite a significant decline, the prevalence of underweight and thinness continues to be high across genders and age groups.
    • The study found that 13.7% of women and 12.5% of men were underweight.
  • Thinness — a measure of being underweight in children — in Indian girls was found to be the highest in the world, with a prevalence of 20.3%.
  • And, it was the second highest in Indian boys, with a prevalence of 21.7%.

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