One in every four Indians is now obese, shows official data from the National Family Health Survey-5 (NFHS-5). Obesity has increased at a national level from 21 per cent to 24 per cent among women, and 19 per cent to 23 per cent among men.
At the same time, the country’s total fertility rate (TFR) has declined to 2 children per woman now, which is below the replacement level of fertility. At this rate, experts say the population will stabilise in 40 years from now.
Obesity, however, is a growing concern. It is the leading cause of several non-communicable and progressive diseases such as hypertension, diabetes and those related to liver and increased risks of stroke (see box).
Doctors pointed out that India is rapidly becoming the land of the obese. “Approximately 25 per cent of men and women in India are overweight and obese. It is worrisome as younger people are getting increasingly afflicted by this essentially urban epidemic,” said V S Chauhan, additional director, minimally invasive, gastrointestinal and laparoscopic surgery, Fortis Hospital, Noida. He added that up to 5 per cent of the Indian population is now morbidly obese (a body mass index of more than 32.5 kg/m2).
Rural men and women are thinner than their urban counterparts. The percentage of obese population is more in urban (33 per cent) than rural areas (20 per cent). Also, there is a steady increase in the proportion of overweight or obese men and women as household wealth increases — from 10 per cent in the lowest wealth quintile to 39 per cent in the highest wealth quintile for women, and from 10 per cent in the lowest wealth quintile to 37 per cent in highest wealth quintile for men.
Puducherry (46 per cent), Chandigarh (44 per cent), Delhi, Tamil Nadu, and Punjab (41 per cent each) have the highest proportion of obese women. Kerala and Andaman and Nicobar Islands (38 per cent), too, have a high percentage of females who are obese. In comparison, Jharkhand and Bihar, followed by Gujarat have the highest proportion of thin women.
On the other hand, Andaman and Nicobar Islands have the highest proportion of overweight men (45 per cent), followed by Puducherry (43 per cent) and Lakshadweep (41 per cent). Bihar, Madhya Pradesh and Gujarat have the highest share of thin men.
The report also highlighted that the level of stunting among children aged below five years has marginally declined from 38 to 36 per cent in the last four years.
Another important indicator for public policy formulation that was highlighted in the NFHS 5 is India’s decline in TFR from 2.2 children in 2015-16 to 2 children per woman now. Nearly one-fourth (23 per cent) of married women aged 15-49 want to have another child, the NFHS noted.
There is a one per cent decline in women aged 15-19, who have begun childbearing from the previous NFHS. Now the median age at first birth among women is 25-49 years.
The TFR ranges from 1.1 in Sikkim to 3 children per woman in Bihar. Thirty-one states and Union Territories, including all the states in the South, West and North, have fertility below the replacement level of 2.1 children per woman, the NFHS showed.
S K Singh, professor at the International Institute of Population Studies, explained that when a set of parents is replaced by two children, it’s a stable rate of population growth. “At the current TFR of 2, it would take India around 40-years before its population growth stabilises, given our current demographic structure,” he said. What happens if the TFR slips further? Singh said that if TFR slipped to, say 1.5, it would mean we have a gradually aging population, and our national policy priorities would change. For example, from investing in child immunisation, we would need to build old-age homes.