Access to obesity management not available to most Indian patients: World Heart Federation report

Mint

18-05-2025

Mumbai: Obesity in India has risen tremendously in the last 35 years, in tandem with rising rates across the world, a new report highlights, and tools to manage obesity are not universally available to most patients.
According to a report by the World Heart Federation (WHF), obesity in adults globally has quadrupled since 1990.
In 2022, a good 878 million adults lived with obesity, compared with 194 million in 1990. The report, released on Saturday, projected that if the current growth trends continue, nearly two out of three adults (over 25 years) could be overweight or obese by 2050.
The World Heart Report 2025—Obesity and Cardiovascular Disease highlights the rising prevalence of obesity and gaps in access to treatment worldwide.
In India, obesity among women has grown at least sevenfold from 1990 to 2024, with 10% of adult women over the age of 20, about 44 million, living with obesity in the country.
Obesity among men, in comparison, rose by 4.9% since 1990, now affecting 26 million Indian men or 5% of India's male population.
India has twice as many obese women as men.
Obesity among children and youngsters—between the ages of 5 and 19—is on the rise as well, the report cautioned.
In India, 5.2 million, or 3%, girls are obese, an increase of 3% from 1990. On the other hand, around 7.3 million, or about 4%, boys are obese, which is an increase of 3.7% from 1990.
As the rate of child obesity continues to increase, children with a high body mass index (BMI) are 40% more likely than their peers to suffer from cardiovascular disease in midlife. BMI helps to assess risk factors for certain health conditions.
The onset of obesity at younger ages can significantly reduce life expectancy, the report said.
Obesity is recognized as a disease, yet there are still significant gaps in treatment across the world.
On one hand, the stigma and misunderstanding of obesity prevent people from receiving adequate treatment. Systemic healthcare gaps compound the problem and contribute to an economic burden worsened by the aggressive commercial practices of companies making cheap, processed food.
In India, access to specific management protocols is not universally available to most patients, Dr Prabhakaran Dorairaj, president-elect of WHF, and executive director of the Centre for Chronic Disease Control in New Delhi, told Mint.
'The management of obesity, unlike, say, hypertension, is fragmented and highly heterogeneous. Most are centred on behaviour change of weight reduction through dietary modification and increased physical activity, which in many cases are not sustainable in the long term,' he said.
Blockbuster weight loss drugs, like Eli Lilly's Mounjaro, available in the West, have received approval only recently in India, 'but access would be limited to a very few due to the high costs of these drugs,' Dr Dorairaj said. 'In extreme cases, bariatric surgery is available but in limited cities.'
Mounjaro, a GLP-1 drug, was launched in India in March. It is still inaccessible to a large number of Indians at ₹ 17,500 monthly for a 5mg dose.
GLP-1 drugs are a class of drugs that mimic the glucagon-like peptide-1 hormone which regulates blood sugar and appetite, and are used to treat type-2 diabetes and obesity.
However, the drug's sales have picked up—consumption tripled in April. According to data from business-to-business platform Pharmarack, Mounjaro reported sales of ₹ 1.42 crore in March and ₹ 4.80 crore in April.
However, as the dosage is once a week, this tripling may be an indicator of adherence to the dosage schedule.
Mounjaro is just the first in a slew of launches expected in India. Danish drugmaker Novo Nordisk is likely to announce the launch of its weight loss drug Wegovy this year. As its blockbuster molecule, Semaglutide, goes off patent in 2026, Indian companies are ready to launch generic copies priced at 90-95%.
The market for weight-loss drugs is expected to boom once prices go down.
However, there is a need for public healthcare interventions to lower the incidence of obesity across the world.
'To tackle the world's mounting obesity crisis, governments must implement cost-effective public health measures that improve public awareness and decrease risk factors, recognising obesity as multifactorial and committing to making full treatment options available, accessible and affordable,' Francisco Lopez-Jimenez, professor of medicine at Mayo Clinic College of Medicine and one of the report's authors, said.
The cost of obesity is not just economic; it also leads to a higher mortality rate among susceptible individuals. Global deaths from cardiovascular disease linked to high BMI have more than doubled, the report highlights.
While cardiovascular diseases already make up 25% of all deaths in India, 5.6% of these deaths can be attributed to high BMI. This is an increase from 1990, when around 15% of all deaths were from cardiovascular diseases, out of which 2.44% could be attributable to high BMI.
Indian women, again, are more likely to die from high BMI-related cardiovascular diseases. In men, 4.6% of all cardiovascular disease deaths can be attributable to high BMI, whereas in women, almost 7% of all cardiovascular disease deaths can be attributed to high BMI.
In 2019, the economic impact of overweight and obesity in India was estimated to be $28.95 billion, according to the World Obesity Federation. This is equivalent to $21 per capita and 1% of gross domestic product (GDP).
The economic impacts are predicted to increase to $838.6 billion by 2060. This is equivalent to $508 per capita and 2.5% of GDP and represents a 29-fold increase in total costs.