Obesity in Indian women is a growing crisis: Nearly half over 35 are overweight
Indian women are increasingly being affected by obesity, and this is starting early in life, doctors warn. In fact, recent data shows that more than half of women aged 18-30 are already overweight, a trend that experts say demands immediate public health attention.A new consensus statement published in the Indian Journal of Obstetrics and Gynecology Research has raised concerns about the rising burden of obesity among women, especially in the reproductive age group. Led by Dr. Nandita Palshetkar from Mumbai's Lilavati Hospital, along with 11 other specialists from across India, the study puts forward clear clinical recommendations on how doctors should assess and manage obesity among Indian women, with specific guidance for those planning a pregnancy.advertisementThe paper is an initiative of the Indian Society of Assisted Reproduction (ISAR), and draws from over 75 studies, including government surveys and global reports.
What the numbers sayAccording to the report, the problem of obesity is not limited to urban or affluent women. In fact, the National Family Health Survey-5 (2019–21) found that 33.2% of urban women and 19.7% of rural women in India are overweight or obese (defined as BMI of more than 25 kg/m2).The numbers climb sharply with age. A study of over 6.4 lakh Indian women found that nearly 49% of those aged 35-49 were overweight or obese. In the 18–30 age group, another study revealed that more than half, 52.4%, were already obese.
According to the report, the problem of obesity is not limited to urban or affluent women. ()
advertisement"The trends are very clear. Obesity is increasing and affecting younger women, including those planning pregnancies. We need urgent action, at the clinical and public health level," the paper states.From PCOS to stillbirths, how obesity affects women's healthObesity in women is linked to a wide range of health complications, some of them unique to women. These include:Irregular periods and infertilityPolycystic Ovary Syndrome (PCOS)Gestational diabetes and high blood pressure during pregnancyHigher risk of miscarriages and stillbirthsUrinary incontinence and uterine fibroidsIncreased risk of C-sections and birth complicationsDoctors say these effects begin early, from puberty, and continue through menopause. Obesity also worsens conditions like depression, metabolic syndrome, and cardiovascular disease in postmenopausal women. The consensus calls on gynaecologists and primary care physicians to routinely assess BMI, waist circumference, and lifestyle factors in women during check-ups — especially if they are planning to conceive.Why losing 5–10% body weight can make a big differenceThe study highlights that even a modest weight loss, as little as 5–10% of body weight, can improve hormonal balance, restore ovulation, reduce insulin resistance, and increase chances of natural conception or IVF success.Women with PCOS who lost weight reported:Better menstrual regularityImproved ovulationHigher live birth ratesLower miscarriage risk
The study highlights that even a modest weight loss, as little as 5–10% of body weight, can improve hormonal balance. ()
In addition, weight loss improves urinary incontinence, mobility, and mental health, enhancing overall quality of life.'By managing obesity early, ideally before conception, we can significantly improve fertility outcomes and reduce risks during pregnancy. Our aim is to help women make small, sustainable lifestyle changes, which can go a long way in protecting maternal, fetal and child health,' said lead author Dr Nanditha Palshetkar, Medical Director, Bloom IVF Lilavati hospital.What works: Diet, exercise, therapy, and when needed, medicinesThe expert panel recommends that lifestyle changes must be the first line of treatment. This includes:Reducing sugar and saturated fatsIncreasing fiber and protein intakeAt least 150 minutes of exercise per weekMindfulness, portion control, and sleep hygieneFor some women, cognitive behavioural therapy (CBT) can help address emotional eating and support weight loss.When lifestyle changes alone are not enough, doctors may consider medication for women with BMI more than 27 and a related health condition, or BMI more than 30.advertisementCurrently, Orlistat is available in India. Semaglutide (2.4 mg) has been approved by the drug regulator but is not yet available in the Indian market. These drugs have shown significant weight-loss effects in clinical trials, alongside improvements in hormone levels and fertility parameters. However, they are not recommended during pregnancy or breastfeeding.Bariatric surgery is an option, but only for someFor women with BMI more than 35 or those with serious health complications, bariatric surgery may be considered. The procedure has been linked to rapid weight loss, improved fertility, better hormone levels, and reduced risks during pregnancy. However, conception is advised only after a 12-month waiting period post-surgery.
When lifestyle changes alone are not enough, doctors may consider medication for women. ()
What should pregnant women do?Doctors warn against using weight-loss medications during pregnancy. Instead, they recommend lifestyle interventions, like diet and exercise, as the safest and most effective way to prevent complications.advertisementWeight gain during pregnancy should be monitored and tailored to BMI categories, while postpartum weight management should involve structured programs aiming for a weight loss of 0.5 kg/week."Breastfeeding should be encouraged, and anti-obesity medications may only be considered after cessation of breastfeeding. For perimenopausal and post-menopausal women, evaluating muscle mass, bone health, and screening for metabolic disorders is crucial before implementing weight management strategies,' said study co-author Dr. Piya Ballani Thakkar, an endocrinologist specialising in diabetes and metabolic disorders.The consensus also offers trimester-specific weight gain guidelines and emphasises postpartum weight management through breastfeeding support, structured diet, and exercise — once breastfeeding stops, medications can be reconsidered under medical advice.Obesity among Indian women is not just about body image, it's a serious medical issue with long-term health consequences. The ISAR-led recommendations provide a much-needed roadmap for doctors to screen, manage, and treat obesity more effectively.Tune InMust Watch
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