How migration to urban areas is expanding waistlines in India

The Hindu

2 days ago

Migration is reshaping Indian bodies—not just metaphorically, but physically, and measurably so. As millions move from villages to cities, the contours of daily life shift: new jobs, new routines, new stresses and new diets. And gradually, their bodies change too.
In a recent analysis of over 31,000 adults aged 45 and above, researchers Bittu Mandal and Kalandi Charan Prasad at the Indian Institute of Technology, Indore report a strong link between rural-to-urban migration and obesity. The longer someone lives in a city, the more likely they are to carry excess weight—especially around the waist, the fat most tied to chronic disease. Migration, they suggest, is not just demographic—it's metabolic.
What the research looked at
To trace how cities imprint themselves on the body, the researchers turned to one of the largest ageing surveys in the world—the Longitudinal Aging Study in India (LASI). Conducted across every State and Union Territory in 2017–18, it captured the lives of over 70,000 adults aged 45 and above.
From this national tapestry, the team pulled a focused thread—31,595 people whose past and present addresses told a story of movement. They zeroed in on those who had left villages for cities, classifying these rural-to-urban migrants by how long they'd lived in their new urban homes: under five years, five to ten, or more than a decade.
Then came the crucial question: Had their bodies changed with time in the city? The researchers examined both body mass index (BMI) and waist circumference—because belly fat, more than weight alone, is often the clearer signal of looming chronic disease. Using multiple statistical models, they asked whether simply spending more time in a city made people more likely to become obese.
What they found
The analysis revealed a clear trend. The longer someone lives in a city, the higher their odds of obesity. Even within five years of migrating, rural-to-urban migrants were nearly twice as likely to be obese as rural non-migrants, with the risk rising further after 6–10 years and again after a decade. 'We did not observe a clear point where the risk stabilises,' said Bittu Mandal, one of the study's authors. This pattern held for both general (measured by BMI) and abdominal obesity.
Among rural non-migrants, just 2.6% were obese, compared to 13.1% for long-term urban dwellers and migrants. This aligns with the Indian Migration Study, which found increased body fat in migrants within a decade, characterised by higher blood pressures, lipids, and fasting blood glucose—patterns consistent across gender, as noted in an earlier work by Varadharajan et al. and Ebrahim et al. The ICMR-INDIAB study further showed that migrants had the highest rates of abdominal obesity and diabetes, surpassing even long-term city dwellers.
The data also highlighted group-level differences. Obesity was especially common among women, wealthier or more educated individuals, and adults aged 45–59, who often adopt sedentary urban jobs and calorie-dense diets more readily than older migrants. 'Many migrants shift from labour-intensive rural work to desk jobs,' Mr. Mandal explained. 'Cities also offer easy access to processed foods, driving abdominal weight gain.'
This is not just a matter of availability but also time. 'Time pressures associated with urban employment lead to increased demand for time-saving in food preparation and consumption,' said Prabhu Pingali, director of the Tata-Cornell Institute for Agriculture and Nutrition. 'Pre-packaged and processed foods are everywhere, often replacing fresh meals in urban diets, especially for the poor.'
Anaka Aiyar, a developmental economist at University of Vermont cautions that even non-migrants aren't spared as urban influence spreads. 'As market access improves in rural and peri-urban areas, processed foods become increasingly available. This shifts diets toward obesogenic patterns, especially for lower-middle-income women in sedentary jobs.'
Filling the gaps
While the study is statistically robust, its cross-sectional design leaves one key question open: does city life cause weight gain—or are heavier people more likely to migrate? Other research in the area bridges this gap.
Sibling-pair studies in India—where migrants are compared to their rural siblings—show a consistent pattern. The migrant sibling is typically heavier, less active, and eats less nutritiously. Both higher calorie intake and lower energy expenditure contribute equally to their greater body fat—driven mainly by fatty diets, sedentary habits, and limited physical activity.
Oyebode and colleagues looked at pooled data of 40,000 individuals from China, Ghana, India, Mexico, Russia, and South Africa and found that occupational activity among migrants was lower and leisure activity higher.
Together, these studies build a robust case—migration alters work, diet, and daily life in ways that foster weight gain.
Policy implications
As more Indians migrate to cities the health risks of that shift are becoming clearer. Yet internal migrants, particularly women and middle-aged adults, often fall through the cracks of public health programmes.
'They are often overlooked,' said Mr. Mandal. 'They face barriers such as lack of documentation, limited awareness, and care disruptions.' He suggests that national programmes - Ayushman Bharat and NPCDCS (National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke)- expand migrant outreach, offer portable benefits, and prioritise targeted screenings.
But the challenge may run deeper than healthcare access. 'Food environments are changing rapidly, while nutrition policies lag behind,' said Prof. Aiyar. 'This disconnect risks leaving low-income and female migrants especially vulnerable.'
Prof. Pingali argues that India's grain-heavy food policy has long limited access to fresh produce. 'Processed foods become default substitutes, especially for the urban poor,' he said. 'Combined with sedentary lifestyles and sugary drinks, this fuels adverse health outcomes.' He calls for a policy shift toward year-round access to fruits, vegetables, and dairy.
From a different angle, economist Arup Mitra, professor at South Asian University and the former director-general of the National Institute of Labour Economics Research and Development, notes that many low-income migrants face basic nutritional hardships in cities. 'Access to healthy livelihoods—whether via sanitation or food—is already limited,' he said. 'And rising living costs only make things worse.'
As India's cities swell and its migrants age, the country must reshape its health response—before citizens start bearing the irreversible burden of neglect.