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The Hindu
18-05-2025
- Health
- The Hindu
Rising obesity among Indian women calls for science-based, community and lifecycle-oriented care, study finds
A study published in the Indian Journal of Obstetrics and Gynecology Research, supported by the Indian Society of Assisted Reproduction, highlighted an urgent public health concern posed by the rising prevalence of obesity among Indian women in their reproductive year. According to the findings, nearly 50% of Indian women aged 35–49 are living with obesity, with even younger women aged 18–30 increasingly at risk. The health implications of this trend extend from menarche to menopause --spanning complications in fertility, pregnancy, and long-term metabolic health. Early intervention and integrating obesity care across health system Experts in reproductive health and endocrinology say the findings should serve as a wake-up call to rethink India's public health strategies and embed obesity care into all layers of the healthcare system. Addressing obesity in the reproductive years is not just about improving fertility -- it's about preventing lifelong complications,' said Nanditha Palshetkar, medical director at Bloom IVF Lilavati Hospital and former president of The Federation of Obstetric and Gynecological Societies of India (FOGSI). Dr. Palshetkar emphasised the importance of early recognition and education. 'If we manage obesity early, ideally before conception, we can significantly improve outcomes for both mother and child,' she said. 'We must start recognising obesity as a disease,'Dr. Palshetkar said, 'It's often the underlying cause of comorbidities like high cholesterol and fatty liver. Unfortunately, there's a widespread perception that simply 'eating well' at home ensures good health -- which can be misleading. There's a serious lack of awareness. Piya Ballani Thakkar, consultant endocrinologist with a specialisation in diabetes and metabolic disorders, stressed the urgent need to integrate obesity screening and counselling into existing national programmes like --Reproductive, Maternal, Newborn, Child and Adolescent Health(RMNCH+A) , which focus on women of reproductive age, children, and adolescents. She called for the expansion of dietitian-led services at the primary care level and use of vernacular media in breaking down the science and disease burden. 'In rural areas, ASHA workers can play a vital role. In areas where ASHAs are absent, local NGOs can help. These systems already exist, we just need to incorporate BMI checks, counselling, and awareness about obesity into ongoing programmes like POSHAN -- nutrition mission, anaemia campaigns, and even HIV or TB outreach,' she added. Need for early screening and lifecycle approach The study reports that 33.5% of urban women and 19.7% of rural women are affected by obesity -- largely driven by lifestyle shifts, sedentary jobs, and high-carb diets. The problem is compounded by poor dietary patterns and reduced physical activity, fueling a rise in conditions like gestational diabetes, PCOS, and even increased miscarriage risk in women with a BMI over 30 kg/m². Dr. Ballani emphasised the need for a lifecycle approach to obesity management in women. 'We have to tackle obesity differently across stages. For women trying to conceive, lifestyle modifications are key, and any anti-obesity medications must be stopped prior to pregnancy. During pregnancy, weight gain needs to be closely monitored based on BMI. Postpartum, structured programmes for weight loss, including breastfeeding encouragement and, if necessary, later reintroduction of medications, are essential,'she said She also noted the need for longitudinal birth cohort studies linking maternal BMI to child health outcomes, and suggested that NFHS data should include pre-pregnancy BMI, waist circumference, and granular lifestyle indicators to better inform policy. She also underlined the unique challenges of peri-menopausal and post-menopausal women, pointing to the need to monitor muscle mass, bone health, and screen for metabolic disorders before initiating weight loss interventions. Stepwise treatment model proposed by study The study proposes a stepwise treatment algorithm designed specifically for Indian women, enabling gynaecologists to assess and treat obesity with culturally relevant approaches. The doctors agree that small, sustainable lifestyle changes-- a high-fiber, low-glycemic diet, moderate daily exercise, and community support-- remain the foundation of treatment. In select cases, medication and bariatric surgery may be necessary. Dr. Palshetkar also noted culturally sensitive physical activity programmes like Garba, Bhangra, and Lezim in schools and community groups, especially in villages. 'Children often dislike traditional physical education. But if you bring in dance forms they enjoy, they're more likely to stay active. These interventions need to be fun, inclusive, and culturally rooted,'she said. On clinical guidelines, Dr. Ballani recommended that stepwise obstetrician-gynecologist (OBGYN) algorithms and BMI-specific weight gain targets be translated into simple, actionable checklists for frontline providers. She emphasised that while lifestyle interventions should be the foundation, pharmacological and surgical treatments must be individualised, reserved for severe cases, and coordinated with endocrinology and OBGYN teams. Call for improved obesity care The broader goal, Dr. Palshetkar stressed, is to recognise obesity as a disease, a shift that could push governments to act. 'Just like the World Health Organisation's (WHO) classification of infertility helped raise awareness and mobilise resources, declaring obesity as a disease will help integrate it into public policy and healthcare. Pre-conception counselling must include guidance on achieving a healthy BMI. Telling a woman to take folic acid is good, but if her BMI is over 30, we're missing a key risk factor,' she said. However, recognising obesity purely through a clinical lens isn't enough. Experts stress that stigma, weight bias, and sizeism remain major barriers to understanding and treating obesity effectively. These social attitudes often prevent individuals from seeking help and can even shape how healthcare providers respond to patients, leading to delayed or inadequate care. As India continues to battle non-communicable diseases like diabetes and cardiovascular disorders, experts say that a more compassionate, science-based understanding of women's health -- free from judgment-- could serve as a powerful preventive approach. 'We have observed that children born to mothers living with obesity have a higher risk of developing obesity themselves,' said Dr. Palshetkar. 'To break this cycle, interventions must begin even before conception.
India Today
15-05-2025
- Health
- India Today
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 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 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 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 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 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 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 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 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 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 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 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 InMust Watch
Time of India
11-05-2025
- Health
- Time of India
Nearly 50% of Indian women aged 35–49 are overweight or obese: Study warns of health fallout from menarche to menopause
Obesity is fast becoming a silent epidemic among Indian women, particularly in urban centres where lifestyle shifts, high-stress environments, and sedentary routines are driving alarming trends. A recent paper published in the Indian Journal of Obstetrics and Gynecology Research, supported by the Indian Society of Assisted Reproduction, draws attention to the disproportionately high burden of central obesity among South Asian 50% of Indian women aged 35–49 are now living with overweight or obesity, underscoring a rising public health concern in their reproductive years. It also noted that women aged 18–30 are showing increased vulnerability to obesity-related health risks at higher rates than men in the same age group, pointing to a crisis spanning to NFHS-5 data, 33.5% of urban women and 19.7% of rural women in India are living with obesity with lifestyle shifts, stress, and sedentary habits are fuelling this rise. The report emphasized the link between poor dietary patterns, reduced physical activity, and the growing incidence of metabolic disorders such as PCOS and gestational diabetes with 23.1% of women with obesity developing the latter during pregnancy, placing both mother and child at risk, with the offspring facing a higher likelihood of Neonatal ICU admission and long-term health issues. Even raising miscarriage risk in women with a BMI over 30 kg/m².Dr Nanditha Palshetkar, Medical Director, Bloom IVF Lilavati hospital, and Past President, FOGSI added, 'Addressing obesity in the reproductive years is not just about improving fertility, it's about preventing lifelong complications. 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.'Dr. Piya Ballani Thakkar, Consultant Endocrinologist specializing in diabetes and metabolic disorders further noted, 'Obesity needs to be addressed differently at every stage of a woman's lifespan. For women with obesity planning to conceive, lifestyle modification is of paramount importance, with anti-obesity medications requiring discontinuation before conception. Weight 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 peri-menopausal & post- menopausal women, evaluating muscle mass, bone health, and screening for metabolic disorders is crucial before implementing weight management strategies'.Encouragingly, a first-of-its-kind stepwise algorithm was designed for OBGs to assess and treat obesity in India women. The paper also highlights that even a modest 5–10% reduction in body weight can significantly improve the overall quality of life along with lifestyle changes including moderate daily exercise and a high-fiber, low-glycemic diet, remaining the cornerstone of treatment, supported by medication and in select cases, bariatric surgery.
