Genes or junk food? How metabolic obesity silently threatens health in India

Once confined to wealthier societies, Obesity has rapidly evolved into one of the most formidable health crises of our era, touching every age, region and economic group. Leading experts warn that “metabolic obesity”, deep-seated fat driving diabetes, heart disease and other serious complications is surging silently, fuelled by genetics, lifestyle changes and unhealthy diets. With public health systems already stretched thin, India in particular faces an imminent time bomb, demanding urgent and wide-reaching interventions before the crisis explodes.

The scale of the problem

Globally, more than 1 billion people are living with obesity, including over 390 million adults and 160 million children, according to WHO. The number of obese children and adolescents aged 5–19 has quadrupled since 1990.

Dr Poonam Sidana, Director – Neonatology & Paediatrics at CK Birla Hospital, Delhi, stresses that prevention must start early. “Evidence shows exclusive breastfeeding for the first six months significantly reduces the likelihood of children becoming overweight later. Beyond six months, age-appropriate complementary feeding and limiting screen time, especially during meals, are key,” she told Firstpost.

“Parents should encourage balanced meals, regular physical activity, and mindful eating. Once a child develops obesity, medical consultation is essential. Management often requires a multidisciplinary approach, with diet and activity forming the foundation,” she added.

The growing risk

By 2050, more than half of all adults and nearly one-third of children could be overweight or obese. The sharpest rises are expected in low- and middle-income countries, where health systems are already strained.

Dr Prabhat Kumar, Sr. Consultant Internal Medicine, Kailash Hospital, highlights the role of medical interventions. “Higher doses of semaglutide (7.2 mg weekly) can lead to nearly 19% weight loss in non-diabetic obese adults, improving blood pressure, blood sugar, and lipids. But careful patient selection is essential due to risks like gastrointestinal side effects and pancreatitis, especially in Indians with the ‘thin-fat’ phenotype.”

Health consequences

Obesity increases the risk of type 2 diabetes, cardiovascular disease, hypertension, stroke, fatty liver disease, sleep apnea, joint issues, and certain cancers.

Dr Swati Kanodia, Consultant Pediatric Endocrinologist at Rainbow Children’s Hospital, warns, “Childhood obesity is more than cosmetic. Extra weight forces the heart to work harder, increasing risks of early heart disease, type 2 diabetes, and other complications. Early warning signs include fatigue, shortness of breath, high blood pressure, or cholesterol irregularities.”

The role of lifestyle and genetics

Dr Pradeep K Deewan, Vice-Chairman & Head of Minimal Access, Robotic & Bariatric Surgery, explains, “Obesity is influenced by both genetics and lifestyle. About 40–70% of obesity risk is genetic, but lifestyle like diet and activity, plays a major role. Even with a genetic predisposition, adopting healthy habits can reduce risks and improve outcomes.”

Metabolic obesity in India

Dr Kashish Gupta, Consultant Endocrinology, PSRI Hospital, New Delhi, notes, “Many Indians appear normal weight but carry excess visceral fat, which can lead to diabetes, heart disease and fatty liver. Sedentary lifestyles, high refined carbohydrate intake, and genetic predisposition are fuelling this hidden epidemic.”

Can the damage be reversed?

“Even small weight loss can improve or reverse health problems,” says Dr Deewan. “Lifestyle changes, early medical intervention, and awareness are key. The benefits are significant if healthy habits are sustained.”

The road ahead

Experts stress that combating obesity requires early screening, healthier diets, regular exercise, family support, and responsible public health policies. Dr Sidana added, “A family-cantered approach, focusing on lifestyle changes and medical guidance when needed, is the most sustainable way to ensure long-term health for both children and adults.”