According to a study published in the noted journal Lancet, India is just behind US and China in this global hazard list of top 10 countries with highest number of obese people.

A country where 270 million people live below the 'poverty line', obesity seems to be a distant issue, meant for the rich kids of first world. But India is under siege: junk food, alcohol and sedentary lifestyle are leading us to silent selfdestruction, making one in every five Indian men and women either obese or overweight.

According to a study published in the noted journal Lancet, India is just behind US and China in this global hazard list of top 10 countries with highest number of obese people.

The study - titled 'Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: A systematic analysis for the Global Burden of Disease Study 2013' - used data collected by international bodies and organisations in various countries like India over three decades. The US topped the list with 13 per cent of the obese people worldwide in 2013, while China and India together accounted for 15 per cent of the world's obese population, with 46 million and 30 million obese people, respectively. According to the study, number of overweight and obese people globally increased from 857 million in 1980 to 2.1 billion in 2013. This is one-third of the world's population.

Overweight in adults is categorised as Body Mass Index of 25 kg/m2 to 30 kg/m2 and obesity as Body Mass Index of more than 30 kg/m2. In 2010, overweight and obesity were estimated to cause 3 to 4 million deaths, 3.9 per cent of years of life lost, and 3.8 per cent of disability-adjusted life-years worldwide, the study said. And the problem is expected to get worse as obesity is increasing and "no national success stories have been reported in the past 33 years." According to Christopher Murray, director of the Institute for Health Metrics and Evaluation (IHME) that conducted the analysis for the study, "In the last three decades, not one country has achieved success in reducing obesity rates, and we expect obesity to rise steadily as incomes rise in low- and middleincome countries in particular." Dr. Pradeep Chowbey, director of the Institute of Minimal Access and Bariatric Surgery at Max Healthcare Institute, said, "If we see the graph of obesity, from 1999 onwards Indians started gaining weight due to urbanisation. There has been gradual economical improvement in our status. The entrance of modern technology and Internet has turned people lazy and stagnant."

With lifestyle disorders forcing more and more people to reel under excess body weight, even relatively younger people are developing joint disorders and knee pain. Excessive weight is associated with a series of health problems, including blood pressure, diabetes, and cardiovascular ailments. Yet another problem is that obesity puts people at an increased risk of developing osteoarthritis. "Osteoarthritis, a degenerative joint disease, involves degradation of the condition of joints mostly due to loss of cartilage and may cause stiffness, locking or pain. Excess weight makes a person more susceptible to osteoarthritis," said Dr. Rajeev K. Sharma, orthopedic specialist and joint replacement surgeon at Indraprastha Apollo Hospital. Obesity has also emerged as a major public health challenge in South Asian countries. Experts say the prevalence of obesity is greater in urban areas, and women are more affected than men.

Further, obesity among children and adolescents too is rising rapidly. The phenomenon in South Asians has characteristic features - high prevalence of abdominal obesity, with more "intra-abdominal and truncal subcutaneous adiposity," experts say. "Dietary guidelines for prevention of obesity and diabetes, and physical activity guidelines for Asian Indians are now available. Intervention programmes with emphasis on improving knowledge, attitude and practices regarding healthy nutrition, physical activity and stress management need to be implemented," said Dr. Anoop Misra, chairman of the National Diabetes, Obesity and Cholesterol Foundation.

According to Dr. Prabal Roy, senior bariatric surgeon at the Asian Institute of Medical Science, Indians had faced undernutrition for a long time and are now being exposed to the "overnutrition of the modern world through globalisation". "India is currently witnessing rising numbers of people in the middle-class who are obese. A lot of the Indian population has started relying on processed foods that contain a huge percentage of trans-fat, sugars, and other unhealthy and artificial ingredients. Obesity is considered the core of many diseases. Increased weight carries significant health risks for some cancers, diabetes, heart diseases and strokes," Roy said. And yet, we seem to do nothing to counter the menace, allowing ourselves to be controlled by a "pandemic", happily shrugging off the dangers with unpardonable nonchalance.

