Addressing Obesity in India: Stakeholders, Obstacles, and Strategies

This report provides a comprehensive overview of obesity as a significant public health issue in India. It highlights the alarming statistics, including the high prevalence of overweight children and the associated health risks. The report delves into the roles of various stakeholders, such as the government, sporting clubs, schools, and international organizations like WHO, in addressing the obesity epidemic. It discusses the government's initiatives, including the implementation of national programs, research efforts, and guidelines for food labeling and advertising. The report also identifies obstacles to effective intervention, such as the perception of India as a developing country and the complex nature of the disease. Furthermore, it suggests potential solutions, including promoting yoga and meditation, and emphasizes the importance of a systems-thinking approach to address the interconnected factors influencing obesity. The report references key studies and reports from organizations like ICMR and WHO, offering a well-rounded perspective on the challenges and potential solutions to the obesity crisis in India.

Health Systems and Economics
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Public health issue – Obesity:
Obesity is a challenging issue, which is denoted by the excessive body fat. The obese people
suffer from behavioural, genetic and environmental factors which cannot be addressed by
general methods such as exercise and dieting. It is a world epidemic and has affected over 30
million Indians. There are several stages of overweight and BMI over 29.9 or from 30 is
considered as a characteristic of obesity. It is a social concern as the people with obesity are
at a high risk of developing health problems such as heart disease, diabetes, and different
types of cancer (Obesity Foundation India, 2018). According to the statistics, India has the
second highest number of obese children, and about 14.4 million children are suffering from
excessive weight (The Hindu, 2017). Overweight and obesity is one of the major public
health issue and leading cause of ill health in India. Obesity is a prominent risk factor for
cardiovascular disease, type 2 diabetes, cancer and few of the musculoskeletal diseases. It is
evident that occurrence of obesity in the Indian population is mainly due to consumption of
fast food, sedentary lifestyle and reduced labour workforce.
Role of stakeholders:
In addressing obesity in Indian population, diverse stakeholders from different sectors and
disciplines should be involved because multiple factors are responsible for the occurrence of
obesity and multiple interventions need to be implemented to control obesity in Indian
population. Indian Government plays role in implementation of national programme for
control of obesity. Government sponsors the programme, communicate the information to the
people, fund the research and invest in infrastructure. Government communicate with the
regional organisations for educating people about obesity and implementing control
measures. Obesity has been recently identified as a major social issue; therefore, the
government has designed a few programs to research the issue. The Indian Council of
Medical Research (ICMR) and Indian Diabetes (INDIAB) 2011, has collected the data from
various states for the prevalence of diabetes and overweight obesity in the country.
In May, 2008, the country has accepted the action plan for the Global Strategy for the
prevention and control of non-communicable diseases. It has six objectives, which includes
promoting interventions, which can reduce the prevalence of obesity in the developing
countries. The government has identified several issues and proposed guidelines with along
with other non-government organizations to curb the issue. Sporting clubs, schools, unions
and special interest groups can reach large population of India and can augment awareness
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about the obesity. Strategic communication can educate, create interest and enforce to change
to healthy lifestyle. The Advertising Standards Council of India (ASCI) is also trying to
regulate the advertising of the junk food. It has established several guidelines such as the
nutrition and health benefit gains of the food must be scientifically substantiated so that it
does not mislead to the customers. Secondly, the advertisers should advertise in such a
manner so that children can easily understand the message (Freedman, 2008).
Academia and industry research and development centres should work in collaboration to
prioritise research activities, implement strategy and develop practically implementable
programmes (Rippe & Angelopoulos, 2012). Employers need to focus on the healthy diet and
mess for employees to increase productivity. Health insurance companies should provide
attractive policies to make obesity treatment and management feasible for all the people.
Civil society should work for protection and promotion of heath for all and create wellbeing
and guard human rights. The government has also issues food labelling and packaging
guidelines so that accurate information can be published on the food packages and labels.
Moreover, the government is also trying to prevent the publishing of misleading information
on the labelling of the food content (Khandelwal & Reddy, 2013).
Along with national organisations, international organisations like WHO, UN and World
Bank should address epidemic of obesity in India.
Obstacles:
Obesity is a stubborn long-term problem and it is not a one-off event. Addressing all these
factors with single solution is the biggest obstacle for implementing systems thinking
approach for addressing obesity. As multiple factors can influence each other in obesity,
alteration in one factor can influence another factor. Hence, balancing all the factors is
difficult task for the prevention of obesity. As obesity is a chronic condition and it is dynamic
in nature, application of single approach over the time period is not possible. Moreover, same
protocol cannot be implemented each time. There is possibility that different results can be
obtained at different points, hence analysis of the results to understand progress of the
systems thinking approach is a difficult task (Wolin & Petrelli, 2009). The biggest challenge
for the implementation of obesity-control programs is the perception of the public and the
government that India is a developing and malnutrition-prevalent country. As a result, most
of the government policies are focussed at promoting nutrition to the people.
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Due to complex nature of the disease, outcomes of the systems thinking would be highly
unpredictable and uncertain. Hence, prior assurance of the success of the systems thinking
approach would be difficult. As systems thinking approach itself is complex; hence, direct
transfer of rules from one case to another is difficult. Systems thinking approach is not useful
in understanding problem of individual factor of obesity because in this approach all the
factors are interconnected. Wide range of resources is required for implementation of systems
thinking approach; however, it not feasible to make available all of these resources at a single
time.
Suggestions
Many interconnected factors like behaviour, background, environment and healthy choices of
the people should be considered for addressing obesity. As obesity is a complex issue,
different aspects of the system like social, economic and environmental factors need to be
considered through systems approach for tackling this issue. All aspects of obesity and their
interconnections need to be considered. Tools and methods should be implemented for
exploring different aspects of obesity. Dynamic nature of obesity and its relationship need to
be considered. Behaviour of the people needs to be changed through incorporation of
collaboration of government, organisations and individuals through dynamic and flexible
ways. Implementing different systems thinking and systems approach can be helpful in
creating environment which will support people in making better decisions for better health
to prevent obesity. An effective way to control obesity is to introduce yoga at school level. It
is a unique Indian exercise, which can foster healthy living. There are several scientific
benefits of Yoga, which can encourage physical activity and prevent stress. It should be
encourages at schools and colleges as it is a low-cost strategy to control obesity and
eventually diabetes and obesity. Another approach to control obesity is performing
meditation. It is a secular method, which can reduce stress; therefore, it is good for health.
Yoga can result in sedentary lifestyle (Unnikrishnan, KAlra & Garg, 2012).
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References
Freedman, J. (2008). The Mental and Physical Effects of Obesity. The Rosen Publishing
Group.
Khandelwal, S., & Reddy, K.S. (2013). Eliciting a policy response for the rising epidemic of
overweight‐obesity in India. Special Issue: Program and Policy Options for
Preventing Obesity in the Low, Middle, and Transitional Income Countries,
14(S2),pp. 114-125.
Rippe, J.M., & Angelopoulos, T.J. (2012). Obesity: Prevention and Treatment. CRC Press.
The Hindu. (2017). ‘India has 14.4 mn children with obesity.’ Retrieved 23 March 2018 from
http://www.thehindu.com/sci-tech/health/india-has-144-mn-children-with-obesity/
article19030849.ece
Unnikrishnan, A., KAlra, S., & Garg, M.K. (2012). Preventing obesity in India: Weighing the
options. Indian Journal Endocrinol Metab, 16(1), 4-6.
Wolin, K.Y., & Petrelli, JU.M. (2009). Obesity: Biographies of disease. ABC-CLIO.
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