Experts’ fears stem from three years of erratic eating habits, a non-exercise routine most of us followed during Covid-19.

Growing waistline is not only an American health worry. For Indians too, it is fast becoming a troublesome public health issue, say top US public health experts, including some of Indian origin, who have seen it growing and now becoming a real health challenge. Having lived for 50 springs in India, and now seeing it bloating from the waist worries me too. It’s time to cut that flab before it triggers more unhealthy signs. For these health experts who spoke to The Sunday Guardian at length, the biggest challenge lies in how to beat the post-Covid-19 effect. Their fears come from nearly three years of erratic eating habits, a non-exercise routine which most of us followed during Covid-19 along with our growing love for the couch and binge OTT watching. To them, a return to Indian home-made platter holds the key to beating obesity!
Says Dr Satheesh Kathula, a practicing oncologist and a clinical professor of medicine: “About 5% of the Indian population is obese, more so in affluent societies. The rise in obesity in young Indians is rather alarming. In a survey, 33% of the students in public schools were obese. This will eventually lead to a high chronic disease burden, if appropriate measures are not taken in a timely fashion.’’
Central abdominal obesity of Indians is a growing risk, says Dr Manoj Sharma, a leading global health promotion expert. “While the causation of overweight and obesity is multifactorial and complex, lifestyle factors play an important role,” says Dr Sharma, who is a Professor and Chair of the Department of Social and Behavioral Health in the School of Public Health at University of Nevada in Las Vegas. Only a strict lifestyle routine holds key, says Dr R. Lingyak Petosa, a Professor of Health and Exercise Science at The Ohio State University. “Regular physical activity and a healthy, balanced, moderate diet play a crucial role in preventing obesity,’’ says Dr Petosa adding, “On a personal level, obesity contributes to a number of chronic diseases, reduced quality of life, loss of functional independence and shortened life span.”
Health experts feel that often people do not realize how sedentary their lifestyle is or how unhealthy their diet is. Many jobs and recreational activities require many hours of sitting each day. Dr Petosa emphasized, “I would recommend that each person do some record keeping to identify how many hours a day they are moving and how many hours they are sitting. A reasonable goal for most adults is to accumulate 60 minutes of activity each day.”
Dr Kathula, who is also the vice-president of American Association of Physicians of Indian origin (AAPI,) cites America, to explain the cost in terms of human lives lost and financial burden. “Obesity claims approximately 300,000 deaths directly or indirectly in the US, and nearly US$ 1.72 trillion in cost for obesity related diseases. In India, it is more due to industrialization and changing food habits and lack of activity. Covid-19 pandemic resulted in lock downs and isolation which certainly increased the rates of obesity especially in adolescents and young adults due to depression and anxiety. It is a known fact that people with depression and anxiety tend to binge eat and unhealthy food can cause more depression and anxiety, a vicious cycle,’’ says Dr Kathula.
Dr Sharma pointed something which is the root cause. “In terms of diet, the traditional Indian diet used to be vegetarian, and that has very rapidly been replaced with larger portion sizes, fast foods, higher saturated fats, and high salt content,’’ says Dr Sharma adding, “People are preferring high calorie fast foods instead of fruits and vegetables.’’ Petosa noted, “Fast food has a high glycemic index and stimulates appetite. Cheap, convenient fast food increases daily calorie intake contributing to obesity.”
But it is not a lost battle yet if we make eating as our conscious activity. “Choosing low fat, low calorie, whole plant-based food helps decrease the weight. Physical activity can not only decrease weight but can be helpful in decreasing the risk of diabetes, heart disease, and stroke.’’
Dr Sharma has developed and tested a robust, fourth-generation behavioral model called the multi-theory model (MTM) of health behavior change that is proving to be useful in combatting obesogenic behaviors. Sharma and his colleagues from around the world have conducted numerous studies and found the benefits of this model in explaining and changing behaviors. Presently, evidence of this model is available from studies done in India, China, Fiji Islands, Ghana, Iran, Italy, Nepal, Nigeria, Pakistan, and various parts of the United States. Dr Sharma noted that for initiating the behavior, it is important for the individual to be convinced that there are more advantages than disadvantages, must have behavioral confidence and there should be receptive changes in the physical environment such as having access to a place where one can exercise for a physically active lifestyle.
For sustaining or maintaining the behavior change Dr Sharma noted, “Three factors are essential namely the ability to transform emotions especially negative ones into goals, constant reflection and practice for change, and support from family, friends, and others in the social environment…While India has developed non-communicable disease care models robust physical activity promotion and dietary strategies at the population level remain to be a lacuna as evidenced by a review of the literature.” Added Dr Petosa: “Several countries have developed public health policies to support regular physical activity and a healthy diet.”
Experts prescribe a few healthy tips: Focusing on physical activity rather than “exercise” is a more inclusive approach. Regular walking with family and friends is a good example of an exercise that most people find acceptable. Likewise eating and cooking at home and eating in moderation are excellent dietary practices. Sharma added, “Social media can be used to organize interest groups around physical activity and healthy food promotion events in the community.” Design social communities to support physical activity and a healthy diet.
Looks like a plan and time to hit the gym!