Asia, South

In Hindu Indian mythology, overweight was seen as a sign of inner contentment, with some statues and other representations of several of the gods often showing signs of central obesity. In historical times, early European traders have included accounts of overweight Indian merchants with cartoons often caricaturing obesity. Even allowing for exaggeration, it was clear that there was a level of obesity among some wealthy Indians for several centuries.

Although Bollywood, the Indian film industry, tends to center its films on slim men and women, obesity is increasing in India, as it is around most of the rest of the world. Atal Behari Vajpayee, prime minister of India from 1998 until 2004, has had a problem with being overweight, with medical operations on both [Page 52]of his knees. Indian prince Kumar Shri Ranjitsinhji (1872–1933) after retiring from cricket, became overweight, and Sri Lankan cricketer turned politician Arjuna Ranatunga (b. 1963) also put on considerable weight after leaving cricket.

However, the modern concern with obesity is not in terms of dealing with a small number of overweight people, but with the massive rise in obesity throughout India, Pakistan, and also Bangladesh, Nepal, and Sri Lanka, especially in the increasing middle class. Much of this has come from the sedentary lifestyle, a lack of exercise and increased access to, and consumption of Western foods. Not only has the increase in obesity created problems of its own, but it has also led to a rise in the levels of diabetes and cardiovascular problems facing many people in South Asia.

As a result, there has been much research on obesity in India, with a website http://www.obesityindia.com promoting the message “Lose Weight. Gain Health.” There is also the All India Association for Advancing Research in Obesity (AIAARO).

As with many other countries in the world, the cause of much of the increasing level of obesity has been the rapid nutritional and lifestyle changes, particularly prevalent in urban areas. As well as obesity, it has also led to a rise in the prevalence of the metabolic syndrome, and this has led to joint studies of obesity and metabolic syndrome, the latter affecting 20 to 25 percent of all urban South Asians.

There is also mounting evidence that obesity in India, as elsewhere in the region, is caused by heredity. Drs. J. Kumar, R. R. Sunkishala, G. Karthikeyan, and S. Sengupta of the Department of Proteomics and Structural Biology, Institute of Genomics and Integrative Biology, New Delhi, carried out a recent study of a genetic variation upstream of insulin-induced gene 2 (INSIG2) (rs7566605) which they believed could be connected with rising levels of obesity. The study was complicated by the lifestyle and diet changes that many Indians have seen during the same period. This led researchers to divide their work between the 1,577 healthy people, and the 610 who were suffering from coronary artery disease. When the two groups were compared, it was found that there was no significant level of association between the polymorphism and body mass index (BMI).

This, as well as other factors, allowed Dr. Kumar and his colleagues to conclude that the variant upstream of INSIG2 could not be shown to be a determinant of BMI in the Indian population. However, there are many other potential genetic links to obesity, and future genome scans may shed insight as to why the overall prevalence of obesity has increased in certain groups.

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