Indians' expanding waistlines ("spare tyres") are no longer just a comedic trope--they’re an urgent medical issue . What was once mocked or even admired is now being scrutinised as a serious health hazard. India is grappling with a surge in obesity, and central fat is emerging as a particularly troubling marker.
In 2021, the country ranked second globally in adult overweight and obesity numbers, trailing only China. A Lancet study warns that if the trend continues, by 2050, nearly one in three Indians could fall into these categories — a staggering projection of 45 crore individuals.
The broader global picture is equally concerning: projections suggest over half the adult population and a significant share of children will be overweight or obese in the coming decades.
Among the various forms of fat accumulation, central adiposity — particularly around the stomach — is now seen as especially dangerous. Experts have long cautioned that this type of fat is linked to serious long-term illnesses, including cardiovascular disorders and diabetes.
Even in the 1990s, research had begun connecting abdominal fat to chronic health conditions. The concern goes beyond appearance — it’s about how fat disrupts the body’s internal systems, especially blood sugar regulation.
South Asians tend to carry more body fat for the same BMI (body mass index) compared to other populations. Their fat often gathers around the torso, sometimes without penetrating deep into visceral layers, yet still causing metabolic strain due to inefficient fat storage under the skin.
This inefficiency forces the body to stash excess fat in internal organs, potentially damaging the liver, pancreas and other metabolic regulators. Even when overall fat seems moderate, the distribution pattern in this population increases disease risk.
Despite being less likely to develop deeply embedded visceral fat, South Asians often suffer more from the consequences, simply because their fat cells can't safely store what’s taken in.
India, the US and China are among a small group of countries that together account for the bulk of global obesity cases. This isn’t just about urban areas or affluence — it’s a national phenomenon affecting all classes.
While the precise reasons behind fat distribution differences remain unclear, researchers suspect a deep historical influence. For generations, food insecurity and famines were common across the subcontinent, conditioning bodies to store energy efficiently.
Abdominal obesity is defined as a waist over 90cm for men and 80cm for women. Among women aged 30 to 49, nearly one in two already show signs of it. Urban populations are more affected than rural ones, with high waist circumference.
To address the expanding waistline, Indian experts have introduced a revised obesity framework that goes beyond BMI, focusing more on fat location and its health impact. The new model identifies two levels: one involving general weight gain without major symptoms, and the other with abdominal fat and related medical complaints.
Those falling in the second category often face conditions like high blood sugar, joint issues or cardiac symptoms — and require more rigorous intervention.
Fat individuals' bodies develop insulin resistance - a condition where the body stops responding properly to insulin, the hormone that helps regulate blood sugar. Abdominal fat disrupts how the body uses insulin, making it harder to control blood sugar.
Health professionals are pointing to rapid dietary shifts as a major cause: increased reliance on fast food, processed snacks and convenient but unhealthy meals has played a key role. Between 2009 and 2019, India saw a dramatic rise in ultra-processed food consumption, alongside countries like Cameroon and Vietnam.
The response, experts say, must go beyond Western templates. South Asians may need almost double the physical activity typically recommended elsewhere to compensate for their unique metabolic challenges.
Weight-loss medications are showing promise, but prevention through movement and better eating remains the first line of defence. Many people with normal weight may still harbour dangerous fat around their waist — a silent but serious threat.
To cut the fat around your midsection, you need tougher lifestyle changes: around 250–300 minutes to offset slower metabolism and less efficient fat storage; plus, drastic diet cut.
