India's Newly Rich Battle With Obesity
Mumbai: India is facing an obesity crisis among its newly wealthy
middle class as millions of its rural poor still struggle for enough
As the country becomes richer, many people are becoming fatter and,
like Westerners, they are seeking medical help. Patients at Dr Sanjay
Borude's clinic choose between keyhole surgery for gastric banding
to cut the size of the stomach and a rarer, more serious gastric bypass
that restricts the amount of food absorbed.
These operations were hardly ever needed in India a decade ago. Now
Borude has an ever-increasing workload at his practice in Mumbai,
formerly Bombay, and he is training doctors from other towns and cities
to meet a growing demand for slimming surgery.
Although obesity in the West is associated with poverty, in the developing
world it is a problem for the newly rich. Borude's clients are from
an urban, professional elite who pay substantial fees to shed their
Seventy-six per cent of women in the capital, New Delhi, are suffering
from abdominal obesity, according to a survey by the All-India Institute
of Medical Sciences. 'It is a serious problem for India,' Anoop Misra,
the co-author of the study, said.
'In major metropolitan areas it is almost epidemic,' said Borude.
'People are living much more sedentary lives. If you are rich, you
can pick up a phone and order a pizza. You have a car, so you don't
need to walk anywhere.'
The problem underlines the vast divide between India's thriving urban
areas and the impoverished rural regions, where millions are struggling
to feed themselves. Around 45 per cent of Indian children under five
suffer from malnutrition, says the World Bank.
Indian society increasingly stigmatises overweight people. Surgeon
Mohan Thomas said half of the patients at his Cosmetic Surgery Institute
in Mumbai wanted help to lose weight. 'Having a beer belly was a sign
of prosperity, but that's changing. Men are concerned about the male
breast area and love handles,' he said.
After 30 years in the US, Thomas returned to India to open his clinic
three years ago, and found the increase in obesity startling. 'Before
I left it was rare, but it's so unremarkable now that no one turns
their heads,' he said. Explosive growth by India's fast-food industry
has fuelled a dramatic change in eating habits. A McDonald's branch
in Delhi is crowded with customers buying Chicken Maharajah Macs.
The chain is expanding to other towns and cities.
Although Indian food was always high in calories, families now spend
more than ever on eating out and buying processed food, according
to a survey published last week.
'Over the last few years there has been an extremely rapid change
in diet - not just in Delhi and Mumbai, but in smaller towns, too,'
said Misra, of the All-India Institute. 'People are snacking in a
new way. Many children no longer take lunch-boxes to school. They
drink cola and eat burgers. There is no awareness among parents that
this is a problem.'
With obesity come related problems, from diabetes to heart failure.
An estimated 25 million Indians have diabetes, and this is forecast
to grow to 57 million by 2025. Doctors say the government has failed
to register the scale of the impending crisis.
'Politicians still ask "How can people here have obesity when they
are dying of malnutrition?" They think malaria and TB are much more
serious,' Misra said.
'You can treat TB with six months of treatment. But diabetes needs
to treated until the patient dies, and heart disease is expensive
to treat. This is going to be disastrous.'
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