India has always been a land of plenty. Historically it was a land that controlled almost 25-30% of global GDP. It is no surprise then that ancient texts write about obesity in uncertain terms. As a matter of fact practices like Yoga developed in India as a holistic system for physical and mental wellbeing.

During the colonial rule India suffered and so did the health of its citizens. Obesity was replaced with starvation. The Bengal famine during 1943 was the epitome of what all was wrong with the colonial rule and administration. The situation continued after independence, the PDS and rationing system ensured that food was available but in limits.

But 1991 changed all that. With global liberalisation India was an active market to many of the food companies. Nestle, Unilever, General Mills, among others introduced many of their global successes in the country. The net result combined with the growing purchasing power of the middle class has resulted in an epidemic that affects 5% of the population today. It also lays the foundation for systemic conditions like Diabetes and circulatory conditions like cardiovascular diseases.

According to reports from the Indian Heart Association India carries almost 60 % of the cardiovascular disease burden of the world. In terms of obesity again India sees more instances of abdominal obesity. During research on 22 different SNPs near to MC4-R gene, scientists have identified an SNP (single nucleotide polymorphism) named rs12970134 to be mostly associated with waist circumference. In this study, more than two thousand individuals of Indian origin participated and the aforementioned SNP is highly prevalent in this group. Also, obesity seems to affect women more than men in India. According to research done by CADI Research, Obesity among women seems to go higher with increasing BMI.

So what’s the real economic cost of obesity?

  1. For starters, I think it is not necessary for people to spend to consume more if they are already obese. Consumption of food should be “means to an end” and not the other way around.
  2. Obesity forms the basis of the other two lifestyle diseases killing India- Hypertension, and Diabetes. Just last week a very serious colleague from my office had a stroke, his condition was exasperated due to diabetes and obesity.
  3. Studies in India estimate that, for a low-income Indian family with an adult with diabetes, as much as 20 percent of family income may be devoted to diabetes care. For families with a diabetic child, up to 35 percent of income is spent on diabetes care.
  4. If you have Diabetes for five years you would have spent around Rs 1,50,000 on diabetes treatment only. After 10 years you would have spent Rs 4,00,000 and after 20 years you would have spent Rs 15,00,000. The increase in cost with time is due to the increase in complications.
  5. To add this the direct cost of diabetes is around Rs 1,00,000 which includes the cost of direct consultation with doctors and the numerous tests that have to be performed.
  6. Then there is the opportunity cost. Is it estimated that a loss of Rs 50,000 per annum per individual due to sick leaves?

So essentially we have a interesting situation, where we spend money to consume and then spend again on healthcare services.

So how can we change this around

  1. Get aware of the disease burden. If overweight then start, looking at dedicating 1 hour per day on exercises. Something as simple as walking daily is a good start.
  2. Lose the habits, drinking, smoking, junk food is again adding to the costs.
  3. Get regular tests done, this avoids surprises and helps you plan to cover for the disease burden. At a minimum, you should get HB1ac test done quarterly.
  4. Pick up Yoga, I have been practicing Yoga for the last 5 years and have immensely benefited from the practice

The cost of healthcare is only going to go up. Just remember that steps taken today can reduce the cost tomorrow, whether to act or not is totally upto you.

Sources

  1. https://cadiresearch.org/topic/obesity/global-obesity/obesity-in-india
  2. https://edition.cnn.com/interactive/2017/10/health/i-on-india-childhood-obesity/
  3. https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/What-is-the-cost-of-diabetes-care/articleshow/49843288.cms

Dr Vikram Venkateswaran

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