Revised Definition of Obesity for Indians
Revised Definition of Obesity for Indians

Revised Definition of Obesity for Indians: What Has Changed and Why It Matters

India’s new obesity definition includes waist size and metabolic health, not just BMI. Find out how this change helps detect obesity early and improve treatment.

Obesity has become a major health crisis in India, affecting people across all age groups and regions. The rise in obesity rates has been particularly alarming after the COVID-19 pandemic, as changes in diet and increased sedentary behavior have led to unhealthy weight gain.

Until recently, obesity was primarily defined using Body Mass Index (BMI), a simple weight-to-height calculation. However, new research has shown that BMI alone is not enough to assess obesity, especially for the Indian population. Indians tend to have higher body fat levels at lower BMI values compared to Western populations, putting them at risk for obesity-related diseases like diabetes, heart disease, and high blood pressure even if their weight seems normal by global standards.

Recognizing this, medical experts in India have updated the definition of obesity, making waist circumference and metabolic health equally important factors alongside BMI. These changes aim to help identify obesity earlier, prevent complications, and ensure better treatment strategies.

Let’s explore what has changed and what this means for you.

How Was Obesity Defined Before?

Previously, obesity was classified based on BMI alone. The cut-off values followed global standards set by the World Health Organization (WHO), where:

  • BMI of 18.5 – 22.9 kg/m² was considered normal weight
  • BMI of 23 – 24.9 kg/m² was classified as overweight
  • BMI of 25 – 29.9 kg/m² was classified as obese type 1
  • BMI of 30 kg/m² or higher was considered obese type 2

However, these values were not well-suited for the Indian population. Several studies have shown that Indians accumulate more fat in the abdominal area and develop obesity-related diseases at much lower BMI levels than Western populations.

For example, a person with a BMI of 23 kg/m² in India might already be at risk for diabetes and heart disease, whereas in Western populations, the same BMI might still be considered healthy. This is due to a unique characteristic often called the “Thin-Fat Indian” phenotype, where a person appears thin but has a high percentage of body fat, particularly around the abdomen.

What Has Changed in the New Definition of Obesity?

Lower BMI Cut-Off for Obesity in India

The BMI cut-off for defining obesity has now been lowered from 25 kg/m² to 23 kg/m². This means that anyone with a BMI of 23 or above is now classified as having obesity in India.

Removal of the “Overweight” Category

Previously, individuals with a BMI of 23 – 24.9 kg/m² were classified as “overweight”. However, research shows that the risk of metabolic diseases increases sharply even at a BMI of 22.7 – 23 kg/m² in Indians. Because of this, the “overweight” category has been eliminated, and obesity is now classified into different stages based on health risks.

Importance of Waist Circumference

The new guidelines recognize that where fat is stored in the body is just as important as how much fat there is.

  • Fat stored in the abdomen (belly fat) is far more harmful than fat stored in other areas like arms or legs.
  • A person with a high waist circumference is at a greater risk for diabetes, high blood pressure, and heart disease—even if their BMI is normal.

New Waist Circumference Cut-Offs for Obesity:

  • Men: ≥ 90 cm (35 inches)
  • Women: ≥ 80 cm (31.5 inches)

Additionally, the waist-to-height ratio is now recommended as an easy-to-use obesity indicator. Your waist should be less than half of your height to be considered in a healthy range.

Staging and Grading of Obesity

Instead of a one-size-fits-all approach, obesity is now divided into two stages based on health risks and further graded based on BMI.

Stages of Obesity

  1. Stage 1 (Preclinical Obesity)
    • BMI ≥ 23 kg/m²
    • No obesity-related symptoms or metabolic diseases
    • May have high waist circumference or increased body fat percentage
  2. Stage 2 (Clinical Obesity)
    • BMI ≥ 23 kg/m²
    • Plus at least one of the following:
      • High waist circumference
      • Metabolic diseases like diabetes, hypertension, or fatty liver
      • Physical symptoms like breathlessness, joint pain, or difficulty in daily activities

Grades of Obesity (Based on BMI)

  • Grade I: 23.0 – 24.9 kg/m²
  • Grade II: 25.0 – 27.4 kg/m²
  • Grade III: 27.5 – 32.4 kg/m²
  • Grade IV: ≥ 32.5 kg/m²

Why These Changes Matter

Early Identification of Obesity

By lowering the BMI cut-off and including waist circumference, people can be diagnosed with obesity earlier—before they develop serious health problems. This allows for preventive action rather than waiting for complications to arise.

Better Treatment and Personalized Management

Since obesity is now classified into stages and grades, healthcare professionals can offer targeted treatment plans based on a person’s specific health risks rather than just their weight.

Greater Awareness for Indians at Risk

Many Indians believe they are not obese because they don’t “look fat.” The new definition raises awareness that excess belly fat is dangerous, even if overall weight seems normal.

Managing Obesity Under the New Guidelines

The revised definition does not change the fundamental approach to weight management—but it emphasizes early intervention.

1. Lifestyle Changes as the First Step

  • Balanced Diet: Focus on whole foods, limit processed foods, and reduce sugar intake.
  • Physical Activity: Include both aerobic exercises (walking, jogging) and strength training to preserve muscle mass.
  • Mindful Eating: Avoid overeating, practice portion control, and eat slowly.

2. Medications for Obesity

  • For individuals with BMI > 27.5 kg/m² or those with serious health risks, doctors may recommend anti-obesity medications like Orlistat, Liraglutide, or Semaglutide.

3. Bariatric Surgery for Severe Obesity

  • Individuals with BMI ≥ 35 kg/m² or BMI ≥ 30 kg/m² with comorbidities may be advised to consider weight-loss surgery.
  • Surgery is only recommended after failure of diet, exercise, and medication over at least six months.

Final Thoughts: What Should You Do Now?

The new definition of obesity is a wake-up call for India. If your BMI is above 23 or your waist circumference is high, it’s time to take action. Even if you feel healthy now, these signs indicate an increased risk of developing chronic diseases in the future.

Simple Steps to Get Started

  1. Measure your waist-to-height ratio—keep your waist less than half your height
  2. If your BMI is above 23, focus on preventing further weight gain
  3. Maintain a healthy diet and regular exercise routine
  4. If you have risk factors like diabetes or high blood pressure, consult a doctor

By understanding and implementing these changes, you can take control of your health before obesity leads to more severe complications. Early action is the key to a healthier future!

Axis Diet is dedicated to empowering individuals with knowledge and practical advice for healthier living. Our articles, grounded in research and expert insights, aim to simplify complex nutritional concepts, offering a comprehensive understanding of various aspects of diet and wellness. While these articles are informative and a great starting point for anyone looking to improve their health, they are for informational purposes only.

For personalized, professional guidance tailored to your unique health needs, we encourage you to consult with Axis Diet’s registered dietitians. Reach out to us at https://www.axisdiet.com/contact/ for expert personalized guidance on your nutritional journey.

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