India is developing its first National Obesity Guidelines after Prime Minister Narendra Modi’s Independence Day warning that obesity has become a “silent crisis” for the country. The Indian Council of Medical Research (ICMR) and the Union Health Ministry are now leading a large, multi-level exercise to create evidence-based protocols for prevention and treatment.

PM Modi’s Warning

From the Red Fort on Independence Day 2025, Prime Minister Narendra Modi cautioned that obesity is emerging as a major health challenge and urged families to cut cooking oil use by about 10 per cent, adopt regular exercise and choose healthier lifestyles. His message came amid data showing that more than one in four Indian adults are now overweight or obese and that weight-related illnesses are putting growing pressure on the health system. The World Obesity Federation has also projected that by 2035, nearly a third of Indians could fall into the overweight or obese category if current trends continue, underlining the urgency of national-level action.​​

At present, doctors in India mostly rely on World Health Organization thresholds and Western clinical guidelines to manage obesity, even though Indian bodies tend to accumulate fat differently and develop diabetes and heart disease at lower body mass index levels. The new initiative aims to create Indian data, definitions and treatment pathways that reflect local patterns such as central obesity, urban–rural inequalities and the coexistence of both undernutrition and overnutrition. Officials say the move also sends a clear signal that obesity is being recognised as a chronic disease and public health priority, not just a cosmetic issue.​

Multi-Tiered Panel Structure

To design the guidelines, ICMR has set up a three-layer structure involving an internal scoping group, a high-level steering committee and a broad-based expert panel of clinicians and public health specialists. The internal scoping panel, headed by ICMR Director General and Health Research Secretary Dr Rajiv Bahl, has already held multiple meetings to decide what the guidelines will include and to study global standards issued by bodies such as the UK’s National Institute for Health and Care Excellence and the American College of Gastroenterologists. This first step is meant to define the boundaries clearly so that later recommendations are focused, practical and suited to Indian realities.​

Above this, a steering committee co-chaired by Dr Bahl and the Directorate General of Health Services, Dr Sunita Sharma, is responsible for giving broad direction to the technical work. In its first meeting in November, the committee recommended that the document follow a “life-course” model, with separate sections for children, adolescents, postpartum women, mid-life adults and the elderly, instead of a one-size-fits-all approach. The committee has also advised that the teams look seriously at traditional options such as yoga for physical activity and Ayush-based dietary guidance, along with modern medical and surgical treatments.​

Expert Panel

The third tier is a 50-member expert group that brings together endocrinologists, physicians, surgeons, nutritionists and public health experts from across the country. This panel has been asked to generate a long list of over 100 clinical and public health questions on topics ranging from screening to long-term follow-up, which will then be narrowed down to around 25 priority questions that will anchor the guideline. Members will examine the latest evidence on lifestyle interventions, older medicines like metformin and newer weight-loss drugs such as GLP-1 agonists, including brands like Mounjaro and Wegovy that have recently entered the Indian market.​​

In recent months, the Indian Medical Association and other experts have expressed concern about the indiscriminate use of these powerful anti-obesity injections by non-specialists, warning of safety risks when there is no proper monitoring. The upcoming guidelines are expected to spell out who should receive these medicines, what tests should be done before starting them, how long they can be used and which specialists are authorised to prescribe them. Alongside drug therapy, the document is likely to update criteria for bariatric surgery and stress that diet and physical activity changes remain the first line of treatment for most people.​​

India’s Unique Obesity Pattern

Indian experts point out that obesity here does not always look like obesity in Western countries, even when the body mass index appears similar. Many Indian men show central or abdominal obesity with a relatively normal overall weight, while a large share of Indian women accumulate fat around the waist and hips in patterns that sharply raise the risk of diabetes, hypertension and heart disease. Studies using National Family Health Survey data have found that about 40 per cent of women and 12 per cent of men in the 15-49 age group are abdominally obese, meaning they carry excess fat around the belly even if they are not very heavy by standard scales.​

Regional differences are also stark, with southern and northern states such as Kerala, Tamil Nadu, Punjab and Delhi reporting very high abdominal obesity rates among women, ranging from roughly 58 to 65 per cent. In contrast, states like Jharkhand and Madhya Pradesh have prevalence figures below 25 per cent, though even there the trend is rising, especially in urban and middle-income groups. Public health specialists describe this as part of India’s “double burden” of malnutrition, where overweight and obesity are increasing even as pockets of undernutrition and anaemia continue, requiring careful balancing of policy responses.​

Timelines

According to senior officials, the full process of developing robust national guidelines usually takes 18 to 24 months in most countries, as it involves wide consultations, systematic evidence reviews and internal approvals. In India’s case, the work started in September 2025 and is planned in phases, with at least one set of guidelines expected by mid-2026, followed by updates or extensions for specific groups and conditions. Once the main document is cleared, a separate “policy group” headed by Dr Bahl and including joint secretaries from the Health Ministry will translate the technical language into simple, actionable messages for the public.​

The government has already revised national dietary guidelines through ICMR-National Institute of Nutrition earlier, focusing on reducing ultra-processed foods, salt, sugar and unhealthy fats while promoting traditional diets and physical activity. The upcoming obesity guidelines are expected to build on this by offering clear advice on screening at primary health centres, referral pathways, and when to move from lifestyle changes to medicines or surgery. For ordinary citizens, officials say the core message will remain straightforward: eat balanced home-cooked food, move more every day, and seek timely medical help when weight starts affecting health.

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