How obesity is fuelling India's growing diabetes epidemic

Obesity elevates the risk of type 2 diabetes. The rising obesity rates are closely linked to increasing diabetes cases in India.

In Short

• Obesity is a major driver of type 2 diabetes
• Having both obesity and type 2 diabetes increases the risk of cardiovascular disease
• With obesity rates rising globally, cases of type 2 diabetes are increasing

Obesity is a major driver of type 2 diabetes, increasing a person's risk by nearly six times compared to those at a healthy weight. A 2023 study revealed that "treating obesity is the cornerstone in the prevention and management of type 2 diabetes."

According to Dr Rakesh Kumar Prasad, Consultant in Diabetology and Endocrinology at Fortis Hospital, Noida, while not everyone with obesity will develop diabetes, factors such as family history, diet, physical activity, stress levels, and gut health also play huge roles in determining a person's risk.

"The strong association between obesity and diabetes has led to the term 'diabesity,' describing the coexistence of both conditions. This term reflects a serious health threat, as having both obesity and type 2 diabetes greatly increases the risk of cardiovascular disease, the leading cause of death," Dr Prasad tells IndiaToday.in.

This connection is grounded in how excess body fat impairs the body’s response to insulin, a hormone crucial for regulating blood sugar.

With obesity rates rising globally, cases of type 2 diabetes are increasing in parallel, making obesity a key contributor to the diabetes epidemic in India. According to India's medical panel, the Indian Council of Medical Research (ICMR), over 11% of India's population has diabetes. ICMR also revealed that at least 25% of Indians are classified as overweight or obese.

The mechanisms linking obesity to type 2 diabetes are multifaceted.

Dr Prasad notes that obesity triggers fat-induced insulin resistance, lipid imbalances (like high triglycerides and low HDL cholesterol), fatty liver (non-alcoholic fatty liver disease, or NAFLD), and dysfunction in insulin-producing cells.

Together, these factors create a metabolic environment that predisposes individuals to prediabetes and, ultimately, type 2 diabetes.

Where fat is distributed also affects diabetes risk.

For example, men with "apple-shaped" obesity, characterised by higher upper-body fat, tend to accumulate fat in the liver, muscles, and pancreas, which elevates their type 2 diabetes risk.

Conversely, women with more fat stored in the lower body (gluteofemoral fat) tend to have better metabolic profiles, with lower blood glucose levels, higher HDL cholesterol, and improved insulin sensitivity.

Addressing obesity through lifestyle changes, dietary improvements, and exercise is crucial in preventing and managing diabetes, especially as obesity continues to fuel the diabetes crisis worldwide, says the expert.