Trends of Obesity Among Adults, Children, and Adolescents in India (1990-2022): A Retrospective Ecological Analysis.

Introduction Obesity is a significant global public health concern, and there has been an increase in the prevalence of obesity globally over the past three decades. A region that has been particularly affected by the increasing trends of obesity over time is the Indian subcontinent region. The study was conducted (1) to assess the trends in the prevalence of obesity in adults, children, and adolescents in India and compare it with the median global prevalence over the past three decades and (2) to correlate the changes in economic, globalization, urbanization, and physical activity parameters and the prevalence of obesity in Indian adults, children, and adolescents over the same period. Methods This is a retrospective, longitudinal, ecological data-based (national- and global-level measures) study of the prevalence of obesity in India over the period from 1990 to 2022. The main outcome was obesity in adults, 10-19-year-olds, and 5-9-year-old children in India. We also compared this to the median global prevalence over the same period. We correlated the prevalence of obesity with gross domestic product (GDP) per capita-purchasing power parity (PPP), globalization score, economic globalization score, social globalization score, the proportion of urbanization, and insufficient physical activity. We used linear regression models to estimate the change in prevalence and Pearson's correlation coefficients for correlation. Results The prevalence of age-adjusted obesity in the adult population was 0.79% in 1990, and it had increased to 7.27% in 2022. The prevalence of obesity in the 10-19-year-olds was 0.082% in 1990, and it had increased to 2.72% in that age group, and it had changed from 0.20% in 1990 to 4.96% in the 5-9-year-olds. The percentage increase in the prevalence of obesity was highest in 10-19-year-old boys and lowest in adult women from 1990 to 2022. The change in the prevalence for the Indian adult male population was 0.145 (95% confidence interval {CI}: 0.132, 0.157; p<0.001), and it was 0.254 (95% CI: 0.236, 0.271; p<0.001) for women. The change in prevalence for both groups (male and female population) was 0.083 (95% CI: 0.075, 0.091; p<0.001) for 10-19-year-olds, and it was 0.153 (95% CI: 0.141, 0.165; p<0.001) for the 5-9-year-olds. The change in the ratio of global prevalence to Indian prevalence was steepest in 1990-1994 for adults and in the 1995-1999 period for the 10-19-year-old and 5-9-year-old age groups. There was a strong and significant correlation between economic, globalization, urbanization, and physical activity parameters. Conclusions With the changes in socio-economic and urbanization patterns in India, obesity has become an important public health concern. Additionally, as the prevalence of obesity increases, associated conditions such as non-communicable diseases, including their complications, may also show an increase and may be an additional burden on the healthcare system. Thus, there is a need to implement targeted national programs to address issues related to obesity in adults. Children and adolescents have shown a sharp increase in the prevalence of obesity in the past three decades in India. Thus, there should be a greater emphasis on the prevention and management of obesity in these groups in the public health programs in India.