What happens beyond the excess weight threshold? Evidence from adult women in India

Background Overweight and obesity rates have skyrocketed over the last three decades, particularly in developing countries. This study examines the prevalent trends, and spatial and temporal patterns of overweight/obesity among India’s adult women. Methods Using unit-level data from the National Family Health Surveys (NFHSs), this study examines the extent of overweight/obesity among adult women. Majority of the extant studies in the Indian context focus on a single metric, i.e. headcount ratio. This approach only considers a single cut-off point and ignores the differences beyond this threshold. However, the obesity burden is unlikely to be evenly distributed. To address this, I incorporate measures that explicitly take this into consideration and resort to a distribution-sensitive metric, i.e. the Foster-Greer-Thorbecke index (FGT), to identify the underlying changes in the body mass index (BMI) distribution. Results The analysis reveals a consistent increase in most FGT index measures, particularly among urban women. The results suggest that interventions should preferably be group-specific and targeted in nature. Conclusions The findings highlight that a distribution-sensitive metric provides a more nuanced understanding of the prevalent inequalities in the BMI distribution. It helps to capture the non-linear health and economic dimensions of the growing overweight or obesity burden in India.