India’s obesity burden is in a rapidly rising trend, yet its true weight among Indian women remains systematically underestimated. The National Family Health Survey-5 reports that 18% of Indian women are overweight and 6.4% are obese using global Body Mass Index (BMI) cut-offs (≥25 and ≥30 kg/m 2 , respectively). However, the World Health Organization Expert Consultation on BMI recommends lower thresholds for overweight at ≥23.0 kg/m 2 and obesity at ≥25.0 kg/m 2 for the Asian population. Applying Asian-specific criteria reveals that an estimated 17% of Indian women currently classified as normal BMI by global standards are already at elevated metabolic risk. The disproportionate burden in women reflects a convergence of biological vulnerability, including post-partum weight retention and hormonal susceptibility with psychosocial stressors arising from dual-role overload and structural barriers, including unsafe public spaces and obesogenic food environments. Viewed through the UNICEF Conceptual Framework on Maternal and Child Nutrition, BMI functions as a late outcome indicator that captures the endpoint of a complex causal cascade while remaining blind to its upstream determinants. This viewpoint reasons for the adoption of Asian-specific BMI thresholds alongside composite anthropometric assessment in national survey and clinical practice, institutionalisation of weight management clinics at the primary care level and a life-course approach addressing biological, psychosocial and structural determinants.
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Saxena et al. (2026) studied this question.
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