India is facing a growing public health crisis — rising rates of obesity and diabetes affecting both urban and rural populations. Currently, over 135 million Indians are suffering from obesity. Diabetes prevalence has reached 9.3 per cent of the adult population, contributing to an economic burden of $8.7 billion annually.

Behind these statistics lie countless individual stories: Children deprived of physical activity in overcrowded urban environments, families reliant on inexpensive processed foods due to economic constraints and overburdened rural healthcare systems struggling to provide timely interventions.

The true cost of this crisis is felt in households across India, where diabetes and obesity are eroding quality of life and economic stability.

In contrast, countries like Japan have managed to keep their obesity rate remarkably low, with only 4.5 per cent of the population classified as obese compared to 42 per cent in the United States. The secret to Japan’s success lies in a blend of cultural habits, balanced diets and progressive health policies that promote healthy living from an early age.

To tackle this crisis effectively, the government must take a leading role. Initiatives like the National Health Policy of 2017 and the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke have laid a foundation for addressing non-communicable diseases. However, these programmes need to be expanded to benefit all sections of the society.

Using human-centered design principles, interventions should be built by understanding the lived experiences of affected individuals. Empathy mapping — exploring what people think, feel and experience in their daily lives — should inform government strategies. Policies that resonate with people’s emotional and practical realities are far more likely to succeed.

Learning from Japan’s holistic approach, India can implement policies promoting mindful eating. Schools in Japan are a critical starting point for this, where children receive nutritional education and enjoy carefully designed meals that balance nutrition and portion control.

Schools can create comprehensive health interventions by charting the stages of a child’s development. This would begin with nutritional education in early childhood, progress to active engagement in sports during adolescence and culminate in shaping lifelong habits by the time students graduate. Mapping these health journeys allows schools to ensure that children receive the right support at each critical stage. Such an approach can be integrated with India’s midday meal programme.

Public awareness is crucial in tackling obesity and diabetes, and the government is well-positioned to lead widespread campaigns. Using both traditional and digital media, campaigns highlighting the importance of a balanced diet and regular exercise can effectively reach various segments of the population. However, awareness alone is not enough; it must be complemented by practical interventions at the community level.

Applying system thinking, public health campaigns must consider the interconnectedness of various social and economic factors. For instance, a public awareness campaign cannot succeed without the availability of safe public spaces. Similarly, nutrition education is only effective if healthy food is affordable and accessible.

Addressing these issues holistically — through a system that links government regulations, healthcare, food production and urban planning — ensures that public health messages translate into real-world impact.

Community involvement is essential in ensuring the success of these campaigns. Local governments can collaborate with community organisations to conduct workshops on diet, exercise and preventive healthcare.

Such initiatives are especially important in rural areas, where access to health education is often limited. Empowering local health workers and community leaders can ensure health messages reach even the most remote populations.

Preventive healthcare is key to reducing obesity and diabetes, as early detection is more effective than treatment. Expanding health screenings for high-risk groups and training community healthworkers to identify and guide at-risk individuals can aid timely intervention.

Strengthening primary healthcare centres, especially in rural areas, ensures better access, early detection and reduces the burden on secondary facilities, leading to improved health outcomes.

Addressing the socio-economic determinants of obesity and diabetes is crucial. Urbanisation, sedentary lifestyles and increased consumption of processed foods are all linked to rising rates of these conditions.

Governments can help shape environments that promote healthier living. Urban planning that encourages walking, cycling and other forms of physical activity can create healthier communities. Providing safe spaces for exercise, such as parks and public recreational areas, can reduce the risk of obesity and related health issues.

Access to healthy and affordable food must be addressed. A World Bank report highlighted that 40 per cent of Indian families depend on calorie-dense, processed foods because healthier options are often unavailable or costly.

The government can help promote the availability of healthy foods through subsidies, support for local agriculture and partnerships with private organisations. Encouraging local food production and reducing reliance on processed, imported foods can make nutritious options more accessible and affordable.

Additionally, stricter regulations on advertising high-calorie foods, particularly to children and better food labelling can empower consumers to make informed decisions about their diet.

India can draw inspiration from successful initiatives in other countries. Mexico introduced a sugar tax on sugary drinks to curb obesity, leading to reduced consumption and improved public health outcomes. Japan's Metabo Law mandates annual waistline measurements for adults over 40, followed by counselling for those at risk, which has reduced obesity rates.

Countries like Denmark, which has implemented policies to reduce saturated fat consumption, have demonstrated that sustained, government-led efforts can lead to improved health outcomes.

Collaboration across sectors is essential for effectively addressing obesity and diabetes. The healthcare sector, education system, food industry and urban planning authorities all have roles to play. A systems thinking approach ensures that interventions are not implemented in isolation but are part of a cohesive plan that addresses every aspect of the obesity and diabetes crisis, from food accessibility to urban planning.

India’s fight against obesity and diabetes must be driven by empathy, innovation and a holistic understanding of systemic challenges. By investing in prevention today, India can not only alleviate the burden on its healthcare system, but also improve the quality of life for millions of citizens, ensuring a brighter, healthier future for all.

Anish Bari is the co-founder of the Obesity Innovation Lab, an Edward S. Mason Fellow at Harvard Kennedy School, and a Global Shaper with the World Economic Forum. Pranjal Pandey is a journalist based in Delhi.

Views expressed are the author’s own and don’t necessarily reflect those of Down To Earth.

Simply Put: AIIMS Darbhanga