One in four Indians obese, new report warns of $29 billion annual economic loss

India could face one a defining health and economic challenge. With one in four Indian adults now obese, a new report notes how obesity and related chronic diseases account for a growing share of India’s health burden, costing the economy an estimated $28.9 billion annually.

The Tony Blair Institute for Global Change (TBI) has published a white Building on Success to Secure India’s Future Health, setting out a bold vision for how India can further its drive on preventive health.

However, the report asserts that India has the foundations to lead globally on prevention. There is one area of health policy where India looks set to lead the prevention agenda: anti-obesity medications (AOMs). These could be game changing for the prevention agenda but at the moment, while highly effective, most of these drugs are prohibitively expensive, the report says.

It points out that obesity and associated long-term conditions lead to higher rates of premature mortality, absenteeism and presenteeism (reduced on-the-job performance) and these effects, in turn, lead to falling productivity, reduced GDP and a lower government tax intake.

“With strong digital infrastructure, a growing network of primary-care centres and world-class pharmaceutical-manufacturing capacity, it can move faster than others to build a prevention-first health system. With strong digital infrastructure, a growing network of primary-care centres, and world-class pharmaceutical-manufacturing capacity, the country can move faster than others to build a prevention-first health system,” the report adds.

The report calls for four key actions, including strengthening of food-environment regulation to reduce consumption of high-fat, sugar, and salt products. Second is to scale digital risk screening across platforms like Ayushman Arogya Mandirs and e-Sanjeevani. Third is to introduce digital incentives for healthy behaviours through the Ayushman Bharat Digital Mission (ABDM). Fourth is to prepare for affordable anti-obesity drugs by India’s pharma sector.

Dr Anoop Misra, chairman, Fortis C-DOC Hospital for Diabetes and Allied Sciences and director, National Diabetes Obesity and Cholesterol Foundation (NDOC) said, “Obesity in Indians behaves differently — it is more inflammatory and metabolically disruptive. Even at lower body mass index (BMI), Indians develop high blood sugar much earlier. The pattern of fat deposition is also distinct, with excess abdominal and visceral fat emerging as the most dangerous form. This abdominal adiposity drives early diabetes, heart disease, and other metabolic illnesses. Addressing this unique, high-risk obesity phenotype is essential for India’s future health.”

Vivek Agarwal, country director, TBI, said, “India’s leadership in digital health gives it a unique opportunity to redefine preventive care for the world. By combining technology, data, and community-driven action, India can not only reduce the growing burden of obesity but also build a stronger, more resilient health system for future generations.”