Obesity is no longer just a concern linked to appearance or weight. It is increasingly being recognised as a major public health challenge because of its close connection with diabetes, heart disease, hypertension and other non-communicable diseases. The issue received renewed attention at the 18th BRICS Summit held in New Delhi on September 12-13, 2026, where leaders recognised obesity and non-communicable diseases as major global health challenges. In the New Delhi Declaration, the leaders reaffirmed their commitment to preventive and promotive healthcare through whole-of-government and whole-of-society approaches. "We recognise that obesity and non-communicable diseases (NCDs) have emerged as major global public health challenges and reaffirm our commitment to strengthening preventive and promotive healthcare through whole-of-government and whole-of-society approaches," the declaration said, reported by PTI. The leaders also endorsed the BRICS Mission for Healthy Lifestyle and the BRICS Roadmap for the Joint Initiative on Healthy Lifestyle Promotion for 2026-2029.

According to Dr Paras Agarwal, Director, Diabetes, Obesity & Metabolic Clinic, CK Birla Hospital, Gurgaon, the recognition is important because obesity is closely linked to the growing burden of metabolic diseases.

Why Obesity Is More Than A Weight Problem

"Obesity is not simply about how a person looks or how much they weigh; it is a metabolic risk factor that quietly shapes the course of Type 2 diabetes, hypertension and heart disease," said Dr Agarwal. Excess body fat, particularly visceral fat stored around the abdomen, can contribute to insulin resistance. This happens when the body's cells become less responsive to insulin, the hormone responsible for helping glucose move from the bloodstream into cells. As insulin resistance increases, the pancreas may need to produce more insulin to maintain normal blood glucose levels. Over time, some people may progress from normal glucose levels to prediabetes and eventually Type 2 diabetes. This process can happen gradually and may remain unnoticed for years.

Type 2 Diabetes Is Being Seen At Younger Ages

Type 2 diabetes was once commonly associated with middle age and older adulthood. However, it is increasingly being diagnosed in younger adults, particularly those carrying excess weight or having other risk factors. These may include:

  • Family history of diabetes
  • Abdominal obesity
  • Physical inactivity
  • High blood pressure
  • Abnormal cholesterol levels
  • Previous gestational diabetes
  • Poor sleep and unhealthy dietary patterns

An earlier diagnosis means that a person may live with diabetes for a longer period, potentially increasing the risk of complications involving the heart, kidneys, eyes, nerves and blood vessels. This makes risk-based screening important. Waiting for symptoms may delay diagnosis because diabetes and prediabetes can remain silent in their early stages.

The Indian 'Metabolic Paradox'

India also faces a distinct challenge sometimes described as the metabolic paradox. A person may have a normal body mass index, or BMI, but still carry a relatively high amount of body fat, particularly around the abdomen. This means that a normal number on the weighing scale does not always indicate good metabolic health. "BMI alone cannot capture where fat is stored or how insulin-resistant a body has become," Dr Agarwal said.

He added that waist circumference, blood pressure, lipid profiles and blood glucose testing, when used appropriately, can provide a more complete picture of metabolic risk. The purpose should not be to create weight-related anxiety or encourage unnecessary testing. Instead, the focus should be on identifying genuine risk factors early.

Why Prevention Must Begin Before Diabetes

Preventing obesity-related disease cannot depend only on treating high blood sugar after diabetes develops. Dr Agarwal said prevention needs to become part of daily life rather than a short period of strict discipline. A balanced diet should include vegetables, pulses, whole grains, adequate protein, fruits, nuts and sensible portions. At the same time, reducing sugary drinks, highly processed foods and frequent deep-fried meals can support healthier weight and glucose control. Crash diets may produce rapid weight loss, but they are often difficult to sustain and may result in muscle loss, fatigue and nutritional deficiencies. A long-term approach is more useful, particularly when the goal is to preserve muscle while reducing excess body fat.

Exercise Can Improve Insulin Sensitivity

Regular physical activity is another important part of prevention. Aerobic activities such as brisk walking, cycling, swimming and jogging can support cardiovascular health and help improve glucose regulation. Resistance training is also valuable because maintaining muscle mass can improve strength, mobility and insulin sensitivity. Combining both forms of exercise may offer greater benefits than relying on only one type. People who are inactive or have existing medical conditions should begin gradually and choose activities suitable for their fitness level.

Prediabetes Is A Window Of Opportunity

Prediabetes should not always be viewed as an inevitable step towards diabetes. It can also be a window of opportunity during which lifestyle changes may help delay or prevent progression. Weight management, regular physical activity, better food choices and improved sleep can all support metabolic health. In selected cases, doctors may recommend medication based on an individual's risk profile. However, medicines should not be started or stopped without medical advice. The key is to identify prediabetes early and take action before blood glucose levels rise further. Obesity Increases Several Health Risks The consequences of obesity extend well beyond blood sugar. Excess weight can increase the risk of:

  • Hypertension
  • Heart disease
  • Stroke
  • Fatty liver disease
  • Sleep apnoea
  • Joint problems
  • Certain cancers
  • Reduced physical mobility

When obesity occurs alongside high blood pressure, abnormal cholesterol and elevated blood glucose, the combined cardiovascular risk may increase further. "Diabetes care that only tracks HbA1c is looking at half the picture," Dr Agarwal said. He emphasised that managing multiple risk factors early is more effective than treating complications individually after they appear.

Healthy Living Cannot Depend On Willpower Alone

Although personal choices matter, obesity prevention cannot be placed entirely on individual willpower. Schools, workplaces, communities, healthcare providers and policymakers all have a role in making healthier choices more accessible. This includes improving access to nutritious food, creating safe spaces for walking and exercise, promoting health literacy and strengthening primary healthcare. Primary healthcare centres can help identify obesity, prediabetes, high blood pressure and other risk factors before they develop into more serious disease.

What The BRICS Healthy Lifestyle Mission Must Achieve

The BRICS Mission for Healthy Lifestyle and the 2026-2029 roadmap represent an important policy commitment. But their success will ultimately depend on how effectively these commitments reach ordinary people. This may include accessible nutrition guidance, opportunities for physical activity, early metabolic screening and stronger counselling services. Obesity must be treated as a medical condition with metabolic consequences rather than a cosmetic concern.

The BRICS leaders' recognition of obesity and non-communicable diseases as major public health challenges reflects a growing global concern. Obesity can increase insulin resistance and raise the risk of Type 2 diabetes, hypertension, heart disease and fatty liver disease. In India, the risk may remain hidden even among people with a normal BMI because body fat distribution and metabolic health are not always reflected by weight alone.

As Dr Paras Agarwal explained, the fight against diabetes must go beyond treating high blood sugar. It should include early identification of obesity and prediabetes, balanced nutrition, regular exercise and coordinated action across communities and healthcare systems. The real test of the BRICS healthy lifestyle roadmap will be whether its policy commitments translate into practical, affordable and accessible ways for people to live healthier lives.



Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.