Once seen as a symbol of wealth, indulgence, and the wisdom of age, the pot belly in India has traditionally carried cultural weight. In literature, it quietly implied comfort or an easy life, while in cinema it stood in for the sluggish bureaucrat, overeating uncle, or crooked cop. Cartoons often caricatured it to poke fun at politicians. In rural India, a large stomach once indicated privilege—evidence that “this man eats well.”
However, what was once laughed at or even respected is now causing serious concern. India is facing a growing obesity crisis, and the unassuming pot belly may be a more serious threat than previously believed.
In 2021, India recorded the second-highest number of overweight or obese adults in the world, with 180 million people affected, trailing only China. A new study published in The Lancet predicts that this figure could reach 450 million by 2050, amounting to nearly one-third of the country’s expected population.
This isn’t just a national problem—globally, over half of all adults and one-third of children and adolescents are projected to struggle with excess weight in the years to come.
Central to India’s obesity crisis is abdominal obesity, more commonly referred to as belly fat. Unlike general obesity, abdominal obesity refers specifically to excess fat accumulated around the midsection. According to medical professionals, it’s not merely a matter of appearance. As early as the 1990s, research established a strong connection between belly fat and chronic diseases such as Type 2 diabetes and heart ailments.
Obesity presents itself in several forms. Peripheral obesity involves fat buildup in the hips, thighs, and buttocks, while generalised obesity spreads fat throughout the body. But the belly fat version is drawing particular attention due to its link to serious health issues.
Current data from the National Family Health Survey (NFHS-5), which for the first time measured waist and hip circumference, highlights the scale of the issue. It found that around 40% of women and 12% of men in India suffer from abdominal obesity. According to Indian health standards, this means a waist size over 90 cm (35 inches) for men and 80 cm (31 inches) for women. Alarmingly, nearly half of Indian women between the ages of 30 and 49 show signs of this condition. Urban residents are more affected than their rural counterparts, with waist size and waist-to-hip ratios being key indicators.
So why is belly fat particularly concerning?
One major factor is insulin resistance. This condition occurs when the body no longer responds effectively to insulin, the hormone responsible for regulating blood sugar levels. Abdominal fat interferes with insulin’s functions, making blood sugar control difficult.
Studies have shown that South Asians, including Indians, tend to carry more body fat than white Caucasians at the same Body Mass Index (BMI), a measure of weight relative to height. But it’s not just about how much fat one has—it’s also about where it’s stored. In South Asians, fat typically accumulates around the trunk and beneath the skin, rather than deeper in the abdomen as visceral fat.
While this might suggest lower levels of the more dangerous deep belly fat, research shows that the larger and less efficient fat cells common in South Asians struggle to store fat under the skin. This excess fat then ends up in vital organs like the liver and pancreas, which play crucial roles in metabolism. The result is an increased risk of diseases such as diabetes and cardiovascular problems.
The exact biological reasons for these fat distribution patterns are still unclear. Numerous genetic studies have been conducted, but none have identified a single gene responsible. However, one hypothesis points to historical factors.
India’s long history of famine and chronic food scarcity meant that generations were accustomed to poor nutrition. To survive, the human body adapted to hoard energy. Since the abdomen is the most expandable part of the body, it became the ideal storage site for fat. “It’s a conjectural but plausible evolutionary theory – one that can’t be proven, but makes sense,” says Dr Anoop Misra, who leads Delhi’s Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology.
In 2023, physicians from the Indian Obesity Commission updated obesity guidelines specifically for Asian Indians. Recognizing that BMI alone doesn’t provide a complete picture, they introduced a two-stage clinical system that better reflects the relationship between fat distribution and health risks.
The first stage includes individuals with a high BMI but without abdominal obesity, metabolic disorders, or physical limitations. In these cases, interventions like improved diet, increased physical activity, and occasionally medication can help.
Stage two involves abdominal obesity and is often accompanied by health issues such as diabetes, knee pain, or irregular heartbeat. This stage indicates a much higher health risk and requires more aggressive treatment.
This new classification model helps doctors determine how urgently a patient needs intervention. According to experts, once belly fat becomes visible, early action is vital. Recently developed weight-loss drugs like semaglutide and tirzepatide have shown success in targeting belly fat.
“As shocking as it may sound, even people with a normal weight can have dangerous levels of belly fat,” warns Dr Misra.
So why is abdominal obesity on the rise in India? Experts point to a shift in lifestyle. Diets now often include more junk food, ready-to-eat meals, greasy homemade dishes, and high-calorie takeout. Between 2009 and 2019, countries like Cameroon, India, and Vietnam saw the fastest increases in per capita consumption of ultra-processed food and beverages, according to research.
What can be done to reverse the trend?
Indian experts argue that standard global guidelines for physical activity might not be enough for South Asians. While European men may maintain health with 150 minutes of exercise per week, South Asians may require 250–300 minutes to counter slower metabolism and the body’s reduced capacity to store fat effectively.
“Our bodies simply aren’t as good at handling excess fat,” explains Dr Misra.
Ultimately, the pot belly is no longer just the subject of jokes or cultural commentary—it’s a clear indicator of rising health risks. With the number of overweight and obese individuals in India projected to skyrocket in the coming decades, experts warn that the country is heading toward a major public health crisis.
India’s expanding waistlines are more than a superficial concern—they are the frontline of a dangerous epidemic. Unless tackled with seriousness, the pot belly could become a nationwide burden, straining not just individual health but the broader healthcare system as well.