New Delhi: The latest National Family Health Survey (NFHS) has found a drastic rise in obesity among children under five years of age in 20 of the 22 states where the study was conducted, with experts attributing it to lack of physical activity and unhealthy food habits.

According to the NHFS-5, several states and Union Territories, including Maharashtra, Gujarat, Mizoram, Tripura, Lakshadweep, Jammu and Kashmir, and Ladakh, have registered several folds increase in the percentage of obesity among children below five years of age in comparison to NFHS-4 conducted between 2015 and 2016.

Only Goa, Dadra and Nagar Haveli, and Daman and Diu registered a drop in the number of overweight children under five years of age, the data showed.

About 13.4 per cent children under the age of five were found to be obese in Ladakh which was highest among the 22 states and Union Territories surveyed, followed by Lakshadweep at 10.5 per cent, Mizoram 10 per cent, Jammu and Kashmir, and Sikkim 9.6 per cent each.

Not just children, rise in obesity has even been recorded in adults in the latest survey in comparison to NFHS-4.

According to the survey data, 16 states and Union Territories registered a rise in obesity among women while 19 states and UTs recorded an increase in obesity among men.

Kerala and the Andaman and Nicobar Islands recorded the highest percentage of obesity among women at 38 per cent. Also, the Andaman and Nicobar Islands and Lakshadweep recorded the highest percentage of obesity among women at over 40 per cent.

Men and women were counted as obese whose body mass index was found to be over or equal to 25.0 kg/m2 while children's obesity was counted in terms of weight-for-height.

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Healthcare experts have attributed the rise in obesity to unhealthy food choices and lack of physical activities among children and even adults.

Sheila Vir, a public health nutrition expert and founder director of Public Health Nutrition and Development Centre, said there is also lack of awareness on what are good food habits.

Also, high-fat and high-sugar foods are easily available and so there is higher consumption of it, she said.

"We have a double burden of undernutrition, malnutrition and overnutrition occurring together. So, I think what to feed a child is what we are going wrong in," Vir said.

In view of the COVID-19 pandemic, she also raised concern over the rise in obesity.

"There might be an increase in obesity among children in view of COVID-19 pandemic as after closure of schools, there was lack of physical activity among children and even in adults in some cases," she said.

Dr. Khan Amir Maroof, Professor at Department of Community Medicine, University College of Medical Sciences and GTB Hospital termed the rise in obesity a "very disturbing sign".

"Obesity is a manifestation of what is rapidly changing in our environment. Of late, we see trends which increase the risk of developing obesity. Environmental factors, such as availability and consumption of junk foods, poor complementary feeding, lack of outdoor activity, and increased screen time on may be the reason for this trend," he said.

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"For children, we need to flag screen time as it has multi-dimensional effects on children, obesity, being one of them. The focus has been on breastfeeding, but now it's time that complementary feeding is also focused upon," Dr Maroof suggested.

About the repercussions of obesity among children, he said non-communicable diseases can develop among obese children earlier than others.

"There are higher chances for them being bullied in schools, neglected or shamed by peers, which lead to mental health problems among them," he said.

Among adults, he said more consumption of ready-to-eat foods, increase in screen time with the 24-hour access to web content, and lack of outdoor spaces seem to be hitting adults with obesity.

He suggested that children, with more stress on complementary feeding practices in the community, and reducing screen time, can be the immediate actions.

"Counselling of breastfeeding mothers of children around 4 months of age should focus on counselling on complementary feeding. We find that all mothers know 'what' to give to the child but 'how much', 'when' and in 'what consistency' need to be explained with respect to complementary feeding. Intervention strategies to reduce screen time are needed," he said.

The NFHS results of 17 states and five Union Territories have been released now as phase-one. The phase-two results covering other states will be released next year, the health ministry had said.

The present NFHS was conducted on 6.1 lakh sample households, involving household-level interviews to collect information on population, health, family planning and nutrition related indicators.

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