How ‘pot belly’ went from status symbol to silent killer

Indian pot belly – once a badge of prosperity, dul, and respect for aging, has long been the target of satire and social commentary.

Literature quietly shows comfort and self-satisfaction. In the film, it became a shorthand for a lazy official, a gluttonous uncle, or a corrupt cop. The manga exaggerated it to make politicians laugh. In rural settings it was once considered a status symbol – a sign that “this man eats well.”

But what was once rejected or celebrated now raises the alarm bell. India’s obesity crisis is escalating – and the seemingly harmless pot belly may be a much bigger villain than we think.

India’s 2021 had the second highest number of overweight or obese adults, affecting 180 million people – lagging behind China alone. a New Lancet Research The number is warning that by 2050 this could skyrocket to 450 million people.

Globally, it is expected that more than half of all adults and more than a third of children will face the same fate.

At the heart of this problem in India is pot belly, or medically abdominal obesity.

This form of obesity refers to the accumulation of excess fat around the abdomen, and doctors say it is more than cosmetic concerns. Until the 1990s, research provided clear links between abdominal fat and chronic diseases such as type 2 diabetes and heart disease.

Obesity isn’t just about the abdomen. It is displayed in different patterns depending on the fat distribution. Peripheral obesity affects the lower back, thighs and butter, while generalized obesity involves spreading fat throughout the body.

The numbers regarding abdominal obesity in India are already troubling. This is the first time I measured my waist and hip size, according to the latest National Family Health Survey (NFHS -5) – 40% of women and 12% of men In India, there is abdominal obesity.

Abdominal obesity according to Indian guidelines means waists above 90cm (35 inches) in men and 80cm (31 inches) in women. Nearly one in two women aged 30 to 49 have already shown signs. Urban populations are known to be more affected than rural populations, with waist circumference or waist-to-lumbar ratios manifesting as a critical red flag.

So why is belly fat so big?

One reason is insulin resistance. This is a condition that stops the body from responding properly to insulin, a hormone that helps regulate blood sugar. Abdominal fat destroys the way the body uses insulin, making it difficult to control blood sugar.

the study We found that South Asians, including Indians, tend to have more body fat than white whites on the same body mass index. (BMI is a simple measure of body fat based on a person’s weight related to height.)

It’s not just how much fat you have – that’s where it goes. In South Asians, fat tends to gather around the trunk and under the skin, but not deep in the abdomen, like visceral fat.

South Asians may have less harmful deep abdominal fat around organs like the liver and pancreas, but studies have found that less efficient fat cells, which struggle to store fat under the skin, are becoming larger. As a result, excess fat flows into important organs that regulate metabolism, such as the liver and pancreas, increasing the risk of diabetes and heart disease.

Scientists still don’t fully understand the biological reasons behind the fat distribution patterns. Many genetic studies have been conducted, but no single gene has consistently explained this trend.

One theory provides an evolutionary route. India has been suffering from hunger and chronic food shortages for centuries, and generations survived with a small amount of nutrition.

In such conditions, the human body was adapted to extreme rarity survival.

The body needed a depot for this energy, and the abdomen was the most expandable area and became the main storage site. Over time, as food became more abundant, this fat store continued to grow – eventually to a harmful level.

“This is a speculative but plausible evolutionary theory. It cannot be proven, but it makes sense,” says Anoop Misra, who leads the excellence of Fortis-C-Doc in Delhi for diabetes, metabolic diseases and endocrinology.

last year, paper Physicians on the Indian Obesity Committee redefine obesity guidelines for Asian Indians and better reflect how body fat is associated with early health risks beyond BMI.

They created a two-stage clinical system that takes into account fat distribution, related diseases and physical function.

Stage 1 includes high BMI, with no abdominal obesity, metabolic disease, or physical impairment. In such cases, lifestyle changes such as diet, exercise and sometimes medication are usually sufficient.

Stage 2 includes abdominal obesity, a harmful visceral fat, and is often accompanied by health issues such as diabetes, knee pain and motion pit. This stage shows higher risk and calls for more intensive management.

This classification guides the strength of the treatment. When belly fat appears, early action is important – new weight loss drugs like semaglutide and tilzepatide have proven effective at targeting it, doctors say.

“The shocking thing is that even people with normal weight can have dangerous levels of belly fat,” says Dr. Misra.

Indian doctors say abdominal obesity is rising due to lifestyle changes – more junk food, takeaway, instant meals, greasy home cooking. Between 2009 and 2019, Cameroon, India and Vietnam grew the fastest in per capita sales of ultra-processed food and beverages, research found.

So, what do you need to do?

Experts say Indians need a more severe lifestyle change than Western norms recommend. While 150 minutes of weekly exercise may be enough for European men, South Asian counterparts require around 250-300 minutes to offset slower metabolism and less efficient fat storage. the study show.

“Our bodies are not just good at dealing with excess fat,” says Dr. Mithra.

In short, the belly of the pot is not just a punch line – it is a warning sign. And India is sitting on health bombs every moment.

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