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India is caught in a cruel nutritional paradox. Even as children in many parts of the country go hungry — stunted, wasted, and malnourished — a contrasting health crisis is also quietly swelling.

The sixth National Family Health Survey (NFHS-6), released by the Ministry of Health and Family Welfare on Friday (May 29), lays bare this uncomfortable contradiction. Adults across the nation are increasingly overweight, diabetic, and hurtling toward a future dominated by lifestyle diseases. While the north and centre still fight the age-old battles of undernutrition. The south, meanwhile, is waging a newer, subtler war — against the excesses of modern living.

India, it turns out, isn’t choosing between hunger and obesity. It’s dealing with both.

Around 31% women, 27% men overweight

The survey found that 30.7 per cent of women in the country aged 15-49 years were overweight or obese in 2023-24, up from 24 per cent in NFHS-5, which was conducted in 2019-21.

Also read: NFHS-6 reveals contraceptives concern despite women’s broad progress in other fields

The proportion of men found to be overweight or obese also rose from 22.9 per cent to 27.3 per cent between the two surveys.

The report also said that 17.8 per cent of Indian women (aged 15-49) and 20.9 per cent of Indian men have a high blood sugar level or are taking medicine to control sugar levels.

The numbers rose from 13.5 per cent from NHFS-5 (2019-21) for women and from 15.6 per cent for men (from NHFS-5).

Alarm for Southern states

However, southern states and Union Territories (UTs) such as Kerala, Puducherry, Tamil Nadu and Andaman and Nicobar Islands are well above the national average, along with some northern states and UTs such as Chandigarh, Delhi and Punjab. Karnataka, Andhra Pradesh and Telangana have also registered sharp increases.

In Kerala, 31.9 per cent of men and 28.9 per cent of women suffer from high blood-sugar levels or are on medication for diabetes. During the previous NHFS, it was 27 and 24.8 per cent, respectively.

Andhra, Kerala lead for men, women, respectively

The survey picked Andhra as the home for the largest number of overweight and obese men (15-49 years) at 47.9 per cent. Only Puducherry (51.5 per cent), Lakshadweep (48.9 per cent) and Chandigarh (48.5 per cent) are ahead of the state.

For men, Tamil Nadu (39.5 per cent), Kerala (37 per cent), Karnataka (36.4 per cent), and Telangana (28.8 per cent) also reported prevalence levels that are either close to or above the national average in terms of obesity.

Also read: Waist-to-height ratio better indicator for obesity risk than BMI: Study

For women, Kerala leads at 46.7 per cent, with Tamil Nadu (44.2 per cent), Andhra Pradesh (41.5 per cent), Karnataka (41.2 per cent), and Telangana (36.3 per cent) also received alarming rankings among other south Indian states. Among the UTs, Puducherry recorded the highest female obesity or overweight at 46.3 per cent. Chandigarh (44 per cent), Delhi (41.4 per cent) and Punjab (40.8 per cent) were some of the northern states with high rankings.

Andaman and Nicobar Islands recorded 38.1 and 38 per cent for women and men, respectively.

Rural-urban divide

In terms of the rural-urban divide, urban Andhra exhibited one of the highest rates of male prevalence at 57.3 per cent, indicating that almost six out of ten men were classified as overweight or obese. Karnataka, on the other hand, noted an urban prevalence of 51.7 per cent among women. Kerala and Andhra Pradesh reported figures of 48.3 per cent and 48.4 per cent, respectively.

What health ministry said

“The emerging challenges such as rising non-communicable diseases, lifestyle- risks and the dual burden of undernutrition and rising overweight/obesity among adults highlight the need for continued focus on preventive healthcare, behavioural change and balanced nutrition strategies,” the health ministry pointed out.

Also read: Why you should worry about childhood obesity

The rise in obesity coincides with the increasing prevalence of elevated blood sugar levels, both of which are major risk factors for non-communicable diseases such as diabetes, cardiovascular ailments and stroke.

The survey conducted in 2023-24 by the ministry, with the Mumbai-based International Institute for Population Sciences playing as the nodal agency, covered 6.79 lakh households across 715 districts and provided vital evidence on population, health, nutrition and family welfare metrics.