Delhi men's obesity declines amidst rising diabetes risk, NFHS-6 data reveals health paradox

NEW DELHI: At a time when obesity is rising steadily across India, Delhi stands out for an unexpected reason. The latest National Family Health Survey (NFHS-6) shows the share of men aged 15-49 who are overweight or obese has declined in the national capital, even as obesity among women and diabetes indicators among both sexes continue to rise.The proportion of Delhi men with a BMI of 25 kg/m 2 or higher fell from 38% in NFHS-5 (2019-21) to 34.8% in 2023-24. In contrast, obesity among women rose from 41.4% to 42.7%. The findings make Delhi an exception tothe national trend. Across India, obesity has risen among both men and women, with prevalence rising from 22.9% to 27.3% among men and from 24% to 30.7% among women.Yet the apparent improvement among Delhi’s men overshadows a growing public health concern. Blood sugar levels have climbed sharply among both men and women, suggesting that metabolic health is deteriorating despite mixed trends in body weight.“The rise in blood sugar levels is a significant trend because it points towards increasing insulin resistance and a growing risk of diabetes. Metabolic health can be affected even in individuals who are not severely overweight, making regular screening important,” said Dr S K Wangnoo, senior consultant, endocrinology, Indraprastha Apollo Hospital. Experts say the divergence between obesity and diabetes trends highlights the limitations of relying solely on BMI as a measure of health.“This apparent disconnect highlights the importance of phenotype: while overall body weight may decline, metabolic health can deteriorate substantially,” said Dr Anoop Misra, chairman, Fortis Centre for Diabetes, Obesity and Cholesterol Disorders.“BMI often fails to capture acritical shift towards abdominal obesity, reflected by increased waist circumference and the accumulation of metabolically harmful visceral fat around vital organs. This visceral fat directly promotes insulin resistance and cardiometabolic risk even when BMI remains stable,” he said.Dr Misra added that a progressive loss of skeletal muscle mass can further worsen metabolic health. “Skeletal muscle is the body’s principal reservoir for glucose disposal. As muscle mass declines, blood sugar regulation becomes impaired. When this is combined with poor physical fitness and increasingly sedentary lifestyles, diabetes risk rises even in people whose weight appears unchanged.”The survey also points to a widening gender gap. While obesity among Delhi men declined, women continued to see a rise. Delhi now ranks 13th among states and UTs for male obesity and eighth for female obesity.Dr Himika Chawla, senior consultant, endocrinology and diabetology, PSRI Hospital, said hormonal differences naturally predispose women to higher body fat levels, but lifestyle changes are also playing a major role.“As more women move into professional fields, they are shifting from active lifestyles to sedentary office jobs involving prolonged sitting. In many households, women continue to prioritise the nutrition and schedules of family members over their own health, while also carrying significant household and workplace stress,” she said while adding increased access to calorie-dense foods, reducing physical activity as cause of rising diabetes rates while poor sleep habits, chronic stress and environmental factors may also be worsening metabolic health.Doctors are also seeing a growing demand for medical weight-loss interventions. According to Dr Misra, more women are seeking treatment for obesity because of greater awareness of its links with diabetes, PCOS, infertility and cardiovascular disease.