PHOTO BY: Image by Mary Pahlke from Pixabay
Obesity

Jaipur, India – Kashmir is picturesque for shutterbugs. Some capture the serene nature and ‘Dal’ lake, other focus on its bleeding terrains with cross border terror, frenzied stone pelters and defensive Indian forces now in peacekeeping role. Media also picks the picture as it chooses; sale-ability is the bigger criteria for them. After revoking special status of the state and separating Ladakh from the state of Jammu and Kashmir after parliamentary debate, constitutional justification and voting process, the changed scenario will dump temporary dullness once scribes start reporting on development footprints in new union territories who are assured of statehood after normalcy is restored. After all, good health of the state is to be tracked when it is promised to be in safe hands.

Surprisingly, the overall health indicator of Jammu and Kashmir is above the national average on most of the categories, but obesity is a major health challenge that the state is faced with. Nearly 30 percent women and over 20 percent men are overweight in the state. This is staggering. As per Health of Nation’s States report (2017), in India over 35 percent of people above 40 years of age have heart and kidney dysfunction, high Body Mass Index (BMI) and high fasting plasma glucose leading to death and disability. Most of the mentioned health problems are linked with obesity. A book ‘Battling India’s obesity Crisis – Fight with Fat’ by Dr Kamal Mahawar delves deep into health delivery systems in India to point out that 5 percent Indians are suffering from obesity and much larger pool of overweight population is moving toward associated diseases. In stark contrast 200 million Indians with about 20 percent of men and 25 percent of women are underweight too. Meaning, India is harboring half the world’s underweight population. What makes this whole ‘Fat debate’ urgent is the fact that clinically both extreme spectrum of undernourished and over nourished or obese are counted as malnourished because both suffer from nutritional aberration.

So, when we read that India is the third most obese country and on the verge of pandemic, do we raise an alarm for our healthcare systems to address this? Kashmiri doctors have been asking for uninterrupted access to medical services for critical patients in current situation when every nook is on vigil, but generally the state must already be on high alert now for lifestyle anomaly and India must also address this health disorder with extra attention from policy makers and media both.

The myth must be busted that obesity is a disease of the rich or of big cities. I also have my domestic help who is not wealthy but she is obese. I have seen people in low income jobs, including laborers, farmers and vegetable sellers who have both belly and body fat. Clearly, it is not wealth or genes as much as the routine where one consumes more calories than they burn and excess calories in the form of carbohydrate or protein gets deposited as fat in the body. And calories and fat are interlinked.

The belly fat which is a big worry for most will melt down only by consuming fewer calories than required each day, suggests this UK based and India bred doctor who has also written a book ‘Ethical Doctor’ hammering hard on the greed of medical practitioners, practice of commission, forced operations, poor health care and clinical malpractices. He also underlines the importance of traditional cooking practices and food culture. We still have most Indian homes where cooking and eating together is a daily family ritual. It is a means to keep family time enjoyable and add a flavor of happiness after a not so healthy working environment making minds heavy each day and leading to stress induced diseases. We need to drop our weight at any cost, on body and mind both without incurring extra cost on preventive health care. Age old grandma cooking style is preferred, trusted for nutritional value and relished more as on YouTube home recipe videos have viewers in millions. And they are all free.

When Kashmiri Pandits also reminisce about good times before they were displaced from their homes to take refuge in their own country, they recall exchange of food and ‘kehwa’ as part of harmonious living without any religious differences. Food has tied people together, every age, every era. Unhealthy living or lifestyle issues were unheard of. Hearts had strong bonds, families shared values, each one cared for each other, and they spent time with people they loved, laughed heartily and never allowed to erect walls that were impervious to emotions. They dined together but never whined over the differences of any sorts. How then this proverbial ‘Fat’ which people could not consume or break down, deposited on their thoughts and spoiled their lifestyle? This has long been debated and argued upon without outcome. This stalemate needed to be broken, with all risks intact.

Unless we identify obesity as a disease the clinical procedures will remain in cosmetic category. The author of the book refers that United States has classified obesity as a disease and insurance industry is made to pay for it, public health resources are diverted for prevention and treatment. He also recommends food labelling with mandatory display of calorie count as well as carbohydrate, protein and fat contents of food for informed choices.

Makes sense. For our mental and physical wellbeing, healthy food and consumption habits, identifying our healthy weight range and monitoring it closely will help us as much as the manufacturing industry doing innovation to keep tasty food healthy too. Let none of our policy decisions cost us high in future and let our fat fight be fought with the weapons of knowledge, science and traditional wisdom. All Indian states must be mapped for obesity and malnourishment status of its population and shift sharply toward indigenous food, traditional cooking practices and quality family time to deal with it.

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