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Contrary to expectations, most of my clients on a weight loss diet, return elated after trips overseas—either they have lost more weight or managed to keep it off, inspite of eating more and even indulging. Obviously, increased walking and physical activity abroad helps burn calories. This is true, despite higher degree of automation and convenience in these countries. This has led me to think about some unique lifestyle and socio-cultural patterns that may have escalated the obesity epidemic amongst urban Indians.  

Decline in physical activity is general. Labour saving devices, automation, cars, passive entertainment etc. are a global phenomenon. Driving to work, driving for errands, watching television, sitting in front of computers, playing video games are almost universal changes across the modern world. What makes urban Indians more sedentary than their Western counterparts is the unique combination of the above factors with inexpensive labour like domestic helps and office peons. Often, domestic helps outnumber family members and office workers.

A white-collared executive (sahib) will also have a chauffeur who not only drives to the last doorstep but also carries the laptop, lunch box and other baggage right into the cabin. Even schoolchildren from affluent families follow the same routine. Doesn’t seem to happen anywhere else in the world, at least for the common man.
A young mother has an exclusive maid and sometimes even a nurse, to help her cope with her newborn, while she may be exempt from the burden of routine domestic chores — quite unlike the West. Topped-up with a mother-in-law who will insist that when she is pregnant, she ‘eats for two’. This could include ladoos and mixtures laden with high-calorie, high-fat ingredients like ghee, butter, cream, milk and nuts. So ingrained are these beliefs that deviating from these usually is hard for young mothers. Crying babies are given a milk bottle to keep quiet, establishing the ‘food for comfort’ stimulus early in life. Marriage itself is such an elaborate event with days of feasting starting weeks before the wedding, continuing even after that.

Another psycho-social phenomenon is that weight watching or diet control is a ‘woman thing’ and not what a ‘real macho man’ should do. Fears about performance and energy loss loom large over these chauvinistic men. Worse still, being big is still a sign of prosperity unlike in the West. The traditional Indian hospitality, so much a part of us, also at times tips over to becoming a hindrance to those trying to shed their extra pounds. Never do we accept a ‘no’ for a ‘no’ (perhaps it may not even be meant as a no!).  Most do not show respect for a person’s dietary regimen (unless medical) and often there could be disdain or curiosity.
Then, the festival calendar is full. There are approximately 140 festivals across the country. Celebrations are always around high-carbohydrate, high-fat sweets and savouries.

The several fasts too become celebrations as they are followed by feasts. Added to all this, is the larger environment, which is non-conducive to outdoor pastime and sports. Urban metros can hardly boast of many cycling tracks and walking paths.
These social and cultural patterns and lifestyle changes with economic affluence coupled with our genetic predisposition to obesity is a deadly cocktail.

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