ISLAMABAD: South Asia is transitioning from communicable diseases and maternal health challenges to confronting non-communicable diseases as the leading cause of death and disability, according to a World Bank report.

Addressing obesity through food systems in South Asia, the report, ‘Nourishing Tomorrow’, says the ratio of overweight individuals and the prevalence of obesity is rising rapidly among both adults and children in all South Asian countries.

Between 2000 and 2022, overweight and obesity rates increased to 27.5 per cent from seven per cent in Bangladesh, 48.4pc from 22pc in Bhutan, 30.5pc from 11.5pc in India, 55pc from 28pc in the Maldives, 31.6 pc from 11pc in Nepal, 56.3pc from 24pc in Pakistan, and 39.4pc from 15.9pc in Sri Lanka.

Overweight and obesity are estimated to cost the global economy $1.96 trillion, a figure that is expected to rise to $4.32tr by 2035.

Economic losses related to obesity are estimated at 3.58pc to 8.73pc of GDP in developing Asian countries, but a lack of studies in this region means that the true value of economic losses is likely to be far higher, the report says.

The rapid rise in obesity-associated non-communicable diseases (NCDs) is a critical public health threat to the region.

While countries across the region have made efforts to combat this threat, the response has been insufficient.

The findings from an analysis of the report highlighted a significant association between obesity and its related co-morbidities like T2DM, hypertension, and CVDs in South Asia.

Overall, half of Type 2 diabetes mellitus is attributable to overweight and obesity, and a similar pattern was observed for hypertension.

The prevalence of underweight among adults has sharply declined across the region over the same period. This period coincides with a significant economic expansion in South Asia, possibly leading to reduced poverty rates, improved food security, and enhanced health care services, especially in reproductive health.

The prevalence of overweight and obesity among children over five years of age in the region is also rising rapidly. Since 2000, the sharpest increase was observed in the Maldives (31pc from eight per cent).

Elsewhere across the region, the rate has risen to: 8.2pc from 2.9pc in Bangladesh, 18.3pc from 5.7pc in Bhutan, 10.3pc from 1.9pc in India, 8.8pc from 3.9pc in Nepal, 18.8pc from 3.9pc in Pakistan, and 17pc from 4.5pc in Sri Lanka.

Child undernutrition

The prevalence of child undernutrition showed a steady decline across all South Asian countries, with the smallest decline observed in the Maldives.

While progress has been made in reducing undernutrition, especially child stunting, South Asia continues to have some of the highest rates globally. Stunting prevalence among children under five years of age ranged from 15.3pc in Maldives to 37.6pc in Pakistan in 2022.

The human and economic costs of this burden are enormous.

The rapid rise in obesity and NCDs in South Asia over the recent decades has coincided with a period of economic growth, rapid urbanisation and changes in lifestyles.

Urbanisation and rising incomes have significantly increased the availability, accessibility, and marketing of energy-dense processed foods and beverages.

Consumption of such items has increased sharply as dietary patterns have shifted towards “Westernised diets”, away from traditional, locally-sourced food.

Urbanisation and technological changes have also significantly reduced occupational and leisure-time PA levels.

Unhealthy diets are a major driver of weight gain, obesity, and multiple NCDs, including CVDs, T2DM, and a number of

cancers. Diets high in sodium, added sugars, unhealthy fats, and high-calorie processed foods and low in whole grains, legumes, fruits, and vegetables significantly increase an individual’s risk of weight gain, obesity, and multiple NCDs.

The report observed that in South Asia, daily per capita intake of healthy foods like milk, nuts and seeds, whole grains, legumes, vegetables, and fruits remains significantly below the levels recommended by the Institute of Health Metrics and Evaluation’s Global Burden of Disease Study for all South Asian countries.

Fruit intake

Low fruit intake remains the leading dietary risk factor, contributing substantially to CVDs and neoplasms. The growing prominence of processed meat and sugary beverage consumption in 2021 reflects a dietary shift towards calorie-dense, processed foods.

Despite progress in some areas, persistent gaps, such as high sodium intake and low fiber consumption, underline the continued need for targeted nutritional interventions.

In Pakistan, 96.5pc of the population consumes unhealthy items rich in fats and sugars, often influenced by cultural practices like indulgent communal meals during celebrations.

More than one billion people living in South Asia _ more than half (54pc) of the region’s population _ were estimated to be unable to afford a healthy diet in 2022. Within the region, the largest number of people unable to afford a healthy diet lived in India (788 million, or 56pc of the population), Pakistan (138m, or 58.7pc), and Bangladesh (82m people or 48pc).

Published in Dawn, July 27th, 2025