How Obesity Is Worsening India’s Infectious Disease Burden

By Admin

11 Feb, 2026

Introduction

India is currently facing a dual health crisis rising non-communicable diseases like diabetes and heart conditions, alongside a persistent burden of infectious diseases. What is increasingly becoming clear is that obesity is acting as a powerful link between the two.

A growing body of research now shows that obesity not only increases the risk of lifestyle-related illnesses but also significantly worsens outcomes from infections. The consequences are already visible in clinical settings across the country.

A Real-Life Case: Sunil’s Repeated Hospitalisations

Thirty-one-year-old Sunil (name changed), a dental equipment dealer from Mumbai, weighed 186 kg when he was hospitalised twice last year in August and December for severe respiratory infections.

Each episode involved worsening breathlessness and critically low oxygen levels, requiring intensive care. Despite being young and having no major chronic illnesses, doctors had to place him on oxygen therapy and non-invasive ventilatory support (BiPAP) during both admissions.

Although he recovered each time, the recurrence of severe infections raised concerns about an often-overlooked risk factor: obesity.

How Obesity Compromised Lung Function

Sunil was diagnosed with class III obesity, the most severe category. This level of obesity significantly increases the risk of comorbidities such as:

• Type 2 diabetes
  
  

• Hypertension
  
  

• Stroke
  
  

• Heart disease
  
  

• Osteoarthritis
  
  

• Impaired breathing
  
  

According to Dr Aparna Govil Bhasker, a laparoscopic and bariatric surgeon, obesity had compromised Sunil’s lung function and reduced his respiratory reserve his extra breathing capacity.

Excess body fat restricts lung expansion, making it harder for the body to cope during infections. While medical treatment helped him recover, repeated hospitalisations highlighted the under-recognised role of obesity in worsening infectious disease outcomes.

Obesity Weakens Immunity and Increases Infection Severity

Obesity is not just about excess weight it fundamentally alters the body’s immune system.

Dr Bhasker explained that excess body fat:

• Impairs immune responses
  
  

• Promotes chronic inflammation
  
  

• Restricts lung expansion
  
  

As a result, infections become:

• More frequent
  
  

• More severe
  
  

• Slower to resolve
  
  

These clinical observations are strongly supported by new global research.

Study Links Obesity to Global Infection Deaths

A large study reported by The Indian Express analysed data from 5.4 lakh individuals and found alarming results. People with obesity faced a 70% higher risk of hospitalisation or death from infectious diseases.

Those with severe obesity carried nearly three times the risk.

The study examined severe outcomes from infections such as:

• Flu
  
  

• Covid-19
  
  

• Pneumonia
  
  

• Gastroenteritis
  
  

• Urinary tract infections
  
  

• Respiratory tract infections
  
  

When extrapolated globally, researchers estimated that obesity contributed to approximately 0.6 million of the 5.4 million infectious disease deaths recorded worldwide in 2023 around 10.8%.

India Faces a Dual Disease Burden

According to estimates from the Global Burden of Diseases (GBD), obesity was linked to one in 26 infectious disease deaths in India in 2023.

In comparison:

• The figure was one in four in the United States
  
  

• One in 11 in China
  
  

As reported in The Lancet, these figures highlight how obesity is amplifying infection risks across countries with varying healthcare systems.

India, already grappling with tuberculosis, respiratory infections, dengue, and other communicable diseases, now faces an added strain due to rising obesity levels.

Broad-Based Study Design and Findings

The research analysed data from:

• 67,000 adults in Finland
  
  

• More than 4.7 lakh participants from the UK Biobank
  
  

Researchers assessed body mass index (BMI) at enrolment and followed participants for an average of 13–14 years.

Key finding:
Individuals with obesity (BMI >30 kg/m²) had a 70% higher risk of hospitalisation or death from infectious diseases compared to those with a healthy BMI.

However, researchers acknowledged that because the data was observational, direct causality cannot be definitively confirmed.

Why Obesity Increases Infection Risk

Several biological mechanisms explain the link:

1. Chronic inflammation weakens immune defense.
   
   

2. Vitamin D deficiency common in people with obesity may increase susceptibility to infections.
   
   

3. Reduced respiratory reserve makes it harder to survive severe lung infections.
   
   

4. Altered immune cell function impairs the body’s ability to fight pathogens effectively.
   
   

These factors collectively increase both infection severity and mortality risk.

The Importance of Weight Management and Prevention

Prof Mika Kivimaki of University College London, the study’s lead author, emphasised that weight management is essential for reducing health risks.

He advised individuals with obesity to:

• Seek prompt treatment for infections
  
  

• Stay up to date with vaccinations
  
  

• Adopt preventive health measures
  
  

In India, where infectious diseases remain widespread, preventive action becomes even more critical.

Obesity as a Major Risk Factor in India

Dr Bhasker stressed that obesity acts as a risk factor for both communicable and non-communicable diseases.

In a country already burdened by infectious diseases, rising obesity levels add a significant and often underestimated strain on the healthcare system.

If current trends continue, India may see:

• Increased hospital admissions
  
  

• Higher ICU demand
  
  

• Rising healthcare costs
  
  

• Greater mortality from otherwise treatable infections
  
  

Conclusion

Obesity is no longer just a lifestyle issue it is a major public health concern that is intensifying India’s infectious disease burden.

Sunil’s case is not isolated. Across the country, obesity is quietly worsening infection outcomes, increasing hospitalisations, and raising mortality risk.

With obesity rates climbing steadily, India must prioritise:

• Public awareness campaigns
  
  

• Preventive healthcare
  
  

• Early screening
  
  

• Weight management interventions
  
  

• Vaccination coverage