When she was in college, Kalpana Ganesh never considered herself overweight. Though she was not lean―at 5’4”, she weighed around 70kg―weight was never an issue as she believed in body positivity. She began piling on kilos gradually and unmindfully, thanks to a thriving hostel life, outside food and late night binge sessions with friends. At 25, she left her hometown of Jabalpur to start her career as a communications professional in Mumbai. Her daily schedule went for a toss, and thereafter, the kilos never came down, necessitating “a zillion paid interventions”.
Now, in her 40s, Ganesh has already spent Rs3 lakh to Rs5 lakh to lose weight. This includes a two-year gym membership, costing around Rs50,000, and an additional Rs18,000 for another six months at a different time. She also spent around a lakh on 10 injections to reduce abdominal fat and Rs30,000 in a quarterly diet programme. And yet, she weighs 115kg. Not that she didn’t shed any kilos. Six months ago, she weighed 124kg, which brought with it full-blown type 2 diabetes. “Losing weight is an expensive proposition now,” quips Ganesh.
Soni Ramani would agree. She is emotionally invested in Narayan Dham in Pune, a nature retreat, which she visits at least once a year for at least 20 days. It costs Rs8,000 per day. Ramani, who teaches differently abled children in a south Mumbai school, swears by the transformation she has felt in the last three years. Once, she was at the retreat for an entire month, during the summer vacation. She now weighs 78kg, down from 90kg. She subscribes to the retreat's extensive programme that involves “trekking, colonic irrigation or enemas, yoga and more”.
As per a report by IMARC, a market research company, the size of the weight management market in India touched Rs1.72 lakh crore in 2022. It is expected to grow to Rs3.15 lakh crore by 2028. This is true across categories, from beverages, food and dietary supplements to fitness equipment and apps and services that include health clubs, medical consultation and procedures. The weight loss or anti-obesity drugs market, consisting pills, fluids and injectibles, which is used in cases of grade 3 obesity, has doubled since 2022, feeding into a demand caused by the sheer rise in the number of obese people in India.
Weight and watch: Kalpana Ganesh (left) with daughter. Ganesh now weighs 115kg. She has spent Rs3 lakh to Rs5 lakh to lose weight over time | Amey Mansabdar
More than half the world's population will be overweight or obese by 2035 unless urgent action is taken to curb the growing epidemic of excess weight, warns a report by the World Obesity Federation. Currently, 38 per cent of the world population―2.6 billion people―is overweight or obese. If current trends continue, the number of people who are clinically obese is expected to rise to more than 4 billion in 12 years. In India, the rate of annual increase of adult obesity is “very high" at 5.2 per cent, while that of child obesity is also at 9.1 per cent. A land that was notorious for malnutrition decades ago is now a land of obesity. The National Family Health Survey-5 (NFHS-5) data from 2019-2021 reveals 33.2 per cent of urban women and 29.8 per cent of urban men (in the age group of 15-49 years) are overweight or obese.
As per Goldman Sachs Research, the global market for anti-obesity medications reached Rs49,000 crore on an annualised basis in 2023; it is expected to reach Rs8.31 lakh crore by 2030. As the market for anti-obesity drugs in India grows rapidly, pharmaceutical majors are competing to enter the market with weight loss drugs. Drugs such as Wegovy (for weight loss) and Ozempic (for diabetes but also used for obesity) have been approved by the US Food and Drug Administration, but are not approved for sale in India. These drugs lead to weight loss by way of an active ingredient―semaglutide―which regulates the appetite and makes one feel full after eating by triggering the glucagon-like peptide-1 (GLP-1) hormone in the small intestine. Novo Nordisk, which launched the semaglutide drug through their brand Ozempic, reportedly said that they are currently engaged in building an obesity portfolio in India. Dr Reddy’s, too, was given approval in September 2023 to proceed with bioequivalence study for semaglutide injection.
The launch of semaglutide (Rybelsus, the oral form of Ozempic) in January 2022 was a game changer, says Dr Manoj Jain, bariatric surgeon at Kokilaben Dhirubhai Ambani hospital, Mumbai. “None of these is approved (for obesity) yet, so whatever drugs people are using are over the counter or through black marketing via Singapore,” he says. “The demand for these is very high here in India. A single strip costs Rs15,000. Hence, it is for those who have loads of money to splurge and want shortcuts to weight loss. As of now, the drugs are only used by endocrinologists for diabetes control, but people are using it for obesity, too.”
Ajay Yadav, a drug distributor based in Mumbai's Andheri, tells THE WEEK that he does a business of close to Rs4.5 crore per month by selling Rybelsus in Mumbai. “The demand is very high, so much so that hardly any stock remains,” he says. “Ozempic and Wegovy are all imported. Starting from 3mg, it goes to 7mg in the next month, and if someone needs a higher dose, then it goes to 14 mg. It costs Rs9,000 for 3mg per month, Rs10,000 for 7mg and Rs11,000 for 14mg.”
And then there is the nutrition and supplements market in India, which is expected to grow from around Rs64,000 crore in 2023 to Rs1.37 lakh crore in 2030, as per research firm Insights10. Marketing professional Devendra Sali, a resident of Thane, paid for “nutritional supplements in the form of churna or powder” from Bengaluru-based Greengold Life. He had two bottles of the Greengold supplements and a year later bought protein powder from a Jaipur-based company. “The reason I opt for these things is that it is difficult for someone like me who is constantly on the go to exercise, and hence these supplements provide quick-fixes for some quick weight loss,” he says. “I spent nearly Rs40,000 on these.”
More and more people are opting for bariatric surgeries, too. According to a report by Global Data, around 40,000 weight management surgeries were performed in India in 2022. Of these, sleeve gastrectomy―a laparoscopic incision in which 80 per cent of the stomach is removed, leaving a tube-shaped stomach about the size and shape of a banana―was the most performed. “Given that we now have insurance that covers these surgeries, it is not only the rich who opt for these,” says Jain. “Also, these surgeries have been proven to be safe, with mortality of just one per cent. While it is essential that those over 32.5 BMI undergo surgery, loads of people in the overweight category, too, opt for surgery. But what we do instead is insert the gastric balloon via endoscopy, which acts like a satiety centre. It must be removed after six months. We now have capsules, too, which, if swallowed, blow up inside. Just a single capsule costs close to Rs2.5 lakh and the market is very much there.”
According to Dr Ramen Goel, a bariatric surgeon with Mumbai's Wockhardt hospital, people started opting for surgeries post pandemic. “During Covid, people realised how diabetes and obesity together make for the most deadly combination, so they have become more health conscious,” he says. “We now have about 30-50 consultations in a week and four to five surgeries a week, including gastric bypass surgery and sleeve gastrectomies.” Post gastric bypass, the stomach becomes smaller and you feel full with less food. It is a surgery that creates a small pouch to restrict food intake and bypasses a segment of the small intestine. Goel says that most patients who come to him are looking at weight loss either because they have co-morbidities or they are conscious about preventing the occurrence of co-morbidities.
Covid-19 also saw an increase in teenage obesity. “During Covid, we saw an average of 20kg increase in weight among teens in one year during Covid,” says Dr Varsha Gorey, senior clinical dietician with Apollo hospitals in Navi Mumbai. “This has fuelled a sharp increase in the desire for weight management and weight loss.”
Dr Manoj Jain
Dr Ramesh Shah, a Mumbai-based family physician, says that it is a well-established fact that Indians, as a race, are more prone to weight gain. “Yet, weight gain is not taken seriously in our country until it becomes a serious problem,” he says. “It has now started to look like everyone wants to lose weight. Weight loss has become the new obsession. The sad part is that there is a difference between weight management and weight loss.”
Almost six months after delivering her first child, Shikha Agarwal, 38, from Mumbai still finds herself slipping into depression. It has little to do with postpartum depression and more to do with her inability to come to terms with her post-pregnancy body―she gained 12kg during pregnancy. But she is not one to give up or give in and has turned to social media for inspiration and motivation. Among the dozens of ‘fit-fluencers’ she follows on social media, she has been surprisingly been motivated by the weight loss journey of Anshula Kapoor, sister of actor Arjun Kapoor. Anshula posted her then and now pictures, when she once weighed 90kg to now 60kg. In an AMA (ask me anything) on Instagram, Anshula shared her meal and fitness plans in full detail. Agarwal could relate to Anshula easily and instantly, as she wasn’t someone boasting of a svelte or toned body but who just wanted to be fit while embracing her body type. And so began Agarwal's journey―she now wears a fitness watch to remind her about her daily runs, has a three-month membership with a calorie counting startup that provides diet meals to her doorstep for Rs12,000 a month, participates in an online yoga session twice a week, and vents out every evening to a friend.
But there is also an unhealthy obsession to look fit, even among the very young. In Pune, 16-year-old twins Siddhi and Riddhi Singh, who will soon be appearing for their Class 10 board exams, are more worried about piling on calories than about the upcoming geometry paper in the school's prelims. Their mother Sarita makes it a point to give the duo full fat milk with almond powder mixed in ghee and honey every day so as to help improve concentration and keep them full. But the girls refuse it, saying they need to maintain their look, else they will be “fat-shamed in school”. And so, they have replaced the milk with a cup of black coffee and aloo parathas during breakfast with yogurt and muesli. “Is this their age to even think about weight loss? But it is so ingrained in our culture now that even children are getting influenced by this growing obsession to look lean and slender,” says Sarita. “They are more bothered about their weight, than I am for mine.” Sarita is overweight by 20kg and has recently joined a walking club that has women from the neighbourhood coming together for brisk walks early in the morning.
In Delhi, Mohini Khurana is contemplating popping the weight loss pill and purchasing an ayurvedic oil recommended by her friend. Khurana's friend was obese and underwent surgery; her weight came down from 109kg to 75kg. Her friend has “since been on pills and oils to assist in weight loss,” says Khurana.
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This desire to have fit bodies, the association of lean and slender with fit and healthy and the fear, paranoia and constant anxiety about contracting lifestyle diseases have reached unprecedented levels during Covid, say experts. According to Anamika Banerji, food and drink analyst, Mintel Reports India, 42 per cent of Indians, especially those in metro cities, associate maintaining their preferred body weight with a healthy lifestyle. This suggests that weight management is an important aspect of wellbeing for consumers. “During the pandemic, limited mobility, the closure of gyms and parks, coupled with emotional eating, made weight management challenging for consumers,” says Banerji. However, Mintel’s research shows that consumers continue to struggle post pandemic. In September 2022, 70 per cent of Indians agreed that it was more difficult to manage their weight now than it was before the pandemic. This may be attributed to increased stress and limited availability of time for physical activity. Additionally, 78 per cent agreed that it was difficult to know who to trust for weight management advice. The report also stated that more than a third of Indian consumers are interested in functional food and drink or supplements that aid in weight loss.
No wonder that low-carb diet has turned into a mini industry in India. Hyderabad hosted the country’s first low-carb diet conference in October 2023. The American Academy of Family Physicians states that low-carb diets can improve blood pressure and blood sugar levels and aid weight control in comparison to DASH (dietary approaches to stop hypertension) diets. In India, the low-carb and high-fat diet has gained traction in the last four years, with the keto diet forming a huge chunk (Rs30 crore) of the larger healthy food market (Rs2,000 crore).
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The healthy snacks market is also growing at a fast rate. Moreover, startups like Bajo Foods recently raised Rs16 crore towards its mission to “reduce the number of carbohydrates that India consumes to 50 per cent from 85 per cent”. CEO of Bajo Foods Sudarshan Gangrade spoke about the unprecedented rise in the demand for food that aids in weight loss. “Bajo Foods provides low-carb food products like keto packaged food with a range from atta to cookies, mixtures, namkeens, and chocolates,” he says. Anindita Sampath, chief executive of Yoga Bar, which makes healthy muesli, protein bars, energy bars, peanut butters and gluten-free oats, is bullish on India's rapidly rising nutrition market. The Bengaluru-based startup is due to be acquired by ITC.
Additionally, plant-based meats make meat alternatives valuable from the perspective of maintaining a healthy body weight, as they are lower in fat and devoid of cholesterol while being high in protein. As per Mintel Reports India’s Plant-based Meat Alternatives, 2023, shared with THE WEEK, the need to maintain a healthy weight is the top reason for consumption, which was cited by 50 per cent of Indians who have eaten plant-based meat. The growing interest is evident, with celebrity couples like Riteish and Genelia Deshmukh launching Imagine Meats and Virat Kohli and Anushka Sharma funding Blue Tribe, another plant-based meat company. The global plant-based food market is expected to reach Rs13.46 lakh crore by 2030, up from Rs2.44 lakh crore in 2020, according to a joint report by Plant Based Foods Industry Association and EY India. And, India's market for plant-based meat is expected to go from Rs332 crore to Rs4157 crore in the next few years, as per Assocham report. Take BBQ Jack, which is actually jackfruit impersonating as meat; it was one of the items in India's largest shipment of plant-based meat sent to the US in 2023 by Wakao Foods.
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Another area that is growing at a rapid rate is the health care-based apps market. As per the India Healthcare Apps Market Report 2021, the apps market was valued at Rs4,341 crore in 2020 and is estimated to reach Rs33,789 crore by 2026. According to Accurize Market Research, India’s fitness and nutrition app market will surpass Rs1.41 lakh crore by 2030. This pertains to apps such as Run Keeper, Fitbit, GoQuii, which guide you on your weight loss journey. This is precisely what Amrapalli Gondave, 33, wanted when she subscribed to a fitness app, free for the first three months. She wanted to see if it could help her “look and feel good”. From morning workouts to food portions to regular reminders for sipping water, it was constantly “active and alert”. “The app was like my mother,” she says. “It would nudge me into eating on time and eating right, to taking my walks every day without fail, to ensuring I was sleeping early at night. This is exactly what I needed.” Three months later, she signed up for the annual membership (Rs6,500). The World Economic Forum published an article recently where it stated that there was a 46 per cent increase in downloads of health and fitness apps all across the world and that India registered the highest number of downloads. The report mentioned there were 58 million new active users in the country.
“A very big influence comes from Bollywood celebrities who hold a big sway in the country and when they promote 'look good, feel good,' that's half the job done,” says Gorey. “Today, in the Instagram culture, looking good has taken top priority and that can happen majorly when one feels good from within, that is when one is in their best shape health-wise. And with leading celebrities like Varun Dhawan, Vicky Kaushal, Sanya Malhotra or Kiara Advani posting their daily workout pictures, it is motivation like no other to get straight to the gym. This humongous weight loss industry―right from physical workouts to nutrition to mental health and wellbeing―is only going to skyrocket in the years to come and India is gearing up for it.”