8 in 10 working Indians are overweight: Most are already sick and don’t know it, says survey

 Source: https://indianexpress.com/article/health-wellness

India’s most common health risks are arriving earlier and staying hidden longer, according to the sixth edition of the Apollo Hospitals’ Health of the Nation 2026 report, which was released on World Health Day.

Based on over three million preventive health assessments conducted across the hospital ecosystem in 2025, the report makes a compelling case for a lifestyle overhaul. Two in three young adults are already at risk of non-communicable diseases (NCDs). In working populations, nearly half have prediabetes or diabetes while eight in 10 are overweight. Gender-specific insights present distinct risks, such as anaemia and early onset of breast cancer. High levels of Vitamin D and B12 deficiencies, along with declining fitness gaps, further highlight the scale of silent health risks.

What are takeaways?

Health risks are already present in young and working populations, even before symptoms appear.

• One in 5 people under 30 were found to be prediabetic. Among those who intervened, 28% reversed to normal. Among those over 50, only 7% did.

• More than half were obese and more than half had abnormal cholesterol.

• Nearly seven in 10 were deficient in Vitamin D, and close to half had low Vitamin B12.

• Nearly two-thirds of under-30s assessed had poor flexibility, strength or balance. Poor physical function is linked to stiffer arteries, higher risk of falls and shorter lifespan.

• Early screening of 20,164 students (aged 17–25) across cities found that two in three had at least one underlying health risk.

• In working populations (average age 38), 8 in 10 were overweight, nearly half had prediabetes or diabetes and one in four had high blood pressure.

• Women show distinct risk patterns, including anaemia and increasing central obesity with age.

• The mean age of breast cancer detection through routine mammography was 51 nearly a decade earlier than in Western populations. Among women over 40 screened, 1 in 359 had breast cancer, all asymptomatic.

This underscores that health risk is not uniform and that structured screening can identify conditions early.

Gut health emerging concern

Altogether 74% of people with fatty liver had completely normal liver enzymes till they did an ultrasound. Undetected fatty liver is linked to higher risk of diabetes and liver disease progression. Only an ultrasound image could catch it. As conditions like diabetes, obesity and high cholesterol built up, gut diversity dropped by about 9% in those with multiple issues.

What do the figures mean

Among over 100,000 people under 30 who came in for a health check, more than half were overweight, more than half had abnormal cholesterol, 7 in 10 were deficient in Vitamin D and close to half were low in B12. These are conditions with no symptoms at this stage, often dismissed as “just stress”.

“The report reflects a shift in the epidemiology of metabolic disease in India. Risk is now emerging earlier, often in the third decade of life, driven by excess weight, physical inactivity and poor dietary patterns. A key observation is that weight gain appears to be the earliest abnormality, preceding changes in blood pressure, lipids and blood glucose. In addition, a substantial proportion of disease remains clinically silent. For instance, fatty liver, coronary calcification and even depression were frequently detected in individuals without symptoms. This highlights that traditional symptom-driven care is no longer adequate,” says Dr Saptarshi Bhattacharya, senior endocrinologist, Indraprastha Apollo Hospital, New Delhi.

For example, if lipid markers are high, a person should take a coronary calcium score, which is a quick, affordable, non-invasive scan that measures calcium deposits in the arteries, a sign that plaque is forming.

“Among over 1,100 asymptomatic people who underwent coronary calcium scoring, 45% had calcification,” says Dr Bhattacharya.

The findings suggest that the main challenge is not lack of detection but lack of timely action. “A substantial proportion of individuals are still in a stage where disease can be prevented or reversed. However, this window is often missed. The clustering of weight gain, abnormal lipids and rising blood glucose point to the need for integrated care rather than isolated interventions. The way forward lies in earlier screening, especially in younger populations, structured follow-up and sustained lifestyle changes. Workplace and college-based programmes, life-stage-specific screening for women, and routine inclusion of mental health assessment can help shift care from late treatment to early prevention,” he adds.