A significant and often overlooked mental health crisis related to body image is affecting a large portion of India's youth, cutting across both ends of the weight spectrum. New research indicates that the psychological burden is severe not just for those with obesity, but equally for those who are underweight.
The Hidden Crisis: Numbers Reveal a Distressing Pattern
A recent study, part of the AIIMS-ICMR research programme on weight management, has shed light on the depth of this issue. Published in the Journal of Education and Health Promotion, the research involved 1,071 young adults aged 18-30 years visiting AIIMS outpatient clinics. It found that a startling 49% of obese participants and 47% of underweight participants reported moderate to severe psychological distress linked to their body image.
This is notably higher than the approximately 36% reported by those with normal or overweight status. The study noted that about 25% of participants were obese and 11% were underweight, with most being students from middle-income households.
Emotional Toll Varies by Weight Category
The research, led by nutritionist and PhD scholar Warisha Anwar, detailed how the nature of distress differs. Obese youth exhibited higher levels of self-consciousness and a loss of confidence. In contrast, underweight youth reported greater feelings of anxiety, loneliness, and embarrassment.
Overall, the data paints a grim picture: over half of the young adults were constantly conscious of their weight, one in three felt less confident, and one in four felt judged by others. The feelings of anxiety, isolation, and embarrassment were most acute at both weight extremes.
Beyond Calories: Experts Call for Integrated Psychological Care
Experts behind the study warn that India's public health approach remains skewed, primarily focusing on obesity while neglecting the psychological burden of being underweight. They stress that weight management is futile without addressing underlying mental health.
"Weight management goes far beyond losing weight," said Prof Piyush Ranjan from the department of medicine. He pointed out that unaddressed emotional concerns are a major reason young people drop out of lifestyle programmes. Integrating psychological screening into routine nutrition care is essential for sustainable outcomes.
Professor Naval K Vikram, chief of the metabolic research group at AIIMS, advocated for person-centred care. This includes early psychological screening, integrated nutrition services, and body-image-sensitive counselling, particularly within educational institutions.
Lived Experiences Behind the Statistics
The numbers are echoed in personal stories. Rohit, 23, who has been underweight since his teens, spoke about how constant comments on his appearance led him to withdraw socially. "People think they're being helpful. They don't realise how exposed it makes you feel," he shared.
On the other end, Meera, 20, who gained weight during the pandemic, expressed a similar erosion of self-worth. "My body suddenly mattered more than my grades. I didn't just gain weight. I lost confidence," she said.
The study concludes that stigma and unrealistic beauty ideals fuel this emotional distress, which in turn critically affects an individual's motivation, adherence to health programmes, and long-term health outcomes. It highlights a major gap in India's largely calorie-centric approach to weight management, where psychological fatigue often leads to disengagement.
