“Indian Pot Belly”: Tracing a Silent Epidemic

Authored by: Srijita Kommaraju

On a summer vacation to my home country, India, I was astonished by how casually my relatives manage their health. Heaping plates full of white rice, rotis, and curries were eaten thoroughly, followed by metformin tablets and insulin injections. This was so normalized that no one thought to question it.

And for a while, I didn’t either. 

But then it hit me. 

Everywhere I looked, my uncles, grandparents, and even strangers passing down the street all shared the same feature: a round, protruding belly pressing against their shirts. It didn’t matter if they were overweight, obese, or underweight: everyone bore the same, distinct belly. 

My observation, however, was not unusual. It instead reflected the broader trend of the “Indian pot belly” trend in some South Asian populations. The “pot belly” is characterized by the accumulation of visceral abdominal fat. This isn’t just a cultural stereotype, but rather biological reality  with evolutionary roots.

Between the 18th and 19th centuries, India endured dozens of severe famines under British colonial rule. During these periods of food scarcity, people that were able to store fat efficiently were more likely to survive prolonged starvation, passing these traits down to future generations. This phenomenon, coined by researchers as “starvation-adapted,” helped to conserve energy and accumulate adipose tissue in the abdominal region [1]. 

However, this adaptation no longer has a purpose in modern society. The shift to sedentary lifestyles and calorie-dense diets has now led to metabolic dysfunction in these populations, many of whom still continue the same practices of calorie-dense diets and accept their chronic illnesses as the inevitable rather than preventable. 

According to the National Family Health Survey, “approximately 40% of women and 12% of men in India suffer from abdominal obesity” [2]. Visceral fat is metabolically active, regulating regulating or impacting hormones and increasing the risk of cardiovascular disease [3]. Consequently, South Asian populations face disproportionately higher rates of type 2 diabetes, hypertension, and other chronic diseases, despite having lower body masses compared to other demographics. 

A 2016 study from Brown University found that surviving even a single famine actually “doubles the risk of diabetes and obesity in the next generation,” even going as far as to increase the risk of cardiovascular disease by 2.7 times [4]. 

Well, if this is the case, then why is belly fat loss so difficult? Why do so many South Asians struggle to lose weight in this region of their body? Due to the density in the South Asian belly, weight loss often appears first in other parts of the body, like the arms or legs. Therefore, solely consuming food in smaller portions will not help. Additionally, many traditional  South Asian diets are not only extremely carb-heavy, but especially calorie dense [5].

The prevalence of abdominal obesity among South Asian populations is not simply the result of poor lifestyle choices, but rather centuries of widespread famine, transforming a previous survival mechanism into a national public health concern. However, understanding how to break down evolutionary genetics and cultural norms can help to develop targeted, culturally sensitive interventions, such as nutrition plans tailored to  South Asian diets, or preventative screening for certain chronic diseases, can help combat this silent epidemic. 

References:

1. Why do Indians have pot belly and what to do about this dangerous area of fat storage. (2025, April 13). The Times of India. https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/why-do-indians-have-pot-belly-and-what-to-do-about-this-dangerous-area-of-fat-storage/articleshow/120258339.cms

2. How history still weighs heavy on south asian bodies today. (2022, March 13). HuffPost UK. https://www.huffingtonpost.co.uk/entry/south-asian-health-colonial-history_uk_620e74fee4b055057aac0e9f

3. Visceral fat: What it is & how it affects you. (n.d.). Cleveland Clinic. Retrieved October 13, 2025, from https://my.clevelandclinic.org/health/diseases/24147-visceral-fat

4. Famine alters metabolism for successive generations | Brown University. (2016, December 12). https://www.brown.edu/news/2016-12-12/famine

5. Fitness coaches reveal why you can’t lose the ‘Indian potbelly’ and it’s more mental than you think. (2024, November 24). Hindustan Times. https://www.hindustantimes.com/lifestyle/health/fitness-coaches-reveal-why-you-cant-lose-the-indian-potbelly-and-its-more-mental-than-you-think-101732440900259.html