Sreekala Warrier / Natasha Sahgal
A Day in the Life: Sreekala Warrier
Battling lifestyle diseases in India’s emerging middle classWhen she was thirsty, needed to wash her clothes, or cook food, Sreekala Warrier used to walk to a well that was a mile away from her home in Kerala, a small town in southern India. She’d simply pull up 10 liters of water and carry it home. Daily meals consisted of idlis, dosas and sambar, all made by mashing rice and lentils with a 15 kg grindstone. Warrier used to do this grinding herself, every day for about an hour. At 23, she weighed 45 kgs, ran miles without panting and could somersault across the street.
Twenty years later, Warrier lives in the metropolis of Mumbai and earns a lot more money. Her plush bank job allows her to sit in an air-conditioned office all day. Her chauffeur drives her to and from work. Once home, Warrier calls the local supermarket to deliver her groceries, tells her maid servant to cook supper, clean the dishes and dust the house—all while she sits with her feet up on her sofa playing spider solitaire on her laptop. Warrier is no rich business woman, she’s one of the thousands of middle class working women in Mumbai.
Warrier is 40 kgs overweight, diabetic, and her knees and back don’t allow her to walk fast or stand for long periods. Her new life, which seems to have changed overnight, means she can’t socialize or dress the way she wants to anymore.
India is booming, jobs are paying a lot more and lifestyles are getting lazier. “I come from a modest upbringing and there was no option of fast food since it was hardly available,” Warrier sighs, “Potato chips, pizzas, Indian deep fried snacks were always such a luxury. Now they are cheap and available at every corner, I make enough money and so it’s difficult to stop myself.”
Warrier isn’t alone. “I started to notice that most people in my office had hanging bellies and huge thighs so I didn’t feel out of place,” she notes. “It was only when I had sudden back aches and was diagnosed with diabetes I decided to take some action.” Then came a series of crash diets, ayurvedic treatments, visits to natural holistic camps where she was made to spend a month without any modern amenities, eat simple boiled food and do yoga and meditations all day. The effects of all this ended the minute she went home and got back to her regular lifestyle.
As in India, increasing urbanization and westernization has brought about major changes in lifestyles of people in other developing countries. Decreased physical activity, diets rich in simple carbohydrates and fats and low in fiber have increased the incidence of obesity in urban Indian females from 15.1% in 2003 to 47.4% in 2007. Other South Asian countries show similar trends. Sri Lanka had an estimated rate of 36.5% obesity among women in 2005, up from 15%-18% in 1996.
With the increase in obesity comes increases in related diseases including diabetes (Type 2 diabetes mellitus), hypertension, dyslipidemia and heart diseases.
India currently has more diabetes patients than anywhere else in the world, and the number is projected to increase from 50.8 million in 2010 to 79.4 million in 2030. It is estimated that by 2020 India will have more individuals with cardiovascular diseases than any other region on earth. Mortality attributed to heart disease in India is expected to rise by 103% in men and 90% in women from 1985 to 2015.
Warrier says that she has heard of bariatric surgery but is too afraid to go through it. She’s heard that it’s dangerous and has numerous side effects. The surgery costs around Rs. 600,000 (more than USD $13,000), a cost that is not covered by typical Indian insurance plans.
Bariatric surgery was introduced to India in 2000. “Until 2007 very few patients underwent surgical treatment for obesity, but it is estimated that 70,000 such operations were performed in India in 2008,” explains Anoop Misra, director of the department of diabetes and metabolic diseases at Fortis Hospitals in New Delhi. The jump in bariatric procedures seems massive but the number is dwarfed by the estimated 120 million overweight Indians.
Since India became an open market economy in early 1990s, a new, urbanized middle class has emerged. Warrier bought her first pair of jeans in early 2010 and many more Indians are following in her footsteps towards a more western lifestyle. A country where thousands still die of starvation is also one of the ten fattest countries in the world. The global health community classifies illnesses like Warrier’s, along with heart failure and obesity as “lifestyle diseases.” If something isn’t done to find the balance between modernization and a healthy lifestyle, it looks as though India will have to deal with a lifestyle crisis.
Author Bio:
Natasha Sahgal lives in Mumbai but spends most of her time traveling between forests of India. When not chasing tigers, she writes environment and health features for various publications.
Photo: Sreekala Warrier / Natasha Sahgal
