Obesity, Socioeconomic Transitions, and the Evolving Social Gradient of Non-Communicable Diseases in Low- and Middle-Income Countries

Non-communicable diseases (NCDs) are now the leading cause of premature mortality in low- and middle-income countries (LMICs), accounting for more than 80% of early NCD deaths worldwide. As LMICs undergo rapid demographic, nutritional, and epidemiological transitions, obesity has emerged as a central driver of cardiometabolic risk—particularly among women. Although NCDs have long been characterised as “diseases of affiuence” in developing country settings, accumulating evidence suggests that this social gradient is weakening. New longitudinal evidence from India provides timely insights into how rising obesity may be reshaping the distribution of NCD risk across socioeconomic groups.

Using two waves of the nationally representative panel data from the India Human Development Survey (IHDS) 2004-05 & 2011- 12, which followed more than 24,000 women of reproductive age over seven years, Barik(2025) assessed the risk of developing non- communicable disease (NCDs) like hypertension, diabetes, or heart disease among the overweight/obese women. The study demonstrates that overweight and obesity significantly increase the likelihood of subsequent NCD onset, independent of age, education, caste, and household economic status. Crucially, the analysis shows that the rich–poor gap in NCD risk narrows sharply once women become overweight or obese, indicating that excess body weight acts as a powerful leveller of disease risk across socio-economic strata.