Motapa (Obesity) in Pakistan: Health Risks and How to Lose Weight Safely

Pakistan is often discussed as a country with an undernutrition problem, and it is — but it now has both problems at once, sometimes in the same household. The National Nutrition Survey 2018 found that among women of reproductive age, 24.2% were overweight and 13.9% obese — and that the combined overweight-or-obese figure rose from 28% in 2011 to 37.8% in 2018. That is a very fast change for seven years.

At a glance

• Overweight or obese among Pakistani women of reproductive age: 37.8% (NNS 2018), up from 28% in 2011
• South Asians develop metabolic disease at a lower BMI than white European populations, so standard cut-offs understate risk here
• Waist circumference matters independently of BMI — where the fat sits changes the risk
• Losing 5–10% of body weight measurably improves blood sugar, blood pressure and fatty liver
• Crash diets and slimming teas reliably fail; the regain is the rule, not the exception

Motapa kya hai — aur kitna wazan "zyada" hai?

BMI nikalne ka tarika: apna wazan (kilo mein) ko qad (meter mein) ke square se taqseem karen. Misal ke taur par 80 kg aur 1.7 m qad = 80 ÷ (1.7 × 1.7) = 27.7.

For South Asians, the usual World Health Organization cut-offs are widely considered to understate risk, because we accumulate visceral fat and develop insulin resistance at lower body weights. Many clinicians in the region therefore use lower thresholds: overweight from about 23, obesity from about 27.5, rather than 25 and 30. Waist is the other half of the picture — above roughly 90 cm in men and 80 cm in women signals central obesity even when BMI looks acceptable. Pet ke ird-gird ki charbi sab se zyada khatarnak hoti hai.

Why it matters — the actual risks

• Type 2 diabetes — the single strongest link, and Pakistan already has the world's highest comparative adult prevalence
• High blood pressure and heart disease
• Fatty liver — present in roughly 47% of people with obesity in a Pakistani meta-analysis
• Knee osteoarthritis — every extra kilo multiplies through the knee joint
• Obstructive sleep apnoea, poor sleep and daytime exhaustion
• PCOS and reduced fertility in both sexes
• Several cancers, including post-menopausal breast cancer

Wazan kam karne ka tarika — what actually works

1. Eat in a modest deficit, not a punishing one

A deficit of roughly 500 kcal a day produces about half a kilo a week. Faster than that and you lose muscle along with fat, and the plan collapses within a month. Bhooka rehna hal nahi hai.

2. Protein at every meal

Daal, chana, anday, chicken, machli, dahi. Protein preserves muscle during weight loss and blunts hunger better than the same calories from refined carbohydrate.

3. Fix the drinks first

Sugary drinks, doodh patti with two spoons of sugar, packaged juices and energy drinks are the easiest calories to remove because you don't feel fuller for having had them. This one change alone often accounts for several hundred calories a day.

4. Roti and rice: portion, not prohibition

Cutting carbohydrate to zero is neither necessary nor sustainable in a Pakistani kitchen. Halve the portion, add a vegetable and a protein, and keep the meal recognisable. Plans you can eat at a family dinner are the plans that survive.

5. Move in a way you will repeat

150 minutes a week of brisk walking is the standard target, plus resistance work twice a week to hold on to muscle. Walking is free, needs no equipment, and is the one most people actually keep doing.

6. Sleep

Short sleep raises appetite hormones and reliably undermines weight loss. This is not a soft factor.

What doesn't work

• Slimming teas and "fat cutter" powders — mostly laxatives and diuretics; the scale moves because you lost water, and it comes back
• Crash and single-food diets — muscle loss, nutrient deficiency, and near-universal regain
• Unprescribed weight-loss injections and appetite suppressants — some are genuinely effective medicines that need supervision, monitoring and a diagnosis; buying them off a pharmacy counter skips all three. See our guide to self-medication
• Sweating in a "sauna belt" — you lose water weight, not fat

When to get professional help

A nutritionist or dietitian builds a plan around what you actually eat rather than a printed sheet, and adjusts it as your weight changes. That is worth doing early if you have tried repeatedly on your own, if you have diabetes, PCOS, thyroid disease or fatty liver alongside, or if your weight is affecting your knees or your breathing.

Find care: browse dietitians and nutritionists near you on DoctorOS — filter by city, distance and rating, and book without a phone call.

If periods are irregular, hair growth has changed, or weight gain was rapid and unexplained, ask a doctor to check thyroid function and consider PCOS or hypothyroidism before assuming it is diet alone.

Frequently asked questions

Kya raat ka khana chhorne se wazan kam hota hai?

Wazan calories ke farq se kam hota hai, waqt se nahi. Raat ka khana chhorne se agar din bhar ki calories kam ho jayen to faida hoga — lekin aksar log agli subah zyada kha lete hain. Behtar yeh hai ke har waqt ka khana chhota kar dein, koi ek waqt bilkul band karne ke bajaye.

Sab se tez wazan kam karne ka tarika kya hai?

Tez tareen tarika aksar sab se na-paidar hota hai. Haftay mein aadha kilo mahfooz aur qabil-e-bardasht hai. Jo log mahine mein 10 kilo kam karte hain, unka wazan wapas aa jata hai — aur wapas aane par charbi zyada aur muscle kam hoti hai.

Do I have to give up roti and rice?

No. Portion size and what you put alongside them matter far more than eliminating them. A smaller serving with daal, vegetables and yoghurt behaves very differently from a large serving on its own.

My BMI is normal but my stomach is large. Is that a problem?

Yes, and it is a well-recognised South Asian pattern — sometimes called "normal-weight obesity". Central fat carries metabolic risk independently of BMI. Measure your waist, and if it is above 90 cm (men) or 80 cm (women), get blood sugar and lipids checked regardless of what the scale says.

Sources

• National Nutrition Survey 2018, Key Findings Report (UNICEF Pakistan) — 24.2% overweight, 13.9% obese among women of reproductive age; 28% → 37.8% since 2011
• World Obesity Federation, Pakistan country report card
• "Prevalence of nonalcoholic fatty liver disease in Pakistan: a systematic review and meta-analysis" (PMC) — 47.43% NAFLD in obesity

For practitioners: if you're a nutritionist, dietitian or bariatric physician in Pakistan, list your practice free on DoctorOS and start taking bookings from patients who are searching for exactly this kind of care.

Cover image: Body Mass Index Spelled Out in Scrabble Tiles with Tape Measure in the Background by doctor4uuk, licensed under CC BY 2.0.