Representative image (AI-generated)

NEW DELHI: Body image anxiety is emerging as a major but under-recognised mental health issue among young Indians, affecting not only those with obesity but also those who are underweight. An Indian study has found that nearly one in two young adults at both extremes of body weight suffer from moderate to severe psychological distress linked to body image.\A recent study published in the Journal of Education and Health Promotion, conducted as part of the AIIMSICMR research programme on weight management in young adults, highlights the depth of this largely hidden crisis. The study of 1,071 young adults aged 18-30 years attending AIIMS outpatient clinics found 49% of obese and 47% of underweight participants reported moderate to severe body image concerns, compared with about 36% among those with normal or overweight status.About 25% of participants were obese and 11% underweight, most of them students from middle-income households, the study found. Underweight youth were almost twice as likely, and obese youth nearly three times as likely, to experience body image distress compared with those of normal weight.Experts involved in the research said weight-related conditions cannot be managed without addressing mental health . “Weight management goes far beyond losing weight,” said Prof Piyush Ranjan, department of medicine. “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.”The study, led by nutritionist and PhD scholar Warisha Anwar, found that while many young adults begin weight-loss programmes with motivation, disengagement is common as psychological fatigue, body image distress, academic pressure and life-stage transitions set in — highlighting a gap in India’s largely calorie-centric approach to weight management. Distress varied by weight: obese youth showed higher self-consciousness and loss of confidence, while underweight youth reported greater anxiety, loneliness and embarrassment; overall, over half were constantly weight-conscious, one in three felt less confident, and one in four felt judged, with anxiety, isolation and embarrassment most pronounced at both extremes.Behind the numbers are lived experiences. Rohit, 23, underweight since his teens,said routine comments on his appearance made him withdraw socially. “People think they’re being helpful. They don’t realise how exposed it makes you feel.” At the other end, Meera, 20, who gained weight during the pandemic, said: “My body suddenly mattered more than my grades. I didn’t just gain weight. I lost confidence.”Researchers said stigma and unrealistic beauty ideals fuel emotional distress that affects motivation, adherence and long-term health outcomes. The study, funded by ICMR cautions that India’s public health response remains skewed toward obesity, neglecting the psychological burden faced by underweight youth.Prof Naval K Vikram, chief of the metabolic research group at AIIMS, called for person-centred care, including early psychological screening, integrated nutrition services and body-image-sensitive counselling, particularly in educational institutions.