By Arunima Rajan

In today's world, where long hours at the desk have become the norm, a new study—Sedentary Work and Expanding Waistlines: A Cross-Sectional Study on Occupational Roles and Abdominal Obesity in India—delivers a sobering message. Researchers Nishikant Singh, Sudheer Kumar Shukla, and Rituparna Sengupta, speaking with Arunima Rajan, challenge the popular belief that a post-work workout is a free pass to health. As many confidently claim, "I exercise after work, so I’m safe." However, the evidence tells a different story: even the most disciplined gym-goers are not immune to the metabolic risks posed by extended periods of sitting. This research reminds us that the effects of a sedentary lifestyle run deeper than what can be countered by exercise alone, urging a closer look at how we work—and live.

What made you decide to study this topic?

The alarming rise of abdominal obesity in India, particularly among working-age adults, served as the impetus for our study. With rapid economic transitions, occupational structures have shifted towards more sedentary jobs, especially in urban and high-income populations. The recent times have also witnessed a global debate about the long working hours affecting work-life balance. Longer working hours equal to lesser time for daily activities which can further affect the health of the individual. While previous research has extensively covered overall obesity, limited studies have explored the link between occupation types and abdominal obesity using nationally representative data. Given that abdominal obesity is a superior predictor of metabolic disorders compared to BMI, our research aimed to fill this critical gap by examining how workplace sedentary patterns contribute to expanding waistlines and related health risks.

**Nishikant Singh, Rituparna Sengupta, and Sudheer Kumar Shukla**

What are the key findings from this work?

High prevalence of abdominal obesity

56% of women and 48.9% of men in India have waist-to-hip ratios (WHR) above the WHO cut-off, placing them at increased metabolic risk.
Among sedentary workers (SW), 57.8% of men and 57.1% of women have abdominal obesity, significantly higher than their non-sedentary counterparts.
8.3% of men and 2.1% of women engaged in sedentary work exhibit WHR ≥1, a marker of severe metabolic risk.

Occupational disparities

Men in sedentary jobs face 20% higher adjusted odds (aOR 1.20) of developing abdominal obesity than those in non-sedentary roles.
Women in sedentary jobs also have significantly increased odds (aOR 1.08), though slightly lower than men.

Wealthier populations are at greater risk

Contrary to the conventional belief at global level, that obesity primarily affects lower-income groups, our study shows higher abdominal obesity prevalence among wealthier individuals, underscoring lifestyle-driven risk factors.

How do these results support or refute others in the field?

Our findings align with global research on sedentary behaviour and metabolic risk. Previous studies have highlighted the detrimental effects of prolonged sitting on cardiovascular health and obesity, particularly in high-income nations. However, India's scenario is distinct due to:

Rapidly growing sedentary employment sectors, particularly in urban settings.
Higher abdominal obesity prevalence among working women, challenging the common narrative that men are more vulnerable to occupational lifestyle risks.
A strong wealth-abdominal obesity association, reinforcing that increased financial stability does not necessarily translate to healthier living.
Our research strengthens the evidence base for workplace health policies, especially in low- and middle-income countries (LMICs) transitioning towards service-sector employment.

Why is this research important? What are the big-picture implications?

India’s rapid economic growth is coupled with the increase in non-communicable diseases, majority of which preventable through lifestyle modifications. This research is important because abdominal obesity is not just about appearance—it is a metabolic time bomb. Unlike general obesity (measured by BMI), abdominal fat is metabolically active, promoting inflammation, insulin resistance, and cardiovascular risks. The key implications are:

Necessary Workplace reforms: Standing desks, walking meetings, and scheduled movement breaks must become standard workplace practices. Additionally, behavioural support and healthcare promotion activities in the office are also need of the hour.
Early screening and intervention: Health assessments in corporate wellness programs should prioritise waist-to-hip ratios (WHR) alongside BMI.
Policy action is urgent: Governments and organisations must integrate sedentary work-related obesity into national NCDs control strategies.

Can you walk me through how you did this study?

We conducted a cross-sectional analysis using nationally representative data from 99,653 women and 91,990 men for which the information on both employment status and biomarker measures on waist and hip were available in the National Family Health Survey-5 (NFHS-5) (2019-21).

Approximately, 100 types of occupations were reported in NFHS data at individual level. On the basis of this information, occupational were categorized into the following:

Sedentary Work (SW) – Office-based/desk bound jobs like professionals, administrators, and traders.
Non-Sedentary Work (NSW) – Labour-intensive jobs like agriculture, construction, and factory work.
Not Working (NW) – Unemployed or retired individuals.

Abdominal obesity was assessed using waist-to-hip ratio (WHR):

WHO cut-off: ≥0.85 (women) and ≥0.90 (men) classified as abdominally obese.
High-risk WHR: ≥1 for both male and female indicated extreme metabolic risk.

We used multivariable logistic regression (adjusted for age, wealth, social status, diet, and other confounders) to assess the association between occupation types and abdominal obesity.

Who does this research affect most?

Corporate and desk-job employees, who spend prolonged hours sitting.
Urban professionals, particularly in IT, finance, and government sectors.
Wealthier individuals, who have higher rates of abdominal obesity due to lifestyle shifts.
Women in sedentary roles, who, despite lower absolute obesity rates, experience a significant occupation-based risk increase.

What should readers know about this topic?

Sedentary work is not just about weight gain—it significantly increases the risk of:

Type 2 diabetes
Hypertension and heart disease
Insulin resistance and metabolic disorders
Hormonal imbalances and reproductive health problems

Small changes in workplace behaviour—like commuting to work by walk, standing up every 30 minutes, taking brisk, small walk in the office—can reduce long-term health risks.

What’s something people tend to misunderstand about this topic?

"I exercise after work, so I’m safe." - this is false. Even regular gym-goers who sit for prolonged hours remain at risk for metabolic complications. Prolonged sitting is an independent risk factor—it cannot be fully counteracted by post-work exercise.

What are the big unanswered questions in this field?

How does remote work impact abdominal obesity trends?
What is the most effective workplace intervention—standing desks, walking breaks, other ergonomic solutions or behavioural support?
How do genetic and lifestyle factors interact with occupational sedentary behaviour?

These questions require longitudinal studies to track long-term metabolic outcomes.

Is there any disagreement among scientists about this subject?

Yes, particularly regarding whether standing desks and movement breaks are sufficient to mitigate metabolic risks. Some argue that only high-intensity exercise can counteract prolonged sitting effects, while others advocate for incremental lifestyle modifications within the workplace.

What are the limitations of this study?

Cross-sectional design – While our study establishes associations, causality cannot be determined.
Self-reported occupational data – Some misclassification may exist.
Lack of physical activity data – NFHS-5 (2019-21) data does not provide granular data on movement patterns within occupations.

Did anything about your findings surprise you?

One of the most striking findings was the significant gender difference in abdominal obesity prevalence. While 56% of women had abdominal obesity compared to 48.9% of men, the association between sedentary work and metabolic risk was stronger in men. Notably, 58% of men in desk-based jobs exhibited abdominal obesity, suggesting that they may experience greater metabolic consequences from prolonged inactivity, potentially due to differences in fat distribution, hormonal regulation, and occupational behaviour patterns.

Another unexpected and concerning finding was the prevalence of extreme metabolic obesity. 8.3% of men and 2.1% of women had a WHR ≥1, a threshold that signifies severe metabolic risk and is strongly associated with type 2 diabetes, hypertension, and cardiovascular disease. Such high-risk fat distribution within the working population underscores the urgent need for workplace-based interventions.

What are the next steps in this line of research?

Our findings establish a strong association between sedentary work and abdominal obesity, but they also raise several important questions that require further exploration. The next steps in this line of research should focus on:

I. Longitudinal studies on workplace sedentary behaviour and metabolic risks

Our study is cross-sectional, meaning it captures associations at a single point in time. Future longitudinal research is needed to track metabolic changes over time in individuals engaged in sedentary occupations. Examining how small workplace interventions (e.g., standing desks, active breaks, or office fitness programs) impact obesity and metabolic health over months or years would provide valuable insights for policymakers and employers.

II. Understanding the biological mechanisms linking sedentary work to metabolic dysfunction

While we have identified strong statistical associations, further research should examine the physiological pathways through which prolonged sitting leads to abdominal obesity and metabolic disorders. Investigating how insulin resistance, inflammatory markers, and fat redistribution patterns are affected by occupational sedentary behaviour could provide new therapeutic targets.

III. Evaluating the effectiveness of workplace health interventions

There is an urgent need to assess the impact of workplace health programs on metabolic risk factors. Future studies should compare different interventions (e.g., structured movement breaks vs. standing desks vs. employer-led fitness initiatives) to identify the most effective strategies for reducing abdominal obesity in office settings.

IV. Exploring the role of remote work and digitalization on obesity trends

The shift towards remote work and hybrid models has altered occupational behaviours. Research should examine whether work-from-home employees are at a higher or lower risk of abdominal obesity compared to traditional office workers, and how home-based interventions (e.g., ergonomic workspaces, virtual fitness engagement) could mitigate risk.

V. Assessing the economic impact of workplace obesity on productivity and healthcare costs

Obesity and its related health complications increase absenteeism, lower productivity, and raise employer healthcare expenditures. Future research should quantify the financial burden of workplace obesity and build an economic case for corporate investment in employee health initiatives.

Got a story that Healthcare Executive should dig into? Shoot it over to arunima.rajan@hosmac.com—no PR fluff, just solid leads.

Beyond the Gym: Confronting the Metabolic Perils of Sedentary Work