Underweight, Overweight, and the Emergence of a Double Burden within Indian Families

Ilana G. Raskind, Emory University
Solveig Argeseanu Cunningham, Emory University
Regine Haardoerfer, Emory University
Shailaja Patil, BLDE University, Bijapur

India, like many low- and middle-income countries, faces a double burden of increasing overweight/obesity and persistent underweight. The family environment is a critical context for weight-related risk and protective factors. We examine patterns of familial clustering of body weight in a remote district of India using a representative sample of ~400 families with data on mixed-gender sibling pairs and primary caregiver. We conducted multi-level dyadic analysis of concordance/discordance in weight status between sibling dyads and child-caregiver dyads. A high degree of variability in child weight occurred at the family level (ICC=0.40). 42.8% of sibling dyads and 72.5% of child-caregiver dyads had discordant body weight. Among discordant child-caregiver dyads, 15% experienced a double burden of an underweight child and overweight caregiver. Younger siblings and boys were more likely to experience this double burden. Consistent with previous literature, the family environment is critical to understanding the emerging presence of intra-household double burden.