0:00:02 > 0:00:06This programme contains scenes which some viewers may find upsetting.
0:00:06 > 0:00:08Think of India as a skinny nation?
0:00:09 > 0:00:10Think again.
0:00:10 > 0:00:13- Oh, my God. - This is an 80 waist shorts.
0:00:13 > 0:00:17Millions of Indians are now morbidly obese.
0:00:17 > 0:00:21I think India is, right now, facing a major health crisis.
0:00:21 > 0:00:24In a country experiencing a fast food invasion,
0:00:24 > 0:00:27I follow the lives of two boys with the same problem...
0:00:27 > 0:00:32I love food. I can't bear not to have food.
0:00:32 > 0:00:34..facing very different futures.
0:00:34 > 0:00:37This is not a cosmetic surgery from any angle,
0:00:37 > 0:00:39this is a life-saving surgery.
0:00:39 > 0:00:41The world's got an obesity crisis.
0:00:41 > 0:00:45India's got that, plus diabetes and it's on its doorstep now.
0:00:57 > 0:01:00CAR HORNS BEEP
0:01:02 > 0:01:04I arrived in Mumbai in time for Diwali,
0:01:04 > 0:01:06the annual five-day festival of lights.
0:01:06 > 0:01:10FIREWORKS BOOM AND CRACKLE
0:01:10 > 0:01:13My parents are Indian, and I visit regularly,
0:01:13 > 0:01:15but this was a first for me.
0:01:15 > 0:01:18Mumbai traffic is bad at the best of times,
0:01:18 > 0:01:21but tonight is New Year's Eve, tomorrow is Diwali
0:01:21 > 0:01:24and everyone is out doing their last-minute shopping for food,
0:01:24 > 0:01:26cos that's what Diwali,
0:01:26 > 0:01:31in fact, any Indian festival, is all about - what you're going to eat.
0:01:32 > 0:01:37India has many traditions, but the pace of change here is amazing,
0:01:37 > 0:01:39especially when it comes to food.
0:01:39 > 0:01:41Look at that. That is brand-new,
0:01:41 > 0:01:42I've never seen anything like that,
0:01:42 > 0:01:46a street food stall in India selling hot dogs and burgers.
0:01:49 > 0:01:51The Bulani family became notorious recently
0:01:51 > 0:01:54for their eating habits and I've been invited
0:01:54 > 0:01:56to join them for their Diwali celebrations.
0:01:56 > 0:02:00FIREWORKS BOOM AND CRACKLE
0:02:00 > 0:02:02Look how beautiful this is.
0:02:02 > 0:02:05Every house has one outside their flat for Diwali.
0:02:08 > 0:02:09Hello.
0:02:09 > 0:02:11Thank you.
0:02:11 > 0:02:12Indian hospitality.
0:02:12 > 0:02:15If you go to someone's house, any Indian household,
0:02:15 > 0:02:17you will always be offered something to drink
0:02:17 > 0:02:20and something to sweeten your mouth as well.
0:02:20 > 0:02:21Right. What's this?
0:02:25 > 0:02:26Indian burger.
0:02:27 > 0:02:28Right, here we go.
0:02:32 > 0:02:33Oh, my God.
0:02:36 > 0:02:39Oh, that's so tasty. Ooh, it's got a kick.
0:02:39 > 0:02:42As they say in India, "It's too good."
0:02:42 > 0:02:44A few years ago,
0:02:44 > 0:02:47the Bulanis' love of food made international headlines.
0:02:48 > 0:02:52This is Sagar Bulani, the family's only son.
0:02:52 > 0:02:55When he was seven and weighing 14 stone,
0:02:55 > 0:02:58he became one of the youngest kids in the world
0:02:58 > 0:03:00to undergo weight-loss surgery.
0:03:03 > 0:03:04How old is he here?
0:03:06 > 0:03:09Wow. How much does he weigh?
0:03:09 > 0:03:1190kgs?
0:03:11 > 0:03:12So, where is Sagar now?
0:03:12 > 0:03:14- Here.- Me.- No.
0:03:14 > 0:03:15Yeah.
0:03:15 > 0:03:17You are not the same kid! Come.
0:03:17 > 0:03:19Oh, my God.
0:03:19 > 0:03:21Where are you? Is it really you?
0:03:21 > 0:03:23Turn around.
0:03:28 > 0:03:30Same eyes. Can you remember that person?
0:03:30 > 0:03:32No.
0:03:32 > 0:03:34I don't. I forgot him.
0:03:34 > 0:03:35You forgot it.
0:03:35 > 0:03:38In India, chubby kids are traditionally
0:03:38 > 0:03:40viewed as a sign of a family's wealth and they're often
0:03:40 > 0:03:45referred to as "healthy", meaning they're not underfed.
0:03:45 > 0:03:47- What do you think? - LAUGHTER
0:03:47 > 0:03:51- They're all having a good laugh. Are you embarrassed?- No.
0:03:53 > 0:03:56THEY LAUGH
0:03:56 > 0:03:58I've just said, "What did you feed your child?"
0:04:08 > 0:04:10She said, "I don't know. I didn't feed him that much."
0:04:10 > 0:04:12So I said, "How did he get so fat?"
0:05:04 > 0:05:09The god-like surgeon who operated on Sagar is Dr Shashank Shah.
0:05:09 > 0:05:11His clinic is in the city of Pune,
0:05:11 > 0:05:14three hours' drive from Mumbai.
0:05:16 > 0:05:19Much of rural India is desperately poor,
0:05:19 > 0:05:22with a third of its population living below the poverty line.
0:05:24 > 0:05:28But it's a different story in India's booming cities.
0:05:28 > 0:05:31It's incredible how much building work's going on and all
0:05:31 > 0:05:36these new office blocks, apartments, hotels - it's coming up so quickly.
0:05:39 > 0:05:42Weight-loss surgery is big business here,
0:05:42 > 0:05:45and Dr Shah's one of the key players.
0:05:45 > 0:05:49One out of every three Indians in urban area would have some grade
0:05:49 > 0:05:51of being overweight or obese.
0:05:51 > 0:05:53- A third?- One out of three.
0:05:53 > 0:05:57It's a pandemic of obesity, secondary type 2 diabetes,
0:05:57 > 0:06:00so it's a pandemic of diabesity.
0:06:00 > 0:06:03- And this is a problem with affluent middle-class India, right?- Yes.
0:06:03 > 0:06:05This is not a problem of the poorer...?
0:06:05 > 0:06:07No, the rural India is still protected
0:06:07 > 0:06:11because India has a diverse problem of under-nutrition in some regions
0:06:11 > 0:06:13- and over-nutrition in some.- Yeah.
0:06:20 > 0:06:23Dr Shah's first patient of the day is a 40-year-old woman,
0:06:23 > 0:06:25weighing more than 22 stone.
0:06:29 > 0:06:32How many times a day do you do this sort of surgery?
0:06:32 > 0:06:34Oh, my God, I do it ten times a day.
0:06:34 > 0:06:35A day?
0:06:35 > 0:06:37Ten times a day, minimum.
0:06:38 > 0:06:42Dr Shah is going to perform a gastric sleeve operation.
0:06:42 > 0:06:45He's going to, essentially, take away a piece of the stomach,
0:06:45 > 0:06:48the curvature of the stomach, to make it smaller.
0:06:48 > 0:06:50And by doing that, he's going
0:06:50 > 0:06:53to remove the part that produces the hormone that makes her feel hungry.
0:06:53 > 0:06:55Now, this is the needle.
0:06:55 > 0:06:57So now, this is the thickness of the wall.
0:06:57 > 0:07:00- And she's only 40? - Yes, she's only 40.
0:07:00 > 0:07:01She's very young.
0:07:01 > 0:07:02Very young.
0:07:02 > 0:07:05I'm going into various layers of fat.
0:07:05 > 0:07:07- This is all fat?- Yes.
0:07:07 > 0:07:10- And now, I'm inside.- Wow.
0:07:10 > 0:07:11Oh, my God.
0:07:14 > 0:07:17What does a high calorie, fatty diet do to us?
0:07:17 > 0:07:22It can induce an array of diseases, like diabetes,
0:07:22 > 0:07:25high blood pressure, heart disease, kidney disease,
0:07:25 > 0:07:30joint destruction, sleep apnoea, infertility.
0:07:31 > 0:07:35Almost every organ in the body can be affected by this.
0:07:36 > 0:07:40All these problems that you're seeing, the amount of fat,
0:07:40 > 0:07:45the fatty liver, the fatty stomach, this is all caused by diet?
0:07:45 > 0:07:49All caused by diet, lifestyle and obesity.
0:07:49 > 0:07:52And this is a major operation, isn't it?
0:07:52 > 0:07:54The risks of any major operations are there,
0:07:54 > 0:07:57and more so because all these patients are high risk.
0:07:59 > 0:08:01And now, this is a stapling device...
0:08:02 > 0:08:07..which is going to suture and cut the stomach at the same time.
0:08:09 > 0:08:11And that's the stomach coming away?
0:08:11 > 0:08:12Yes.
0:08:12 > 0:08:15You just don't think of India as having an obesity problem.
0:08:15 > 0:08:17You don't think of it as a fat nation.
0:08:17 > 0:08:23India is now a global hub of diabetes and it's purely because of obesity.
0:08:25 > 0:08:27'Now that the woman's stomach has been cut in two,
0:08:27 > 0:08:29'the surplus half is removed.'
0:08:33 > 0:08:35And that is the stomach that you have removed?
0:08:35 > 0:08:37That is the stomach which came out.
0:08:38 > 0:08:40That's it.
0:08:40 > 0:08:41It's...
0:08:41 > 0:08:43Out it comes.
0:08:44 > 0:08:47'Half of the population in India is under 25 years old,
0:08:47 > 0:08:52'and Dr Shah is operating on an increasing number of young people.'
0:08:52 > 0:08:5716-year-old girl, who was 140 kilograms.
0:08:57 > 0:09:00And this is just one of them, and there are hundreds of them.
0:09:00 > 0:09:02These are only a few volunteers.
0:09:02 > 0:09:05How have you seen it increase in the last five years?
0:09:05 > 0:09:10When I started ten years back, we hardly had one adolescent coming,
0:09:10 > 0:09:15but in the last five years, probably 25% of the clinic is becoming
0:09:15 > 0:09:17a clinic for adolescent obesity.
0:09:26 > 0:09:31Mumbai is the centre of the country's economic revolution.
0:09:31 > 0:09:32In the course of a generation,
0:09:32 > 0:09:36more than 100 million Indians have been raised out of poverty.
0:09:38 > 0:09:41Giant shopping malls have sprung up all over the city.
0:09:42 > 0:09:46I visited a shop that caters for the growing middle class.
0:09:47 > 0:09:52Look at the size of this shirt. Oh, my God.
0:09:52 > 0:09:53That is massive.
0:09:55 > 0:09:56How big is that?
0:09:59 > 0:10:02The Mukherjee family opened their extra-sized clothing store,
0:10:02 > 0:10:07Largely Yours, after being inspired by trips to America.
0:10:07 > 0:10:10Obesity is one of the leading problems in the country today,
0:10:10 > 0:10:13so I thought it was very important to have a genuine big-sized
0:10:13 > 0:10:15garment store in India.
0:10:15 > 0:10:19This is the only tape in the country which goes up to 90 inches.
0:10:19 > 0:10:2190 in...!
0:10:21 > 0:10:25- Yes. - Nobody can be this big and be alive.
0:10:25 > 0:10:26Trust me, we have customers with 80 waists,
0:10:26 > 0:10:28so I had to keep ten inches spare.
0:10:28 > 0:10:30And you get somebody who's bigger than that.
0:10:30 > 0:10:34This platform is thanks to one of our customers who was, like, a 68 waist.
0:10:34 > 0:10:38He tried to stand by the platform and, ta-loom, the whole floor went.
0:10:38 > 0:10:40There was a big hole inside.
0:10:40 > 0:10:43- Look at that shirt. - SHE LAUGHS
0:10:43 > 0:10:45I mean, obviously, nobody's that big?
0:10:45 > 0:10:47Oh, yes.
0:10:47 > 0:10:49We've sold these. I don't keep anything for show.
0:10:49 > 0:10:51Nobody is this big.
0:10:51 > 0:10:52Yes. Trust me.
0:10:52 > 0:10:54You are... Seriously, you're having me on.
0:10:54 > 0:10:56- You have not sold this shirt to somebody.- We have.
0:10:56 > 0:10:58Trust me, we had ten of these.
0:10:58 > 0:11:00I thought that was a display thing.
0:11:00 > 0:11:03I thought that was, like, part of the promotion.
0:11:04 > 0:11:07This is more of a service industry for me,
0:11:07 > 0:11:12because I like to serve people who are genuinely in need.
0:11:12 > 0:11:14You know, it's more of a profession like a doctor,
0:11:14 > 0:11:17where people come and thank you for what you're giving them
0:11:17 > 0:11:19because this is just not available outside.
0:11:19 > 0:11:21There are young kids nowadays who come to us who are,
0:11:21 > 0:11:23like, 60 waist, 68 waist.
0:11:23 > 0:11:25So, Indians are getting as fat as Americans?
0:11:25 > 0:11:27Absolutely. Absolutely. Trust me.
0:11:27 > 0:11:30Americans, the only thing is, they have weight all over the body.
0:11:30 > 0:11:32They have big thighs, big shoulders.
0:11:32 > 0:11:34Indians, the biggest problem is the tummy.
0:11:34 > 0:11:37Are you going to try and lose weight, Mr Mukherjee?
0:11:37 > 0:11:41I need to maintain myself! Come on, I'm a brand ambassador! THEY LAUGH
0:11:45 > 0:11:48'As well as adopting American-style waistlines,
0:11:48 > 0:11:53'Indians are also embracing Western-style consumerism.
0:11:53 > 0:11:57'In two years, sales of luxury goods have rocketed by nearly a third
0:11:57 > 0:12:00'and the country's new rich spend in one day
0:12:00 > 0:12:04'what their grandparents would earn in a month.'
0:12:05 > 0:12:10'India is also getting a taste for Western-style fast food.
0:12:10 > 0:12:13'Up on the food courts, I met up with 20-year-old Adit Chetty
0:12:13 > 0:12:15'and his fellow students.'
0:12:15 > 0:12:17Hey, Adit. How are you?
0:12:17 > 0:12:21- I'm fine.- Good to meet you. Anita. Nice to meet you.
0:12:21 > 0:12:23- And these are your buddies? - Yeah, these are my friends.
0:12:23 > 0:12:25Hey, how are you?
0:12:25 > 0:12:27- So, this is your hang-out, is it? - ALL:- Yeah.
0:12:27 > 0:12:28The mall?
0:12:28 > 0:12:30Why do you come here?
0:12:30 > 0:12:34Because this is one place where we get everything - cinema, eat.
0:12:34 > 0:12:36This is the place where you can chat along,
0:12:36 > 0:12:38so this is our second home for us.
0:12:38 > 0:12:40So, how much do you weigh?
0:12:40 > 0:12:41126.
0:12:41 > 0:12:44126 kilos? Wow!
0:12:45 > 0:12:47Wow!
0:12:47 > 0:12:49- Your weight, for you is not an issue?- No, not at all.
0:12:49 > 0:12:52- Not at all?- Not at all.
0:12:52 > 0:12:54- Why is that? - Because I like the way I am.
0:12:54 > 0:12:57We don't have any issues. We love him like that.
0:12:57 > 0:12:59You love him...just as he is.
0:12:59 > 0:13:01He's a teddy bear.
0:13:01 > 0:13:04'All things that other kids, I also can do. So I don't think 126...
0:13:04 > 0:13:06'It's just a number, for me.'
0:13:08 > 0:13:12Right. Of all these places you want to eat, where are we going?
0:13:12 > 0:13:13- McDonald's.- McDonald's?
0:13:16 > 0:13:18Why wouldn't you go for Indian food?
0:13:18 > 0:13:21Basically, Indian food we regularly eat at our homes and we love
0:13:21 > 0:13:25eating McDonald's burger, especially that fish one - Filet-O-Fish.
0:13:25 > 0:13:28- It's yummy.- How many can you eat at once?
0:13:28 > 0:13:30I can go up to six.
0:13:30 > 0:13:31- Six?- Yeah.- In one sitting?
0:13:31 > 0:13:35- Yeah.- Right. You know what you want.
0:13:36 > 0:13:40The average cost of a fast-food meal is around £3.50.
0:13:40 > 0:13:43This, in a country where two-thirds of the population
0:13:43 > 0:13:46lives on less than £2 a day.
0:13:46 > 0:13:48What have you ordered? Two Filet-O-Fish.
0:13:48 > 0:13:50Yeah, two Filet-O-Fish.
0:13:50 > 0:13:52- Yeah? - And medium fries for all of us.
0:13:52 > 0:13:55How old were you when you first started eating McDonald's?
0:13:55 > 0:13:56Somewhere around ten.
0:13:56 > 0:13:57- Ten years old?- Yeah.
0:13:57 > 0:13:59So, you've been eating McDonald's for ten years?
0:13:59 > 0:14:02That tag line, "I'm Lovin' It."
0:14:02 > 0:14:04That's perfectly suiting me, I'm loving it.
0:14:05 > 0:14:08So, you have no desire to lose any weight, then?
0:14:08 > 0:14:10- No.- Are you not concerned about your health?
0:14:10 > 0:14:14I'm concerned about my health, but I don't think my health,
0:14:14 > 0:14:17right now, is at something... adverse effect or as such.
0:14:17 > 0:14:19I think I'm good at the moment.
0:14:19 > 0:14:22Is this a snack, or is this lunch, or is this...?
0:14:22 > 0:14:23- What would it be?- It's a munch.
0:14:23 > 0:14:25- It's a munch?- A munch.
0:14:28 > 0:14:30'Adit's family is part of the new middle class,
0:14:30 > 0:14:33'who moved to Mumbai from rural India.'
0:14:33 > 0:14:34Hello. How are you?
0:14:34 > 0:14:38'His dad's an accountant and his mum, Sujata, is a teacher.'
0:14:38 > 0:14:40- Adit's mum?- Yeah. - Pleased to meet you.
0:14:40 > 0:14:43Join us, have a seat. Have a seat.
0:14:43 > 0:14:45- I know that Adit is your only son. - Yeah, he is my only son.
0:14:45 > 0:14:49And you dote on him? You love him very much?
0:14:49 > 0:14:50Yes, yes.
0:14:50 > 0:14:52Does he get whatever he wants?
0:14:52 > 0:14:54Yeah, almost.
0:14:54 > 0:14:56- Almost he gets.- Yeah?
0:14:56 > 0:14:58Do you think he should lose weight?
0:14:58 > 0:14:59Yes, yes, yes.
0:14:59 > 0:15:02Now once, at least one-and-a-half year more,
0:15:02 > 0:15:04for him to finish his education.
0:15:04 > 0:15:08After that, I'm going to be very strict in that.
0:15:08 > 0:15:11But because he doesn't get time, you see, by the time he gets home...
0:15:11 > 0:15:13Even if gets back 7:00, 7:15,
0:15:13 > 0:15:157:30, then he has to have his bath
0:15:15 > 0:15:18and all his work by nine o'clock, he has to go to college.
0:15:18 > 0:15:20Do you think he wants to lose weight?
0:15:20 > 0:15:25I don't think so. Do you feel so? He is so happy with his weight.
0:15:25 > 0:15:28After a year, maybe I start reducing weight.
0:15:28 > 0:15:31- After a year?- Yeah.- You're not going to start right now?- No.
0:15:31 > 0:15:33What if I did this?
0:15:33 > 0:15:35And said, "That's it, Adit,
0:15:35 > 0:15:40"those two Filet-O-Fishes were your last ever McDonald's?"
0:15:40 > 0:15:42Yeah. You'd up and walk, would you?
0:15:42 > 0:15:44Then I'd go to Pizza Hut.
0:15:44 > 0:15:46McDonald's is over, pizza still remains.
0:15:48 > 0:15:52And there you have a 20-year-old who weighs 126 kilograms.
0:15:54 > 0:15:57He needs to see a doctor, that's what he needs to do.
0:15:57 > 0:15:59I think he needs a wake-up call.
0:16:10 > 0:16:15These kids are experiencing a lifestyle revolution.
0:16:15 > 0:16:18The previous generation dined out sparingly and children walked
0:16:18 > 0:16:22or cycled to school with a packed lunch made by their mothers.
0:16:24 > 0:16:26Being rich in a poor country today
0:16:26 > 0:16:29means kids are driven everywhere and games are more likely to be
0:16:29 > 0:16:32played on a computer than in the street or playground.
0:16:34 > 0:16:36The huge pressure on academic achievement,
0:16:36 > 0:16:40which is prized above all else, has led to more sedentary lifestyles.
0:16:41 > 0:16:46It's no wonder a third of pupils in some private schools are obese
0:16:46 > 0:16:50and all of those kids are likely to stay obese into adulthood.
0:16:53 > 0:16:59I love food. I just love food. I can't bear not to have food.
0:16:59 > 0:17:02Everything to me is tasty, if it tastes good.
0:17:02 > 0:17:04I love Lebanese. I like everything.
0:17:06 > 0:17:09All the vendors around the school know him, and they ask him,
0:17:09 > 0:17:10"Is it the usual?"
0:17:10 > 0:17:15Everyone knows what harm it has, but for the taste they say,
0:17:15 > 0:17:16"OK. Forget it.
0:17:16 > 0:17:21"We can just enjoy and we'll forget about the gain and the inch gain."
0:17:23 > 0:17:27'13-year-old Kaleb weighs 109 kilos, around 17 stone,
0:17:27 > 0:17:32'and his weight is a serious concern for his mother Dimple.'
0:17:32 > 0:17:35Problem with him is he can't control the weight gain
0:17:35 > 0:17:38and it's an average of five kilos a month.
0:17:38 > 0:17:40- That's a lot.- That's a lot.
0:17:40 > 0:17:43We've tried everything. He's gone to a couple of very well-known dieticians who have
0:17:43 > 0:17:46helped Hollywood stars. But he's just a child.
0:17:46 > 0:17:49How much can you curb a child on his food habits?
0:17:49 > 0:17:51He has to have an active lifestyle,
0:17:51 > 0:17:53but because of his weight he can't play a sport.
0:17:53 > 0:17:57What's the largest you've been? What the heaviest you've been?
0:17:57 > 0:17:58- Right now.- Right now?
0:17:58 > 0:18:01And it's been going up five kilos every month?
0:18:01 > 0:18:04- Yes. - You don't have to lift a finger.
0:18:04 > 0:18:07People get into their air-conditioned cars,
0:18:07 > 0:18:09their driver takes them to their air-conditioned office,
0:18:09 > 0:18:14someone will bring them their lunch. It takes sedentary lifestyle to a whole new lifestyle, doesn't it?
0:18:14 > 0:18:16It does. I mean, even if you're a normal middle-class family,
0:18:16 > 0:18:18you can afford your cook,
0:18:18 > 0:18:20you can afford driver and you can afford servants.
0:18:20 > 0:18:22Everything else is done for you.
0:18:22 > 0:18:23I have friends that make jokes like,
0:18:23 > 0:18:26"I can live without my husband, but I can't live without my maid!"
0:18:26 > 0:18:28THEY LAUGH
0:18:28 > 0:18:29Hello, Kaleb.
0:18:32 > 0:18:35Ah, very nice. Very nice.
0:18:35 > 0:18:38There are many underlying reasons why people have eating issues,
0:18:38 > 0:18:41and Kaleb experienced tragedy when he was very young.
0:18:43 > 0:18:47At the age of four, his father died of a heart attack.
0:18:47 > 0:18:50Do you think the death of your husband might have affected him
0:18:50 > 0:18:53psychologically, in terms of his eating and his habits?
0:18:53 > 0:18:56Definitely, cos when he sees his friends going out on annual trips
0:18:56 > 0:19:01with family, he knows the father, mother, sister, sibling setup.
0:19:01 > 0:19:05And then he comes home he's like, "Where are we going?"
0:19:05 > 0:19:07And the first question is, "It's just the two of us, right?"
0:19:07 > 0:19:13So, both of us resorted to eating, taking our food as our best friend.
0:19:13 > 0:19:16One day I woke up and said, "No, I have to give him
0:19:16 > 0:19:19"a very good life and I need to lead a healthy lifestyle myself."
0:19:19 > 0:19:21So, I started shedding off the kilos
0:19:21 > 0:19:24and I realised that I had stopped but he hadn't -
0:19:24 > 0:19:27he was still taking comfort in what he was eating.
0:19:29 > 0:19:32- Are these your buddies? - No, they tease me lot.
0:19:32 > 0:19:36- What do they say? - You know...
0:19:36 > 0:19:38Call me "fat-ass" and all that.
0:19:38 > 0:19:40- Fat-ass?- Yeah.
0:19:40 > 0:19:45They see me walking, they laugh and then they call me stuff
0:19:45 > 0:19:46and I just ignore them.
0:19:46 > 0:19:48They keep on doing it all the time.
0:19:48 > 0:19:51How bad did the teasing get?
0:19:51 > 0:19:57Well, really bad, like, you know - terms like, "You have manboobs."
0:19:57 > 0:19:59And he was very depressed about it.
0:19:59 > 0:20:00How does that make you feel?
0:20:00 > 0:20:04- Can't be nice?- I feel really hollow inside, like...
0:20:04 > 0:20:05Makes you feel hollow inside?
0:20:05 > 0:20:06Yeah.
0:20:07 > 0:20:11I don't want to live with such a thing so I want to lose weight,
0:20:11 > 0:20:13but then I love food so much.
0:20:13 > 0:20:14Yeah.
0:20:15 > 0:20:18It could probably drive someone to suicide or, you know,
0:20:18 > 0:20:20hurt themselves.
0:20:20 > 0:20:22And do you think that's where Kaleb was heading?
0:20:22 > 0:20:25I think that's where Kaleb was heading, yes.
0:20:25 > 0:20:27Um, he had tried it once...
0:20:27 > 0:20:29- To kill himself?- To kill himself.
0:20:29 > 0:20:34Um, we lived on the 13th floor and, um, and...
0:20:34 > 0:20:37the window was wide open and he just climbed on it
0:20:37 > 0:20:40and he wanted to jump out.
0:20:40 > 0:20:45I just held on to him with all my might and pulled him back.
0:20:45 > 0:20:46And that's when I realised...
0:20:46 > 0:20:48And I went to school in my pyjamas.
0:20:48 > 0:20:50I didn't even bother getting ready
0:20:50 > 0:20:53because I needed to talk to the principle of who had driven
0:20:53 > 0:20:56Kaleb to a point where his life was not important to him.
0:21:01 > 0:21:05Keeping Kaleb away from the food he loves is not going to be easy.
0:21:05 > 0:21:08The face of India's high street is changing dramatically.
0:21:12 > 0:21:14Since KFC arrived in the mid-90s,
0:21:14 > 0:21:17all of the major fast-food chains have followed.
0:21:17 > 0:21:21As Western markets slow, emerging economies, like India,
0:21:21 > 0:21:23offer the best hope for massive expansion.
0:21:28 > 0:21:31Chandra Bhushan from the Centre for Science and Environment
0:21:31 > 0:21:36is campaigning for tighter controls of the fast-food industry.
0:21:36 > 0:21:41Ten years back, you would have not seen this McDonald's
0:21:41 > 0:21:43and the KFC here.
0:21:43 > 0:21:46How reflective is this of a major city in India, then?
0:21:46 > 0:21:50I think it reflects the change that is happening in the culture of the country.
0:21:50 > 0:21:52And would you see this Calcutta, in Delhi...?
0:21:52 > 0:21:54- Absolutely. You see it everywhere. - Bangalore?
0:21:54 > 0:21:56Even in small towns.
0:21:56 > 0:22:00You go to a street in a small town, you will have a McDonald's there.
0:22:00 > 0:22:03- The Golden Arches will be there to greet you.- Absolutely, yeah.
0:22:03 > 0:22:06'In the new India, traditional street vendors
0:22:06 > 0:22:09'are being crowded out by the fast-food giants.'
0:22:09 > 0:22:13The traditional food in this country is very healthy.
0:22:13 > 0:22:15This is steamed rice cake.
0:22:15 > 0:22:19Then he will give you a nice chutney.
0:22:19 > 0:22:22- Mm, it smells amazing. - And a little bit of vegetables.
0:22:22 > 0:22:25- Yep.- Vegetables and lentils.
0:22:25 > 0:22:26Very healthy.
0:22:26 > 0:22:29So that is a plate of, what I would describe as,
0:22:29 > 0:22:32Indian fast food - we got it pretty quickly.
0:22:32 > 0:22:36Ten rupees for something that looks incredibly tasty and it is healthy.
0:22:39 > 0:22:41Mm.
0:22:41 > 0:22:44Oh. It's got a kick to it.
0:22:44 > 0:22:47- It's spicy.- It's spicy. - Oh, my God.
0:22:47 > 0:22:50- Thank you.- Thank you very much.
0:22:50 > 0:22:54So why, Chandra, would people choose to buy
0:22:54 > 0:22:56McDonald's, KFC, Domino's, Subway, and not eat this?
0:22:56 > 0:23:00I think the reason is, when these fast-food joints come,
0:23:00 > 0:23:02they're massively advertised.
0:23:02 > 0:23:05So, from television to newspaper to billboards,
0:23:05 > 0:23:10you have glamorous advertisement about these foods.
0:23:10 > 0:23:13But there is no-one who is going to advertise about this healthy food.
0:23:13 > 0:23:14Yeah.
0:23:14 > 0:23:19'Unlike the UK, where fast-food ads are banned from kids' TV,
0:23:19 > 0:23:22'in India companies are allowed to market to children.'
0:23:23 > 0:23:26Is there no advertising standards agency here?
0:23:26 > 0:23:28There is, but it's a voluntary agency.
0:23:28 > 0:23:30They do put out guidelines,
0:23:30 > 0:23:33but obviously their power to enforce is very poor.
0:23:35 > 0:23:38'Chandra's organisation produced India's first ever
0:23:38 > 0:23:39'report about fast food.'
0:23:41 > 0:23:44'It raised concerns that companies were providing less
0:23:44 > 0:23:46'information about their products to Indian consumers
0:23:46 > 0:23:48'than to those in the West.'
0:23:48 > 0:23:52The industry has grown at a much faster pace than regulation,
0:23:52 > 0:23:56and that's why these companies are getting away with this.
0:23:56 > 0:23:59'For his report, Chandra analysed a range of fast foods
0:23:59 > 0:24:01'bought on the high street.
0:24:01 > 0:24:06'He found that the fast food sold in India contained, for example,
0:24:06 > 0:24:07'more harmful trans fats than
0:24:07 > 0:24:10'similar products for sale in the West.'
0:24:11 > 0:24:12The point is very clear.
0:24:12 > 0:24:16These companies are not telling Indians what they're eating, OK?
0:24:16 > 0:24:19But why do Indians need to be told? It's junk food.
0:24:19 > 0:24:23It's junk food is fine, but at least they have to make an informed choice.
0:24:23 > 0:24:27Right now, they absolutely don't know that, for example,
0:24:27 > 0:24:30this might have a lot of trans fats. They shouldn't be eating it.
0:24:30 > 0:24:32So, why are Indians aspiring to this?
0:24:32 > 0:24:34Why do they want to want to eat it?
0:24:34 > 0:24:37That's what the dream is all about, to have a Western lifestyle,
0:24:37 > 0:24:38to...to...
0:24:38 > 0:24:41When you pick up a burger, and when a kid is given this burger
0:24:41 > 0:24:45it's about living the life of a Western kid.
0:24:45 > 0:24:47OK, so this is really popular...
0:24:47 > 0:24:49'But some of the products designed
0:24:49 > 0:24:52'for the Indian market are even more unhealthy.
0:24:52 > 0:24:55'For example, McDonald's Spicy Paneer Wrap,
0:24:55 > 0:24:57'at a whopping 800 calories,
0:24:57 > 0:25:01'contains far more fat than any product they sell in the UK.'
0:25:02 > 0:25:07The health cost of this food, as it is being eaten now, is enormous.
0:25:07 > 0:25:11We should not be doing the wrong thing that West has already done.
0:25:11 > 0:25:13For example, first becoming fat,
0:25:13 > 0:25:16then spending a huge amount of money of healthcare.
0:25:16 > 0:25:18That's what West has done, that's what UK has done.
0:25:18 > 0:25:20That's what America is doing right now.
0:25:20 > 0:25:22We have to learn from their mistakes
0:25:22 > 0:25:24and devise policies which will work for us.
0:25:24 > 0:25:27So, we need to tell people what to eat, we need to put
0:25:27 > 0:25:31regulations in place so that these companies are reined in.
0:25:31 > 0:25:33Then there has to be a massive education.
0:25:33 > 0:25:35A school education is very important.
0:25:35 > 0:25:38Kids must be told how bad these foods are.
0:25:38 > 0:25:41It's a long battle, it's a hard fight, but we are able to fight it.
0:25:47 > 0:25:50Health education in India is limited
0:25:50 > 0:25:51and a lack of access to information
0:25:51 > 0:25:54means there's very little awareness.
0:25:57 > 0:26:01Most young people, like Adit, know that fast food is fattening,
0:26:01 > 0:26:05but they seem unaware of the long-term problems of obesity.
0:26:05 > 0:26:09I was hoping he might come round to the idea of finding out more.
0:26:10 > 0:26:12Adit?
0:26:12 > 0:26:14It's Anita.
0:26:14 > 0:26:15How are you?
0:26:15 > 0:26:19Listen, Adit, if you're up for it, I've made a few phone calls
0:26:19 > 0:26:21and there is a doctor in Bombay - a very good doctor -
0:26:21 > 0:26:24who is prepared to see you for a check-up.
0:26:27 > 0:26:29Are you up for it?
0:26:29 > 0:26:31Good. OK.
0:26:31 > 0:26:32That's...
0:26:32 > 0:26:33Yeah? Brilliant.
0:26:35 > 0:26:37Wow. He said yes straight away.
0:26:38 > 0:26:42Um, I think that's quite a big step for him.
0:26:42 > 0:26:45I don't even think he realises how big it is.
0:26:48 > 0:26:50While Adit thinks about his medical,
0:26:50 > 0:26:53Kaleb and his mum have a life-changing decision to make.
0:26:55 > 0:26:59Over the past 12 months, he's tried dieting and exercise,
0:26:59 > 0:27:01but hasn't lost weight.
0:27:01 > 0:27:03Dimple is so worried about her son's physical
0:27:03 > 0:27:05and psychological condition,
0:27:05 > 0:27:08she's gone to see Dr Muffazal Lakdawala,
0:27:08 > 0:27:11who's one of Mumbai's top weight-loss surgeons.
0:27:11 > 0:27:14Kaleb, basically when we're looking at options,
0:27:14 > 0:27:16because you've tried the diet and exercise route,
0:27:16 > 0:27:20you do know that you've got a whole load of crap going into your system.
0:27:20 > 0:27:22Because you're eating the kind of things, absolutely,
0:27:22 > 0:27:25that any dietician would not want you to eat.
0:27:25 > 0:27:27- All right? - That's mostly on weekends.
0:27:27 > 0:27:29If we can't do something to reverse this trend
0:27:29 > 0:27:32and make you lose weight, and manage to get you
0:27:32 > 0:27:36to maintain weight loss, there are surgical options.
0:27:36 > 0:27:39'Dr Lakdawala is recommending a gastric band operation,
0:27:39 > 0:27:42'which will make Kaleb's stomach smaller.
0:27:42 > 0:27:44'Not only will this reduce his weight,
0:27:44 > 0:27:48'but it should avoid the onset of diabetes,
0:27:48 > 0:27:50'which his family has a history of.'
0:27:50 > 0:27:53How are you feeling about it, Kaleb?
0:27:53 > 0:27:55- A bit too excited.- Are you excited?
0:27:55 > 0:27:56- Why are you excited?- I'm nervous.
0:27:56 > 0:27:59- I know, how are you feeling, Mum? - I'm nervous.
0:27:59 > 0:28:02- Why are you excited?- So, I get to become thin, and who wouldn't?
0:28:02 > 0:28:06There are advantages to it - I get better friends and, you know...?
0:28:06 > 0:28:09- Better friends?- More friends. - Yeah, yeah.
0:28:09 > 0:28:12Better-looking friends. THEY LAUGH
0:28:12 > 0:28:13Add a girl in front of that!
0:28:15 > 0:28:17This is life-changing, right now.
0:28:17 > 0:28:21This is absolutely, at 13, now your life is about to change.
0:28:21 > 0:28:23That's the best part.
0:28:28 > 0:28:29Wow.
0:28:29 > 0:28:3213 years old, he's going to have a life-changing operation,
0:28:32 > 0:28:35and we're going to get to see him go through it.
0:28:40 > 0:28:43Diabetes is a disease caused by high blood-sugar levels,
0:28:43 > 0:28:47and it can lead to heart disease and strokes.
0:28:47 > 0:28:51India has the largest diabetes population in the world,
0:28:51 > 0:28:54with more than 50 million sufferers,
0:28:54 > 0:28:58and Indians are believed to be more prone to the condition.
0:28:58 > 0:29:02Why has India got such a major problem with diabetes and obesity?
0:29:02 > 0:29:04Why India in particular?
0:29:04 > 0:29:05Er, genetically as Asians
0:29:05 > 0:29:09and as Indians we are predisposed to developing type 2 diabetes.
0:29:09 > 0:29:11There is something called the thrifty gene theory.
0:29:11 > 0:29:14What the thrifty gene basically means is that in years gone back,
0:29:14 > 0:29:18when out forefathers didn't have so much to eat, whatever they got,
0:29:18 > 0:29:19they used to conserve.
0:29:19 > 0:29:21Today, when we have too much more,
0:29:21 > 0:29:23we are still conserving what little we do have.
0:29:23 > 0:29:25And when you have too much, you conserve more.
0:29:25 > 0:29:28And that is leading to a host of diseases
0:29:28 > 0:29:30and they're becoming more and more obese.
0:29:30 > 0:29:33It's genetics that loads the gun and environment which pulls the trigger.
0:29:38 > 0:29:42For India's kids it's an environment that's changing dramatically.
0:29:44 > 0:29:47Multinationals are not the only ones cashing in.
0:29:47 > 0:29:51Local entrepreneurs are chasing the youth market by repackaging
0:29:51 > 0:29:53traditional street food as fast food.
0:29:56 > 0:29:58Jumbo King is the city's first domestic chain
0:29:58 > 0:30:02and sells a deep-fried potato burger called vada pav.
0:30:03 > 0:30:06The franchise has more than 40 outlets already,
0:30:06 > 0:30:09and it's millionaire owner Dheeraj Gupta
0:30:09 > 0:30:13has plans to open another 250 across the country.
0:30:13 > 0:30:15Hello.
0:30:16 > 0:30:18- Hi, how are you? Hello.- Anita.
0:30:18 > 0:30:20- Hi, Anita.- How are you?
0:30:20 > 0:30:22- Good, I'm very good.- Mr Jumbo King.
0:30:22 > 0:30:24- Ah, yes.- What do you sell?
0:30:24 > 0:30:28We have this traditional snack, it's the vada pav,
0:30:28 > 0:30:32this sells about two millions units in Mumbai everyday.
0:30:32 > 0:30:35Not us, the whole, that's how many people.
0:30:35 > 0:30:39Two million of these potato burgers.
0:30:39 > 0:30:42Those are the combinations, the combos that we have with Pepsi.
0:30:42 > 0:30:45- There's the Schezwan Jumbo King right at the end.- The Chinese one.
0:30:45 > 0:30:47- So this is Indian street food? - Absolutely.
0:30:47 > 0:30:49Tell me about this idea then,
0:30:49 > 0:30:52why did you decide to open a shop like this
0:30:52 > 0:30:55and market it like this and call it Jumbo King?
0:30:55 > 0:30:59Jumbo King is entirely inspired by McDonalds.
0:30:59 > 0:31:02We realised that Indian food needs to be branded similarly.
0:31:02 > 0:31:04So you've basically taken the Western model,
0:31:04 > 0:31:06- the western fast food model.- Yes.
0:31:06 > 0:31:09Why would the man on the street come to Jumbo King
0:31:09 > 0:31:11and not go to the vada pav guy over the road?
0:31:11 > 0:31:1350% of India's population is below 25.
0:31:13 > 0:31:16These are the guys who are coming to us...
0:31:16 > 0:31:20because there is a feeling of cool to come
0:31:20 > 0:31:22and eat at a Jumbo King rather than at one of those.
0:31:22 > 0:31:25It's cooler to be here, it's about where you're seen eating vada pav.
0:31:25 > 0:31:26Yes.
0:31:43 > 0:31:49The Indian fast food market is estimated to be worth £7 billion.
0:31:49 > 0:31:52By 2016 it's expected to double
0:31:52 > 0:31:57as domestic chains like Jumbo King adopt Western-style marketing.
0:31:57 > 0:32:00And you sell fries as well. Oh, it says, "Introducing French Fries."
0:32:00 > 0:32:04- Yes.- So this is a new thing. More carb.- Oh, yes.
0:32:04 > 0:32:07- We're just trying it out. - Potato with your potato.
0:32:07 > 0:32:09Yes.
0:32:10 > 0:32:13What made you come up with the name Jumbo King?
0:32:13 > 0:32:17My five-year-old daughter, that time she was five years old,
0:32:17 > 0:32:19she could remember Jumbo King.
0:32:19 > 0:32:20We are like, we have a name that
0:32:20 > 0:32:22if a five-year-old child can remember it,
0:32:22 > 0:32:24you have a simple name.
0:32:24 > 0:32:26- Are we going to see more fast food outlets in India?- Oh, yes.
0:32:26 > 0:32:28Indian or Western?
0:32:28 > 0:32:31- Both.- And what happens when India gets health conscious?
0:32:33 > 0:32:35We have a brown bread Jumbo King,
0:32:35 > 0:32:39and we're going to come out with a non-fried baked version.
0:32:39 > 0:32:42As soon as the customer starts demanding healthier stuff.
0:32:42 > 0:32:45We'll be the first to move along with the market.
0:32:45 > 0:32:47- So the demand has to be there first? - Yes.
0:32:49 > 0:32:51Hello, Adit.
0:32:51 > 0:32:52How are you?
0:32:52 > 0:32:55'Adit's agreed to come for a checkup.'
0:32:55 > 0:32:59'It will be the first time he's seen a doctor in five years.'
0:32:59 > 0:33:01He doesn't think there's a problem, you know.
0:33:01 > 0:33:03He doesn't think there's a problem.
0:33:03 > 0:33:06- He's very happy. - I don't think there's any problem.
0:33:06 > 0:33:08- You don't think there's a problem? - No.
0:33:08 > 0:33:11I think if I can cut down on my food, it should be good enough.
0:33:14 > 0:33:16That's 1.70 centimetres.
0:33:18 > 0:33:20That's 56 inches.
0:33:22 > 0:33:24Put your feet on the tile.
0:33:26 > 0:33:30That's fine. OK. That's 142.2.
0:33:30 > 0:33:32- You told me you were 126. - Yeah.
0:33:34 > 0:33:37You've got quite a shocked expression on your face.
0:33:37 > 0:33:39Previously I was around 126.
0:33:39 > 0:33:41When was that?
0:33:41 > 0:33:43When I last weighed.
0:33:43 > 0:33:45- A year.- A year ago.- Yeah.
0:33:45 > 0:33:46So, now you're...
0:33:46 > 0:33:51- Almost 20-odd kilos up from last year.- Yeah, in a year.
0:33:55 > 0:33:58Adit weighs more than 22 stone
0:33:58 > 0:34:01and Doctor Lakdawala's team will be advising him
0:34:01 > 0:34:03on what this means for his health.
0:34:06 > 0:34:08...if you've consciously done anything
0:34:08 > 0:34:10in the past few years to lose weight?
0:34:10 > 0:34:13- Two years back I had joined the gym. - Right.
0:34:13 > 0:34:16- But that was only for three, four months.- OK.
0:34:16 > 0:34:18Anything else that you might have tried?
0:34:18 > 0:34:20No, nothing.
0:34:20 > 0:34:24The fat percentage that he has is around 44%.
0:34:24 > 0:34:28Now for a boy of his age it should be around the 20 mark.
0:34:28 > 0:34:31Your ideal body weight should be around 70 to 75 kilos.
0:34:31 > 0:34:34He's almost twice this wait.
0:34:34 > 0:34:37Medically that fits into a super obese category, OK?
0:34:37 > 0:34:40When he was small, younger in his age,
0:34:40 > 0:34:44when we met the doctor the doctor said that was just baby fat.
0:34:44 > 0:34:46He's in the morbidly obese category.
0:34:46 > 0:34:50He's in the fattest group of people on the planet.
0:34:50 > 0:34:52The only thing I notice, just walking,
0:34:52 > 0:34:55he's got a few marks on the neck.
0:34:55 > 0:34:57This is not dirt.
0:34:57 > 0:35:01You might keep scrubbing it as much as you want and it will not go away.
0:35:01 > 0:35:03This is a precursor for type two diabetes.
0:35:03 > 0:35:06I'll tell you right now, we've not done his blood test,
0:35:06 > 0:35:07but if you were to do his blood test,
0:35:07 > 0:35:10I can better understand on paper that he'll have insulin resistance,
0:35:10 > 0:35:12just from seeing these signs.
0:35:12 > 0:35:17The doctor believes Adit's so heavy he's beyond dieting or exercise.
0:35:17 > 0:35:22His only option now is a costly weight loss operation.
0:35:22 > 0:35:25This is not a cosmetic surgery from any angle,
0:35:25 > 0:35:27this is life-saving surgery.
0:35:27 > 0:35:31This surgery basically gives that ray of hope to people
0:35:31 > 0:35:33who are looking at only darkness at the end of the tunnel,
0:35:33 > 0:35:36and for morbidly obese people that's what we do.
0:35:36 > 0:35:39Doctor, that child there, after doing the surgery,
0:35:39 > 0:35:41has not lost so much weight.
0:35:41 > 0:35:44He's lost loads. Sujata, are you looking at the same picture as me?
0:35:44 > 0:35:47This kid is humongous,
0:35:47 > 0:35:49this kid is half his size.
0:35:49 > 0:35:51Right now this kind of new culture
0:35:51 > 0:35:54that has kicked into India of junk food and everything,
0:35:54 > 0:35:59we all know as parents, as doctors, as professionals,
0:35:59 > 0:36:02we all know that junk food is bad for your health,
0:36:02 > 0:36:05but somehow it's tasty, and that's the biggest problem.
0:36:05 > 0:36:08But I had read once in a newspaper,
0:36:08 > 0:36:10somewhere abroad in a Western country,
0:36:10 > 0:36:14a man used to just have burgers,
0:36:14 > 0:36:19he always used to have fast food and he died at the age of 105.
0:36:19 > 0:36:22There are freak cases, like that man would probably be a freak case.
0:36:22 > 0:36:25But it is not always correct.
0:36:25 > 0:36:30If you have this fast food and all, the person will not survive for long.
0:36:30 > 0:36:33It's nothing like that. I don't... It's just a misconception.
0:36:33 > 0:36:34What do you think, Adit?
0:36:36 > 0:36:40I don't know. At the moment I don't know anything. I think...
0:36:41 > 0:36:45- Don't look at mum.- Yeah, don't look at mum. What are you saying.
0:36:45 > 0:36:49We will ask mum something else. What would you like?
0:36:49 > 0:36:51I don't know what to think.
0:36:51 > 0:36:54I wasn't expecting so much weight.
0:36:54 > 0:36:59- What were you expecting?- 130, maybe, 120.- But even 130 is really big.
0:36:59 > 0:37:00Yeah.
0:37:00 > 0:37:03So even if you were 130, what would you have thought?
0:37:03 > 0:37:05"That's OK. That's fine."
0:37:05 > 0:37:07No, actually I didn't know that it had
0:37:07 > 0:37:08so many problems associated with it.
0:37:10 > 0:37:12And so they will arrange another appointment now
0:37:12 > 0:37:15- to get his blood test done and everything?- Yes.
0:37:15 > 0:37:17We'll reschedule his blood test and stuff like that,
0:37:17 > 0:37:19so at least they're aware of where he stands.
0:37:25 > 0:37:28My gut feeling is this kid will come for surgery, not now,
0:37:28 > 0:37:29but maybe next three months,
0:37:29 > 0:37:31but maybe by the next six months to a year.
0:37:31 > 0:37:36If this kid doesn't have surgery he'll come back to me at 180 kilos
0:37:36 > 0:37:39five years from now. Diabetic, hypertensive, sleep apnoea,
0:37:39 > 0:37:41really unwell.
0:37:41 > 0:37:43But he will definitely come.
0:37:43 > 0:37:49The chances of him going on to lose this weight, when he's 50 BMI,
0:37:49 > 0:37:52is extremely, extremely remote.
0:37:58 > 0:38:01Around the world weight loss surgery is controversial,
0:38:01 > 0:38:03especially for young people.
0:38:04 > 0:38:07It's often seen as treating the symptoms, not the cause,
0:38:07 > 0:38:11and doctors can be accused of jumping too quickly to operate,
0:38:11 > 0:38:15especially when they charge thousands of pounds.
0:38:15 > 0:38:19But shedding weight by conventional means can be hard work.
0:38:21 > 0:38:24I joined 16 year old Simarin for a work out.
0:38:24 > 0:38:27Her parents are opposed to the idea of surgery.
0:38:28 > 0:38:32For me, to come down every week thrice to do this
0:38:32 > 0:38:35means I'm very, very, very committed.
0:38:35 > 0:38:39- Yes, good.- Waking up at 5:30 in the morning and coming down here.- 5:30?
0:38:39 > 0:38:43Yeah, cos you've to get up, get ready, come down,
0:38:43 > 0:38:46warm up a little bit and then we start at 6:30.
0:38:46 > 0:38:50What's driving you to want to lose all the weight?
0:38:50 > 0:38:52Just the fact that every... I take my weight everyday.
0:38:52 > 0:38:58And I'm genuinely a very focused person, so for me, if I am not losing
0:38:58 > 0:39:02even a little bit everyday, I get very frazzled and I don't like it.
0:39:02 > 0:39:05So just the fact that every time I stand on the weighing scale
0:39:05 > 0:39:08I'm losing a little bit everyday, that's what keeps me...
0:39:08 > 0:39:10- Keeps you going. - That's what keeps me going.
0:39:12 > 0:39:16Six months ago Simarin weighed over 16 stone.
0:39:16 > 0:39:19Since then she's lost more than 15 pounds
0:39:19 > 0:39:23after her mum, Poonam, joined her on a diet.
0:39:23 > 0:39:26And she's still got about 20, 25 kgs to lose. So, it's a lot to go.
0:39:26 > 0:39:28It's a lot to go.
0:39:28 > 0:39:30Would you ever consider any alternatives methods
0:39:30 > 0:39:32- of losing the weight? - No way.
0:39:32 > 0:39:34I do not, as a lifestyle,
0:39:34 > 0:39:37want to teach my children the easy ways to succeed.
0:39:37 > 0:39:40That is the kind of thing I want my children to learn -
0:39:40 > 0:39:42there is no shortcut to success in life.
0:39:42 > 0:39:46You can do it for one thing, what about the rest of your life?
0:39:46 > 0:39:48So, I am absolutely anti that.
0:39:48 > 0:39:50She has cried and told me, "Mom, do that.
0:39:50 > 0:39:52"Don't make me go through all this."
0:39:52 > 0:39:54So at times when I used to get very irritated
0:39:54 > 0:39:56because I'm not getting enough food or whatever,
0:39:56 > 0:40:00I would just be like, "Just finish it off, let's be done with it."
0:40:00 > 0:40:02But then she's always been very anti.
0:40:02 > 0:40:05At that point it was very hard to understand but now I know.
0:40:05 > 0:40:08I've lost so much weight I know I'm much happier doing it this way.
0:40:08 > 0:40:10I would never allow her to do...
0:40:10 > 0:40:12I'm happy then, she's like this.
0:40:12 > 0:40:14But no easy way.
0:40:14 > 0:40:17MUSIC: "Gangnam Style" by Psy
0:40:20 > 0:40:23Simiran's parents can afford a fitness coach,
0:40:23 > 0:40:24a dietician
0:40:24 > 0:40:26and a personal Zumba teacher
0:40:26 > 0:40:29who visits once a week to give the whole family a work out.
0:40:36 > 0:40:38Most kids in India don't have this option,
0:40:38 > 0:40:40so they don't have this choice.
0:40:40 > 0:40:42But if they do, they certainly don't have parents
0:40:42 > 0:40:44who are prepared to go through it with them.
0:40:44 > 0:40:46Cos that's what it takes in order to lose weight
0:40:46 > 0:40:48in a culture like the Indian food culture.
0:40:48 > 0:40:51You need the entire family to change their attitude towards food
0:40:51 > 0:40:52and not just the kid.
0:40:56 > 0:40:59She has the support of a couple of very wealthy parents
0:40:59 > 0:41:02who are able to provide her with the best weight loss treatment
0:41:02 > 0:41:04that you can buy.
0:41:04 > 0:41:06Including a Zumba teacher come to your house.
0:41:26 > 0:41:28- Yes.- Woo. APPLAUSE
0:41:32 > 0:41:35But Simarin is the exception, not the rule.
0:41:35 > 0:41:38Medical professionals are bracing themselves
0:41:38 > 0:41:41for a massive diabetes surge in the next 20 years,
0:41:41 > 0:41:45and estimate the number of sufferers will reach the 100 million mark.
0:41:47 > 0:41:50I wanted to know what the food industry thought about
0:41:50 > 0:41:52the country's obesity pandemic.
0:41:52 > 0:41:56So I visited the National Restaurant Association of India,
0:41:56 > 0:41:57a trade body for domestic
0:41:57 > 0:42:01and international companies, to meet Riyaaz Amlani.
0:42:01 > 0:42:04You're on the verge of an obesity crisis in this country.
0:42:04 > 0:42:06One in five kids are overweight.
0:42:06 > 0:42:09What I'm trying to get from you is at what point do you accept
0:42:09 > 0:42:11that you have a part to play in it
0:42:11 > 0:42:13and that you need to be responsible for what's going on.
0:42:13 > 0:42:15We're definitely not a bunch of, you know,
0:42:15 > 0:42:19people who sit in boardrooms going, "How can we take over the world?"
0:42:19 > 0:42:20We are conscientious,
0:42:20 > 0:42:23we do feel about our customers and we do feel that
0:42:23 > 0:42:26we contribute positively to society in many ways,
0:42:26 > 0:42:27and we take a lot of pride in that.
0:42:27 > 0:42:30Sure, but do you accept your responsibility
0:42:30 > 0:42:31and your part to play in it?
0:42:31 > 0:42:34- Absolutely.- If you say yes, what are you doing about it in that case?
0:42:34 > 0:42:36Look, we do have, in all the restaurants,
0:42:36 > 0:42:38we make it a point to have healthy options.
0:42:38 > 0:42:42- Like what?- We have salads, we have grilled stuff.
0:42:42 > 0:42:44We have low carb stuff, stuff with low salt.
0:42:44 > 0:42:47But when we actually go out there we provide these healthy options,
0:42:47 > 0:42:50we find that when people are ordering at restaurants,
0:42:50 > 0:42:51it's not what they want.
0:42:51 > 0:42:53When customers start demanding...
0:42:53 > 0:42:55healthy food,
0:42:55 > 0:42:58restaurants will have no choice but to give them healthy food.
0:42:58 > 0:42:59If customers demand unhealthy food,
0:42:59 > 0:43:02restaurateurs will have no choice but to give them what they want.
0:43:02 > 0:43:04- It's just the way it is.- Yeah.
0:43:04 > 0:43:06And that's something we need to understand.
0:43:06 > 0:43:08We are one revolution behind the Western world.
0:43:08 > 0:43:10You're comparing it to the West,
0:43:10 > 0:43:13and I would describe India, in terms of its fast food, as the Wild West.
0:43:13 > 0:43:16In the UK you get access to nutritional information.
0:43:16 > 0:43:17It's transparent,
0:43:17 > 0:43:20you're not allowed to advertise aggressively towards children.
0:43:20 > 0:43:22You cannot open a restaurant,
0:43:22 > 0:43:24a fast food joint within 400 metres of a school.
0:43:24 > 0:43:26- Let me ask you a question.- Yeah.
0:43:26 > 0:43:29Now, let's just say that I take all this information
0:43:29 > 0:43:31and I put it up on a website.
0:43:31 > 0:43:34You think that's going to stop people from eating the product?
0:43:34 > 0:43:37But I just want to know what responsibility you will take.
0:43:37 > 0:43:40You are a powerful body, a lot of people have signed up to you,
0:43:40 > 0:43:42including all the big international brands,
0:43:42 > 0:43:46you could implement change at least within your own group.
0:43:46 > 0:43:51Honestly, this has not been an issue which has been top of my,
0:43:51 > 0:43:54you know, the Indian restaurateurs consciousness, really,
0:43:54 > 0:43:56to be honest with you.
0:43:56 > 0:43:59It's not been something which is top of my...
0:43:59 > 0:44:01But, yeah, there is merit in what you're saying.
0:44:01 > 0:44:05There should be more transparency on what we put out there.
0:44:05 > 0:44:08There should be more responsibility and we'll start looking into that.
0:44:08 > 0:44:11I'm quite shocked that you said it's not been an issue.
0:44:11 > 0:44:13Are you saying there's no discussions being taken place
0:44:13 > 0:44:17about nutrition and health generally amongst your body?
0:44:19 > 0:44:22It is not a burning issue, let's just put it that way.
0:44:22 > 0:44:24It's not something that we talk about all the time.
0:44:24 > 0:44:28If there's not going to be a demand for a product,
0:44:28 > 0:44:30what is the point of selling it if nobody is going to buy it?
0:44:40 > 0:44:42It's quarter past five in the morning.
0:44:42 > 0:44:45It's the morning of the surgery
0:44:45 > 0:44:47for Kaleb.
0:44:47 > 0:44:48And...
0:44:48 > 0:44:50I'm feeling a little nervous for him,
0:44:50 > 0:44:53so goodness knows how he's feeling.
0:44:53 > 0:44:56I'm going to get ready and go round to his house
0:44:56 > 0:44:59and go down to the hospital with both of them.
0:45:02 > 0:45:03- Morning, Dimple.- Morning.
0:45:03 > 0:45:07- How are you?- Good, how are you? - Yeah, very well, thank you.
0:45:14 > 0:45:16I told my mum.
0:45:16 > 0:45:20She was absolutely shocked that I'm going through with the surgery.
0:45:20 > 0:45:23But I mean, she's like, "You're the mum, you decide.
0:45:23 > 0:45:25"You take that call."
0:45:27 > 0:45:30It's a big decision to put your child through.
0:45:30 > 0:45:32I thought for something else that I've not tried yet
0:45:32 > 0:45:35and that probably might work.
0:45:35 > 0:45:38He's my entire world, and he's in your hands.
0:45:41 > 0:45:44So how busy is it today? Have you got lots of surgeries lined up?
0:45:44 > 0:45:48We do about five or six a day, and that's when we're exhausted.
0:45:48 > 0:45:52At one point we have 200 kgs coming in and 190 kgs coming in,
0:45:52 > 0:45:56and you have four of five of those, it's exhausting.
0:45:56 > 0:45:58India is a developing nation,
0:45:58 > 0:46:01and they are all the multinationals coming into India at the moment.
0:46:01 > 0:46:03It's a growing economy.
0:46:03 > 0:46:04But the side effects to it,
0:46:04 > 0:46:06all these fast foods are going to be this.
0:46:06 > 0:46:09So the government needs to take a stand and say, "No more in schools.
0:46:09 > 0:46:11"No more below this age group."
0:46:11 > 0:46:14It will come when they realise the magnitude of the whole problem.
0:46:17 > 0:46:19Kaleb's having a gastric band fitted
0:46:19 > 0:46:22which will reduce the size of his stomach.
0:46:23 > 0:46:25It's a serious operation
0:46:25 > 0:46:28but less drastic than the gastric sleeve operation I saw before.
0:46:31 > 0:46:33Why would you not give him the sleeve?
0:46:33 > 0:46:36Because he has to still grow.
0:46:36 > 0:46:38I don't want to remove a part of the stomach
0:46:38 > 0:46:40- which contains the ghrelin hormone. - Right.
0:46:41 > 0:46:43And how many 13-year-olds have you done?
0:46:43 > 0:46:44This is the first.
0:46:44 > 0:46:48I'm very, very reluctant when I have to operate on kids.
0:46:48 > 0:46:49I try not to.
0:46:55 > 0:46:59You've got more 13-year-olds having these kind of problems
0:46:59 > 0:47:01than the adults.
0:47:01 > 0:47:04And just imagine that you have a whole population of people
0:47:04 > 0:47:06becoming diabetic by that time.
0:47:06 > 0:47:09We should prevent this kind of growing menace somewhere
0:47:09 > 0:47:11and nip it in the bud.
0:47:11 > 0:47:12That's your gall bladder.
0:47:13 > 0:47:17- And that's where your heart is. Can you see it?- Oh, wow, yeah.
0:47:17 > 0:47:21We're getting a good look inside Kaleb here, aren't we?
0:47:21 > 0:47:22This is the fat.
0:47:24 > 0:47:25So where is India heading?
0:47:25 > 0:47:29If we teach the kids, maybe you'll save the next generation
0:47:29 > 0:47:30if not this.
0:47:33 > 0:47:34What's that?
0:47:34 > 0:47:38I'm just touching that area of fat where it's stuck
0:47:38 > 0:47:39and getting rid of that.
0:47:43 > 0:47:47Now he's cut away the fat the doctor's ready to fit the band.
0:47:48 > 0:47:50- So it's going in now? - Yeah.- That's it.
0:47:52 > 0:47:54And that's its new home.
0:47:54 > 0:47:57Now my endeavour is to pull all this fat down
0:47:57 > 0:48:00- and then to put the band around this area.- Mm-hm.
0:48:00 > 0:48:02I'm going to now pass the band across.
0:48:04 > 0:48:07So could this be sending out a message that says,
0:48:07 > 0:48:10"If you don't want to exercise and diet, this is a quick fix."
0:48:10 > 0:48:11No, no, no, no.
0:48:11 > 0:48:14It's not a quick fix. It's the only fix that you might need.
0:48:14 > 0:48:18And so my advice to most youngsters is, "Don't go down that path."
0:48:20 > 0:48:23Just explain where will his food go now then,
0:48:23 > 0:48:25which part of the stomach will it go into.
0:48:25 > 0:48:26This is the food pipe.
0:48:26 > 0:48:29The food will come here, this is a pouch
0:48:29 > 0:48:31which will then hold the food back.
0:48:31 > 0:48:34So basically you will only be able to consume
0:48:34 > 0:48:36- a tiny amount of food at a time. - Yep.
0:48:36 > 0:48:39And because he's having this surgery now at such a young age,
0:48:39 > 0:48:42- is this going to help prevent him from getting diabetes?- Yeah.
0:48:42 > 0:48:44Hypertension, all the other bits and pieces
0:48:44 > 0:48:46that come with being overweight?
0:48:46 > 0:48:50As we had heard from him is that his entire family is mostly diabetic.
0:48:50 > 0:48:52So with this kid we at least prevent him
0:48:52 > 0:48:55from ever going beyond this point.
0:48:55 > 0:48:59Hopefully he should lose around 30-odd kilos with this surgery,
0:48:59 > 0:49:03and then grab that opportunity with both hands.
0:49:04 > 0:49:07Every time I operate on a kid this young
0:49:07 > 0:49:09I just wonder, why couldn't he have done something better?
0:49:30 > 0:49:32So, perfect. It's gone perfect.
0:49:34 > 0:49:36Wow.
0:49:36 > 0:49:37- I'm a little bit...- Of course.
0:49:37 > 0:49:39- He's fine?- He's absolutely fine.
0:49:41 > 0:49:46All of a sudden it's just dawned on me that he's a 13-year-old kid.
0:49:46 > 0:49:48He's having major gastric surgery
0:49:48 > 0:49:53that should only be done on adults really who have had...
0:49:53 > 0:49:57a life of living really badly. He's 13.
0:49:57 > 0:49:59Wake up, wake up, wake up.
0:50:00 > 0:50:02Wake up, wake up, wake up.
0:50:03 > 0:50:05Come on.
0:50:05 > 0:50:07Give me your bright smile, baby.
0:50:07 > 0:50:09Open up your eyes, Kaleb.
0:50:15 > 0:50:17I'm sure this is going to be a very positive thing.
0:50:17 > 0:50:19From now on he's...
0:50:19 > 0:50:20He's going to be...
0:50:20 > 0:50:22It's going to be a life-changing thing, so...
0:50:22 > 0:50:24No regrets.
0:50:38 > 0:50:40I hadn't seen Adit since his checkup
0:50:40 > 0:50:43and I wanted to know about his test results.
0:50:43 > 0:50:47But it seems he hadn't even turned up for his follow-up appointment.
0:50:48 > 0:50:52But it's only a blood test, Adit, like, it would take...
0:50:52 > 0:50:56like ten minutes to do and then you get the results within a day.
0:50:58 > 0:51:01But, Adit, what is more important than your health?
0:51:01 > 0:51:04What about all the things that the doctor was saying?
0:51:04 > 0:51:06You don't think there's any urgency?
0:51:08 > 0:51:10I'll speak to you later.
0:51:10 > 0:51:13You can rest now. OK. OK. Bye.
0:51:15 > 0:51:17Wow.
0:51:17 > 0:51:21OK, that is a kid who's just gone home and put his head in the sand.
0:51:21 > 0:51:23He says he doesn't want the blood test
0:51:23 > 0:51:26because it's going to disrupt his studies
0:51:26 > 0:51:27and he's got exams going on at the moment.
0:51:29 > 0:51:31I just think it's nonsense.
0:51:31 > 0:51:33I just think he doesn't want to have to deal with it.
0:51:33 > 0:51:35PHONE RINGS
0:51:36 > 0:51:38Oh, it's Adit.
0:51:38 > 0:51:40Just calling back.
0:51:40 > 0:51:41Hey, Adit.
0:51:43 > 0:51:46Hey. Hello. Hello, Sujata.
0:51:46 > 0:51:48MOUTHS: His mum.
0:51:58 > 0:52:01So you're not interested in what the doctor has to say?
0:52:01 > 0:52:02You're not interested.
0:52:02 > 0:52:05What about all the stuff he was saying about his diabetes,
0:52:05 > 0:52:09the marks on his neck, hypertension, high blood pressure, cholesterol?
0:52:12 > 0:52:14You think he said all that to make money.
0:52:16 > 0:52:19I'm not hassling you, Sujata, and I don't, lis...
0:52:19 > 0:52:21MOUTHS: Wow.
0:52:22 > 0:52:24OK. Thank you. Bye-bye.
0:52:26 > 0:52:27Wow.
0:52:27 > 0:52:30Right, she was absolutely fuming and irate, and she ended
0:52:30 > 0:52:31the phone call by saying that,
0:52:31 > 0:52:35"I will tell the world that I'm happy with my son's fatness
0:52:35 > 0:52:37"and I know what's best for him and I'll do what I want."
0:52:37 > 0:52:40And they have no intention of having a blood test or going
0:52:40 > 0:52:42back to see the doctor.
0:52:42 > 0:52:44We can't argue with that, it's his mum.
0:52:58 > 0:53:01I was on my way round to see Kaleb the day after his surgery.
0:53:05 > 0:53:09He was already back home, less than ten hours after the operation.
0:53:09 > 0:53:10Hey, Dimple.
0:53:10 > 0:53:13Hi, come on in.
0:53:13 > 0:53:15- How are you?- Good.
0:53:15 > 0:53:19- There we go. Some flowers. - Thank you.
0:53:19 > 0:53:22- This is my dad. - Pleased to meet you, how are you?
0:53:25 > 0:53:27Hey, Kaleb.
0:53:27 > 0:53:28How are you feeling, Kaleb?
0:53:30 > 0:53:32Fine. A little bit sore?
0:53:32 > 0:53:35You want to show Anita how it looks.
0:53:35 > 0:53:36Shall we see.
0:53:39 > 0:53:41And how are you feeling?
0:53:41 > 0:53:43When I walk it hurts.
0:53:43 > 0:53:46- You've got a little bell there. - What's the bell for?
0:53:46 > 0:53:48- To call me.- That's brilliant.
0:53:48 > 0:53:50Are you feeling hungry?
0:53:51 > 0:53:52No.
0:53:52 > 0:53:53Stomach's hurting.
0:53:53 > 0:53:55- But you're not feeling hungry?- No.
0:53:55 > 0:53:58It takes me half an hour to finish this much of food.
0:53:58 > 0:54:01- Half an hour?- Yeah.
0:54:01 > 0:54:03But you're not thinking about food though, are you?
0:54:03 > 0:54:05It's the last thing on my mind.
0:54:05 > 0:54:08So your bronchitis will improve.
0:54:08 > 0:54:10Your sugar levels with improve.
0:54:10 > 0:54:14It also means that you won't have more problems further down the line.
0:54:14 > 0:54:16- Yeah.- And he's not looking at diabetes for ever.
0:54:18 > 0:54:20That's gone, ever.
0:54:21 > 0:54:23So that's wow, that's amazing.
0:54:25 > 0:54:29Dimple had kept Kaleb's operation a secret from her father.
0:54:32 > 0:54:36Dimple actually hasn't told her dad that Kaleb's had the surgery
0:54:36 > 0:54:39and she's going to tell him right now.
0:54:39 > 0:54:41I don't know how he's going to react.
0:54:41 > 0:54:44Where they come from, this is not a typical thing to do.
0:54:44 > 0:54:47This is not something that you would want to consider.
0:55:37 > 0:55:38Don't cry.
0:55:47 > 0:55:49Kaleb is...
0:55:49 > 0:55:51the apple of their eyes.
0:55:51 > 0:55:53This is the reason I didn't tell him.
0:56:00 > 0:56:02You want to see me thin?
0:56:02 > 0:56:03Thin. Yeah.
0:56:09 > 0:56:12Papa, this is going to be very, very good for Kaleb.
0:56:22 > 0:56:24This will work. This will work.
0:56:33 > 0:56:36It's an exciting time for those of use who know and love India.
0:56:36 > 0:56:39Many of the country's deep-seated problems
0:56:39 > 0:56:41shows signs of finally being tackled.
0:56:44 > 0:56:47But there is a downsize to the rapid economic development.
0:56:49 > 0:56:50India's obesity crisis means that
0:56:50 > 0:56:54the same generation that's benefiting from the new wealth
0:56:54 > 0:56:58is also facing an increased risk of diabetes and heart disease.
0:57:03 > 0:57:07I hope that the operation will mean a better future for Kaleb at least.
0:57:08 > 0:57:09Has there been any weight loss?
0:57:09 > 0:57:11- I only know it's been a few days. - Yeah, six kgs.
0:57:11 > 0:57:13Six kilos!
0:57:15 > 0:57:17- That's incredible.- I know.
0:57:17 > 0:57:21If in five days I lose six kgs then I'm on my highway.
0:57:21 > 0:57:24- Express way. - You are on the express way.
0:57:24 > 0:57:27- I mean, this is about lifestyle now, isn't it?- Yeah.
0:57:27 > 0:57:29I think I am getting to the lifestyle already.
0:57:29 > 0:57:31- Already?- Yeah.
0:57:36 > 0:57:38Well, Dimple's dealt with her son's issue
0:57:38 > 0:57:40and the only way she knew how by going to the doctors,
0:57:40 > 0:57:43and yes, she's probably prevented him from having
0:57:43 > 0:57:45cardiovascular problems, diabetes,
0:57:45 > 0:57:48but India has a huge crisis on its hands with obesity
0:57:48 > 0:57:51and diabetes and they need to wake up to it.
0:57:53 > 0:57:57The authorities in India have been slow to recognise
0:57:57 > 0:57:59the health risks of a fast food revolution.
0:57:59 > 0:58:03At the moment, economic growth and tax revenues from the food industry
0:58:03 > 0:58:05are more important than regulation.
0:58:07 > 0:58:10Change will probably only come as it has become to in the West
0:58:10 > 0:58:14when the problem becomes so widespread in India
0:58:14 > 0:58:16that it can no longer be ignored.
0:58:50 > 0:58:53Subtitles by Red Bee Media Ltd