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Most Indian men put on weight slowly from their mid-twenties, often about a kilo a year, because a desk job, a long commute and late dinners burn a little less than they eat. Several things speed it up in men in particular: quitting cigarettes, heavy drinking, night shifts, belly fat that pulls testosterone down, loud snoring from sleep apnoea and, less often, an underactive thyroid.
Quitters gained about 4.7 kg on average in the year after stopping smoking, and shift workers were 25% more likely to be overweight. Losing weight without trying is a separate signal. In a man who has not changed his food or exercise, it can point to uncontrolled diabetes, an overactive thyroid or an infection.
Why do men gain weight in their twenties and thirties?
For most men the gain begins with the first job. Lunch comes from the canteen or a delivery app, the commute takes an hour each way, and weekend cricket gives way to errands. Appetite does not shrink to match the smaller amount of movement.
Asian data back up the timing. A Singapore study (Whitton) followed 9,655 Chinese, Malay and Indian adults for about four years. Those aged 21–30 gained about 3.5 kg more than those over 60, the largest gain of any age group. Marriage went with extra gain in women but not in men, which runs against the idea of the well-fed husband.
The gain usually arrives in stretches rather than evenly. A year of late calls with a US client, with dinner eaten twice, or the year after a baby arrives, when the morning walk quietly stops, can account for half of a decade's kilos.
Indian men also store more of it around the abdomen, and at a lower weight, than men of European origin. That is why the Indian consensus guidelines (Misra) use lower cut-offs. For Asian Indian adults a BMI of 23–24.9 counts as overweight and 25 or more as obesity, and a waist of 90 cm or more in men marks abdominal obesity.
Low testosterone and belly fat drive each other in men
A 2022 review by two Australian endocrinologists (Wittert) looked at how testosterone changes with age and weight. In healthy men without obesity, it falls only slightly with age, at least until very old age. Fat stored around the organs accounts for most of the drop seen in heavier men.
Visceral fat brings insulin resistance, inflammation and changes in brain signalling that reduce what the testes produce. Blood tests then show low testosterone with normal pituitary hormones, which the review calls the functional hypogonadism of obesity. With less testosterone, muscle is harder to build and keep, so more of each extra kilo is stored as fat.
In the studies reviewed, testosterone rose in proportion to the weight men lost, and men with levels below 16 nmol/L had a higher risk of type 2 diabetes. For a man with a large waist and a low morning testosterone, the waist is usually where a doctor starts.
Sources: [2]
Why do men gain weight after quitting smoking, drinking heavily or working nights?
Nicotine dulls appetite and slightly raises the energy the body burns, so stopping usually brings some gain. A pooling of 62 studies of people who quit and stayed off cigarettes (Aubin) found an average gain of about 1 kg in the first month. It reached 2.9 kg by three months and 4.7 kg by a year, most of it early. About 16% lost weight over the year and 13% gained more than 10 kg.
That is no reason to keep smoking, since the heart and lung benefits of quitting far outweigh a few kilos. It does mean the first three months deserve a plan: roasted chana, cucumber or fruit within reach for the moments a cigarette used to fill, and a daily walk.
Alcohol carries 7 calories per gram, close to fat, and the snacks served with it add more. A 2015 Ottawa review (Traversy) found light to moderate drinking was not clearly linked to weight gain, but heavy drinking was. Three or four large pegs with namkeen and chicken tikka on a Saturday can come to around 1,000 calories, and the fried snacks are often a bigger share than the drinks.
Many Indian men work nights in IT support, hospitals, security, transport and factories. A 2018 review of 26 studies with more than 311,000 workers (Liu) found shift workers were about 25% more likely to be overweight and 17% more likely to have obesity than day workers. Keeping the main meal at a fixed time, carrying food from home and protecting one block of sleep in a dark room all help.
Loud snoring, a slow thyroid and some long-term treatments can add weight
Loud snoring with pauses in breathing is the main sign of obstructive sleep apnoea, which is more common in men. A Wisconsin study (Peppard) followed 690 working adults for four years. A 10% gain in weight predicted about a 32% rise in breathing pauses an hour and a sixfold higher chance of moderate or severe apnoea, while a 10% loss predicted about a 26% fall. Poor sleep leaves men tired, hungry for quick energy and less likely to exercise, so the two feed each other.
An underactive thyroid explains a smaller share. In an eight-city Indian survey (Unnikrishnan), about 5% of men had hypothyroidism, a third the rate in women, and many had never been diagnosed. Tiredness, constipation, feeling cold and slow weight gain together are the usual picture, and a TSH test settles it. Tiredness from a slow thyroid or bad sleep is one more reason the scale creeps. A doctor-led plan that starts with a home blood test checks these first, then aims for losing up to 20% of body weight while keeping muscle.
Gain that is fast, or that shows up as swelling, needs a different check. Puffy ankles, a tight ring or breathlessness when lying flat suggest fluid held by the heart, kidneys or liver. Fat collecting on the face, belly and upper back while the arms and legs thin out, with purple stretch marks, is a rare sign of excess cortisol.
Steroids taken by mouth for months, several antidepressants and antipsychotics, and some older sugar treatments can add weight too. Stopping anything a doctor started is a decision to make with that doctor, who may have an alternative that suits your weight better.
Check it yourself in 2 minutes: your waist, your BMI and one question for whoever sleeps nearby
Measure your waist in the morning at the level of the navel, standing relaxed and breathing out normally. At 90 cm or more, the Indian guidelines count it as abdominal obesity, whatever your weight looks like.
Then work out your BMI: weight in kilograms divided by height in metres, squared. At 1.72 m and 78 kg that is 78 divided by 2.96, about 26.4. On the Indian cut-off of 25 that counts as obesity, even though most friends would call it normal for a man of forty. Write both numbers down with the date.
Last, ask your wife or roommate whether you snore loudly, gasp or stop breathing at night. If the answer is yes and you wake unrefreshed or doze off in meetings or at traffic lights, a sleep study is worth discussing with a doctor. The Wisconsin data show weight and apnoea pushing each other along.
What causes weight loss in men without trying?
Losing weight without changing food or activity is a different signal from gaining it. Doctors look closely when a man loses more than about 5% of his body weight over six to twelve months without trying, about 4 kg for an 80 kg man. A belt that needs a new hole or a collar gone loose is often the first thing noticed.
In Indian men, uncontrolled diabetes is one of the commonest reasons. When blood sugar runs very high, glucose leaks into the urine and takes its calories with it, so thirst, frequent urination and weight loss arrive together. An overactive thyroid speeds up energy use and often brings a racing heart, tremor and heat intolerance. Tuberculosis and other long infections, depression, heavy drinking, and gut or liver disease are also on the list.
Cancer is the cause people fear most. A 2021 review in older adults (Gaddey) found that other conditions were the commoner causes, though cancer still accounted for up to a third of cases. In 6–28% no cause was found even after testing.
A doctor will usually begin with a blood count, sugar and HbA1c, thyroid, liver and kidney tests, inflammation markers, a urine test and a chest X-ray. Fever, night sweats, a cough lasting weeks, a change in bowel habit or blood in the stool make the visit urgent.
Sources: [8]