OBJECTIVES: Recent changes in lifestyle has triggered an increased prevalence of obesity even in  developing countries such as India. Obesity is known to be correlated with increased risk of Type 2 Diabetes and Cardiovascular diseases. The burden of obesity may be underestimated as Indians are at higher risk of comorbidities with comparatively lower BMI. The aim of our research was to assess the epidemiology and burden of obesity in India. METHODS: International and Indian medical databases (MEDLINE, EMBASE, dmri.in) as well as archives of Indian medical journals (nmji.in, japi.in) were searched to collect information regarding epidemiology and burden of obesity. RESULTS: Our search retrieved 27 relevant publications. The prevalence of obesity among Indian adults was setting-dependent. In rural areas, obesity was diagnosed in 5.1% - 8.5% and 5.2% - 12.7% of men and women, respectively. In urbanized regions 15.9% - 38.2% of men and 23.5% - 47.6% of women were obese. Evidence for burden of obesity was sparse and based on single trials reporting increased risk of diabetes (RR = 8.45 [1.09; 65,36]), hypertension (RR = 2.19 [1.16; 4,13]) and breast cancer (RR = 2.27 [1.28; 4,01]) in obese as compared to normal-weight patients. No correlation between overweight and excessive risk of death was found. Obesity and diabetes place a significant economic burden on society mainly due to indirect costs including productivity loss, decreased household earnings and higher dependence on welfare. Indeed, 15%-25% of household income is spent on treatment of diabetic patients in India, and with the rising incidence, this will only worsen over time. CONCLUSIONS: Obesity and diabetes burden the constrained healthcare system of India and the entire society, leading to lost productivity and decreased household incomes. With the rising prevalence, this burden will only worsen unless effective measures to address the same are put in place.