If someone had told me two years ago that I would lose over 50 kilos without setting foot in a gym or giving up real food, I would not have believed it. But here I am—healthier, sharper, and more confident than I have been in years. My transformation, however, did not begin with a fitness influencer or a fad diet. It began in a hospital bed.

Over the past decade, my body has been through an unrelenting series of medical challenges—each one demanding its own kind of resilience. From a heart attack to chronic infections, surgeries, and even a near-fatal road accident, it has been a continuous test of endurance. Physical pain is one thing, but the emotional toll of living in constant recovery mode is something else entirely.

At my heaviest, I weighed 144 kilos—a number that didn’t just show up on the scale, but in every aspect of my life. I had outgrown more than just my clothes; I had outgrown the energy and confidence I once took for granted. Everyday tasks left me breathless. My sleep was broken. And slowly, without realising it, I had started slipping away from the person I once was.

I wasn’t someone who lived an indulgent or careless life. In fact, I had tried to lose weight many times. But each time I gathered the will to begin, my health threw me off track.

It was frustrating not because I was not trying, but because life kept getting in the way. Over time, the cycle took a toll. I began gaining more weight, developed sleep issues, and struggled with constant fatigue. When your health becomes unpredictable, it quietly chips away at your sense of control. You’re not just dealing with pain or procedures—you’re also navigating fear, isolation, vulnerability, and the exhausting cycle of hope and relapse. Add to that the silent effects of sleep apnea and chronic fatigue, and it becomes harder to distinguish where the physical discomfort ends, and the emotional struggle begins.

Everything changed in late June 2023, when I was hospitalised again. This time, a doctor suggested that I use a BiPAP machine to help me sleep better. That small intervention became the turning point. For the first time in years, I slept through the night and woke up refreshed. That single improvement gave me the energy and the courage to take the first step towards the new me. I began walking. I gave up alcohol to cut out empty calories. From that point on, I didn’t look back.

I didn’t follow any crash diet or subscribe to anything extreme. It took me a while to figure out what would work for me, however. I loved my tandoori chicken and yummy paneer butter masala, the naans, and the oh-so-tasty parathas. I had read enough to know that a daily calorie limit was the starting point. In the beginning, I didn’t think much about nutrients—I just focused on staying within the calorie limit.

Over time, I realised that the nutritional quality of my food matters as much as the quantity, if not more. I started making changes and started feeling noticeably better when I shifted to a more mindful, balanced approach with the right foods. Soon, I was paying closer attention to eating enough proteins, the right (moderate) amount of fats, loading up on low-carb vegetables, cutting out unnecessary carbs, and limiting fruits and beverages. And no alcohol at all. I made my own meal plan—something that would satisfy me both physically and mentally, without feeling like punishment. Eventually, I realised that a high-protein, low-carb, high-fat diet suited my body best.

The trick was also keeping my meals simple and consistent. Chicken, eggs, paneer, fish, curd/Greek yoghurt, and green vegetables became my friends, and I made it a point to eat three proper meals a day while ensuring I never skipped breakfast. I realised soon enough that if the monotony works for you, there is no harm in being repetitive. 

While green tea became a morning and evening beverage favourite, breakfast usually included lightly roasted paneer or stir-fried mushroom or chicken sausages, a couple of eggs (boiled or omelette, sometimes with cheese), curd, and an occasional small portion of fruit. For lunch, I stuck to two small chapatis, two low-carb veggies (like cabbage, cauliflower, beans, mushroom, beetroot, etc.), a protein source like chicken or fish, and curd or Greek yoghurt. For dinner, I stick to grilled chicken or fish, sometimes a salad or tikka, and eggs or paneer.

No intense workouts were needed. Walking daily and staying disciplined with my diet made all the difference. I did not hire a trainer, join a gym, or consult a nutritionist this time—and that was a conscious choice. Every time I had joined a gym in the past, the workouts suggested by trainers would quickly burn me out. The pace was too much, especially at my heaviest; and I knew I wouldn’t be able to sustain it. I did a lot of reading and learned something crucial: fat loss is driven far more by diet than exercise—nearly 80% of the work is what you eat, followed by moderate movement and good rest.

The tougher challenge, however, was mental. There were weeks when nothing seemed to change. I constantly reminded myself: I didn’t gain this weight overnight, so how could I expect to lose it overnight? I focused on small, repeatable habits. I tracked my food. I created routines. And gradually, things started shifting.

It all came down to discipline. Fancy plans or short bursts of motivation wouldn’t get me there—only consistency would. I followed what I now call the 3Es: Eat right, Exercise regularly, and Eliminate excuses. My clothes got looser. I had to dig out jeans I hadn’t worn in over a decade. I started recognising myself again, not just in the mirror, but in the way I felt.

Eventually, I began sharing my journey on Instagram. I just wanted to share what was working for me in an honest, relatable way. To my surprise, people started listening. They said my journey gave them hope—and if I could do it, so could they.

So far, I’ve lost 57 kilos and I’m still going. Today, I’m working on a simple, no-nonsense guide to weight loss and offering personalised consultations. Not as a nutritionist or fitness coach, but as someone who’s been through it, who understands the struggles, and who wants to help others feel like themselves again.

The weight loss journey isn’t about chasing a number. It’s about showing up for yourself. It’s about reclaiming your energy, your joy, and your life.

Niraj is on Instagram @fitwithNBJ

India, home to 138 million older adults, is witnessing a rapid demographic transition, with the proportion of the population aged 60 and above increasing from 7.4% in 2001 to a projected 13.2% in 2031. File photograph
| Photo Credit: RAGU R

Even within a universal healthcare system, there continue to remain marked disparities in access to care among older adults, with distance to healthcare facility posing a critical barrier, said a study published in The Lancet Regional Health Southeast Asia titled ‘Miles to go before I seek: distance to the health facility and health care use among older adults in India’. It further noted that ensuring availability of health services within reach and reducing geographical barriers are paramount towards ensuring an equitable and inclusive healthcare system where no one is left behind.

The study points out that while a lot of research has explored financial constraints and health literacy as barriers to healthcare access, there is limited evidence on how physical distance impacts healthcare utilisation and health-seeking behaviours in older adults in India. For this paper, researchers used the nationally representative Longitudinal Ageing Study of India (LASI) (Wave-1, 2017–18) consisting of 31,902 older adults’ data to analyse the average distance travelled by older adults for their routine and acute healthcare needs and concomitant healthcare utilisation through an equity lens.

Distances travelled

In India, access to healthcare is often restricted by factors including availability of local health services, financial constraints, low health literacy, and inadequate family or social support systems. India, home to 138 million older adults, is witnessing a rapid demographic transition, with the proportion of the population aged 60 and above increasing from 7.4% in 2001 to a projected 13.2% in 2031. Nearly half of these populations have multiple long-term or debilitating conditions that demand continuous and coordinated health care.

The study notes that older adults, on an average, travelled a distance of 14.54 km to seek outpatient services and 43.62 km for inpatient care respectively. For two-thirds (67%) of urban older adults, the availed outpatient facility was within 10 km of reach, while for their rural counterparts, it was 28.3 km, revealing a significant urban-rural disparity. This grew disproportionately for in-patient care, where the distance and time taken was two times higher for rural sexagenarians compared to their urban counterparts. For in-patient admission, 95 per cent arranged their own mode of transport, while 5 per cent used ambulance services, with no significant urban-rural difference.

Further both out-patient and in-patient care utilisation was high (73% and 40% respectively) when the facility distance was within 10 km. As the distance increased, a commensurate decline in the out-patient utilisation was observed, being 17% and 10% for facilities at 11–30 km and 30 km or more respectively. Additionally, for women, those living alone, and those with low education and income, this decline was more pronounced. Around 19% of rural older adults had to travel at least 60 km to avail of in-patient care. The situation was similar for urban dwellers with 10% travelling at least 60 km for in-patient care.

Risk of adverse outcomes

Long travel times and distant facilities act as a potential barrier to receiving timely and essential healthcare for this population which could posit high risk of adverse outcomes, warned the study adding that addressing transportation barriers could be a key strategy to improve access to care among the geriatric population, especially those residing in rural areas.

“Various studies have shown that interventions aimed at minimising transportation barriers among low-income, remote and older populations not only improves access to medical care but patient outcome as well, while being cost-efficient. Future research must develop and demonstrate how community-based transport service can be embedded within as a model for implementation for geriatric care. Given the rising number of ageing populations who are home-bound, a shift from clinic-based out-patient care to home-based primary care merits consideration through a mix of mobile medical van, digital healthcare and inclusive social support,’’ recommends the study.

It adds that there is a need to design and formulate strategies on how existing Ayushman Arogya Mandir (community-based primary care centres) can be strengthened to meet the comprehensive healthcare needs of growing geriatric population.

India, with its high population density, prevalence of infectious diseases, and over-the-counter availability of antibiotics, has a long and winding road to travel in order to counter AMR. Photograph used for representational purposes only
| Photo Credit: istock.com/Dr_Microbe

Antimicrobial resistance (AMR), often labelled as a silent pandemic, is one of the most pressing global health challenges of our time. As pathogens evolve to withstand the drugs currently available to counter them, our ability to treat infections is rapidly eroding. A recent study funded by Wellcome and the United Kingdom Department of Health and Social Care’s Fleming Fund, estimates that bacterial AMR alone will cause 39 million (3.9 crore) deaths between 2025 and 2050, which translates to three deaths every minute – a shockingly stark statistic. AMR also threatens to undo decades of progress made against infectious diseases such as tuberculosis, typhoid and pneumococcal pneumonia, among others, with new multidrug resistant strains now in circulation.

In 2016, in response to the continually escalating global threat of AMR, the United Nations General Assembly (UNGA) convened its first High-Level Meeting (HLM) to address the root causes of AMR, develop national action plans, regulate antimicrobials, and promote awareness and best practices. With this mandate, many countries prepared their national action plans. India launched its plan in 2017, a six-pronged approach including improving awareness, reducing infections, optimising antimicrobial use, strengthening surveillance, increasing investment, and enhancing India’s leadership in AMR.

Last year, the UNGA reconvened for a second high-level meeting to review global progress on AMR. Its outcome was a strong political commitment by the 193 member countries to identify gaps, invest in sustainable solutions, improve R&D, strengthen surveillance, and ensure constant monitoring in the lead-up to the next review in 2029.

The path to combating AMR in India

India, with its high population density, prevalence of infectious diseases, and over-the-counter availability of antibiotics, has a long and winding road to travel in order to counter AMR. It is meeting the challenge head-on. India has not only expanded and built on its genomic surveillance capabilities to stay ahead of AMR, but government bodies such as the Indian Council of Medical Research (ICMR), the National Centre for Disease Control (NCDC) and the Indian Council of Agricultural Research (ICAR) have also established surveillance networks that focus on priority pathogen groups and communicate critical data to policymakers and researchers. However, while genomic sequencing can help track how pathogens evolve and acquire resistance, it still doesn’t have direct utility in helping clinicians make difficult, and urgent, lifesaving decisions.

India’s genomic capabilities can be most effectively leveraged in two key ways. First, public health experts should use genomic data to anticipate microbial evolutionary trajectories and emerging AMR trends. This can inform the most appropriate choice of antibiotics when patients are treated empirically (which is mostly the case). Second, diagnostic companies should use large-scale population genomics to build precision tools that could be made available at, or near the point-of-care. For example, genomic studies on Salmonella enterica serovar Typhi (the bacterium causing typhoid fever) reveal how the H58 lineage has acquired multidrug resistance over time. Researchers identified single nucleotide polymorphisms (SNPs) from whole-genome sequencing data, which are now being used to create targeted molecular diagnostics. This enables faster and more cost-effective detection of drug-resistant strains, instead of sequencing each circulating strain.

At the Christian Medical College, Vellore (CMC), the country’s reference AMR institution, researchers are sequencing representative strains to generate important epidemiological data and trends. They are also using genomic markers for rapid and robust diagnosis, supporting the national AMR efforts under the mentorship of ICMR.

The urgent need for new drugs

In addition to enhanced surveillance and smart diagnostics, we urgently need new drugs. Developing new antimicrobials is scientifically complex, financially risky, and often commercially unattractive. India’s robust biotech ecosystem, high burden of endemic infectious diseases, and proven capacity for affordable manufacturing create the ideal environment for innovation. When these strengths are combined, they will not only accelerate India’s fight against AMR but also improve global access, especially for low- and middle-income countries (LMICs).

Recent breakthroughs from India, such as the introduction of novel antibiotics like cefepime-enmetazobactam, cefepime-zidebactam, nafithromycin, and levodifloxacin, mark a significant global advancement in the fight against multidrug-resistant pathogens, particularly the WHO’s critical priority threats. These drugs offer new therapeutic options that can reduce reliance on carbapenems and last-resort agents like colistin. At a time when the world is looking at a fast-drying antibiotic pipeline, this progress offers a glimmer of hope. Such leadership in developing new antibiotics underscores India’s growing scientific and regulatory capabilities, paving the way for increased international collaboration and faster global approvals.

A communication strategy

Given the magnitude of the AMR crisis, genomic surveillance and integrated public health systems can only work efficiently if they are supported by a carefully designed communication strategy to improve awareness. In India, where antibiotics can often be bought over the counter without a prescription, innovative and human-centered advocacy should be prioritised more than it currently is. This includes antimicrobial stewardship among healthcare professionals, including both physicians, pharmacists and other unorthodox or informal practitioners that form an important pillar of frontline healthcare delivery. Moreover, it should be reiterated that vaccination is not just important in preventing viral diseases that do not require antimicrobial treatment or multidrug resistant diseases, but also in reducing antimicrobial usage.

To communicate the gravity of the situation effectively, innovations that can simplify data and generate actionable evidence will play a central role. One such example is AMRSense, an award-winning collaboration between IIIT-Delhi, CHRI-PATH, and 1mg.com, which is using AI to collect data across the clinical, animal, and environmental axes in a true One Health approach and using predictive modeling to guide targeted interventions.

The challenge of tackling AMR is immense, and we are at an inflection point. Acting alone or in an uncoordinated and siloed fashion will not produce the desired results. India has the tools, the talent, and the urgency to lead the world in curbing antimicrobial resistance. But all scientific efforts need to be unified and communicated to the general public and experts alike, in ways that resonate with them. Only then will we be on our way to winning the fight against AMR.

(Dr. Ankur Mutreja is a genome scientist and microbiologist, and the Director, Strategy, Partnerships and Communications at PATH. amutreja@path.org Dr. Tikesh Bisen is a Public Health Specialist – Surveillance at PATH. tbisen@path.org Dr. Balaji Veeraraghavan is a Professor at the Christian Medical College & Hospital, Vellore. His research focus is on vaccine-preventable invasive bacterial diseases and Antimicrobial Resistance in clinically relevant pathogens. vbalaji@cmcvellore.ac.in)