Whenever you are feeling anxious or stressed, the first thing you are told to do is control your breath. There are many different breathing techniques that you can try, like yoga breathing practices like Ujjayi breath, alternate nostril breathing, and deep diaphragmatic breathing.

Diaphragmatic breathing, often called belly breathing, is a simple way to use your diaphragm muscle to breathe more effectively. The Cleveland Clinic explains that the diaphragm is a dome-shaped muscle at the bottom of your lungs. When you inhale, it moves down, making space for your lungs to fill with air. Your belly pushes out as this happens. When you exhale, the diaphragm moves up, pushing the air out. This type of breathing is different from chest breathing, where only your chest moves. You can do this breathing technique anywhere, anytime, and no one will even notice. It's a great tool for calming down quickly.

Why Do You Need Breathing Exercises

The reason why this is the go-to response for stressed people is because when you are stressed, your breathing becomes fast paced. The Cleveland clinic explains that stress triggers a fight or flight response in your body. Your body goes into survival mode as it thinks it is in danger. Some symptoms of this include, racing heart rate and blood pressure increase, this means that you are breathing quickly and heavily in order to move nutrients and oxygen into important muscles of your body.

Benefits of Belly Breathing

Belly breathing has many good things about it. It helps calm your nervous system, which is important when you're stressed. It activates a nerve called the vagus nerve, which helps your body relax. When you breathe slowly, your heart rate also slows down, and your body feels less stressed. It helps you control your feelings, like anxiety and fear, so you can think more clearly. This kind of breathing also helps your lungs work better by taking in more oxygen. It can even help you sleep better because it calms your mind. By practicing regularly, you can feel calmer and more relaxed every day.

How to Practice Diaphragmatic Breathing

Certain conditions like Chronic Obstructive Pulmonary Disease (COPD) do make it difficult to work the diaphragm effectively. Your lungs rise and fall naturally, however with COPD air often becomes trapped in your lungs. Make sure you speak to a healthcare professional in case you are facing any difficulties while breathing.

To start, find a comfy spot. You can lie down with your knees bent or sit with your feet flat on the floor. Put one hand on your belly and the other on your chest. Now, breathe in deeply through your nose. Let your belly push out while your chest stays still. Hold your breath for a moment. Then, slowly breathe out through your nose or with your lips a little bit closed, letting your belly go back in. Do this four to six times, slowly and deeply. As you get better at it, you can do more breaths. Practice this every day, even when you're not feeling stressed, to feel calmer all the time.

Millions of office workers spend eight to 10 hours at a desk on a regular basis. While sitting in one place may seem harmless, staying in the same position for prolonged periods can gradually affect muscles, joints, mobility and even metabolic health. Those are some of the reasons why experts call "sitting the new smoking".

Physiotherapists agree that the problem is not just 'bad posture'. The bigger concern is spending too much time without changing positions or moving your body.

HealthandMe spoke to Dr. Swapnil Keny, Consultant Orthopaedics & Joint Replacement, Fortis Hospital, Kalyan and Dr. Preeti Tare, Physiotherapist, P. D. Hinduja Hospital and Medical Research Centre, Khar about what office workers need to do to minimise the risks from sitting for prolonged periods.

Effects Of Prolonged Sitting

Dr. Swapnil Keny explains, "When sitting at a place becomes uninterrupted and constant posture, it builds pressure on the muscles of the neck, shoulders, back, and hips. The hip flexor muscles may become tight, and the glutes muscles along with other postural muscles may become inactive. The effects are not limited to the spine: prolonged sedentary behaviour is also associated with poorer metabolic and cardiovascular health."

Dr. Preeti Tare similarly points out that the earliest consequence may simply be a reduction in movement rather than an obvious injury.

Dr. Tare says, “The first change I notice is usually not an injury, but reduced movement. The hip and ankle joints spend hours in limited positions, while the glutes, deep abdominal muscles and upper-back muscles contribute less. The neck and shoulders compensate, especially when we lean towards a screen. Over time, this can reduce joint mobility, muscle endurance, and tolerance for everyday movement. Prolonged sitting can also affect blood circulation and metabolic health, so the impact goes well beyond back pain.”

Also read: That 3 PM Energy Crash May Be More Than Work Stress: Are You Missing Key Nutrients?

One Habit Experts Want Office Workers To Change

If there is one change office workers should make, both experts agree that it is to stop sitting continuously for hours.

“I would ask office workers to stop sitting continuously for hours. Set a reminder to stand up, walk a little or change position regularly. This simple habit reduces the time the same muscles and joints remain under static load. It is more useful than trying to maintain a “perfect” posture all day,” says Dr. Keny.

Dr. Tare recommends being even more proactive rather than waiting for discomfort to appear. She says do not wait for symptoms to appear. From time to time, make it a habit to get up and move around consciously.

These small changes, like walking to speak to a colleague instead of sending a message, standing during a phone call or taking the longer route to refill a water bottle, can help break up prolonged periods of inactivity and alleviate risks.

She says, “Break up sitting before your body starts complaining. Don’t wait for back pain or stiffness to remind you. Every 30–45 minutes, get up, walk to refill your water, speak to a colleague, or simply move around for a couple of minutes. From a physiotherapy perspective, frequent movement is important because tissues respond better to changing loads than to staying in one position for hours. The best posture is ultimately your next posture.”

Also read: World Physiotherapy Day - Beyond Surgery: Why Physiotherapy Decides How Well You Really Heal

Is An Hourly Break Really Enough?

One of the most important points office workers must remember is that moving around once every hour is bare minimum. It should also not become an excuse for remaining inactive for the rest of the day.

“Hourly breaks are a good starting point, but they are not a complete solution. The total amount of movement across the day matters too. A few minutes of walking every hour cannot fully replace regular exercise, walking during breaks and an active commute. Think of movement as a daily habit, not just a reminder on the computer,” says Dr. Keny.

Dr. Tare agrees that movement breaks and overall physical activity play different roles. In other words, the goal should be to reduce sedentary time while also building regular physical activity into the day.

“Both matter, but they serve different purposes. Short movement breaks interrupt the long, uninterrupted periods of sitting, while your overall daily activity builds strength, endurance and cardiovascular fitness. Someone who gets up every hour but remains inactive outside work is still largely sedentary. I encourage patients to think in layers: break up sitting during work, walk whenever possible, and include structured exercise during the week. No single movement break can compensate for an otherwise inactive day.”

Routine Movement For Desk Workers

Office workers do not necessarily need elaborate exercises between meetings. Instead, experts recommend weaving frequent movements throughout the existing workday.

“It is good practice to sit and stand alternatively and walk while on calls wherever feasible, throughout the day. Add a few gentle exercises such as shoulder rolls, neck movements, hip stretches and repeated sit-to-stand movements. Outside work, aim for regular walking and exercise. The idea is not to work out at your desk, but to maintain the movement of the body all the time,” says Dr. Keny.

Dr. Tare suggests a similar approach built around consistency rather than intensity. Desk workers need to stop treating movement as a separate activity.

Stand during calls, walk during breaks, change sitting positions, take regular short walks and incorporate simple movements throughout the workday.

“I prefer a routine that is realistic enough to follow every day. Alternate between sitting and standing, take a short walk every 30–45 minutes and use phone calls as opportunities to move. Twice or three times during the day, do a few sit-to-stands, shoulder movements, gentle spinal rotations and calf raises. Walk during your lunch break if possible. The aim isn't to turn your workstation into a gym; it is to prevent eight hours from becoming eight hours of almost no movement.”

A person's body mass index (BMI) may seem normal while they may already be at a significant metabolic risk. According to experts at the first AIIMS Obesity Summit in New Delhi, which is themed “Decoding Obesity: Biology to Remedy,” this is particularly observed frequently among South Asians.

Addressing the summit on Saturday, AIIMS Director Dr Nikhil Tandon said obesity cannot be understood simply through numbers. He argued that doctors need to look beyond weight and BMI to understand where fat is distributed in the body and how the individual's overall health is affected due to the additional fat.

“People will say, you know, subcutaneous is all right, visceral is bad,” Tandon said, referring to the difference between fat stored under the skin and fat accumulated around internal organs. He said that while measures like waist circumference remain essential, they do not fully capture the complete complexity of obesity.

South Asians Face Higher Metabolic Risk Even At Lower BMI

Tandon spoke about how South Asians can develop metabolic issues at lower BMI levels because of differences in fat distribution in the body. “A lot of people of South Asian descent may not qualify as people who are obese, but because of central disposition of fat, they can have metabolic, maybe metabolically unhealthy at very, very low BMIs,” he said.

He compared the body types and prevalence of lifestyle disorders in South Asians and Pima Indians, mentioning that South Asians showed a substantially higher incidence of diabetes at lower BMI levels. He said that obesity should not be assessed solely by what we see on the weighing scale.

“If at similar numbers, two people have very different health outcomes, then you have to understand the reason for the difference in health outcomes rather than be fixated in the number,” Tandon said.

Also read: Thin Outside, Fat Inside: Why A Slim Body May Still Hide Metabolic Health Risks?

Obesity Does Not Occur Due To Willpower Issue

The summit's discussions also challenged the idea that obesity can be managed by just eating less and exercising more.

Prof Naveet Wig, patron of the summit, shared his own experience of repeatedly gaining and losing weight, explaining that his experience had reinforced the complexity of obesity.

“It is a relapsing disease. It is a relapsing problem. It is a chronic problem,” he said, adding that obesity involves multiple factors including genetics, environment, behaviour, sleep, muscle, adipose tissue, the gut and the brain.

He also cautioned against using medication like GLP-1 as many may turn it into a substitute for comprehensive obesity care. “We can't let drug become a doctor,” Wig said, stressing the importance of nutrition, exercise, sleep and preservation of muscle mass.

He noted that modern obesity care now includes GLP-1 therapies, including oral options, as well as surgical treatments. He questioned whether enough attention is being paid to nutrition, muscle preservation and sleep when these treatments are used.

Also read: Can You Really Lose 5 Kg In A Week With Just 4 Minutes Of Exercise? Japan's Viral Workout Explained

Prevention May Need To Start Much Earlier

Tandon also stressed that obesity prevention cannot begin late in adulthood. He explained that body weight, blood pressure, cholesterol and glucose tend to follow patterns established early in life. Major changes in these trajectories could be due to underlying influences that need to be addressed.

“You don't go to sleep at night with a BMI of 23 and wake up with a BMI of 30,” he said, explaining that obesity as a process that develops over time.

He argued that eating habits, physical activity and other behavioural patterns become established early, making childhood and early-life interventions particularly important.

Ultimately, Tandon said, preventing weight gain in the first place may be easier than trying to reverse obesity later.

“Once you become obese, it's incredibly difficult to lose weight. And once you lose weight, it's incredibly difficult to sustain that weight loss,” he said.

The experts say that obesity treatment should focus not simply on making patients lighter, but on making them healthier by paying attention to metabolic health, fitness, nutrition, muscle mass, sleep and long-term sustainability.

For years, the weighing scale has been one of the simplest ways to assess health. A person with a “normal” Body Mass Index (BMI) is often considered healthy, while being overweight or obese is viewed as the primary warning sign. But what if someone looks slim on the outside and still carries a significant metabolic risk on the inside?

This is where the concept of TOFI—“Thin Outside, Fat Inside” becomes important. TOFI describes individuals who may have a normal BMI or appear lean but carry a higher proportion of visceral fat—fat stored deep inside the abdomen around vital organs. Unlike the visible fat under the skin, visceral fat is metabolically active and can contribute to inflammation, insulin resistance and other metabolic abnormalities.

Research has shown that Asian Indians tend to develop abdominal and visceral fat at lower BMI levels compared with several other ethnic groups. They may also have relatively lower muscle mass. As a result, a person can appear slim, have a seemingly reassuring weight, and yet have an increased risk of metabolic disease.

Why does this matter?

Also read: From Insulin Resistance to Fertility: Understanding the Metabolic Side of PCOS

The important message is that BMI alone does not tell the complete story. BMI measures weight in relation to height, but it does not distinguish between muscle and fat or indicate where fat is stored. That is why measurements such as waist circumference can provide valuable additional information. A larger waist can indicate increased abdominal fat and may signal higher cardiometabolic risk even when BMI falls within the normal range.

Being normal weight does not automatically mean being TOFI. However, people with a sedentary lifestyle, low muscle mass, increasing waist circumference, family history of diabetes, unhealthy dietary patterns, poor sleep or metabolic abnormalities may warrant closer assessment.

Simple health checks such as blood pressure, fasting glucose or HbA1c and lipid profile can provide important clues. Depending on the individual and clinical situation, doctors may also recommend assessment of liver health or body composition.

What can we do?

The solution is not simply to focus on losing kilograms. For a normal-weight person carrying excess visceral fat, the goal should be to improve body composition and metabolic health. Regular physical activity—particularly strength training combined with aerobic exercise—can help build or preserve muscle and improve insulin sensitivity.

A balanced diet rich in vegetables, whole grains, pulses, adequate protein and fibre, while limiting excess refined carbohydrates, sugary foods and ultra-processed foods, is equally important. Adequate sleep, stress management and avoiding prolonged sedentary periods are also essential components of metabolic health.

By Dr Farah Ingale, Director - Internal Medicine & Consultant – Diabetologist, Fortis Hiranandani Hospital, Navi Mumbai