TIME TO THINK DIF­FER­ENTLY ABOUT OBE­SITY

DE­SPITE GLOBAL EF­FORTS TO STEM THE OBE­SITY EPI­DEMIC, NO COUN­TRY HAS SUC­CEEDED IN DE­CREAS­ING IT IN THE LAST 33 YEARS.

Qatar Today - - INSIDE THIS ISSUE - The con­tent for the ar­ti­cle was provided by John­son & John­son Med­i­cal De­vices Middle East.

De­spite global ef­forts to stem the obe­sity epi­demic, no coun­try has suc­ceeded in de­creas­ing it in the last 33 years.

World­wide obe­sity has more than dou­bled since 1980, with al­most 30% of the pop­u­la­tion over­weight or obese. In the Middle East, obe­sity rates among adults are ex­cep­tion­ally high at more than 37% in Kuwait and more than 35% in Qatar, Saudi Ara­bia and Jor­dan, ac­cord­ing to lat­est WHO fig­ures.

Ex­perts said that one prob­lem is that most cam­paigns to com­bat the dis­ease have overly sim­pli­fied obe­sity by fo­cus­ing on healthy eat­ing and ex­er­cise, when the re­al­ity is that obe­sity is not a life­style choice, but a chronic dis­ease with com­plex ori­gins. In ad­di­tion, sim­pli­fy­ing obe­sity poses the risk of stig­ma­tiz­ing peo­ple with obe­sity in­stead of treat­ing them as pa­tients and pro­vid­ing them with ac­cess to vi­able treat­ment op­tions. The be­lief that obe­sity is a life­style choice re­mains prom­i­nent, sig­nif­i­cantly af­fect­ing the psy­choso­cial well-be­ing and be­havioural pat­terns of peo­ple with obe­sity.

Ac­cord­ing to Dr Na­dia Ah­mad, Se­nior Ad­vi­sor for Obe­sity So­lu­tions at John­son & John­son Med­i­cal De­vices Middle East, weight bias is so­ci­ety's last ac­cept­able form of dis­crim­i­na­tion and is largely driven by

lim­ited un­der­stand­ing of obe­sity.

She says that en­vi­ron­men­tal, so­cial and di­etary fac­tors and as­pects re­lat­ing to com­mon med­i­ca­tions, stress and sleep can all play a role so there is no ‘one size fits all' ap­proach to com­bat­ing obe­sity.

A grow­ing body of re­search sup­ports the con­cept of ‘set point', which posits that re­gard­less of what you would like your weight to be, your brain has its own sense of how much body fat you should re­tain and reg­u­lates en­ergy in­take and ex­pen­di­ture to main­tain lev­els within a ‘set point' range.

More­over, re­search sug­gests that when peo­ple with obe­sity go on a low-calo­rie diet then there are sig­nif­i­cant al­ter­ations in ap­petite hor­mones lead­ing to in­creased food in­take and re­duc­tions in en­ergy ex­pen­di­ture, in­clud­ing changes in ‘mus­cle efficiency', that can to­gether in­crease body weight.

Mea­sures to in­tro­duce health­ier food op­tions at schools, to tax sug­ary drinks and to en­cour­age peo­ple to ex­er­cise are all im­por­tant steps to­wards pro­mot­ing a healthy life­style, but some in­di­vid­u­als still strug­gle to lose weight based on life­style mod­i­fi­ca­tion alone and may re­quire phar­ma­cother­apy and metabolic surgery.

In ad­di­tion, while preven­tion is crit­i­cal for the next gen­er­a­tion, it is of lit­tle use to those al­ready se­verely af­fected by obe­sity as they are vul­ner­a­ble to se­ri­ous co­mor­bidi­ties such as di­a­betes, hy­per­ten­sion and car­dio­vas­cu­lar prob­lems, which ul­ti­mately lead to short­ened lives.

The Middle East and North Africa (MENA) re­gion is at the epi­cen­tre of an obe­sity and di­a­betes crisis, ac­cord­ing to Dr Karl Miller, Chief Med­i­cal Of­fi­cer at JJMD Middle East and Vice Pres­i­dent of the Obe­sity Academy Aus­tria. There are 318,000 deaths caused by di­a­betes each year in the re­gion alone.

Di­a­betes preva­lence in MENA stands at 10.8%, the sec­ond high­est among re­gions mon­i­tored by the In­ter­na­tional Di­a­betes Fed­er­a­tion (IDF), which projects the num­ber of peo­ple with di­a­betes in MENA to in­crease by 110% to 82 mil­lion in 2045 from 39 mil­lion in 2017.

Spend­ing on di­a­betes care in the re­gion, as a per­cent­age of to­tal health ex­pen­di­ture, stands at 17% com­pared with 12% glob­ally, ac­cord­ing to the IDF, which said health­care ex­pen­di­ture in MENA is ex­pected to in­crease by 67% to $35.5 bil­lion by 2045 from $21.3 bil­lion in 2017.

The ris­ing so­cial and eco­nomic bur­den of obe­sity re­quires a new ap­proach to tack­ling this chronic dis­ease. The cur­rent pa­tient path­way to sur­gi­cal in­ter­ven­tion can take as long as eight years, ac­cord­ing to Dr Ah­mad, even though metabolic surgery is as­so­ci­ated with higher di­a­betes re­mis­sion rates, low­ered mor­tal­ity risk, fewer com­pli­ca­tions, higher weight loss and im­proved qual­ity of life than short and long-term con­trol mech­a­nisms.

To make real progress in the fight against obe­sity, part­ner­ships are re­quired at every level to guide pa­tients ap­pro­pri­ately through the treat­ment path­way, i.e., preven­tion, ac­cess to treat­ment and longterm fol­low-up

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