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The latest report from the World Obesity Federation, which was released on World Obesity Day (March 4), predicts that 51 per cent of the world's population will be impacted by overweight or obesity by 2035 if current trends continue.
The report estimates that more than four billion people will be impacted by the increasing rates of obesity, particularly in low or middle-income countries in Africa and Asia. What this also means is that the economic impact of overweight and obesity is likely to surpass $4 trillion within 12 years if prevention and treatment do not improve at a rapid rate.
“At almost 3 per cent of global GDP, this is comparable with the impact of Covid-19 in 2020,” the report mentions.
The World Health Organisation defines obesity as abnormal or excessive fat accumulation that poses a risk to one’s health. A body-mass index (BMI) of over 25 is considered overweight and over 30 is considered obese.
While low to middle-income countries are most affected, obesity has also become a growing problem in the UAE, with high rates identified both in children and adults.
According to the Global Obesity Observatory, the UAE has a national obesity risk score of 7/10 (10 being the highest risk) based on obesity prevalence, rate of increase, likelihood of meeting the 2025 target amid other factors.
“Communities need to realise obesity is not a cosmetic problem but a serious health condition,” said Dr Henna Kutty, lifestyle medicine specialist and holistic health coach, adding that being overweight or obese could lead to various other ailments including cardiovascular diseases such as heart disease and stroke, sleep apnea, infertility, diabetes and hypertension.
The most common factors leading to obesity and overweight in the UAE include the growing prominence of sedentary lifestyles, increasing dependence on unhealthy diets that are high in saturated fats, sugar, and salt, and lack of physical activity.
“Sedentary behaviour with lack of physical activity and opting for unhealthy food on a constant basis are the leading causes for the rapid increase in the rate of overweight and obese patients in our practice,” said Dr Mahir Shqeir, who’s a general practitioner and board eligible internist at Reem Hospital, Abu Dhabi.
According to Juhi Bhambaney, a Dubai-based clinical dietician dealing with cases of overweight and obesity, gut health (gastrointestinal health) influences every aspect of one’s health. Poor gut health can lead to poor mood and health of the gut microbiome, which can influence metabolism, leading to overweight and obesity.
Healthy eating practices incorporating adequate protein and plant-predominant eating patterns along with regular movement and workouts are of utmost importance to eradicate such issues. Eating a healthy diet that is rich in fruits, vegetables, whole grains, and lean protein is essential for maintaining a healthy weight. Avoiding processed and junk foods, high-calorie beverages, and excessive amounts of sugar and saturated fats can help prevent obesity.
“Avoid eating out as much as possible and limit it to 2-3 meals a week,” said Juhi. “You can try to choose options which give you some nutritional value. For example: Asian and Mediterranean cuisines usually have vegetables in many of their meals, so you can opt for those and avoid fat-rich meals.”
Mindful eating can also aid monitoring hunger levels to avoid overeating. Paying attention to body's hunger and fullness cues can help promote healthy weight management.
While preventative measures could sound fairly simplistic with an abundance of ‘eat right and exercise’ mantras flying around the Internet, how much of the prevention journey is actually governed by individual choice?
Although BMI is a screening tool it doesn’t always act as a diagnostic tool, added Dr Henna. “There are a number of causes which put a person at risk for obesity and it’s not always appearance related. The person could look healthy but still have excessive fat accumulation in their system.”
Stephan Guyenet's book, The Hungry Brain, presents the theory that weight gain is not primarily a product of a lack of willpower, but rather an evolutionary mismatch between our brains, genetics, and environment. He argues that our brains have evolved to respond to certain cues, such as high-calorie foods, as signals of abundance and safety, and therefore encourage us to eat more of them.
“If a young child is passing by McDonald’s and gets a whiff of those burgers, he or she will naturally be drawn towards the smell,” noted Dr Henna, adding that in most cases, these signals are already present at birth, which naturally increase the desirability of junk food as one grows up. “Genetic predisposition can increase the risk of weight gain and interact with other risk factors in the environment, such as unhealthy diets and inactive lifestyles.”
Guyenet suggested that to address the problem of obesity, people need to understand and address the underlying causes of overeating, rather than simply relying on willpower and self-control. It requires creating environments that promote healthy behaviours, such as limiting the availability of unhealthy foods and promoting physical activity, as well as improving the understanding of the complex biological and psychological factors that contribute to obesity.
“A lot of awareness campaigns and in-clinic practices surrounding positive mindset shifts are required to gain positive results,” said Dr Henna.
A good work-life balance can help people avoid the triggers that usually lead them to unhealthy eating patterns. “Prioritising work-life balance will help you allocate time for meal preparation and regular exercise,” said Juhi.
According to the dietician, obesity and overweight are challenges that surface due to a variety of factors and each of them adversely impacts the other. Citing a 32-year-old woman who consulted her for weight loss requirements, Juhi mentioned: “She would skip meals, eat mostly from restaurants, always had poor gut health, poor sleep and high levels of stress owing to her busy job. She also suffered from insulin resistance all which pointed towards a lack of work-life balance.”
Simple steps like planning and preparing meals can help ensure that you're eating a healthy and balanced diet and prevent temptations to eat unhealthy foods.
Better work-life balance can also lead to getting adequate sleep, which is essential for maintaining a healthy weight. Poor sleep habits can disrupt hormones that regulate appetite, leading to overeating and weight gain, added Dr Henna.
“One thing the UAE Government has already done is take that step towards having a four-and-a-half-day work week,” said Dr Parag Rane, specialist general and laparoscopic surgeon, Zulekha Hospitals.
“This is great for prioritising work-life balance because now people are getting more time for themselves, which means they can incorporate workouts in their routines more easily.
“Reducing the working hours will definitely improve people’s efficiency and will definitely improve the health of the population,” he added.
Given the hyper-busy lives of most people today, mental health concerns have become more prevalent than ever before. “Many of us are unable to address the psychological issues we go through on an everyday basis, such as stress, sadness, anxiety,” said Dr Henna.
“People are chronically stressed, which causes the body to constantly be in a state of ‘fight or flight’ causing an increase in stress hormones that further increase fat storage,” she added.
Moreover, when we don’t try to understand the root cause of our emotions, it can result in mindless eating habits and binge eating, to temporarily fill the emotional void we might be experiencing through bingeing on ‘comfort food’. “In the day and age of instant gratification, emotional eating has been a common occurrence. We either look for comfort through social media or through food. This leads to non-hungry eating, especially, consuming calorie-dense foods,” said Juhi.
“Prioritising stress management and mental health is extremely important as it's a major trigger for obesity.”
Obesity and its risk factors have somewhat become a norm within society, noted Dr Henna. “This is not only affecting adults but children as well. Clearly, we are raising a generation of unhealthy individuals, who have developed a clear addiction towards processed sugar and junk, which is now considered normal.”
A study in 2019 also reported obesity in children to be among the biggest healthcare challenges in the UAE. “Childhood obesity is a major public health concern,” said Dr Parag.
“In a child who is obese due to overfeeding or by consuming high-calorie diets, the number of cells and the size of the fat cells increases. If you were obese in your childhood and you managed to reduce the weight, you may once again put on that weight in adulthood if your lifestyle changes. Then it becomes very difficult to treat it.”
The Ministry of Health and Prevention launched the National Nutrition Strategy 2022-2030 which aims to create healthier school settings and coordinate efforts to encourage healthy eating habits. “The UAE is taking a lot of steps in this direction. The country is committed to reducing childhood obesity through effective partnership with all stakeholders to promote strategic policy, systems and environmental changes,” said Dr Henna.
Seeking support from friends, family, or a healthcare professional can help you achieve and maintain a healthy weight. A support system can provide motivation, accountability, and guidance on making healthy lifestyle changes.
Accountability can be a great way to create healthy habits, when dealing with non-communicable diseases. “Team up with a health coach, who will help you set realistic health and wellness goals and provide accountability coaching,” Dr Henna advised.
Holding greater accountability towards your actions can also start in a family-setting. “As a Physician, I believe in working with families to tackle obesity. The results are better when each family member motivates the other. Certain tasks, such as working out together, preparing grocery lists and making meal plans as a family can be fun and effective ways to create healthy habits,” she said, adding that healthier families will start building healthier communities.
Lastly, it’s as important to get a baseline checkup done from time to time, to avoid any long-term issues to take place. “Keep checking your weight and BMI regularly and if there is an increase in BMI above 25, you should visit specialised clinicians to start a proper diet, exercise and behavioural plan to start losing weight,” Dr Maher said.
“Especially in cases where people have obesity-related complications such as diabetes, hypertension, elevated cholesterol levels and coronary artery diseases.”
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