Obesity epidemic threatens health and economies in Saudi Arabia, UAE

Saudi Arabia ranks among the worst affected countries globally due to rising obesity, according to a new report that exposes the enormous health and economic burdens of overweight people across the GCC.

Both Saudi Arabia and neighboring UAE face a growing public health crisis as rates of obesity and weight-related non-communicable diseases continue to rise, according to data from the World Obesity Federation’s World Obesity Atlas 2024 report released this week ahead of World Obesity Day on March 4.

The report reveals that if current trends hold, then over half the population in both the countries will be overweight or obese by 2035, posing risks of chronic diseases, reduced quality of life, and multi-billion-dollar burdens on national economies.

According to the report, more than three-quarters of Saudi women (78 percent) are overweight, placing the Kingdom fifth worldwide after Tonga, Samoa, Kuwait, and Jordan in terms of obese women. Meanwhile, 76 percent of Saudi men are obese, giving the nation the 11th spot on the global obesity index.

Projections estimate adult obesity prevalence will continue to climb by approximately 2.4 percent annually in the Kingdom without significant intervention. This translates to an estimated 1.3 million obese adults by 2030.

Similarly, the UAE harbors an escalating obesity epidemic, with excessive weight diverting nearly $12 billion from its economy each year.

Latest statistics position the UAE as the 11th most affected country worldwide for obesity among women, with more than a third (37.2 percent) of its female population classified as obese. The country is ranked fifth on the global obesity index, with 40 percent of 11 to 16-year-olds and 20 percent of children under the age of 11 classified as obese.

Across the GCC, soaring obesity rates are sounding alarm bells due to the immense burdens on health systems and economies. The report warns proactive measures are urgently needed to alter the region’s trajectory before the problem becomes uncontrollable.

Obesity impacting Kingdom’s future generations

Along with afflicting adults, obesity threatens Saudi Arabia’s youth as well, with more than four out of 10 boys and three out of 10 girls under 20 living with obesity.

Comparatively, the Kingdom ranks fourth-worst globally for childhood obesity among boys and 14th for girls.

Without strategic interventions, it is estimated that more than 60 percent of Saudi children will be obese by 2035. This equals to more than 5.7 million young citizens facing heightened risks of lifelong health complications.

Research consistently demonstrates obesity significantly elevates the chances of developing numerous non-communicable diseases (NCDs), including type 2 diabetes, heart diseases, stroke, and cancer.

Obesity draining Saudi Arabia’s health system, economy

Apart from endangering generations of Saudis, obesity is directly linked to 1.1 million lives lost in 2019 from weight-related NCDs. The Atlas 2024 report ties costly health burdens to reduced productivity due to disability and premature deaths and with soaring obesity-related healthcare costs in Saudi Arabia.

UAE struggles with soaring obesity rates and costs

In neighboring UAE, elevated BMI likewise extracts immense costs, with nearly $12 billion lost from its economy annually.

The report says, despite its standing as a beacon of global leadership in many health initiatives, from polio eradication to neglected tropical diseases and cervical cancer prevention strategies, the nation is grappling with a growing obesity crisis that, without significantly scaled-up efforts, will become ever more serious in the coming years.

Johanna Ralston, CEO of the World Obesity Federation, said: “The cost of business with obesity, with fragmented and siloed efforts here as in most countries, means the UAE is expected to see a continued rise in the numbers of people living with obesity and shocking increases in the economic impact of disability and deaths associated with the disease.”

“Armed with this new data, it is time to take decisive steps to turn the tide on the obesity epidemic. This data serves as a wake-up call for policymakers to implement new strategies aimed at reducing obesity and its associated economic burdens,” Ralston added.

According to Ralson, despite efforts in the UAE to address the problem of obesity in recent years – from making women’s fitness options accessible to all to the implementation of an excise tax on sugar-sweetened beverages, strict health and nutrition guidelines for school meals and encouraging restaurants to display the calorie content of every meal– it is clear that much more needs to be done.

However, with projections that more than 6.5 million adults in the UAE will be living with obesity by 2035 – comprising more than 4.5 million men – the time for action is now.

The nation currently spends more than $1.4 billion in direct healthcare costs, treating weight-related illnesses – a figure set to escalate to $1.9 billion by 2035.

Meanwhile, obesity saps the UAE economy of $10.3 billion in indirect costs such as reduced manpower and productivity. Experts forecast this may reach an exorbitant $30.7 billion by 2035 if the obesity epidemic spirals out of control.

Dr. Sara Suliman, a consultant endocrinologist and diabetologist, said: “Some countries in the MENA region have made significant strides to treat and manage obesity.The UAE, for example, has put in place standards of care for obesity management since 2008. As a region with some of the highest rates of obesity, we have initiated a working group – soon to become a registered society – with the support of the World Obesity Federation to produce unified guidelines, supporting education and raising awareness on obesity and how best to tackle it.”

Suliman further said: “The main barriers to obesity management include recognition of obesity as a disease, education of healthcare professionals as well as the affected individuals and their families, clear management guidelines and support from all sectors involved in the prevention and management of obesity.”

‘No one-track approach’ can tackle obesity

Dr. Mavin Macauley, a consultant endocrinologist At Abu Dhabi’s Burjeel Hospital, told Al Arabiya English that “no one-track approach can be considered” to solve GCC obesity crisis.

“Multiple approaches should be used in combination over a period to improve obesity outcomes and understanding the evidence and implementing it is crucial,” he explained. “ For example, in general, exercise alone does not make someone lose weight. While the evidence suggests that aerobic exercise may play a role in weight management when used with dietary changes. A public health initiative about healthy food choices is also important. Food choices are very subjective.”

Furthering the implementation of proactive measures to address obesity is “essential”, considering its impact, said the doctor.

“Developing a targeted and unified approach to obesity and its associated problems is a right approach. Access to community-based dietary interventions is crucial for promoting healthier eating habits among individuals. Additionally, expanding access to dieticians through a wider range of insurance coverage can provide individuals with personalized guidance and support in managing their diet effectively.”

Public measures needed

The doctor said compulsory food labeling in supermarkets can also empower consumers to make informed choices about their food purchases, promoting greater awareness of nutritional content and aiding in healthier decision-making.

Reducing the availability of high-calorie drinks can also help curb excessive calorie intake, contributing to efforts to combat obesity and promote healthier beverage options.

“Also, regulating take-away food stores can help ensure that food offerings meet certain nutritional standards, promoting healthier options and reducing the prevalence of calorie-dense, unhealthy foods in the market.”

He said doctors and specialists need regular up-to-date training on tackling obesity among patients.

“Continuous medical educational (CME) programs focusing on obesity, including how to recognize its signs and symptoms, as well as how to appropriately refer individuals for evaluation and management, can (also) significantly enhance healthcare professionals’ understanding and approach towards obesity.”

“Recognizing events such as World Obesity Day can provide a platform for fostering a cohesive cross-sector response to the obesity crisis, encouraging collaboration and concerted efforts among various stakeholders towards addressing this pressing issue.”

The Atlas 2024 report correlates rising GDP with increased obesity in countries undergoing rapid economic growth. This pattern is evident across the GCC, underscoring the need for policies countering obesogenic environments.

Soaring global obesity

Shifting focus to the global obesity scenario, the Atlas report paints a similarly bleak outlook, revealing that no country is on track to meet the World Health Organization’s target of halting obesity prevalence by 2030.

It predicts more than half of the world’s population will be overweight or obese by 2035, without significant action, and exposes the dire impact of high Body Mass Index (BMI) on global health.

The Atlas 2024 report says while 42 percent of adults were categorized as obese or overweight globally in 2020, the number will soar to 54 percent by 2035.

Among young people aged 5 to 19 years, the prevalence of high BMI is expected to skyrocket from 22 percent (430 million) in 2020 to more than 39 percent (770 million) in 2035.

The report indicates that a staggering 56 million people, encompassing both adults and children, succumb to various ailments annually, resulting in the loss of 2.5 billion years of healthy life.

NCDs, particularly cancers, coronary heart disease, stroke, and diabetes, account for 41 million deaths and 1.6 billion disability-adjusted life-years (DALYs).

Four major NCDs – diabetes, stroke, coronary heart disease, and cancer – account for nearly four million of these fatalities.

The toll doesn’t stop there.

A high BMI is robbing the world of more than 120 million person-years annually due to these leading NCDs.

Three-quarters of these avoidable deaths and diseases are concentrated in middle-income countries, revealing a harsh reality: The majority of those grappling with and succumbing to NCDs due to high BMI are in lower-resource and developing nations.

More alarming is the trajectory the planet is on.

The Atlas report predicts that if current trends persist, then by 2035, a staggering 750 million children aged between 5 and 19 years will grapple with being overweight.

This statistic translates to two out of every five children globally, with a majority residing in middle-income countries. These children face heightened risks of early onset of NCDs, with an estimated 68 million at risk of high blood pressure, 27 million facing hyperglycemia, and 76 million dealing with low HDL cholesterol due to their high BMI.

The World Obesity Federation said while efforts have been made to address this crisis, without a major and coordinated intervention, obesity rates are poised to surge.

The Atlas report highlights a concerning correlation between high BMI and economic development, indicating that nations with rapidly expanding economies are witnessing a simultaneous surge in people who are overweight.

This week the World Health Organization and an international group of researchers warned that more than a billion people globally are now considered obese.

They say obesity is so prevalent it has become more common than being underweight in most nations, including many low and-middle income countries that have previously struggled with undernourishment.

“A staggering number of people are living with obesity,” said Majid Ezzati, senior author of the paper published in The Lancet on Thursday and a professor at Imperial College London.

The findings, considered among the most authoritative of independent estimates, are based on data from more than 220 million people in more than 190 countries.

While obesity rates are plateauing in many wealthier countries, they are rising rapidly elsewhere, Ezzati added. And while being underweight is becoming less common globally, in many countries it remains a significant issue, leaving increasing numbers of countries facing what is known as the “double burden” of malnutrition.

“In the past, we have been thinking of obesity as a problem of the rich. Obesity is a problem of the world,” said Francesco Branca, head of nutrition at the WHO, in a press conference.

Obesity and planetary health

In the World Obesity Atlas, the data further underscores the intricate link between high BMI and global environmental challenges, tying in factors such as greenhouse gas emissions, urbanization, plastic waste, sedentary lifestyles, and high consumption of animal-based products.

The relationship between high body mass and planetary health is two-directional, with climate change and its causes contributing to increased obesity levels, while on a population level, some evidence suggests that the needs of a growing population with a high BMI will increase greenhouse gas (GHG) emissions, by small margins compared to other sources of emissions.

“In modern food systems, more than 3 kcal of fossil fuel energy is required to produce 1 kcal of food energy. High body mass implies a greater need for food energy, which in turn results in a greater consumption of food products and greater fuel consumption when motorized transport is used,” noted the report.

Notably, a staggering 700 megatons of CO2 (carbon dioxide) equivalent emissions are attributed to high BMI, which is equal to 1.6 percent of global GHG emissions.

While the Atlas 2024 report emphasizes that blaming individuals is unjust, it does underscore the role of systemic factors, particularly in the food industry. Profit-driven motives of food and beverage companies contribute to unhealthy dietary patterns and environmental degradation.

Importantly, the financial implications of neglecting this health crisis are colossal globally.

The report warns that by 2035, high BMI could slash the global economy by more than $4 trillion, equivalent to nearly three percent of global GDP.