A combination of major lifestyle and dietary changes over the past few decades, harsh weather conditions that limit outdoor activities and a genetic predisposition has led to an obesity crisis in many parts of the Middle East, especially in the Gulf Co- operation Council (GCC) states of Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the United Arab Emirates (UAE).
This report is based on five in-depth interviews with senior obesity experts from the region, complemented by extensive desk research. The main findings of the research are as follows.
The prevalence of obesity in the region is among the highest in the world. According to data from the World Health Organisation (WHO), obesity rates among adults are exceptionally high in the region, at more than 37% in the UAE, almost 40% in Kuwait and more than 42% in Qatar. Prevalence among women is generally significantly higher in the region than among men, and rates for young adults and teenagers top global charts for obesity and overweight. There has also been a marked increase in disability- adjusted life years (DALYs) due to obesity in the region.
High levels of obesity in the region are the result of a complex combination of interconnected environmental, cultural and biological causes. Diets and lifestyles have changed significantly in the region over the past decades. Food remains important for social, cultural and entertainment purposes, but a formerly Mediterranean-style diet has increasingly been replaced by a reliance on fast food. Meanwhile, levels of physical activity have plummeted amid an increasingly sedentary lifestyle, a lack of sidewalks, high temperatures, rapid urbanisation and technological developments. Biology also plays a major role, including genetic susceptibility and a complex gene-environment interaction caused by the desert location. Women’s risk of obesity often increases with childbearing, exacerbated by cultural factors such as restrictions on their public role and movement.
Obesity is a major economic burden on countries in the region. This is in part due to the link of obesity with associated conditions, such as diabetes, hypertension and cardiovascular problems. According to the International Diabetes Federation, spending on diabetes care in the Middle East and North Africa (MENA) region, as a percentage of total health expenditure, is already the highest globally. Studies show that spending on non-communicable diseases (NCDs)—many of which are linked to and exacerbated by obesity—could double between 2013 and 2022.
A widespread public perception in the region is that obesity is a symptom of diabetes or hypertension, rather than a disease in itself. Although public awareness of the problem is growing gradually as governments and populations realise the health problems associated with excess weight, obesity is not yet seen as a metabolic disorder in its own right. Experts say that this perception ultimately makes it more challenging to care for patients, for example highlighted by the fact that insurers frequently refuse to cover interventions in the region. A lack of data on the effectiveness of interventions as well as a lack of role models, especially among medical practitioners, compounds the problem.
Governments need to move on several fronts if they want to advance a more integrated response to the obesity crisis. Experts interviewed for this report have identified major policy gaps that need to be bridged. Governments must make sure that rudimentary preventive programmes, including education in schools, are in place and include families. In order to tackle childhood obesity, a more integrated approach involving nurse practitioners, family physicians and even social workers is required, with a stronger focus on preventive strategies for reproductive-aged women. Governments may also have to consider more aggressive regulatory measures, such as bans on the sale of sugary drinks in or near schools or taxes on unhealthy food. For those who are already obese, experts recommend better training of professionals with expertise in the complexities of obesity, particularly the creation of multidisciplinary teams to treat patients, with a core team including specialists in obesity medicine and management, dieticians and even specialist psychologists.
