(MENAFN - Khaleej Times) Doctors must adopt new treatments that look beyond diet, exercise and surgery if they hope to stem the Middle East's rising obesity epidemic.
Despite global efforts, no country has succeeded in decreasing obesity in the last 33 years. Worldwide obesity has more than doubled since 1980, with almost 30 per cent of the world population overweight or obese. In the Middle East, obesity rates among adults are exceptionally high, at more than 37 per cent in Kuwait and more than 35 per cent in Qatar, Saudi Arabia and Jordan and 31.7 per cent in UAE, according to latest WHO figures.
Experts said that one problem is that most campaigns 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 stigmatising people with obesity instead of treating them as patients and providing them with access to viable treatment options. "Weight bias is society's last acceptable form of discrimination and is largely driven by a limited understanding of obesity," said Dr Nadia Ahmad, founding director of the Obesity Medicine Institute in Dubai and senior advisor for Obesity Solutions at Johnson & Johnson Medical Devices Middle East (JJMD).
"Environmental, social, 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 combatting obesity," she added, speaking during a webinar organised by JJMD to explore the science and societal aspects that underpin 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 thus regulates energy intake and expenditure to maintain levels within a 'set point' range.
Moreover, research suggests that when obese people go on a calorie-deficit diet, there are significant alterations in appetite hormones leading to increased food intake and reductions in energy expenditure including changes in 'muscle efficiency' that together can 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 in promoting a healthy lifestyle, but some individuals still struggle to lose weight based on lifestyle modification alone. They may require pharmacotherapy and metabolic surgery.
Dr Matthew Kroh, chief of the Digestive Disease Institute at Cleveland Clinic Abu Dhabi, opined: "There are new, evolving therapies that aren't surgical to target obesity and weight-related diseases that previously haven't been widely available. They are techniques or devices that are deployed through an endoscope, which is a small tube passed through the mouth and allows us to access the stomach and small intestine. With them, we can treat obesity and weight-related diseases without any incision of the abdominal wall."
Procedures to reduce appetite include endoscopic sleeve gastroplasty, in which sutures are used to decrease the stomach size, and intragastric balloon placement, in which the balloon occupies space within the stomach. Each approach reduces the amount of food the patient needs to feel full, so eats less.
In addition, while prevention is critical for the next generation, it is of little use to those already severely affected by obesity, which can lead to serious co-morbidities such as diabetes, hypertension and cardiovascular problems, and ultimately shortens 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 and vice president of the Obesity Academy Austria). There are 318,000 deaths caused by diabetes each year in the region alone.
The rising social and economic burden of obesity require a new approach to tackle this chronic disease. The current patient pathway to surgical intervention can take as long as eight years, according to Dr Nadia, 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 controls in the short- and long-term.
"Obesity is a spectrum," Dr Kroh said. "On that spectrum of disease, many patients will be treated with diet and exercise, some with medications, and many treated effectively and long-term with surgical intervention. But there are some patients that either aren't eligible for surgery or don't want surgery, while diet and lifestyle changes take tremendous long-term dedication. Many will lose weight in the short term but then regain that weight. These new therapies target those in-between patients."
Asma Ali Zain Associated with KT for 15 years. Covers health issues, Pakistan community, human interest stories as well as general topics for daily news or features.