Saudi Journal of Obesity

ORIGINAL ARTICLE
Year
: 2018  |  Volume : 6  |  Issue : 2  |  Page : 49--52

Riyadh Obesity Forum Proceedings (December 1–2, 2018), Day 1 Theme: Magnitude of the problem and interventions to prevent and control obesity


Mohammed Alnaami1, Khalid Alrubeaan2, Ayoub Aljawaldeh3, Fahad Bamehriz4, Ahmed Alghamdi5, Abdulaziz Al Othman6, Meshal Al Aqeel7, Hazzaa Alhazzaa8, Khalid Al Omari9, Nasreen Alfaris10, Adnan Mofti11,  
1 Chairperson − Scientific and Organizing Committee − SASMBS, Kingdom of Saudi Arabia
2 Head of Academic Affairs and Research Center − SBAHC, and Former Director − Diabetic Center KSU
3 WHO Regional Nutrition Advisor
4 Director of Minimally Invasive Surgery Fellowship Program − KSU
5 National Leader of the Optional Health Care System
6 President of the Saudi Society for Clinical Nutrition
7 Consultant Psychiatrist and Psychotherapist (KSAU-HS)
8 Head, Lifestyle and Health Research Center − PNU
9 General Supervisor of Obesity and Endocrinology Program − KFMC
10 Director of the Fellowship Program for Obesity Medicine − KFMC
11 President − SASMBS

Correspondence Address:
Prof. Mohammed Alnaami
The Saudi Commission for Health Specialties (SCFHS) 6591 Samahah Street – Al Safarat District, Riyadh 12511-3158
Kingdom of Saudi Arabia




How to cite this article:
Alnaami M, Alrubeaan K, Aljawaldeh A, Bamehriz F, Alghamdi A, Al Othman A, Al Aqeel M, Alhazzaa H, Al Omari K, Alfaris N, Mofti A. Riyadh Obesity Forum Proceedings (December 1–2, 2018), Day 1 Theme: Magnitude of the problem and interventions to prevent and control obesity.Saudi J Obesity 2018;6:49-52


How to cite this URL:
Alnaami M, Alrubeaan K, Aljawaldeh A, Bamehriz F, Alghamdi A, Al Othman A, Al Aqeel M, Alhazzaa H, Al Omari K, Alfaris N, Mofti A. Riyadh Obesity Forum Proceedings (December 1–2, 2018), Day 1 Theme: Magnitude of the problem and interventions to prevent and control obesity. Saudi J Obesity [serial online] 2018 [cited 2022 Jun 30 ];6:49-52
Available from: https://www.saudijobesity.com/text.asp?2018/6/2/49/331872


Full Text



 Forum aims and objectives − Mohammed Alnaami



This forum aims to improve obesity prevention and management by:developing opportunity to experience the best public health practices globallyempowering the Kingdom of Saudi Arabia (KSA) health professionals to collaborate, innovate and help shape the future of KSA public health landscapecreating the largest platform in the KSA for innovative ideas and approaches to prevention and proper management practices, policies, and research that encourage further collaborations across multiple sectors and professions (Health in All Policies)inspiring setting to start new research, strategies, best practices, and innovationinteractive networking and knowledge exchange forum at the KSA, GCC, Regional, Arab, and International level to identify, discuss, and troubleshoot current public health issues across a range of disciplines and sectors for integrated comprehensive care of obesitysupporting and nurturing the next generation of healthcare leaders;engaging global and diverse voices, ideas, vision, initiatives, and actions toward combating obesity;Strengthen and transform the global effort to combat obesity and influence decision-making at national level; andbuilding multidisciplinary networks to promote a national public health activity within the frame of 2030 KSA vision.

Learning objectives

The forum delegates will be better prepared to:identify challenges and related solutions, trends, emerging issues, and gaps;explore the current status of obesity prevention and management evidence, research, policy, and practice;effective evidence-based education programs and health-promotion practices;evaluate strategies for knowledge and skill translation; anddevelop and access a network of colleagues and partners for initiating or expanding obesity prevention and management initiatives.

Recommendations

Establish a national obesity control committee "Experts’ Panel" within the structure of the National Center for Disease Prevention and Control that is interprofessional, authorized, and independent, with the following responsibilities:Lead and administer the project with bylawsSet the components and resources of the obesity prevention and control systemCollect and study available data and research in obesity prevention and controlSetting standards, policies, guidelines, best practices, interventions, and programs thatpromote the vision of the projectPreparation and implementation of national strategies in this fieldDevelop programs for continuous education and training for relevant professions and other stakeholdersMonitoring and evaluating the system as a wholeEstablish international networking and disseminate successful experiences and research in this fieldBuild healthy environment and implement collaborative interprofessional anti-obesity programsDevelop assessment methods and tools, establish adequate measurements criteria, and make use of assessment and monitoring results for further improvementUse media, schools and universities, primary healthcare and community centers as conduits for dissemination of research and successful results in this fieldIncrease availability of healthy food and pure water, decrease consumption of sugars and saturated fat in the community, and promote physical activity throughout lifeProvide state-of-the-art health care for overweight and obese individuals from primary care centers, through tertiary care facilities, to highly specialized bariatric centersParticipate in national and international campaigns and programs

 Obesity and diabetes epidemic in Saudi Arabia − Khalid Alrubeaan



Recommendations

Alert policy makers in Saudi Arabia to consider the implementation of preventive lifestyle interventions that include weight control programsFor preventing metabolic syndrome, policy makers should consider the promotion of a healthy diet and physical activity in the planning of future healthcare strategies in Saudi Arabia

 Proposed priority areas of action and suggested interventions to prevent obesity − Ayoub Aljawaldeh



Saudi Food and Drug Authority engaged in implementation of the healthy food strategy to promote public health by reducing food content of sugar, salt, saturated, and trans-fat. They signed a pledge with nine global companies to reduce sugar, salt, and fat in their products. Other national companies started to follow.Nutrition information to consumers, including implementing fact-based nutrition labeling and promoting healthy diets and lifestyles, were implemented. Big efforts by Ministry of Health for Public awareness of front of pack labeling.Launched “Calories Display Regulation” in menus of restaurants, bakeries, cafeterias, ice-cream stores, fresh fruit stores, coffee and sweet shops to be mandatory by January 1, 2019.Menus will be inspected by Ministry of Municipal and Rural Affairs (MOMRA).Issued a Regulation to eliminate Trans-Fats: Code No (GSO 2483), which should not exceed 2% and 5% of total fat as follows: 2% in oil and fat products such as margarine and 5% in the fat component in other food products.Review the regulation Code No (GSO 2362/2014) for salt in bread which stated that salt should not exceed 1.8% by dry weight. A draft regulation Code No (GSO 05 FDS 5008/2017) to regulate salt in bread and cereal products from Emirates Authority for Standardization and Metrology (ESMA). Salt limits in bread in the UAE to 0.5 g.Fact-based nutrition: Public awareness of community was created through provision of sufficient nutrition information. Traffic light labeling was suggested for all food products.Sin Taxes sugar sweetened beverages and soft drinks: Two tax excise by General Authority for zakat (GAZT): A tax rate of (50%) for soft-drink beverages. A tax rate of 100% for energy drinks.National public awareness and motivational communication were implemented for physical activity, including mass media campaigns for physical activity behavioral change.Saudi strategies on the prevention and management of obesity were developed. The Saudi guidelines on the prevention and management of obesity were prepared. Formal and on the job training were organized to build staff capacity. More than 175 scientific lectures and workshops for the health technicians and physicians were conducted on obesity management. Approximately, 5878 health practitioners participated in training activities.Development and production of Information, Education, and Communication (IEC) materials: Around 300,000 health awareness content and 230 rollup were distributed at regions in KSA. Screening campaigns for obesity were conducted in public places 116 early detection and screening locations in 20 health regions. Around 36,731 visitors were screened and intensively educated on obesity and its related risk factors.Health education materials were distributed to all participants. National surveys on obesity and risk factors were conducted HIS Couple researches in obesity under the topic were published (Knowledge and training needs of primary healthcare physicians regarding obesity management in Saudi Arabia). Ministries of Health and Education implemented initiative for obesity control project through School Development of a practical “Calories Guideline” to reduce weight (1200–2200 kcal).TOT guideline training for practitioners at all regions in KSA Health Program for adoptingphysical activities and active life style among students Rashaka.

 Bariatric education and training − Fahad Bamehriz



Recommendations

Increase of obesity-related topics teaching in health professions undergraduate curriculaExpose residents (graduate health professions) to more obesity training and practiceCreate more fellowship programs in the KSA to educate and train graduates in bariatric subspecialties, for example, surgery, medicine, psychology/psychiatry, nutrition, exercise, etc.Provide more outreach programs to transfer experiences of bariatric surgery and other specialties from urban to less-urbanized and rural areas

 How to build obesity care pathway: A future model − Ahmed Alghamdi



Recommendations

Establish wellness programs run and followed by the health institute (hospital/cluster) within the catchment area.Pathway developmentPrivileging system (accreditation)Establish the one stop clinic (OSC) to service as multidisciplinary approachEstablish and utilize in the service the following initiative:Step down and post discharge servicesLength of stay initiatives such as preoperative blood management protocol, pain management protocol, and enhance recovery after surgery (ERAS) protocolCreate bundled care management with known KPI and set of clinical outcome based on time from procedure performance and final desired results. The idea is toward accountable care system, starting with episode cost payment given in retrospective fashion. This payment is only given after clinical outcome of interest is achieved. For example, laparoscopic sleeve gastrectomy, after 1 year with 55% of excess weight reduction and no leakage or malabsorption complications.

 Dieting and nutritional support for the management of obesity − Abdulaziz Al Othman



Recommendations

Establish policies guidelines and procedures that involving all aspects of medical managementImprove quality of prevention and management of obesity and enhance better life style including healthy nutrition and physical activitiesCollaborate with other health societies and related professional to improve quality of services

 Psychological evaluation and management in obesity − Meshal Al Aqeel



Recommendations

Recruit and train more bariatric psychiatrists/clinical psychologistsInvolve clinical psychologist in the bariatric multidisciplinary teamIntroduce more bariatric cognitive behavioral therapy (CBT) programs

 Obesity, physical activity, and sedentary behaviors among Saudi Children and Adolescents: It is time for action − Hazzaa Alhazzaa



Recommendations

Promoting physical activityReducing sedentary behaviorsImproving sleep and dietary habits among Saudi youth population, especially more so among young females

Details are presented in the paper (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3107691/).

 Role of the multidisciplinary team (MDT) on obesity management − Khalid Al Omari



Recommendations:

MDT to be mandatory for the following cases:Body mass index (BMI) more than 50Severe heart failureUncontrol diabetes mellitus (DM)Type 1 DM and poor control status with frequent diabetic ketoacidosis (DKA)Uncertain type of DMPatient requiring wheelchair or any aids due to shortness of breathing (SOB)Mood disorders like severe depression or patients with substances abuseSevere gastroesophageal reflux disease (GERD) with Barrett diseaseSevere renal impairment with glomerular filtration rate (GFR) less than 30Chronic liver disease with portal hypertension (HTN)Patient with frequent thromboembolic disorders or at a risk of bleedingAll revisional surgeriesMDT should be held regularlyMDT members should include: medical, surgical, psychologist and/or psychiatrist, nutritionist, anesthesiologist

 Advances in the medical management of obesity and its complications − Nasreen Al-Faris



Recommendations

To include metabolic surgery as a treatment for T2DM in patients with a BMI of 35 and above; and to consider metabolic surgery as a treatment for patients with T2DM who cannot achieve adequate glycemic control despite of being on antidiabetes drugs with a BMI 30–35.To make more pharmacotherapy for obesity available in the country; and to take the initiative to make pharmacotherapy available through government initiatives rather than depending on industry to make these important interventions available.To support the mandate of inclusion of obesity education at all levels: medical school, residency, and fellowship training.

 Update on surgical management of obesity − Adnan Mofti



At present time, bariatric surgery remains the only effective method to treat morbid obesity and its comorbidities on relatively a reasonable save and cost-effective out comes. However, the available facilities of bariatric and metabolic surgeries can only accommodate 1% to 2% of the burden of the morbid obesity and its comorbidities.It is of paramount importance to focus the efforts and resources to prevent obesity to start with to reduce its ever-increasing prevalence.Encouragement and enforcement of life style changes and practices among the communities from infancy to advanced age toward health life.