There is significant evidence for the existence of worldwide increase of obesity in children. The problem is not only confined to developed countries; as there has been significant increase in middle and low income countries, and Saudi Arabia is not an exception. The problem of obesity in developing countries further impacts on the burden of disease in these countries. Individual nations need to be informed of the magnitude of the obesity problem in their different settings and an effective comprehensive approach including, formulation of effective health policies and health legislation development will enable development of long-term measures that address obesity epidemic. This article highlights the magnitude of obesity in Saudi Arabia and attempts to suggest policies and strategies potential to addressing obesity problems in Saudi Arabia. Multiple determinants of obesity are discussed related to the Saudi context.

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Childhood obesity is considered as a serious health problem worldwide. The aim of this review is to evaluate the prevalence and the trends of obesity among Saudi children. A full search was conducted for all articles published between 2000 and 2012 on obesity in Saudi children. The latest national data revealed that the rates of overweight and obesity among school-age children have reached 23% and 9.3%, respectively. However, the rates of overweight and obesity among preschool children were reported as approximately 15% and 6%, respectively. A variation in the prevalence of obesity and overweight in children among geographical regions of the Kingdom was noted. Eastern and central regions have the highest prevalence of obesity and overweight and southern regions have the lowest prevalence of obesity and overweight. Both regional and national studies showed a trend of rising obesity over time. This review demonstrated that Saudi children have a high prevalence of obesity and being overweight with a rising trend. In light of these findings, it is evident that a national strategy is required to treat and prevent this serious health problem.

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Overweight and obesity affect more than 75% of the total population in Saudi Arabia. Almost all age groups are affected in general and adults particularly. In order to introduce high quality health-care for these individual, it is mandatory to establish clinical guideline that will help health-care providers to manage this common problem at all levels. This guideline was adapted from Scottish Intercollegiate Guidelines Network and other international guidelines for prevention and management overweight and obesity. The guideline will cover preventive and curative aspects of overweight and obesity and could be implemented at primary, secondary, and tertiary care levels in Saudi Arabia.

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Overweight and obesity affect more than 75% of the total population in Saudi Arabia. Almost all age groups are affected in general and adults particularly. In order to introduce high quality health-care for these individual, it is mandatory to establish clinical guideline that will help health-care providers to manage this common problems at all levels. This guideline was adapted from Scottish Intercollegiate Guidelines Network for management of obesity after taking permission in this regard. The guideline will cover preventive and curative aspects of overweight and obesity and could be implemented at primary, secondary, and tertiary care levels in Saudi Arabia.

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Background: Childhood obesity is one of the most serious health challenges of the 21st century. The problem is global and the prevalence is increasing at an alarming rate. Objectives: To determine the prevalence and risk factors of overweight and obesity among Saudi primary school students in AlAbnaa primary schools in Tabuk. Materials and Methods: A cross-sectional study was conducted among primary schools students in AlAbnaa Schools in Tabuk, Saudi Arabia. Sampling frame included all genders. In the first stage, a sample of four primary schools had been selected using simple random technique-two primary school for boys and two for girls. In the second stage, stratified sampling technique had been used. The data was collected through a self-administered validated questionnaire. Height and weight of the subjects were measured and body mass index (BMI) was calculated. Recently published 2007 World Health Organization (WHO) growth charts which depended on data from widely different ethnic backgrounds and cultural settings were used for defining overweight and obesity among students. Results: A total of 331 out of the target study subjects of 350 responded to the survey giving a response rate of 94.6%. Age of the respondents ranged from 6-13 years old and the mean age was 9.7 ± 2.1 years. The prevalence of overweight and obesity among male primary school students were 7.3% and 17.4%, respectively while the prevalence among female students were 12.4% and 20.9%, respectively. Overweight and obesity were more prevalent among student living with both parents (P = 0.031), with highly educated parents (P = 0.008), with history of maternal obesity (P = 0.001), with working mothers (P = 0.024), and with smaller family size (P = 0.004). Conclusion: The results of the current study provide alarming evidence-based data on the considerable prevalence of childhood overweight and obesity among Saudi primary school children in Tabuk, Saudi Arabia.

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Obesity is a global epidemic, preventable, and a disease of clinical and public health significance. It has emerged as a major risk factor for the development of disability, several other noncommunicable diseases, and premature death. This review summarized epidemiological studies related to the obesity prevalence and identified its potential risk factors among the Arab population in the United Arab Emirates (UAE). PubMed, Scopus, ScienceDirect database, and other local journals were searched to identify relevant literature by means of appropriate keywords to retrieve studies conducted in the UAE. Search limits were restricted to studies in English language, between 2007 and 2016, and on the UAE population (both citizens and expatriates). The search yielded 15 studies regarding the prevalence and risk factors of obesity, including cross-sectional studies (n = 11), a population-based survey (n = 1), a retrospective cohort study (n = 1), and qualitative focus group surveys (n = 2). Cross-sectional studies found that the prevalence of obesity ranged between 16 and 28.4%, with a higher proportion of adult females being more obese than males in UAE. This increasing obesity prevalence places a large burden on healthcare costs and usage. Furthermore, some potentially essential risk factors were identified, which would help to guide future research strategies. This review signifies a promptly increasing obesity prevalence in the UAE and suggests that extra effort is needed for preventive and curative strategies to reduce the burden of this common condition.

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The number of patients undergoing bariatric surgery increases every year, as obesity has become a major cause of several comorbidities. The frequency of complications associated with this procedure has been increasing. Here, we present a case of 32-year-old male with ataxia and peripheral polyneuropathy after a sleeve gastrectomy procedure, who went on to develop progressive weaknesses in the extremities within a duration of 8 months after surgery, and was admitted to hospital for neurological consultation and treatment. The case report highlights the symptoms that bariatric surgeons must detect and review the treatment.

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Background: Previous research suggested that obesity is associated with an increased risk of mental illness. Depression, stress, and anxiety are among the psychological problems that are commonly associated with obesity among students. However, evidence linking obesity to mental illness is inconsistent. Objectives: The objective of this study was to investigate the associations between mental disorders (in particular the depression, anxiety, and stress) and obesity in the male students of King Khalid University (KKU). Subjects and Methods: A cross-sectional study was conducted including male Saudi students enrolled in KKU at Abha City during the academic year 2013-2014. A multi-stage random sampling technique was adopted. Data were collected using the Arabic version of the depression anxiety stress scale. Results: The study included 389 university students. Their age ranged between 18 and 26 years with a mean age of 21.2 ΁ 1.5 years. They were almost equally distributed between four colleges (Medicine, Pharmacy, Sciences, and Languages and translation). Overweight was reported among 22.1% of the students whereas obesity was reported among 18.3% of them. The overall prevalence of depression, anxiety, and stress were 48.1, 58.9, and 40.4%, respectively. The association of obesity with depression, anxiety, and stress was found statistically significant (P < 0.001, <0.001 and <0.003, respectively). Conclusion: The prevalence of overweight and obesity are considerably high among male University Students in Abha. These findings suggest that obesity is associated with depression, anxiety, and stress. Prospective studies will ultimately be required in order to clarify the temporal relation between obesity and common mental disorders.

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Obesity is an escalating global epidemic with exponential increasing rates in Saudi Arabia and Gulf Countries. Obesity has adverse effects on patients’ health, psychology, and socioeconomic status. In addition, it is a burden on societies when obese individuals become less productive in their work and governments spend more money for their accommodation in the society and health care expenditure. A comprehensive interprofessional system approach inclusive of broad environmental and social interventions and individuals’ psychological and behavioral changes is required to produce positive impact on obesity prevention and control in societies. The aim of this project is to involve concerned health care and non-health professions, policy makers, and other stakeholders to work together within a system framework. The idea of this project was initiated at the first residential meeting of the Manipal University – Foundation for the Advancement of International Medical Education and Research (FAIMER, Philadelphia, USA) International Institute for Leadership in Interprofessional Education (MUFIILIPE) Fellowship Program, Manipal, India, in May 2015. The literature collected and carefully selected includes major reports, policies, guidelines, and interventions done at several sectorial levels; best-evidence practices on communities, health care professions, schools, and workplaces; implementation strategies, success stories, and barriers; and studies on assessment of the effectiveness and impact of these interventions. Out of hundreds of articles and reports in obesity and related NCDs published nationally and worldwide, this project documents and discusses local interventions and programs in this field with lessons learned. In addition, best-evidence practices/interventions, and policies that have worked globally to prevent and manage obesity are discussed and extrapolated to our local settings. Aided by national and international expert groups, this project tries to document a road map for a multisectorial interprofessional system approach to prevent and control obesity in the region to influence its impact on individuals and society.

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The purpose of this paper is to provide an overview of the prevalence of childhood obesity in Saudi Arabia and discuss the effectiveness of school-based intervention. The efforts of the Rashaka Initiative in controlling childhood obesity are also described. Obesity is defined as excessive or abnormal fat accumulation in the body as a result of an imbalance between energy intake and expenditure. Childhood obesity has a negative impact on health and may lead to high cholesterol, hypertension, fatty liver, diabetes, and sleep apnea. As childhood obesity has a strong likelihood to continue into adulthood, it can contribute to noncommunicable diseases later in life. According to the latest data, the percentage of obese children between 5 and 18 years was found to be 11.3%. To promote a healthy lifestyle, and prevent and control obesity in Saudi population, the Ministry of Health established two programs through the primary healthcare center: (1) Diet and Physical Activity Program and (2) Obesity Control Program. To control obesity among school children in the Kingdom of Saudi Arabia, the Ministry of Health in cooperation with the Ministry of Education launched “RASHAKA Initiative”. This initiative aims to promote a healthy lifestyle by improving dietary behavior, increasing physical activity, and increasing the awareness of obesity risks. It also aims to identify methods of prevention as schools are appropriate institutions for preventive interventions.

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Background: Insulin resistance (IR) is one feature of obese patients with type 2 diabetes and associated with a clustering of metabolic abnormalities. Obesity per se is one component of a cluster of metabolic abnormalities that included the hyperinsulinemia. Objectives: This study aims to assess the status of IR in obese nondiabetic subjects using HOME-IR index and demonstrate the therapeutic effect of metformin as an insulin sensitizer. Materials and Methods: A total number of 76 out of 97 obese male completed the study. The subjects assigned to receive a single-dose of metformin (850 mg/daily) for 3 months. Anthropometric measurements and the following biochemical tests were carried on before and after treatment: Fasting serum glucose, glycosylated hemoglobin, and fasting serum insulin. The basal metabolic rate (BMR), HOMA-IR, and insulin sensitivity (IS) were calculated using a specific formula. Results: Metformin therapy resulted in a significant decrease in body mass index of obese subjects. This effect is associated with significant decrease BMR. Significant decrease HOMA-IR observed in Classes I and II obesity (62.95% and 65.13%, respectively) and to a lesser extent in Class III (72.48%). Significant improvement in glycosylated hemoglobin was observed in Classes I and II obesity. HOMA-IR index is significantly correlated with glycosylated hemoglobin before and after treatment. Conclusions: Metformin improves IS in nondiabetic obese men besides its favorable effect in reducing the body weight.

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Context: Saudi Arabians suffer from overweight and obesity, which contribute significantly to the poor control of diabetes mellitus (DM) and hypertension (HTN). Aim: To assess the effect of overweight and obesity on diabetes and HTN control in Aseer region, KSA. Materials and Methods: The study was conducted by the end of the year 2010. All medical records were assessed by trained doctors and nurses working in the Chronic Disease Clinic at each primary health care center (PHCC) using a check list derived from the quality assurance manual of PHC. The Chronic Disease Services were based on the recommendation of the relevant guidelines. Data entry and analysis was carried out using Statistical Package for Social Sciences. P-values less than 0.05 were selected for statistical significance. Results: The prevalence of obesity among diabetics and hypertensive patients was 46% and 54%, respectively. The diabetic patients with good control comprised 21% of the study population, while less than one-third of the patients had fair diabetic control and about half of the diabetics had poor diabetic control. About more than one-third of patients had good control of HTN and less than one-third suffered from overweight and more than half had obesity. Conclusion: This study demonstrated that most of DM and HTN patients in PHCCs, Aseer Region, KSA, suffered from overweight and obesity, which contribute significantly to the poor control of DM and HTN.

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Background: Overweight and obesity, initially thought to be the problem of the developed countries, are rapidly rising in the developing countries constituting a high proportion of nutritional problems in these countries. Several factors, including changing lifestyle and improved economic power, are believed to contribute to this trend. This pattern if unchecked is known to lead to several medical complications. We thus aim to assess and compare the prevalence of overweight/obesity among primary school pupils from the public and private schools as well as determine factors contributing to the rising trend. Materials and Methods: Four hundred and twenty primary school children from public and private schools were selected using multistage stratified random sampling. Relevant information was obtained using a questionnaire, and anthropometric indices were recorded. Data obtained were analyzed using EPI INFO version 3.5.1. and frequencies were compared using Chi-square. Results: Seventy-three (17.4%) of the 420 pupils studied were found to be overweight/obese. Pupils from private school accounted for the majority of these cases with 28 (13.3%) and 29 (13.8%) of them being overweight and obese, respectively. High socioeconomic class and consumption of energy-dense diet were significantly associated with high prevalence of overweight/obesity (P < 0.001). In contrast, regular physical activity was significantly associated with low prevalence (P < 0.001). Conclusion and Recommendations: Prevalence of overweight/obesity among primary school pupils is quite high in Lagos, Nigeria. High socioeconomic class, consumption of energy dense food, and lack of adequate physical activities appear to be major factors contributing to this high prevalence. Introduction of daily school meal and mandatory physical activity in all the schools would go a long way in imbibing healthy eating and lifestyle pattern into these children. Public nutritional education and campaign on the importance of healthy lifestyle and complications associated with overweight and obesity would probably reverse the trend.

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Background and objectives: Overweight as well as obesity is a risk factor of maternal morbidity and mortality in Nigeria. This study assessed the meal pattern and incidence of overweight and obesity among market women in a Southwest community, Nigeria. Materials and Methods: This cross-sectional study involved 250 market women randomly selected by multistage sampling technique. Respondents’ personal characteristics and meal pattern were obtained through a pretested interviewer-administered questionnaire. Their weight and height were measured and used to calculate their body mass index (BMI), which was categorized into underweight (BMI < 18.5 kg/m²), normal weight (BMI = 18.5–24.9 kg/m²), overweight (BMI = 25.0–29.9 kg/m²), and obesity (BMI ≥ 30 kg/m²). Data were analyzed using the Statistical Package for the Social Sciences version 16.0. Results: The mean age of the market women was 37.31 ± 15.31 years and 50 (20.0%) of them had no formal education. Majority of participants ate three meals (64%) while 27% ate more than three meals per day. Breakfast meal was usually skipped by 163 (65.2%) of the women and 155 (62.0%) and 190 (76.0%) women often ate breakfast and lunch meals, respectively, outside the home. The prevalence of underweight, overweight, and obesity was 25.2, 16.0, and 8.0%, respectively. Women’s BMI was significantly associated with their age, marital status, family type, and level of education. Conclusion: This study reveals the high prevalence of overweight and obesity among the market women. Older age, marriage, and monogamous family adversely influenced overweight/obesity. Nutrition education is recommended as an intervention strategy.

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Background: Obesity is a risk factor for many chronic diseases and some malignancies. It became as international epidemic, particularly in Western and Gulf countries. Objectives: To determine the prevalence of obesity and overweight among resident physicians in the postgraduate training programs of Saudi Board in Aseer Region, KSA. Subjects and Methods: This cross-sectional study was conducted during October to November 2013. Data were collected through a questionnaire developed by the researchers, which included the demographic data, weight and height measurements, and dietary habit using food frequency questionnaire. The first researcher met all the respondents and measured their weight and height, then every subject was asked to fill the self-administered questionnaire. Results: Out of 255 invited residents, 82.7% participated in this study. The mean age of the respondents was 27.9 ± 2.6 years. Almost two-thirds of them (66.8%) were males. Majority of them (96.2%) were Saudi. Overweight and obesity were reported among 36% and 23.2% of the residents, respectively. Obesity was significantly higher among male than female resident physicians (31.9% vs. 7.1%), P < 0.001. Taking of potatoes chips, sweets, pizza, never drinking skimmed milk, and never drinking semi-skimmed milk were significantly associated with obesity among resident physicians. Conclusion: Frequency of overweight and obesity was high among Saudi Board residents in Aseer Region and significantly higher in male than female physicians. Taking of potatoes chips, sweets, pizza, never drinking skimmed milk, and never drinking semi-skimmed milk were significantly associated with obesity among resident physicians.

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Obesity is a growing epidemic affecting all ages in both industrialized and developing countries. The most common suggested cause of this epidemic is the increasing levels of urbanization and lifestyle changes toward sedentary life and adopting "western" dietary patterns. The association between obesity and type 2 diabetes mellitus (T2DM) has been reproducibly observed in cross-sectional and prospective studies across various populations, even when using different fatness measures and diagnostic criteria for T2DM. However, there are some modifying factors that make such an association complex and multifactorial. These modifying factors include the duration of obesity, body fat distribution, physical activity, diet, and genetics/ethnicity. This review aims to summarize the evidence of this association and its potential modifying factors.

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Obesity is the problem of children, adolescents and the elderly because it is a problem that affects all ages. Obesity leads to many metabolic disorders diabetes, hyperlipidemia, hypertension, angina, depression, indigestion and arthritis. There were several studies and reviews presented on the treatment modality in literature for obesity. But there are no comprehensive reviews on anti-obesity drugs till date. In the present review, we are presenting the pharmacological management of obesity. The literature search carried out using electronic search engines through PubMed, Biological Abstracts, BIOSIS PREVIEWS, Current Contents^® /Clinical Medicine, Current Contents^® /Life Sciences, EBSCO, ScienceDirect, Ingenta, Springer, Wiley Interscience, J-STAGE, Google scholar and Scifinder from 1990 to September 2013. Based on this search, we are presenting a brief review on pharmacological management of obesity, with a focus on the drugs used in the past, present and future. From this search, it is revealed that some of the drugs approved earlier for treating obesity were withdrawn from the market (Phentermine, Dexfenfluramine, Fenfluramine and Sibutramine). Some of the older drugs are introduced in combination form (Phentermine + Topiramate (Qnexa), Empatic, Concave). Most of the adrenergic and serotonergic drugs possesses adverse effects like increasing heart rate and hypertension. Similarly, some new drugs came into the market for treating obesity (Lorcaserin, Orlistat,) and few are in clinical trials in different phases of drug development (APD-365, CD-945,598, MK-0364, ATL-962, GT-389-255, AOD9604, Leptin, Peptide3-36, obinepitide and TM30338). The drugs that are under clinical trials were subjected for evaluating the safety and efficacy. We have to see in the future how many of these drugs are going to be available for treating obesity.

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Obesity is one of the common health problems in Saudi Arabia. It affects almost one third of adult population and one tenth of children and adolescents. In order to prevent and control obesity among Saudi population, it is mandatory to have national program with definite objectives and strategies. The aim of this paper is to identify priorities for integrated strategies to prevent and control obesity and to define roles and responsibilities of various stakeholders including individuals, families, community, organizations and agencies in KSA as the first step in a process to develop integrate national program to prevent obesity.

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Background and Objectives: In Saudi Arabia, overweight and obesity affect more than 75% of the adult population. National studies concluded that the two most contributing factors leading to obesity epidemic in Saudi Arabia are intake of imbalanced diet and lack of regular physical activities. The purpose of this paper is to study the trial of weight loss and the factors that determine it among adult overweight/obese in Abha city, southwest Saudi Arabia. Materials and Methods: This cross sectional study was conducted in Aseer Mall, Abha city during August 2014. To achieve the objectives of this study, the investigators created a questionnaire in Arabic language with the following parts: demographic data, history of any medical condition, awareness about current weight, awareness about harm of obesity, past trials to lose weight, types of interventions to lose weight, and results of trial. The questionnaire was validated by two family physicians and then administered by well-trained nurses to all adult people visiting to “Obesity Exhibition” which was executed by Saudi Arabian society of metabolic and bariatric surgery (SASMBS) in August 2014 for 1 week. Data of the questionnaire were coded, entered and analyzed by SPSS. Results: A total of 422 clients visited the obesity exhibition site during 1 week of the study. Out of them, 263 individuals (62%) were either overweight or obese. The mean age was 36 years; majority of participants were females (71%) and married (67%); housewives and officers constituted 27 and 29% of participants, respectively. About 85% of them knew their current weight, and 92% reported that obesity may give harmful effect on their health. More than 80% of the participants mentioned that they tried to lose their weight in the past, but about quarter (26%) of them reported its success. About one third (37%) of them used both diet and exercise; 3% of them used drugs, while 26% used traditional therapies as an intervention to lose weight. Most of participants (74%) fail to lose weight as they were not adequately compliant with diet and exercise. Average weight loss was 7.5 kg (standard deviation = 6 kg) and a minimum of 1 kg. It was found that females (27%) use herbal products to reduce their weight when compared to males (6%) (P = 0.000). Practicing a physical activity to lose weight was higher among males (31%) compared to females (19%), but no association was found with other demographic variables. Conclusion: Majority of obese patients failed to achieve the target weight loss. The underlying reasons for failure were poor compliance to diet and physical activities.

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