Obesity

Obesity is an increase in body weight beyond the normal limit as a result of excessive or abnormal accumulation of fat, which harms the individual’s health. This increase results from an imbalance between the energy consumed from foods and the energy consumed by the body.

Given that obesity is linked to many chronic diseases such as high blood pressure, high cholesterol, type 2 diabetes, heart disease and stroke, the American Medical Association classified it in 2013 as one of the chronic diseases.

Causes of Obesity

• Following an unhealthy diet and lack of movement. This is one of the reasons for the spread of obesity among children, which usually continues into adulthood. Social factors lead to the acquisition of wrong eating habits within the family.
• Some diseases, such as an underactive thyroid gland, Cushing’s syndrome and others.
• Some medications, such as antidepressants, some diabetes medications, some epilepsy medications and others.
• Lack of sleep.
• Getting older.
• Pregnancy.
• The genetic factor, which has a role in some cases of obesity.

How Is Obesity Measured?

Body Mass Index for Adults

The most common measurement, because of its ease of procedure. It is calculated by dividing the body weight in kilograms by the square of the height in meters, to determine whether the weight of an adult is appropriate for their height.

This indicator is used for adults aged 20 and over. It is not used for categories such as:

• Athletes.
• Children.
• Adolescents.
• Pregnant women.

Classification of adults according to body mass index and incidence of diseases associated with obesity (WHO.1998):

Weight classification	Body mass index (kg/m2)	The risk of diseases associated with obesity
Underweight (thin)	Less than 18.5	Suffering from diseases other than obesity
Normal weight	18.5-24.9	-
Weight gain (pre-obesity)	25-29.9	The risk increases
First degree obesity	30-34.9	Middle
Second degree obesity	35-39.9	Intense
Third degree obesity (excessive)	40 and more	Very dangerous

Growth Charts for Children and Adolescents

Weight in children and adolescents is classified using Saudi growth charts for body mass index by age as follows:

• The body mass index falls between 85% and 94% of the growth chart in the presence of weight gain.
• The body mass index is at the 95% or higher level of the growth chart indicating obesity.

Weight classification for children and adolescents using the Saudi growth curve according to age and gender:

Category	Growth chart for children and adolescents
Under normal weight	Below the 5th percentile
Normal weight	5th to below the 85th percentile
Overweight	85th to below the 95th percentile
Obesity	95th percentile or higher

Waist Circumference and Central Obesity

Central obesity is the accumulation of fat in the abdominal area, and it is classified by measuring waist circumference. Fat accumulated in the abdominal area is more dangerous than fat in the buttocks or any other part of the body, as people with central obesity are at greater risk of developing diabetes, heart disease and premature death.

This measurement can be used as an additional method in adults who suffer from overweight or first-degree obesity (BMI between 25-34.9 kg/m2). It is not used for the following cases:

• Adults with a BMI of less than 25 or a BMI of 35 or above.
• Athletes.
• Children and adolescents (ages under 18 years).
• Pregnant women (gestational age more than 20 weeks).
• Those who cannot stand up straight (such as those who are crippled), or those who suffer from problems in the waist area (such as a hernia or tumor, or who have undergone a recent surgical procedure).

Central obesity classification for adults according to waist circumference and number of chronic diseases:

Gender	Normal rate	Danger	Extreme danger
Man	Less than 94 cm	From 94-101 cm	102 or more
Women	Less than 80 cm	From 80-87 cm	88 or more

What Are the Complications of Obesity?

In Adults

• Heart disease.
• Stroke.
• Type 2 diabetes.
• High levels of cholesterol or triglycerides.
• High blood pressure.
• Arthritis and bones.
• Temporary sleep apnea.
• Some psychological problems, such as poor self-confidence and social isolation, which lead to depression.
• Some types of cancer, such as colon, rectum, breast, uterus, pancreas, prostate, esophagus, liver and kidney cancer.
• Gallbladder diseases.
• Non-alcoholic fatty liver disease.
• Gynecological diseases, such as infertility and irregular menstruation.
• Skin problems, such as difficulty healing wounds.

In Children

Disease complications:

• Increased risk of diabetes (type 2).
• Cardiovascular diseases.
• Respiratory problems when playing and sleeping.
• Damage to joints.

Social and psychological complications: such as social isolation and loss of self-confidence, which leads to depression.

Complications that appear in old age: the persistence of obesity into advanced stages of life and the accompanying risks that threaten health.

How Is Obesity Treated?

• Following a healthy diet and increasing the level of physical activity.
• Behavioral modifications and changing nutritional and physical misconceptions.
• Weight loss medications under medical supervision and follow-up.
• Obesity surgery according to the directions of the treating physician.

How Can Obesity Be Prevented?

Commit to a healthy, balanced diet and regular physical activity.

In Children

• Encourage children to eat five servings of fruits and vegetables a day.
• Encourage the child to eat without distractions, and limit screen time to less than two hours a day.
• Encourage the child to engage in physical activity for at least an hour in their daily schedule.
• Encourage the child to stay away from soft and sweetened drinks, and replace them with drinking enough water daily.

In Adults

• Reduce consumption of energy-dense foods.
• Eat main meals regularly.
• Eat high fiber foods.
• Eat slowly and control the portion of the meal.
• Drink enough water a day.
• Avoid unhealthy diets.
• Read the nutritional label behind the products for healthier choices.
• Do physical activity for at least 150 minutes per week, and increase the daily rate by 300 minutes or more per week.
• Make sure to sleep well.
• Monitor your weight once a week.

Obesity in Numbers

Worldwide

In adults: World Health Organization statistics for 2016 indicate that more than 1.9 billion adults (18 years and over) suffer from being overweight, and 650 million people suffer from obesity. If the spread of obesity continues its current path, half of the world’s adult population will suffer from overweight or obesity by 2030. Obesity is also a major burden on the global economy, amounting to about $2.0 trillion (2.8%) of global GDP. Therefore, obesity is considered one of the largest economic losses in the world. It is also responsible for about 5% of deaths around the world.

In children:

• 41 million children under the age of five suffer from obesity.
• 340 million children and adolescents between the ages of 5 and 19 are obese.

In Saudi Arabia

In adults: according to the results of the National Health Information Survey for the year 2019:

• The obesity rate in Saudi Arabia among adults (18 and over) reached 20.2%, and overweight 38.2%.
• The prevalence of obesity was higher among women at 21.4% compared to men at 19.2%.

In children: the percentage of children who suffer from overweight and obesity in the Kingdom in 2012:

Group	Overweight	Obesity
Children under five	15%	6%
Children five years and older	23%	9.3%

The Kingdom of Saudi Arabia ranks third in the Arab world in obesity rates.