World Obesity Federation
Lifestyle Diseases
Middle East expert group publishes recommendations for obesity treatment The prevalence of obesity in the Middle East is one the highest in the world. It is particularly worrying as obesity is associated with several potentially life-threatening comorbidities which also have a high prevalence in the region, such as type 2 diabetes and hypertension. A recently published report notes that in the Gulf and Lebanon the provision of obesity care has proved challenging for a number of reasons including: insufficient reimbursement for treatment; a lack of available pharmaceutical options; a heavy reliance on bariatric surgery; a lack of obesity education in medical schools and elsewhere and; in some cases, the lack of formal guidelines and recommendations for the prevention, management and treatment of obesity. Left unchecked, the projections for the increasing prevalence of obesity and its associated comorbidities in the region are indeed worrying. This prompted the establishment of the Gulf & Lebanon Recommendations Expert Group following a meeting of regional and international clinical and policy experts under the auspices of the World Obesity Federation in Oman in December last year. The key purpose of the expert group was to draw up a set of
26 I M I D D L E
E A S T
recommendations for the treatment and management of adult obesity in the Gulf and Lebanon. The Gulf & Lebanon Recommendations Expert Group comprises representatives of Bahrain, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia and the United Arab Emirates. Their document – Regional Recommendations for the Treatment and Management of Adult Obesity in the Gulf & Lebanon – was published in October by the World Obesity Federation. (See Resources below to download the report.) It is an important document which should go a significant way to easing the burden obesity by providing clear recommendations and guidelines for the treatment and management of obesity by healthcare workers in the region. Importantly, it emphasises that our perspective of obesity must change to one in which obesity is viewed as “a chronic, progressive and relapsing disease that is the result of a combination of factors, including genetic susceptibility and environmental influences”. The authors state: “It is hoped that global recognition of obesity as a disease will not only improve understanding of the complexity of the condition, but also
H E A L T H
provide impetus for effective public health policy and intervention.” They note that with the development of these regional recommendations for obesity this could lead to better co-ordinated efforts to improve care for obese individuals in the region. Clinical care pathways The recommendations lay out the ideal obesity care pathway for those living with obesity who may desire medical support to live healthier lives. The recommendations are followed by a synopsis of current activities in the represented countries to highlight progress to date and areas for improvement. Although the recommendations deal specifically with adult (≥18 years) obesity, they do acknowledge the importance of managing childhood obesity and say they “hope that we will be able to extend the recommendations to children and adolescents in the future”. Without going into the detail of the recommendations – you should download the document for this – the recommendations make use of the Edmonton Obesity Staging System which provides a framework for clinical decision-making, prioritisation and management and can roughly
