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Gaskin CJ, Cooper K, Stephens LD, Peeters A, Salmon J, Porter J. Clinical practice guidelines for the management of overweight and obesity published internationally: A scoping review. Obes Rev 2024; 25:e13700. [PMID: 38296655 DOI: 10.1111/obr.13700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 10/17/2023] [Accepted: 12/20/2023] [Indexed: 02/02/2024]
Abstract
With the increasing prevalence of obesity placing additional demands on healthcare systems, many jurisdictions and professional bodies have developed clinical practice guidelines to support practitioners in the management of people with overweight and obesity. This scoping review aimed to identify key features of contemporary guidelines for the clinical management of overweight and obesity. Searches of MEDLINE, Guidelines International Network's international guidelines library, and other grey literature sources identified 38 guidelines of 18 countries and one region published since 2010. Guidelines were developed by committees (n = 36, 95%) that comprised knowledgeable experts (n = 36, 95%) and were multidisciplinary (n = 33, 87%), with limited consumer representation (n = 11, 29%). Guideline documentation incorporated review questions (n = 23, 61%), systematic reviews (n = 25, 66%), evidence grading systems (n = 33, 87%), processes for reaching consensus (n = 19, 50%), and guideline review details (n = 28, 74%). Treatment approaches included in most guidelines were nutrition and physical activity (n = 38, 100%), psychology (n = 37, 97%), pharmacotherapy (n = 32, 84%), and bariatric surgery (n = 31, 82%). Most guidelines targeted populations based on age (n = 30, 79%). Guidelines contained recommendations for pregnancy (n = 12, 32%), older adults (n = 9, 24%), and people with eating disorders (n = 8, 21%). Future guidelines would benefit from involvement of consumers including groups known to be at increased risk of overweight and obesity, targeted guidance for at risk groups, and consideration of weight bias and stigma.
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Affiliation(s)
- Cadeyrn J Gaskin
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Institute for Health Transformation (IHT), School of Health and Social Development, Deakin University, Geelong, Australia
| | - Kelly Cooper
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Lena D Stephens
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Institute for Health Transformation (IHT), School of Health and Social Development, Deakin University, Geelong, Australia
| | - Anna Peeters
- Institute for Health Transformation (IHT), School of Health and Social Development, Deakin University, Geelong, Australia
| | - Jo Salmon
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Judi Porter
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
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2
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DeCicco JP, Barajas-Gamboa JS, Dang JT, Diaz Del Gobbo G, Raza J, Abril C, Guerron AD, Pantoja JP, Hegazin SB, Corcelles R, Rodriguez J, Kroh M. Bariatric Surgery Outcomes in Patients with Severe Obesity Compared to Patients with Non-Severe Obesity at A New Institution in The United Arab Emirates. J Clin Med 2024; 13:1907. [PMID: 38610672 PMCID: PMC11012827 DOI: 10.3390/jcm13071907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/04/2024] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Abstract
Background: Bariatric surgery is an effective treatment for weight loss, but a higher body mass index (BMI) may lead to higher postoperative complication rates. This study aims to compare perioperative and postoperative outcomes between UAE patients with severe obesity (SO) [BMI ≥ 50 kg/m2] and non-severe obesity (NSO) [BMI < 50 kg/m2] undergoing primary bariatric surgery. Methods: From September 2015 to July 2019, 542 patients, 94 SO (56.5 ± 6.2 kg/m2) and 448 NSO (41.8 ± 4.1 kg/m2), were retrospectively reviewed. Results: Patients with SO were younger (33.8 ± 13.4 vs. 37.0 ± 11.5 years, p = 0.02) but otherwise had similar demographic characteristics. Their rates of Roux-en-Y gastric bypass (39.4% SO vs. 44.4% NSO, p = 0.37) and sleeve gastrectomy (60.6% vs. 55.6%, p = 0.37) were similar. There were no differences between perioperative complications (6.4% SO vs. 5.8% NSO, p = 0.83), major postoperative complications (5.3% vs. 3.5%, p = 0.42), readmissions (5.3% vs. 3.3%, p = 0.36), or reoperations (3.2% vs. 2.7%, p = 0.78). There were no mortalities. Their total body weight loss was comparable at 12 months (28.1 ± 10.2% vs. 29.0 ± 7.7%, p = 0.58). Conclusions: Although a higher BMI may pose operative challenges, UAE patients with SO do not have worsened outcomes in bariatric surgery, demonstrating similarly low morbidity to patients with NSO, and similar rates of improvement in their BMI.
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Affiliation(s)
- Jamie P. DeCicco
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA; (J.P.D.); (C.A.); (R.C.); (J.R.)
| | - Juan S. Barajas-Gamboa
- Department of General Surgery, Cleveland Clinic Abu Dhabi, Abu Dhabi 112412, United Arab Emirates; (J.S.B.-G.); (G.D.D.G.); (J.R.); (A.D.G.); (J.P.P.); (S.B.H.)
| | - Jerry T. Dang
- Department of General Surgery, Cleveland Clinic, Cleveland, OH 44195, USA;
| | - Gabriel Diaz Del Gobbo
- Department of General Surgery, Cleveland Clinic Abu Dhabi, Abu Dhabi 112412, United Arab Emirates; (J.S.B.-G.); (G.D.D.G.); (J.R.); (A.D.G.); (J.P.P.); (S.B.H.)
| | - Javed Raza
- Department of General Surgery, Cleveland Clinic Abu Dhabi, Abu Dhabi 112412, United Arab Emirates; (J.S.B.-G.); (G.D.D.G.); (J.R.); (A.D.G.); (J.P.P.); (S.B.H.)
| | - Carlos Abril
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA; (J.P.D.); (C.A.); (R.C.); (J.R.)
- Department of General Surgery, Cleveland Clinic Abu Dhabi, Abu Dhabi 112412, United Arab Emirates; (J.S.B.-G.); (G.D.D.G.); (J.R.); (A.D.G.); (J.P.P.); (S.B.H.)
| | - Alfredo D. Guerron
- Department of General Surgery, Cleveland Clinic Abu Dhabi, Abu Dhabi 112412, United Arab Emirates; (J.S.B.-G.); (G.D.D.G.); (J.R.); (A.D.G.); (J.P.P.); (S.B.H.)
| | - Juan Pablo Pantoja
- Department of General Surgery, Cleveland Clinic Abu Dhabi, Abu Dhabi 112412, United Arab Emirates; (J.S.B.-G.); (G.D.D.G.); (J.R.); (A.D.G.); (J.P.P.); (S.B.H.)
| | - Safa Botros Hegazin
- Department of General Surgery, Cleveland Clinic Abu Dhabi, Abu Dhabi 112412, United Arab Emirates; (J.S.B.-G.); (G.D.D.G.); (J.R.); (A.D.G.); (J.P.P.); (S.B.H.)
| | - Ricard Corcelles
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA; (J.P.D.); (C.A.); (R.C.); (J.R.)
- Department of General Surgery, Cleveland Clinic, Cleveland, OH 44195, USA;
| | - John Rodriguez
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA; (J.P.D.); (C.A.); (R.C.); (J.R.)
- Department of General Surgery, Cleveland Clinic Abu Dhabi, Abu Dhabi 112412, United Arab Emirates; (J.S.B.-G.); (G.D.D.G.); (J.R.); (A.D.G.); (J.P.P.); (S.B.H.)
| | - Matthew Kroh
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA; (J.P.D.); (C.A.); (R.C.); (J.R.)
- Department of General Surgery, Cleveland Clinic, Cleveland, OH 44195, USA;
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Tham KW, Abdul Ghani R, Cua SC, Deerochanawong C, Fojas M, Hocking S, Lee J, Nam TQ, Pathan F, Saboo B, Soegondo S, Somasundaram N, Yong AML, Ashkenas J, Webster N, Oldfield B. Obesity in South and Southeast Asia-A new consensus on care and management. Obes Rev 2023; 24:e13520. [PMID: 36453081 PMCID: PMC10078503 DOI: 10.1111/obr.13520] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 10/04/2022] [Accepted: 10/06/2022] [Indexed: 12/03/2022]
Abstract
Obesity is a chronic disease in which the abnormal or excessive accumulation of body fat leads to impaired health and increased risk of mortality and chronic health complications. Prevalence of obesity is rising rapidly in South and Southeast Asia, with potentially serious consequences for local economies, healthcare systems, and quality of life. Our group of obesity specialists from Bangladesh, Brunei Darussalam, India, Indonesia, Malaysia, Philippines, Singapore, Sri Lanka, Thailand, and Viet Nam undertook to develop consensus recommendations for management and care of adults and children with obesity in South and Southeast Asia. To this end, we identified and researched 12 clinical questions related to obesity. These questions address the optimal approaches for identifying and staging obesity, treatment (lifestyle, behavioral, pharmacologic, and surgical options) and maintenance of reduced weight, as well as issues related to weight stigma and patient engagement in the clinical setting. We achieved consensus on 42 clinical recommendations that address these questions. An algorithm describing obesity care is presented, keyed to the various consensus recommendations.
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Affiliation(s)
- Kwang Wei Tham
- Singapore Association for the Study of Obesity, Singapore
| | | | - Sioksoan C Cua
- Division of Pediatric Endocrinology, Philippine General Hospital, Metro Manila, Philippines.,Department of Pediatrics, Chinese General Hospital, Cardinal Santos Medical Center, Manila Doctors Hospital, Metro Manila, Philippines
| | | | - Mia Fojas
- Department of Biochemistry and Molecular Biology, University of the Philippines College of Medicine, Manila, Philippines
| | - Samantha Hocking
- Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, Australia.,Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Boden Initiative, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - June Lee
- Upper Gastrointestinal and Bariatric Surgery, Department of Surgery, Changi General Hospital, Singapore
| | - Tran Quang Nam
- Department of Endocrinology, Ho Chi Minh City University Medical Center, Ho Chi Minh City, Vietnam
| | - Faruque Pathan
- Department of Endocrinology, Ibrahim Memorial Diabetes Center, Dhaka, Bangladesh
| | - Banshi Saboo
- Dia Care Diabetes Care and Hormone Clinic, Ahmedabad, Gujarat, India
| | - Sidartawan Soegondo
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia.,Diabetes Connection and Care, Eka Hospitals, Jakarta, Indonesia
| | | | - Alice M L Yong
- Department of Internal Medicine, RIPAS Hospital, Bandar Seri Begawan, Brunei Darussalam
| | | | | | - Brian Oldfield
- Department of Physiology, Monash Biomedicine Discovery Institute, Monash University, Melbourne, Australia
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4
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Al Sabbah H, Assaf EA, Al-Jawaldeh A, AlSammach AS, Madi H, Khamis Al Ali N, Al Dhaheri AS, Cheikh Ismail L. Nutrition Situation Analysis in the UAE: A Review Study. Nutrients 2023; 15:nu15020363. [PMID: 36678240 PMCID: PMC9861891 DOI: 10.3390/nu15020363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/01/2023] [Accepted: 01/04/2023] [Indexed: 01/14/2023] Open
Abstract
This review study aimed to assess the nutrition situation in the UAE using published data from 2010 to 2022. It highlights the gaps and challenges that prevail in addressing the nutrition-related problems in the UAE and the opportunities that have been overlooked. The available literature indicates that the UAE is burdened with more than one form of nutrition-related problems, including being underweight, being overweight, obesity, micronutrient deficiencies, and nutrition-related chronic diseases. It is clear that data on micronutrient deficiencies, protein-energy malnutrition, obesity, diabetes, and other nutrition-related diseases among the UAE population are extremely scarce. The UAE has a high prevalence of obesity and diabetes; however, limited studies have been conducted to document this nutritional phenomenon. Few examples of published data are available assessing the burden of stunting, wasting, and being underweight among children under five years of age. Despite the importance of protein-energy malnutrition, no recent publications analyze its prevalence within the UAE population. Therefore, future studies must be conducted, focusing on malnutrition. Based on the literature, and bearing in mind the magnitude of the health issues due to the UAE population's nutrition negligence, there is an urgent need to assess the population's nutrient behaviors, to aid policy decision-makers in developing and implementing effective health policies and strategies.
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Affiliation(s)
- Haleama Al Sabbah
- Department of Health Sciences, College of Natural and Health Sciences, Zayed University, Dubai P.O. Box 144534, United Arab Emirates
- Correspondence: ; Tel.: +971-56-950-1179
| | - Enas A. Assaf
- Faculty of Nursing, Applied Science Private University, Amman 11931, Jordan
| | - Ayoub Al-Jawaldeh
- World Health Organization Regional Office for the Eastern Mediterranean, Cairo 11516, Egypt
| | - Afra Salah AlSammach
- Health Promotion Department, Ministry of Health, Dubai 20224, United Arab Emirates
| | - Haifa Madi
- Health Promotion Department, Ministry of Health, Dubai 20224, United Arab Emirates
| | - Nouf Khamis Al Ali
- Health Promotion Department, Ministry of Health, Dubai 20224, United Arab Emirates
| | - Ayesha S. Al Dhaheri
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 15551, United Arab Emirates
| | - Leila Cheikh Ismail
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford OX3 9DU, UK
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5
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Fernandez-Luque L, Al Herbish A, Al Shammari R, Argente J, Bin-Abbas B, Deeb A, Dixon D, Zary N, Koledova E, Savage MO. Digital Health for Supporting Precision Medicine in Pediatric Endocrine Disorders: Opportunities for Improved Patient Care. Front Pediatr 2021; 9:715705. [PMID: 34395347 PMCID: PMC8358399 DOI: 10.3389/fped.2021.715705] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 06/17/2021] [Indexed: 12/16/2022] Open
Abstract
Digitalization of healthcare delivery is rapidly fostering development of precision medicine. Multiple digital technologies, known as telehealth or eHealth tools, are guiding individualized diagnosis and treatment for patients, and can contribute significantly to the objectives of precision medicine. From a basis of "one-size-fits-all" healthcare, precision medicine provides a paradigm shift to deliver a more nuanced and personalized approach. Genomic medicine utilizing new technologies can provide precision analysis of causative mutations, with personalized understanding of mechanisms and effective therapy. Education is fundamental to the telehealth process, with artificial intelligence (AI) enhancing learning for healthcare professionals and empowering patients to contribute to their care. The Gulf Cooperation Council (GCC) region is rapidly implementing telehealth strategies at all levels and a workshop was convened to discuss aspirations of precision medicine in the context of pediatric endocrinology, including diabetes and growth disorders, with this paper based on those discussions. GCC regional investment in AI, bioinformatics and genomic medicine, is rapidly providing healthcare benefits. However, embracing precision medicine is presenting some major new design, installation and skills challenges. Genomic medicine is enabling precision and personalization of diagnosis and therapy of endocrine conditions. Digital education and communication tools in the field of endocrinology include chatbots, interactive robots and augmented reality. Obesity and diabetes are a major challenge in the GCC region and eHealth tools are increasingly being used for management of care. With regard to growth failure, digital technologies for growth hormone (GH) administration are being shown to enhance adherence and response outcomes. While technical innovations become more affordable with increasing adoption, we should be aware of sustainability, design and implementation costs, training of HCPs and prediction of overall healthcare benefits, which are essential for precision medicine to develop and for its objectives to be achieved.
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Affiliation(s)
| | | | - Riyad Al Shammari
- National Center for Artificial Intelligence, Saudi Data and Artificial Intelligence Authority, Riyadh, Saudi Arabia
| | - Jesús Argente
- Department of Pediatrics & Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, Instituto de Investigación La Princesa, Universidad Autónoma de Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red (CIBER) de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- IMDEA Food Institute, CEIUAM+CSIC, Madrid, Spain
| | - Bassam Bin-Abbas
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Asma Deeb
- Paediatric Endocrine Division, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - David Dixon
- Connected Health and Devices, Merck, Ares Trading SA, Aubonne, Switzerland
| | - Nabil Zary
- Institute for Excellence in Health Professions Education, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | | | - Martin O. Savage
- Department of Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine & Dentistry, London, United Kingdom
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Inocian EP, Nolfi DA, Felicilda-Reynaldo RFD, Bodrick MM, Aldohayan A, Kalarchian MA. Bariatric surgery in the Middle East and North Africa: narrative review with focus on culture-specific considerations. Surg Obes Relat Dis 2021; 17:1933-1941. [PMID: 34332910 DOI: 10.1016/j.soard.2021.06.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 05/19/2021] [Accepted: 06/18/2021] [Indexed: 12/26/2022]
Abstract
There is an increasing volume of bariatric surgeries in the Middle East and North Africa (MENA), but the context of bariatric surgery in the region is not fully understood. Incorporating culture-specific considerations in the provision of care to patients who undergo bariatric surgery may help to optimize outcomes after surgery. We conducted a narrative review of published research studies on bariatric surgery in the MENA region, highlighting cultural and contextual aspects relevant to the care of bariatric surgery patients who undergo surgery in this geographic area. The authors searched the following online databases: PubMed, CINAHL, Embase, and Academic Search Elite from 2010-2020 for studies conducted in 18 countries in the MENA region. This narrative review identifies cultural-specific considerations that may affect bariatric care and outcomes in 6 domains: knowledge of bariatric surgery; mental health, body image, and quality of life; influence of family; religion and lifestyle; preoperative practices; and healthcare access. Provision of culturally congruent care may help patients to achieve the best possible outcomes after bariatric surgery. Results may inform efforts to provide safe and culture-specific care in the MENA region, as well as those who migrate or seek care in other countries. More research is warranted on this heterogeneous population to optimize postsurgery weight trajectory and psychosocial adjustment.
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Affiliation(s)
- Ergie P Inocian
- School of Nursing, Duquesne University, Pittsburgh, Pennsylvania.
| | - David A Nolfi
- Gumberg Library, Duquesne University, Pittsburgh, Pennsylvania
| | | | - Mustafa M Bodrick
- Health Academy, Saudi Commission for Health Specialties, Riyadh, Saudi Arabia
| | - Abdullah Aldohayan
- Department of Surgery, King Saud University Medical City, Riyadh, Saudi Arabia
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McAuliffe FM, Killeen SL, Jacob CM, Hanson MA, Hadar E, McIntyre HD, Kapur A, Kihara AB, Ma RC, Divakar H, Hod M. Management of prepregnancy, pregnancy, and postpartum obesity from the FIGO Pregnancy and Non-Communicable Diseases Committee: A FIGO (International Federation of Gynecology and Obstetrics) guideline. Int J Gynaecol Obstet 2020; 151 Suppl 1:16-36. [PMID: 32894590 PMCID: PMC7590083 DOI: 10.1002/ijgo.13334] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Fionnuala M McAuliffe
- UCD Perinatal Research Centre, School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland
| | - Sarah Louise Killeen
- UCD Perinatal Research Centre, School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland
| | - Chandni Maria Jacob
- Institute of Developmental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK
| | - Mark A Hanson
- Institute of Developmental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK
| | - Eran Hadar
- Maternal-Fetal Medicine Unit, Rabin Medical Center, Petach-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - H David McIntyre
- Mater Research, The University of Queensland, South Brisbane, Qld, Australia
| | - Anil Kapur
- World Diabetes Foundation, Bagsvaerd, Denmark
| | - Anne B Kihara
- African Federation of Obstetricians and Gynaecologists, Khartoum, Sudan.,Department of Obstetrics and Gynecology, School of Medicine, University of Nairobi, Nairobi, Kenya
| | - Ronald C Ma
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China.,Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong SAR, China
| | | | - Moshe Hod
- Mor Comprehensive Women's Health Care Center, Tel Aviv, Israel.,FIGO Pregnancy and Non-Communicable Diseases Committee, International Federation of Gynecology and Obstetrics, London, UK
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Abstract
Abstract
Purpose of Review
Rapid economic growth in the Gulf Cooperation Council (GCC) states over the last half-century has been associated with a rise in obesity and cardiovascular morbidity and mortality. In this review, we shed some light on the factors driving the obesity epidemic, promising interventions to overcome this public health crisis, and challenges precluding a successful public health impact.
Recent Findings
Overweight and obesity rates have nearly tripled in the GCC countries over the past four decades. Cardiovascular morbidity and mortality have been rising in parallel. Several sociodemographic, environmental, and behavioral factors have been correlated with sedentary lifestyle and unhealthy diet habits, and ultimately the rise in overweight and obesity rates. Numerous studies have documented factors unique to the population of the Arab Gulf states, but high-quality data is scarce. Despite the growing awareness of the extent of the problem, several barriers to weight loss and physical activity need to be addressed. A few interventions to combat obesity at different levels have been reported with some promising outcomes. Using the social-ecological model (SEM), we review recently published interventions and discuss some challenges to overcome in order to make progress in fighting the obesity epidemic in the GCC.
Summary
Obesity prevalence has been mounting worldwide, and the Arab Gulf states are no exception. This public health crisis is drawing the attention of policymakers and several stakeholders. However, a lot needs to be done to reduce the burden of obesity and improve cardiovascular risks in the Arab Gulf states.
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Caterson ID, Alfadda AA, Auerbach P, Coutinho W, Cuevas A, Dicker D, Hughes C, Iwabu M, Kang J, Nawar R, Reynoso R, Rhee N, Rigas G, Salvador J, Sbraccia P, Vázquez‐Velázquez V, Halford JC. Gaps to bridge: Misalignment between perception, reality and actions in obesity. Diabetes Obes Metab 2019; 21:1914-1924. [PMID: 31032548 PMCID: PMC6767048 DOI: 10.1111/dom.13752] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 04/03/2019] [Accepted: 04/16/2019] [Indexed: 12/14/2022]
Abstract
AIMS Despite increased recognition as a chronic disease, obesity remains greatly underdiagnosed and undertreated. We aimed to identify international perceptions, attitudes, behaviours and barriers to effective obesity care in people with obesity (PwO) and healthcare professionals (HCPs). MATERIALS AND METHODS An online survey was conducted in 11 countries. Participants were adults with obesity and HCPs who were primarily concerned with direct patient care. RESULTS A total of 14 502 PwO and 2785 HCPs completed the survey. Most PwO (68%) and HCPs (88%) agreed that obesity is a disease. However, 81% of PwO assumed complete responsibility for their own weight loss and only 44% of HCPs agreed that genetics were a barrier. There was a median of three (mean, six) years between the time PwO began struggling with excess weight or obesity and when they first discussed their weight with an HCP. Many PwO were concerned about the impact of excess weight on health (46%) and were motivated to lose weight (48%). Most PwO (68%) would like their HCP to initiate a conversation about weight and only 3% were offended by such a conversation. Among HCPs, belief that patients have little interest in or motivation for weight management may constitute a barrier for weight management conversations. When discussed, HCPs typically recommended lifestyle changes; however, more referrals and follow-up appointments are required. CONCLUSIONS Our international dataset reveals a need to increase understanding of obesity and improve education concerning its physiological basis and clinical management. Realization that PwO are motivated to lose weight offers an opportunity for HCPs to initiate earlier weight management conversations.
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Affiliation(s)
- Ian D. Caterson
- Boden InstituteCharles Perkins Centre, University of SydneySydneyAustralia
| | - Assim A Alfadda
- Obesity Research Center and Department of MedicineCollege of Medicine, King Saud UniversityRiyadhSaudi Arabia
| | | | - Walmir Coutinho
- Catholic University of Rio de Janeiro, State Institute of Diabetes and EndocrinologyRio de JaneiroBrazil
| | - Ada Cuevas
- Departamento de NutriciónClínica Las CondesSantiagoChile
| | - Dror Dicker
- Internal Medicine D, Hasharon Hospital Rabin Medical CenterPetah TikvaIsrael
- Sackler School of MedicineTel Aviv UniversityTel AvivIsrael
| | - Carly Hughes
- Fakenham Weight Management ServiceFakenham Medical PracticeNorfolkUK
- University of East AngliaNorfolkUK
| | - Masato Iwabu
- Department of Diabetes and Metabolic DiseasesThe University of TokyoTokyoJapan
| | - Jae‐Heon Kang
- Department of Family Medicine, Kangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulSouth Korea
| | - Rita Nawar
- The Weight Care Clinic, Dubai Healthcare CityDubaiUnited Arab Emirates
| | | | | | - Georgia Rigas
- St George and Sutherland Clinical School, Faculty of MedicineUniversity of New South WalesSydneyAustralia
| | - Javier Salvador
- Department of Endocrinology and NutritionClínica Universidad de NavarraPamplonaSpain
- CIBER Fisiopatología de la Obesidad y NutriciónInstituto de Salud Carlos IIIMajadahondaSpain
| | - Paolo Sbraccia
- Department of Systems MedicineUniversity of Rome Tor VergataRomeItaly
| | - Verónica Vázquez‐Velázquez
- Clínica de Obesidad y Trastornos de la Conducta Alimentaria, Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránCiudad de MéxicoMexico
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