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Is bariatric surgery the solution for obesity?

Increasing obesity levels in the country have brought bariatric surgeries into the spotlight as one of the fastest growing markets in the country and region.

There is no family in the GCC that is not directly affected by either an overweight issue or obesity, said experts at the Global Crisis of Obesity event organised by The Economist last week in Dubai.

“This, in turn, leads to serious chronic illnesses such as diabetes type II whereby patients are four times as likely to be hospitalised,” says Dr Mussaad Al Razouki, Chief Business Development Officer of Kuwait Life Sciences Company (KLSC).

As of 2014, 37.2 per cent of the UAE population is obese of which 33.8 per cent are males and 45.1 per cent are females.

Figures also show that the demand for obesity surgery is expected to be 80,000 in 2020, an addition of 50,000 obesity surgeries from 2014 in the region. The average cost of obesity surgery is Dh9,187 to 55,125 ($2,500-15,000).

However, obesity and related ailments are a burden on governments. In GCC, bariatric surgery is offered by both government and private sectors. While governments do it free of cost for nationals, private hospitals charge differently.

“The cost of treating diabetes can run up to $1-2 million per patient a year which places a heavy financial burden on our petro-based economies, especially in an era of depreciating oil prices,” said Dr Mussad.

Confronting obesity in the UAE

A report titled ‘Confronting Obesity in the UAE’ by The Economist’s Intelligence Unit was also launched at the event.

Surgical options are comparatively popular in the UAE among both adults and increasingly also children. In Abu Dhabi, where 30 per cent of school children are either overweight or obese, bariatric surgery has been performed on teenagers as young as 13.

However, since awareness of the obesity problem is relatively recent, surgical interventions have yet to be considered as part of a more coordinated, strategic approach to treating obesity.

As per the report, with nearly one-third of the population below the age of 15, growing rates of childhood obesity present a looming threat to the UAE’s health budget and the wider economy. Some 18 per cent of boys aged 13-15 and just under 12 per cent of girls in that age group were found to be obese in a 2010 global school-based health survey, according to the WHO.

The percentage of students who were overweight increased to 38.4 per cent in 2010, from 21.5 per cent in 2005, despite the fact that reported levels of physical activity rose in the same period.

In early 2015, the McKinsey Global Institute estimated the annual economic burden of obesity in the UAE at Dh22 billion (US$6b).

According to the International Diabetes Foundation, the UAE has one of the highest comparative prevalence rates of diabetes in adults in the world (19 per cent in 2014).

Lifestyles have become more sedentary, aided by the low cost of domestic help and increased dependence on cars, at the same time as diets have become less healthy owing to a prevalence of fast foods high in fat, sugar and carbohydrates.

“One significant issue is that obesity in the US is a disease of the poor, while in the Middle East it is a disease of the rich,” says Abdishakur Abdulle, associate director of the Public Health Research Centre at New York University’s Abu Dhabi campus.

It is a lack of awareness of the biological underpinnings of the condition that is preventing a more comprehensive and integrated approach to treating it, notes Nadia Ahmad, an internal medicine and obesity specialist and director of the Obesity Medicine Institute in Dubai.

The report also notes: “UAE nationals, who make up between 10 and 15 per cent of the population, have access to lifestyle, medical and surgical interventions; dieticians are increasingly popular (to the extent that some have mini-celebrity status); and the fitness trend is growing in popularity.”

Dr Nadia says that she sees Egyptians, Jordanians, Lebanese, South Asians, Europeans and Americans among patients at her clinic and observes that “many of those patients” are severely obese.

Policymakers in the UAE have yet to adopt the multidisciplinary approach to treating obese patients.

The UAE is aiming to take a leading role among the GCC states in trying to confront the epidemic, says Dr Abdulle. “There are enormous efforts being made to reduce obesity, but to have an effect on the population level will take a considerable amount of time.”

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