Introduction
Obesity is a significant public health issue in the UAE since it predisposes individuals to severe chronic diseases.
85.5% of the 9.3 million residents of the UAE population live in cities and lead sedentary lifestyles as of 2016. World Health Organization (WHO) estimates that in 2010, 25% of Emirati men and 40% of women were obese. Obesity rates in the UAE have doubled from 16% to 34% since 2000, and severe obesity (BMI ≥ 40 kg/m2 ) has increased from 2% to 11% (Abusnana et al. 2018, p. 414).
The prevalence of obesity in the UAE increases the number of complications related to this disease. This problem determines the need to develop recommendations for the UAE region to improve the quality of obese patients’ treatment and reduce the burden on the local healthcare system.
Methods
A multidisciplinary group of international and regional experts participated in developing consensus recommendations for treating obesity in the UAE (Abusnana et al., 2018, p. 415). Based on clinical experience, the group proposed recommendations and circulated them to the Emirates Medical Association and Family Medicine Society practitioners for endorsement.
In diagnosing obesity, it is essential to primarily consider the patient’s BMI and waist circumference (WC). For patients with confirmed obesity, assessing the co-morbidities related to excess weight is recommended.
A multidisciplinary approach is recommended for treating obesity. Obesity management should consider several patient body composition characteristics, thus not focusing entirely on BMI.
A comprehensive lifestyle intervention allows patients to manage obesity more effectively than conventional care. In this regard, obesity management involves maintaining a caloric deficit, increasing physical activity, and behavioral therapy.
Diet therapy involves maintaining a caloric deficit of 500-750 kcal/day. Therefore, it is possible to prescribe a daily intake of 1200-1500 kcal for women and 1500-1800 kcal for men (Abusnana et al. 2018, p. 418). However, if patients experience co-morbidities or are unable to follow the diet, it is necessary to change the diet plan.
Regarding physical activity, a minimum of 150 minutes/week of moderate physical activity is recommended for obesity treatment. For weight maintenance, it is recommended 200-300 minutes of physical activity per week (Abusnana et al., 2018, p. 419).
An essential factor in managing obesity is appropriately assessing the patient’s psychological attributes that can affect the treatment process. In this aspect, practitioners should consider the possible adverse impact on treating disorders, including dysthymic disorder, major depressive disorder, generalized anxiety disorder and binge eating disorder (Abusnana et al., 2018, p. 417). In addition, it is necessary to address personality factors that influence the patient’s perception of therapy to provide the appropriate treatment.
Pharmacotherapy is considered for patients with BMI > 30 kg/m2 without co-morbidities or BMI ≥ 27 kg/m2 with co-morbidities and is used in addition to lifestyle intervention (Abusnana et al., 2018, p. 420). This type of treatment should be utilized on a long-term basis, considering the lack of evidence of the efficacy of short-term pharmacotherapy treatment. Examples of drugs used for pharmacotherapy in obesity treatment include orlistat and liraglutide (Abusnana et al., 2018, p. 420).
Bariatric surgery is considered for patients with a BMI ≥ 40 kg/m2 and no co-morbidities; or ≥ 35 kg/m2 with one or more co-morbidities (Abusnana et al., 2018, p. 423). For patients undergoing this intervention method, it is necessary to conduct a psychological stability assessment for a successful surgery and further weight management.
A critical aspect of obesity management is maintaining treatment outcomes. In this regard, patients need to maintain an appropriate level of physical activity and avoid risk factors for weight gain.
Conclusion
This paper contains consensus recommendations for managing obesity and addresses the high prevalence of the disease in the UAE. Recommendations in the paper include various methods of diagnosing and treating diabetes, including recommendations for maintaining weight loss.
Reference
Abusnana S., Fargaly M., Alfardan S.H., Al Hammadi F. H., Bashier A., Kaddaha G., McGowan B., Nawar R., & Sadiya, A. (2018). Clinical practice recommendations for the management of obesity in the United Arab Emirates. Obesity Facts, 11, 413–428. Web.