Abu Dhabi: According to the World Health Organisation (WHO), at least 2.8 million people die every year for being overweight or obese. The worldwide prevalence of obesity has more than doubled between 1980 and 2014, with 13 per cent of the world’s adult population alone found to be obese last year.
In a survey released this year by Zurich International Life, 47.5 per cent of UAE residents were overweight, with a BMI of between 25 and 30, while another 13 per cent were obese, with a BMI of over 30. Since the average BMI in the UAE is 25.6, the average UAE resident is considered overweight.
Forty per cent of 11-to-16 year olds and 20 per cent of children under the age of 11 in the UAE are obese, according to Wafa Helmi Ayesh, Director of Clinical Nutrition Department at Dubai Health Authority. And an obese child is likely to grow into an obese adult.
So how are people ending up obese in the UAE? Many point to the contribution of a poor lifestyle — long working hours, lack of activity due to high temperatures during the hotter months and the readily available fast food choices. But are these good enough excuses?
Absolutely not, say experts.
Dr Farhana Bin Lootah, Internal Medicine Specialist, Imperial College London Diabetes Centre, Abu Dhabi, doesn’t completely agree with the view that lifestyle in the UAE has contributed to the high rise in obesity. The number of fast food chains may have increased, in the UAE, she argues, but so have the number of gyms. For every new fast food restaurant a person chooses to go to, there is a gym nearby he can also consider using.
Obese people, says Dr Farhana, are 85 per cent more likely to develop Type 2 diabetes, which is lifestyle related. “Fifty per cent of people who have diabetes, specially Type 2, don’t know they have it. So it’s very important to be screened for it.”
She advises anyone who has a bit of ‘tummy’, a family history of diabetes or an unhealthy lifestyle to get screened for Type 2 diabetes. “If you catch it as pre-diabetes, it’s like a yellow card. You can reverse it,” she says. She warns that if pre-diabetes develops into diabetes, there is no going back.
Dr Farhana describes what she calls “a chronic silent disease”, a disease that sees sugar levels in the blood increase to high level. If this is not treated, the sugar (glucose) will try and damage the blood vessels. High sugar levels in the eye, with time, can cause blindness. High glucose in the nerves can cause them to be oversensitive (cause a lot of pain) or the opposite — cause loss of sensation. Risk of heart problems are much higher than of other health issues related to diabetes type 2, she warns.
Wafa says, “If you are obese, you are simply abusing your body.”
She lists the number of diseases that people with obesity are more likely to suffer from; Type 2 diabetes, cardiovascular diseases, blockage of arteries, cancer, skin diseases, osteoporosis and gout.
The habit of eating out and away from the family dinner table is a factor that Wafa believes is contributing to the rise in obesity. Through DHA’s eating healthy awareness campaign, she discovered that families were eating together only twice a month. This has a very negative effect as the children are not being observed when they are eating which can result in developing bad food habits.
Gulf News profiles three individuals who talk of their battle with the bulge.
“I’ve been obese ever since I can remember,” says 25-year-old Fatima Suhail, a Pakistani national residing in Sharjah. It’s hard to see her 96kg of body weight through the loosely fitted abaya. “Truth is, I don’t feel good about myself at the moment. I try to conceal my weight by wearing really loose clothes,” she says, unafraid to confess her weakness.
Fatima is 170cm in height and weighs 96kg, which gives her a BMI of around 32, and qualifies her as clinically obese. She says the death of her mother at age three was when it all began. Her packed lunches to school and food at home consisted of chocolates, biscuits and chips followed by burgers, fries and fizzy drinks. “I would munch on slabs and slabs of chocolate without feeling guilty. Because that was the only pleasure at that time,” she says, trying to explain why she chose this path. “So it all started from there and, eventually, it became a culture, an everyday habit.”
Fatima’s diet these days consists of takeaway food, generally from breakfast all the way through to dinner, with unhealthy snacks throughout the day. Evidence of this is clear in the kitchen of her Sharjah apartment. A fast food breakfast is waiting on a plate. Cans of cola are stacked on the work top. A big plastic bag full of various crisps takes up ample space in another corner.
Although her father makes an effort to cook on Fridays for the whole family, she admits she would rather have takeaway food.
“I don’t remember when was the last time I ate a meal which was cooked at home with happiness — because I am so tuned to eating food outside and feeding myself junk.”
She scrolls through the contacts on her mobile, half of them are numbers for fast food chains. She concedes that she rarely exercises, because when she does, she tires very quickly.
Fatima did not screen for diabetes despite her unhealthy lifestyle. Two years ago, she was shocked when she was diagnosed with Type 2. “Being told to be on constant medication and to watch what I ate was not something I ever expected. Never,” she says.
But the diagnosis could not alter this self-confessed fast food and chocolate lover’s ways. She admits that she doesn’t always take her medication. The diabetes status now serves as an excuse to have chocolate. “So I go, ‘OK, I am diabetic, my sugar is low and I am eating the whole bar. And I only get satisfied when the bar is over.”
Fatima’s obesity has resulted in a number of other health issues including asthma and joint pain. Doctors have warned her that if she doesn’t get her weight under control, her legs may not be able to support her body weight.
“[Even thinking about it] is very, very scary,” she says.
Mohammad Kasim Al Dhuhaibat
While Fatima is scared even thinking about her legs not being able to support her weight one day, this eventuality came to pass for 29-year-old Mohammad Kasim Al Dhuhaibat.
In 2013, Mohammad weighed 185kg. One day, his knee finally could not take his weight any more and it collapsed. He had to have two surgeries and spent months in hospital. The time spent in hospital lying immobile made him gain more weight. By the time he left the hospital, he weighed 196kg.
Because he was the eldest of his siblings, his family would always shower him with love in the form of food. He continued eating huge volumes of food after he got out of the hospital and got more unhealthy. “Mostly it was fast food,” he says. He would eat out with friends two to four times a week and homemade meals became fewer.
“I had many problems when I reached that weight [of 196kg],” says Mohammad. “I could not breathe at night. When I woke up in the morning, I would experience pain on the side I had slept on.”
Even the simple act of climbing a few steps became a problem for him as he turned short of breath. “In 2010, 2011, 2012, I tried many times to lose weight.” His various attempts at dieting, he said, failed. It ended up making him believe that he was doomed to be overweight.
After Mohammad’s knee collapsed, his doctor warned him to lose his excess weight or there was a 90 per cent chance that his knee would collapse again. “From this point, I decided to change my life,” says Mohammad. He sought the advice of a friend who encouraged him to join a gym.
In Marcus Smith, of InnerFight, Mohammad found the help he was looking for. In over a year, Mohammed managed to lose 100kg. “This is a very big number for me, from my original weight at 196kg. What I lost is equal to half my weight.”
He attributes his weight loss to switching to healthy eating habits and exercise. “I achieved this through healthy food, NOT DIET,” he says. “And I started to exercise.”
Abdul Gafour Al Awadhi
Abdul Gafour before, left, and after the gastric bypass surgery.
There are people that due to an injury or a medical condition cannot exercise and are genetically more tuned to putting on weight. Abdul Gafour Al Awadhi injured his back playing rugby and was unable to exercise from then on which caused him to gain weight and become obese. “Every month, I was gaining 5kg,” he says. When he reached 152kg, his health problems increased. “I was choking at night, I wasn’t breathing. Oxygen level in the blood for a normal person is 98 to 99 per cent. For me, it started to drop below 30 per cent,” says Al Awadhi. Doctors advised him to lose weight or they would have to incise the extra meaty tissue from his throat. This type of surgery, he was warned, could potentially result in his loss of voice, “so I said I will lose weight”.
He says he tried many diets but without exercise he would lose weight but put the weight back on again. Finally, desperate to get his life back, he decided to go in for gastric bypass surgery. “You have five locations they will cut into to be able to remove your gut from inside,” he says. Post-surgery, this makes for many uncomfortable weeks to be endured.
After he recovered, he lost the excess weight and can now do many tasks that he couldn’t before turning obese. “Life is good now,” he says. Even though he has lost around 50kg and is enjoying a lighter life, he says he wouldn’t recommend surgery to others looking to drastically drop weight. “If they can lose weight through diet and sport, [it’s better]. I don’t recommend surgery. Because you are allowing yourself to be cut up. But diet and sport [as a way to lose weight] is better, healthier,” he advises.
‘You don’t need to go to a gym to fix your food habits’
Marcus Smith, of InnerFight, took Mohammad under his wing and helped him reach his weight loss goals. His gym is a refurbished warehouse, decorated with inspirational quotes and cross fit equipment. At the time Gulf News visited him, Marcus was giving an early evening class. He was marching up and down the class, observing each participant, correcting them if necessary. Our presence and cameras did not seem to save anyone who was taking the class lightly as he yelled at them to shape up.
“I saw Mohammad about a year ago. He was unable to sit in a normal chair,” recalls Marcus. “I told him there was a good risk that he would be dead in five years.”
The message got through to Mohammad and he started to focus on changing his lifestyle.
First Marcus began by fixing Mohammad’s food habits. “When you are used to eating that kind of food and that kind of quantity, it’s difficult to change,” he says. Next, Marcus worked on Mohammad’s “terrible” sleep pattern and his lack of movement.
If they hadn’t been able to get Mohammad to change his eating habits, Marcus says he would not have achieved the results he did.
The secret to not becoming overweight is to pay attention to what you are putting into your body, says Marcus. “A lot of people think they need to run more, or they need to join this gym or that. A lot of the time, the problem [of overweight] starts way back. Look at what you are putting into your mouth. So many people just don’t look at what’s going into their stomach,” he says.
Smith sees first-hand the results of unhealthy living on a daily basis in his gym. More and more people on the obesity spectrum are approaching experts like him to seek help. “There are an incredible number of people out there who are in the same boat as Mohammad. Why is that?” Smith pauses before answering his own question. “We are seeing, on a global scale, plenty of icons in the field of sport linked with fast food brands. So children start to make this connection that because my hero — whether he be a football, cricket or whatever player — is eating this food, I can eat it too,” says Smith. “It’s like this: when you learn a language at an early age, you learn it well. When you acquire bad habits at an early age, you keep them.”
Smith says he understands the long working hours and rushed lifestyle of most people in the UAE doesn’t make it easy for them to take time out for routine exercise but “you do not have to go to a gym to fix your food”.
Simple solutions from experts to lead healthier life
Dr Farhana Bin Lootah, Internal Medicine Specialist, Imperial College London Diabetes Centre, Abu Dhabi
If you are taking a phone call, stand up. That little movement has shown to reduce the chance of heart disease, diabetes. Imagine if you could do just that little bit.
Get your sugar craving from fruits.
If you cook food at home, you know what’s going into it.
If you read a food label and the list of ingredients make no sense, it’s not healthy.
30 minutes of exercise, 5 days a week, prevents diabetes type 2.
Wafa Helmi Ayesh, Director, Clinical Nutrition Department, Dubai Health Authority
Eat with the family at least 3 times a week.
Stay hydrated because dehydration increases obesity, increases fat.
Reducing 100 calories from your daily intake will reduce 5kg of fat per year. Not weight fat. 100 calories is like a glass of milk or 2 apples. Remove 5 spoons of sugar which is 100 calories.
You can have a small cake, which is 140 calories. But have it in the middle of the day, at 4pm, for instance. Not in the evening.
Half of your dinner plate should consist of fruit and vegetables, the other half should be whatever you like. If you are from India, you like chappati, if you are from Italy, you like pasta, if you are from UAE, you like biryani. These foods should be the other half.
Marcus Smith, Founder, InnerFight
We will circle for as long as it takes in a car park, especially in Dubai, to get the closest to the door. I encourage everyone to park 800 metres from where they are and you will get 800 metres of exercise on the way to the shop and 800 metres on the way back. That’s 1.6km of exercise you’ve done without actually having to join a gym, so it hasn’t cost you any money.
You can do that in an office, take the stairs instead of an elevator.
You can sleep more [hours].