When it comes to obesity around the world, there is one constant: more money, more problems. The world’s dependence on foreign oil has allowed people in the Gulf States to go from impoverished to belt-busting. With the influx of money, hardier lifestyles of the past have given way to very little physical labour, an expansion of fast-food chains and swaths of the population moving from one air-conditioned environment to another without breaking a sweat. As a result, Saudi Arabia and Qatar are among the fattest countries in the world, in even worse shape than the United States.
The heavyweight champion, however, is Kuwait. It can be tough to notice the bulge under the traditional clothing, but the tiny nation of fewer than three million leads the eastern Mediterranean for obesity prevalence among men (36 per cent) and women (48 per cent), according to the International Association for the Study of Obesity (IASO). Compare that to Canada, where the prevalence of obesity is 27 and 24 per cent for men and women respectively. “They have a culture where entertainment is food,” says Philip James, president of IASO. “And they don’t have to do any physical activity because everyone drives around in luxurious cars.” Children fare badly, too: more than 45 per cent are overweight or obese.
Eating habits are partly to blame. Inside exquisite shopping malls are endless fast-food options: KFC, Fatburger, New York Fries. “They’ve got everything we have here and more,” says Andrew Faust, a fellow at the Pulitzer Center who was in nearby Dubai last July to report on its obesity crisis. In a region that restricts alcohol, the concern is high-sugar drinks. “They bombard every guest and drink multiple glasses of fruit juice a day,” James says.
Getting people to exercise outside is also tough, with summer temperatures often hovering around 45°C. “If you are physically active, it’s only because you are really zany and involved in camel races,” James says. Not surprisingly, Saudi Arabia, Kuwait and the United Arab Emirates are among the top 10 sedentary countries in the world, with inactivity rates well above 60 per cent, according to a July 2012 study from the scientific journal The Lancet. The rankings were based on the percentage of the population that got fewer than the recommended 30 minutes of exercise a day. Women did especially poorly on this front. Female athletics is hardly a priority in the region. In Saudi Arabia, Human Rights Watch reported in July, private female gyms have been closed down; women are still forbidden to drive, meaning many are confined to their homes.
The new normal in the region has led to a wealth of problems, none more obvious than diabetes. Kuwait, Qatar, Saudi Arabia, Bahrain and the U.A.E. are among the top 10 in the world for diabetes prevalence, according to the International Diabetes Federation. Approximately one in five have the disease, which is blamed for more than 18,000 deaths last year in these five countries alone. “It’s caught people off guard just how rampant it is,” says Leonor Guariguata, a biostatistician at the IDF.
The Arab Center for Nutrition has implemented dietary guidelines similar to the U.S.’s “food pyramid”or “food plate.” Five years ago it created the “food dome,” which has five categories taking the shape of a mosque. “If you go to the portions, it’s no different than other countries,” says Abdulrahman Musaiger, head of the centre, located in Bahrain. At the top of the dome is an exercise recommendation: “Practise medium activity like walking 30 minutes most days.”
Some, at least, are heeding the message. In Kuwait, Diet Care, a weight-loss centre, has teamed up with the Taiba Hospital to create a 28-day meal program and a nationwide campaign, “Get Healthy Kuwait.” Two years ago, the campaign got 500 calls a day, says Zaki Mahmoud, sales manager at the company. Today, its seven clinics get more than 5,000 calls a day. Other businesses are cashing in on big lifestyle changes, too. Fitness First has 32 gyms in the region and is planning a massive expansion, according to Gulf Business. They hope to have up to 100 clubs in the next five years.
Prevention of obesity, not treatment, is the answer, says James—although the treatment model has takers, too. Bloomberg Businessweek reported that Kuwait performed more than 5,000 stomach-stapling procedures last year (compared with 3,000 in Canada). “The doctors in the area are having a ball,” James says. “They’re some of the richest doctors in the world, but they have very little training in public health.” If broader lifestyle changes aren’t adopted, some of those doctors may find themselves with a troubling new niche: last year, the Gulf News quoted doctors in Qatar saying bariatric (weight-loss) surgeries are taking place for children aged 14, and may soon have to start for those young as eight.