Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy. Body mass index (BMI), which compares weight and height, is used to define a person as overweight or underweight. There are more than one billion overweight adults and 300 million of them obese. It is in fact a worldwide chronic disease affecting over 300 million adults. Excess body fat is the largest nutritionally related problem in the world, excess intake of food (carbohydrate, protein and fat) can lead to obesity or at least the maintenance of an overweight body (Puska, Nishida & Porter 2003). Obesity has become a major problem in the UAE. The main causes of the obesity are diet, lifestyle and education. One of the main reasons of obesity is the diet. Obesity is a concern for all countries and has become a major problem in UAE. The reports conclude that young emirates eat more of the high carbohydrate, high fat burgers and pizza in fast food restaurants. Most of the local population are having sedentary habits and do not exercise regularly (Chenoweth, 2007). The majority of people are leading a much more sedentary lifestyle compared to their parents and grandparents. Previously, people were doing shopping while walking down. With increase in number of shopping malls and supermarkets people moved from using their feet to driving their cars to get their provisions. In UAE, dependence on the car has become so strong that many people will drive even if their destination is only half-a-mile away. There are number of studies to know the reasons for obesity and finding of one of the studies suggest that although multiple factors can account for weight gain, the basic cause is an excess of energy intake over expenditure. The second main reason for obesity is the lifestyle. The various reasons like not having adequate sleeping, certain medications and change of lifestyle is second main reason of obesity( Simopoulos, 2005).
There are adverse consequences of the obesity. It leads to heart disease, diabetes and other conditions. The quality of life suffers as the obesity not only affects the individual but the country as whole. This can even lead to depression, eating disorders and crash diets which can impact the productivity of the country. There is urgent requirement to examine the causes of this problem and find solutions. Obesity has become a major problem in the UAE. Over 60% of Emirati nationals are overweight (Kunju John, 2010).
The studies conclude that the obesity can be prevented in many ways and best time is from the young age. Parents should advise teenagers to stay away from fatty foods and unhealthy types of living. It will help the teenagers to prevent teenagers from chronic diseases like diabetes, high cholesterol, high blood pressure, heart disease and cancers. Obesity will prevent arthritis, heart disease, poor eyesight and many more. Many people are losing out on exercise and children are suffering the most (Stern, Kazaks, 2009).
One of the studies gives the opinion that when the modification of lifestyle and diet are not successful, physicians may recommend drug therapy for obese patients. There is growing national and international concern regarding the obesity prevention and treatment as the disease proves to be cost to the individual and the country (Wolin, Petrelli, 2009).
CAUSES OF OBESITY
UAE is a major oil exporting country and has witnessed substantial economic growth and development since last three decade. There is socio economic progress was prompted by the economic progress and brought a drastic change in lifestyle and eating habits of the citizens with increasing numbers of Emirates adopting a high fat, high sugar, processed food diet with minimum physical activity. World Health Organization (WHO) during their survey observed that of the entire population of UAE over the age of 20 years, 19.1 per cent of women and 21.5 per cent of men has diabetes and now the country is struggling to cope with worryingly high rates of obesity and diabetes in children. In response, the government has initiated a campaign in public schools to teach healthy eating habits and serve healthier food, such as natural juices, fresh fruit and vegetables (Fiki, 2008).
Sedentary lifestyle
Sedentary lifestyle is one of the major reasons for the rise of obesity in the UAE. The studies have indicated that there is lack in physical activity as part of the Emirati culture and is therefore not instilled in children by parents. It has been emphasized that if the awareness of the adverse impacts of obesity is started with ladies it will help the next generation to incorporate physical activity into their lifestyle. In UAE, physical activity is not encouraged for women and PE is not part of girls' development, and this is evident in their weak motor skills. The opinion of various authors stressed the urgency of incorporating healthy living into UAE's lifestyle (Naidoo, Moussly,2009).
Change in food habits
The growth in obesity in UAE is disturbing which is prevalent as overweight and obesity among children has taken over the increase in developing and developed countries. In the context of Arabian Gulf countries and the United Arab Emirates in particular, it has led to major health problem in the past three decades as a result of economic boom. The recent studies in the regard suggest that in the United Arab Emirates (UAE) the prevalence of childhood obesity is increasing dramatically, already surpassing the high levels of obesity found amongst children and adolescents in the USA and Europe. In a similar study Al-haddad et al., reported that the frequency of obesity is two to three times greater than the recently published international standards in the UAE (Musaiger,2008).
Medical experts say they are treating young adults in their mid-20s for heart disease caused by lack of exercise and poor diet. World Health Organization (WHO) figures show one child in three in the UAE is overweight or at risk of becoming so. About 25 per cent of pupils drink one or more cans of carbonated drinks a day, and 18 per cent eat in fast-food restaurants three or more times a week. Only 18.5 per cent eat fruit and vegetables five or more times a day, according to WHO figures. Based on the studies conducted by the students of Zayed University students in Abu Dhabi it was noted that 65 per cent of males prefer healthy food while 35 per cent prefer fast/convenient food. This compared to 70 per cent of females who preferred healthy food and 30 per cent who preferred fast/convenient food. Further investigation found that 17 per cent of people with special needs are unwilling to go to restaurants because they have difficulty in communicating with others. This indicates the trend of fast food in UAE which is also one of the reasons for causing high fat food intake in UAE teenagers (Naidoo, Moussly, 2009).
Factors related to increase in Income
UAE is one of the world's richest countries. Obesity is increasing across all ethnic groups in UAE and the increase is particularly severe among local emirates (Join the movement to tackle obesity). WHO in 2004, showed 73% of females and 66% males are overweight in UAE. UAE is one of the fifth most obese nations in the world following the USA, Turkey, Mexico and Egypt. This indicates that the UAE is one of the fattest countries in the world. The study indicates that local residents in the country seem to be taking steps to tackle the growing problem with 33 percent of our respondents said that they have changed their food habits and now exercise regularly. As in other countries, obesity in UAE has become one of the major health problems in UAE and is associated with several chronic diseases. There is a lack of quantitative and qualitative research and studies on obesity. This creates the need for affective action, either to study factors contributing to the occurrence of obesity or to establish programmes to control it. In order to achieve this, the following recommendations should be considered (Musaiger 2004).
Lack of awareness of Physical activity
Adopting healthy habits for lifetime weight control includes regular physical activity and nutritious eating. However, it could be argued that the life style of today's children and adolescents is too sedentary. Recent research (Mr. Anthony, Courier Mail, Feb. 2002, pg. 29) shows that 60% of Australian children are involved in sports group, however 95% of Australian children spend 20 hours of watching television, playing Nintendo and computer games or surfing the Internet. Poor eating habits mean that the children are at higher risk. Eating patterns that have been related with over-consumption of high calorie foods are eating when not hungry, before main meals, while watching television and doing homework. Psychologist, John Irvine states that parents should set the example for their children. "Kids are much more likely to copy than learn from a lecture, so we have to get more active for our kids," he said. Mr. Anthony also states that parents should be encouraging their children to get active and setting a good example. This shows that what children learn about eating habits and nutrition from their parents has a direct impact on what they will eat.
According to the WHO study large numbers of UAE nationals are becoming obese because "they are being spoiled by their high incomes". The report in The Bulletin, the WHO's International Journal of Public Health, says "high incomes and a taste for fast food and sugary drinks have pushed nationals of the UAE into the obesity club". The study indicate that teenagers enjoy eating at restaurants. They watch at least three hours of TV a day, more in summer. People used to cook at home. "Low levels of exercise and overeating the wrong foods - all this has led to increasing obesity. It starts early in childhood. "There is no control of the food in the school canteens where they sell fast food and soft drinks. Of course, this is not something linked to the UAE alone. But in Europe and the US, people realise they need to change their diet and lifestyle. There is not that same awareness in this part of the world."
Genetically factors
Some individuals have a genetic tendency to gain weight and store fat. Although not everyone with this tendency will become obese, some persons without genetic tendency do become obese. This is because our genes determine rates of metabolism. Wardlaw, Insel and Seyler suggest that genetic background accounts for about 70% of weight differences between people. A child chance of obesity depends on the parents.
In addition to the above factors, there are other main reasons for increase in obesity:
Due to change in lifestyle, teenagers take little sleep which increase the weight.
There is imbalance in hormones due to higher pollution. Hormones control body weight. And many of today's pollutants affect our hormones.
The hard work in hot or cold environment uses the calories but the change in comforts has increased the chances of increase in obesity.
Certain medications cause weight gain, for example, steroid hormones, diabetes drugs, some antidepressants, and blood pressure drugs. Use of these drugs is on the upswing.
At times the obesity is also linked to fertility. There's some evidence obese people are more fertile than lean ones. If obesity has a genetic component, the percentage of obese people in the population should increase (Goodman, 2006)
ACTION TO BE INITIATED
The awareness of the disadvantages of obesity has led some of the universities in UAE to promote healthy living amongst its students. Dubai Women's College (DWC) is one of the examples and the organization has taken responsibility for its students' health by integrating nutritional and physical education (PE) into the first year student curriculum. Suzanne Trease, Chair of the Department of Health and Physical Education has reported that students are taught about health and wellbeing right from the basics of food intake and energy levels. Healthy living is reinforced by the college administration and cafeteria that serves no fast foods or meals containing trans-fats, and bans soft drinks on campus.
At Dubai Women's College fitness training has become part of the curriculum. Students are assigned two hours of physical activity a week, an hour of theory, plus homework. Howard Reed, the college's director, has been pushing for better health and fitness standards in schools since settling in the UAE from the United States almost two decades ago.
The UAE has drafted strategy with support from WHO which will focus on health and nutrition education, improve food consumption patterns with more focus on vegetables and fruits, food fortification with micronutrients, food labelling and marketing and school feeding programmes.
Making changes
After the initiation of DWC other institutions also picked up on the importance of the youth's growing health problems. Dr Nabeel Ebrahim, chancellor of Abu Dhabi University (ADU), informed that the university plans to introduce an academic programme in health sciences, which will include the study of obesity. In the meanwhile, short courses and seminars as well as awareness campaigns organised by the on-campus clinic help educate students and staff on the matter. The problem of obesity may not be severe in some of the university campuses but the rate of growth in obesity is spreading more beyond the campus community. The organisations are taking steps as it is a growing problem and had to be properly tackled which needs preparation (Naidoo, Moussly,2009).
Nutrition as base for prevention of disease
The obesity concern has been taken at the highest level in Government. Based on the report published in Med Guru on July 12,2010, UAE health ministry targeted anti-obesity programme for teens. Obese teens in the United Arab Emirates (UAE) have been advised by the health ministry to attend specialized anti-obesity programmes. The UAE department of health education and promotion under the ministry of health has recently launched a 'No to Obesity' programme, in order to create awareness among youth regarding obesity along with implementing physical training sessions.
Prevention is better than cure
The studies evidence that children who already have developed obesity need to be diagnosed and treated early. The treatment involves adopting a healthier lifestyle and in some cases by using medication. There are numerous recommendations from international authorities for early diagnosis, prevention and treatment of obesity-related complications. Throughout childhood, maintaining a balanced diet, decreasing fat intake and limiting the amount of 'junk' food and sugar-soda is the key. Obese schoolchildren in the UAE eat more snacks between regular meals (most of which are fried snacks, rather than fruits and vegetables), eat school meals rather than home-cooked meals and consume more servings of soda. One extra serving of regular soda (which contains 120 calories per serving) can produce a 50 kg increase in body weight over 10 years. A study published in The Lancet in 2001 showed that such habits increase the chance of childhood obesity by 60%.
Treatment of Obesity
There is medical treatment for weight loss reduction which should be started and followed under the care of a physician and/or a nutritionist. A weight-loss program may include:
Exercise (the Surgeon General has called for 30 minutes of physical activity on most days of the week)
A low-fat, high-complex carbohydrate, high fibre diet
Behaviour modification to change eating behaviour
Social support
Medications
Although several diets have become quite popular as effective ways of losing weight, none of them has been proven to be vastly superior in rigorously conducted, large-scale clinical trials. The key (and only) reason for the success of any dietary plan is that it make you consume fewer calories than what you are expending. Current guidelines recommend drug treatment for individuals, especially those with other obesity-related health conditions, who have failed to respond adequately to dietary and behavioural modifications. A limited number of medications are available for the treatment of obesity.
There is treatment of obesity through surgery also. Jebel Ali Hospital, a multi-specialty boutique medical facility organised a seminar on obesity at the Al Murooj Rotana Hotel which had an attendance of over 100 doctors from different fields of medicine. This is just one of the many initiatives undertaken by the hospital which offers opportunities to medical practitioners to keep abreast with the latest trends in the medical field. The continued medical education programme (CME) featured a series of talks and discussions on the latest global research and current lines of treatment available for obesity.
AIM & OBJECTIVES OF THE STUDY
The main aim of this study is to examine the impact of obesity in teenagers in UAE
The objective of the study
Study the growth in obesity in teenagers in UAE.
Study the impact of obesity in teenagers
Examine the reasons for obesity in teenagers
Put forward few preventive steps to be taken
METHODOLOGY
The data has been collected from various studies. The analysis is primarily based on the data collected through the questionnaire distributed to 20 teenagers with varying gender and age groups and the latest news in the media reports. The theoretical information has been collected from the various journal articles and news reports.
ANALYSIS AND INTERPRETATION OF DATA
The data has been collected on the basis of questionnaire and reviewed for the conclusion drawn. The review of the data is most important as correct data is must for the use of making any conclusion of the study. The results need to be interpreted to take a decision to solve the problem. The information collected is as much as it could be under the prevailing circumstances. The decision is directly linked to keeping of good records; the information is used early for making correct decisions.
GENDER
10
50
50.0
50.0
10
50.0
50.0
100.0
20
100.0
100.0
Male
Female
Total
Valid
Cumulative
Perce
AGE GROUP
Age
16-20
21-25
26-30
Boys
5
5
0
Girls
5
3
2
10
8
2
DO YOU KNOW WHAT OBESITY IS
Yes
18
No
2
Total
20
0
5
10
15
20
25
YES
NO
TOTAL
Series1
DO YOU THINK PARENTS SHOULD BE BLAMED FOR TEENAGE OBESITY
Yes
14
No
6
Total
20
DO YOU THINK THAT BEING OVERWEIGHT IS SOMETHING THAT A TEENAGER INHERITS FROM THEIR PARENTS
Yes
11
No
9
Total
20
IS JUNK FOOD THE MAIN CAUSE OF TEENAGE OBESITY
Yes
16
No
4
Total
20
IS A HEALTHY DIET SOLUTION FOR TEENAGE OBESITY
Yes
18
No
2
Total
20
WILL EXERCISE HELP IN DECREASING TEENAGE OBESITY
IS TEENAGE OBESITY A MAJOR PROBLEM IN OUR SOCIETY NOW A DAYS
Yes
15
No
5
Total
20
DO YOU THINK DEPRESSION CAUSES TEENAGE OBESITY
Yes
16
No
4
Total
20
DO YOU THINK THE FOOD IN THE UNIVERSITY CAFETERIA COULD BE ONE OF THE CAUSES OF OBESITY IN CAMPUS
Yes
14
No
6
Total
20
DO YOU THINK THE AMOUNT OF TEENAGE OBESE PEOPLE WILL INCREASE WITH TIME
Yes
17
No
3
Total
20
WHO DOES YOU THINK IS BLAMED FOR TEENAGE OBESITY? STATE WHY?
Reasons are given as following by respondents
Parents
Friends
Unhealthy food
Lack of awareness
Self carelessness
Which gender of sex suffers teenage obesity more? State why
Respondents viewed as following
Female - as most female sit at home and lack exercise, take more food
Both
How can you avoid being obese
Suggestions are given as following by respondents
Exercise
Taking diet food
Taking healthy food
Avoiding fast food
Parents should plan food habits to their children
SUMMARY, OBSERVATIONS & CONCLUSIONS
In scientific terms, obesity becomes predominant when a person consumes more calories than he or she burns. What causes this imbalance between calories in and calories out may differ from one person to another. There are number of causes which may include genetic, environmental, psychological, and other factors may all play a part. The study undertaken is very limited and is done for find out the causes in the limited sample.
The total sample of 20 includes 50% boys and girls equally which has been done purposely to know the views of both genders. The study has been done with 50% of the individuals up to the age of 20 years as the obesity in this environment starts form the young ages due to change in food habits especially the junk foods intake is famous in this age. The sample includes 40% of the individuals up the age of 25 years as the obesity starts from 16 years and food habits are changing in the student age which is up to 25 years.
It is not surprising to find out that the 90% of the individuals in the sample selected was aware of the obesity and its presence in the younger ages. Only 10% were unaware which means that they were casual in the approach and were just living with the prevailing change in food habits without knowing its adverse impacts. In one of the study of Health Policy Research it was opined that adolescents are more likely to eat at least five servings of fruits and vegetables a day if their parents do. Contrarily, teens whose parents eat fast food or drink soda are more likely to do the same. The study undertaken also confirms this view as 80% of the individuals are of the opinion that 70% of the parents can be blamed for wrong food habits of the younger generations.
Obesity tends to run in families which suggest the genetic cause. Families do share diet and lifestyle habits that may contribute to obesity. Separating these from genetic factors is often difficult. Even so, science shows that heredity is linked to obesity. In one study, adults who were adopted as children were found to have weights closer to their biological parents than to their adoptive parents. In this case, the person's genetic makeup had more influence on the development of obesity than the environment in the adoptive family home. The study undertaken by us also shows that 70% of the sample agrees that it overweight is due to hereditary causes.
The link between childhood obesity is directly related to children's exposure to ads that publicise unhealthy foods, as per one of the studies conducted by Frederick J. Zimmerman and Janice F. Bell, of the University of California - Los Angeles. The results as per study undertaken also in line with the previous studies with 80% individuals are of the opinion that major cause of obesity is the trend of junk food famous amongst the teenagers. There is no doubt that eating a healthy diet is beneficial both for weight loss and for improving long-term health. With new diets solutions, it's hard to know what to eat, what to avoid and who to believe. Especially in the child's eating habits, the situation often becomes even more confusing. The previous research studies are in line with the results from this study as 90% of the sample is of the opinion that food selection should be better with nutritious contents and it will reduce the obesity. The studies show that children and adults should eat between five and nine servings of fruits and vegetables each day. Not only are most fruits and vegetables low in fat and calories, but they also are full of essential vitamins and minerals, fiber and other substances that promote good health. In addition, studies have found that diets rich in fruits and vegetables may reduce the risk of certain cancers and other diseases.
There is evidence in almost all the studies that regular exercise along with proper nutrition is a battle against obesity. In most of the studies it is opined that regular exercise is a common denominator for formerly obese children who have kept the weight off for a long period of time. The exercise will improve the quality of life and the same opinion is shared during this study as 100% of the individuals felt that exercise is necessary for bringing down the obesity.
The medical science indicates that teenage obesity has reached the point where it is beginning to cause health problems in young people not normally seen until later in life. Though it is a fact that modern society has brought us many amazing benefits, including antibiotics to treat life-threatening infections and new methods of cultivating food to feed an ever-growing population, it has also produced a serious health epidemic: teenage obesity. The study confirms the view that 80% of the individuals are of the opinion that the obesity in teenagers is major problem in society.
There are number of studies in USA and other countries which show that teens dealing with teen obesity also deal with social discrimination which can be devastating. Overweight or obese teens often have low self esteem which keeps them from joining in many activities with other teens. Obese teens may also suffer from depression which can lead to a viscous circle of staying at home watching TV and does not involve in regular exercise. The study also indicates that 80% of individuals are of the similar opinion. In the similar conditions 70% of the individuals are of the opinion that canteen food is responsible for the cause of obesity.
It is a common feature in all countries that once obesity settles into the lifestyle it is very difficult to get out of the bad habits that got you there in the first place. 85% of the individuals are of the opinion that there is increase in the rate of obesity and may continue in future. Without diet the exercise regime will not work to any degree and without exercise a diet will only progress so far without muscle building which is essential for losing extra weight as the program goes on.
The study also indicates that most of the obesity cause is the bad food habits of the teenagers. Parents have role in advising the teenagers to avoid junk food but what they eat outside and in colleges and university canteens cannot be monitored by the parents alone. It is the food habits which are most responsible for obesity.
Girls have tendency to be more obese as normally the boys try to join gym and do the regular exercise but girls may not do the same.
It can be concluded safely form the sample study that in today's world, more individuals are aware of the risk of obesity. Individuals' doctors and the media both talk a lot about these risks. Since there are a lot of individuals today who is overweight, obesity has been considered to be the next big health problem. A lot of individuals think that obesity looks unattractive, but that is a matter of opinion. The real concern with obesity is not on looks, but on overall health. It is thought that depression and unhappiness might cause obesity in some individuals. Helping these individuals to be happier may help them lose weight. It is possible, though, that this is not really the case. Some individuals also deal with obesity because they are addicted to food.
Good parenting, regular exercise, nutritious food are the main solutions for avoiding the obesity in teenagers. Advertisements in media and medical journals making people aware of the serious repercussions are the other methods to avoid obesity. Government should start campaigns and all the educational institutions should engage themselves in solving this problem.
RECOMMENDATIONS
Based on the seriousness of the issues it is recommended as follows:
Authorities for framing polices guidelines should be made aware of the importance and seriousness of the problems of obesity and its cost to the health care system budget.
Education department should be given responsibility to include sound and reliable information on management of obesity in school and university curricula.
Government should arrange for conducting research studies and make national programme to prevent and control obesity. Such a programme should be part of a national plan to prevent diet-related chronic disease. The obesity is cause for number of other serious diseases and there is urgent need to implement obesity control programme which should also include: dietary management of obesity; promotion of physical activity; health education campaigns; training courses for health workers; the drawing up of regulations and legislation to control advertising of prescription drugs and equipment that claim to reduce obesity; and consideration of the possibility of providing facilities for practising physical activity and exercise in the community.
