According to a recent United Nations report, more than 1 billion people worldwide suffer from obesity, including 650 million adults, 340 million adolescents and 39 million children who are overweight and obese. As this number continues to rise, the World Health Organization estimates that by 2025, approximately 167 million people will be overweight or obese and have poor health. Between 1975 and 2016 obesity reached epidemic proportions worldwide and nearly tripled worldwide. According to the World Health Organization (WHO), in 2016, more than 1.9 billion adults aged 18 or older were overweight.

Obesity and its risks

The Saudi Society for Family and Community Medicine, in collaboration with the Saudi company “Pfizer”, held a press conference last Monday evening as part of an awareness campaign on “Dangers of High Blood Pressure and Obesity”. On the 15th, “Asharq al-Awsad” was attended. I am here discussing obesity and its two major complications, diabetes and hypertension.

Dr. Hussain Saad Bahar Al-Badawi, member of the American Board of Obesity, Saudi Society for the Study of Obesity, head of the diabetes unit at My International Clinic Campus in Jeddah and one of the speakers at the conference, said obesity affects the heart, liver, kidneys, joints and reproduction. , he explained that overweight and obesity are defined as a disease that affects most of the body’s systems and can be harmful to health. system.

He explained that the World Health Organization (WHO) defines obesity as abnormal fat accumulation or excess fat accumulation that is harmful to health. The World Obesity Federation (WOF) defines obesity as a chronic, relapsing disease process and emphasizes the need for immediate action to prevent and combat this global epidemic. The American Medical Association (AMA) recognizes obesity and overweight as both a chronic medical condition (a true disease state) and an urgent public health problem, and it works to define obesity and its complications, and intervention as an essential medical imperative. Service. The US Food and Drug Administration (FDA) warns of the chronic, degenerative health risks of obesity, defined as excess body fat.

The World Health Organization has emphasized that obesity also leads to a group of non-communicable diseases such as type 2 diabetes, cardiovascular disease, high blood pressure and stroke, various types of cancer and mental health problems. According to the United Nations Health Organization, obese people are three times more likely to be hospitalized due to COVID-19.

Obesity is classified based on a body mass index (BMI) above normal (above 18.5 – below 25). Body mass index is measured by dividing weight (kg) by the square of height in meters (m2).

The World Health Organization considers BMI to be the most appropriate measure currently available at the global population level for overweight and obesity. Average BMI is between (25-30) pre-obesity, (30) obesity, first degree (30-35) obesity, second degree (35-40) obesity, (over 40) third degree. obesity. Among G20 countries, the Kingdom of Saudi Arabia has the highest obesity prevalence rate among G20 countries (37.7%), followed by the United States (37.3), Turkey (32.9), Canada, Australia, Mexico, Argentina and Britain (30.5), 30, 29.5, 29.2, 28.8), Italy ranks lowest in obesity prevalence (20.7), followed by France, Brazil, Germany and Russia (22.4, 22.8, 23.2, 23.5).

Complications of obesity

Dr. Hussain Badawi says obesity has many problems, the most important of which are:

Cardiovascular diseases: Stroke – Hyperlipidemia – Hypertension – Coronary heart disease – Pulmonary embolism – Thrombosis – GERD – Urinary incontinence.

> Type 2 Diabetes: Prediabetes.

Stiffness of the knee joint: arthritis.

Cancers – Depression – Anxiety – Sleep and respiratory arrest – Asthma – Chronic back pain – Hypogonadism.

> Polycystic Ovary Syndrome – Pregnancy complications – Infertility / Impaired fertility.

> Obese people have higher percentages than healthy people, such as: 3% stroke – 3.5% heart failure – 8% ischemic heart disease – 9% polycystic ovary syndrome – 19% depression – 21% diabetes type 2 and heart attack – 35% GERD Symptoms – 40 percent sleep apnea – 51 percent high blood pressure – 52 percent knee osteoarthritis.

According to the International Journal of Clinical Medicine 2022, the most important recommendations for the management of overweight and obesity in adults in Saudi Arabia are:

Recommendation 13: In obese adults with a BMI equal to or greater than 30 kg/m2 or with or without comorbidities, liraglutide 3 mg or semaglutide 2.4 mg may be used in addition to lifestyle interventions on a case-by-case basis.

Recommendation 14: Some precautions should be taken when prescribing GLP-RA drugs (liraglutide 3mg or semaglutide 2.4mg): dose titration is required and should be consistent. Advise for gastrointestinal effects, discontinue if pancreatitis is suspected. As for liraglutide, use with caution when starting or increasing the dose in patients with renal disease due to the potential risk of acute kidney injury.

Obesity and diabetes

And about obesity and diabetes. Dr. Hussain Badawi Several studies have found that obesity drugs delay type 2 diabetes.

60% of patients with prediabetes at screening returned to normal glycemic status after one year of treatment with liraglutide 3.0 mg, compared with 33% on placebo.

The improvement was 2.7-fold greater with liraglutide 3.0 mg compared with placebo, and the risk of developing T2D within 3 years was reduced by 79 percent with liraglutide 3.0 mg versus placebo.

Obesity and blood pressure

Dr. Ashraf Amir, a family medicine consultant at the International Medical Center in Jeddah, vice president of the Saudi Society for Family and Community Medicine and one of the speakers at the conference, spoke to “Your Health” and pointed out blood pressure. Produced by the force pushing blood through the blood vessels and the contraction and relaxation of the heart muscle, the two types of pressure are systolic pressure, which is the force the heart pumps blood around the body, and diastolic. Pressure, which is the blood pressure between heartbeats.

Hypertension is a condition where blood pressure is measured above 140/90mHg; This causes the heart to work harder and the blood vessels to work harder. High blood pressure develops over many years, and high blood pressure is a major risk factor for heart disease, stroke, and other serious problems. High blood pressure can be detected and controlled early.

Ideal blood pressure is less than (120/80) mm Hg, normal pressure (120-129/80-84) mm Hg, pre-hypertension (130-139/85-89) mm Hg, hypertension First (140-159 / 90-99) mm Hg, high blood pressure, second stage (160 – 179 / 100 – 109) mm Hg, high blood pressure, third stage (above 180 / above 110 ) mm Hg.

Diagnosis rates are low (45 percent), nearly one-third (28 percent) of those diagnosed with high blood pressure are untreated, and approximately 37 percent have uncontrolled blood pressure. The prevalence of high blood pressure in Saudi Arabia is approximately 15.2 percent, according to a recent health survey conducted by the Saudi Ministry of Health.

Causes of high blood pressure include:

> Unknown (Primary) Cause: It is very common; It develops gradually over many years.

> Known Cause (Secondary):

> Certain kidney or hormonal problems – Thyroid problems – Sleep apnea – Congenital malformation of blood vessels from birth.

> Certain types of medication (cortisone – birth control pills – anti-bleeding and pain relievers).

> Drug abuse.

The most important risk factors are: heredity – advanced age – gender. – Obesity – Smoking – Drinking alcohol – Psychological stress – Unhealthy diet with excess salt – Diabetes and other chronic diseases – A sedentary lifestyle and lack of physical activity.

Complications of high blood pressure include: hardening of blood vessels – stroke – heart failure – angina pectoris – kidney failure – vision loss (blindness) – impotence – peripheral artery disease – memory and concentration problems.

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