1. Obesity and Diabetes A National Health Crisis Project Presented by : Kamil Salamah, M.D. FACS General Secretary Saudi Diabetes & Endocrine Association

2. Definition:  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 and/or increased health problems.medical conditionbody fatlife expectancy  Obesity increases the likelihood of various diseases, particularly heart disease, type 2 diabetes, obstructive sleep apnea, certain types of cancer, and osteoarthritisvarious diseasesheart diseasetype 2 diabetesobstructive sleep apneacancer osteoarthritis Obesity

3.  Saudi Arabia ranks #5 in the world for obesity : 35.6 % of the population meet criteria to be declared obese.  As of July, 2012 the Saudi population was 20,958,428 which means 7,461,200 people qualified as being obese. Global Rankings of Obesity

4.  No. 6 Kuwait 23.9% prevalence  No. 7 Saudi Arabia 23.4% prevalence  No. 8 Qatar 23.3% prevalence  No. 9 Bahrain 22.4% prevalence  * Saudi Arabia ranks 2 nd highest in the Middle East Global Rankings of Diabetes ( as of 2012: IDF/WHO)

5.  Ages 15-24: 1.5 million are obese  Ages 25-54: 3.3 million are obese  Ages 55-64: 306,000 are obese  Ages 65 and up: 22,236 are obese  Saudi Arabia has one of the youngest populations in the world, and with a life expectancy of 74 years, will have to deal with an ever growing obese population. The end result will be a country with debilitating diseases. Obesity by Age Group

6.  Of the people diagnosed with type II diabetes, about 80 to 90 percent are also diagnosed as obese. This fact demonstrates the link between diabetes and obesity.  Being overweight places extra stress on the body in a variety of ways, including it’s ability to maintain proper blood glucose levels. In fact, being overweight can cause the body to become resistant to insulin. If you already have diabetes, this means you will need to take even more insulin to get sugar into your cells. And if you don’t have diabetes, the prolonged effects of the insulin resistance can eventually cause you to develop the disease. Obesity and Diabetes?

7.  Type 2 diabetes: represents 90% of the diabetics in Saudi Arabia and is found in 30% of the Saudi population age 20 and above.  Type 2 DM for ages 10-18 is mainly due to obesity: (percent of diabetes in this age group still to be determined)  The Kingdom spends approximately SR 30 billion/year on the treatment of diabetes: SR 5000/pt./year( not including complications). What is the Cost?

8.  30% of diabetics have diabetic nephropathy  65% of dialysis (kidney disease) patients are diabetic  Dialysis sessions cost approximately 1500SR per session (average 3 sessions per week per patient) -234,000 SR per patient per year  2011 the Health Care Budget was 70 Billion SR (11% of the total national budget) approximately 772,200,000 was spent on dialysis treatment= 1.1 % of the budget. Diabetes and Kidney Disease

9.  Prevention! What Can We Do???

10.  Ministry of Commerce  Ministry of Cultural and Information  Ministry of Health  Organization of Youth Welfare  Saudi Food and Drug Administration  Ministry of Agriculture  Ministry of Education  Decision Makers  Community Leaders  Civil Societies Public National Project

11.  Insure compliance with Healthy Food Standards of the Saudi Food and Drug Administration Ministry of Commerce

12.  Refrain from advertisements of food and beverages that are not compliant with SFDA (Saudi Food and Drug Administration)  Hold healthy lifestyle promotional campaigns  Participate in coverage of social activities promoting healthy lifestyles  Sponsor sports activities for schools and colleges  Hold campaigns to support charitable organizations that help combat obesity and diabetes  Stop commercials that support unhealthy foods and drinks to children and teenagers. Ministry of Cultural and Information

13.  Establish a National Diabetic Registry (NDR)  Require data submission by all healthcare providers  Support standardized treatment ( best practice standards) for diabetes and obesity  Promote diabetic teaching programs for inpatient and outpatient settings  Promote dietary services for all healthcare facilities  Provide educational materials that meet the standard of care and best practice Ministry of Health

14.  Provide CMEs (continuing medical education) activities for healthcare providers (physicians, nurses, educators, dieticians)  Support activities nationwide to combat obesity and diabetes  Work to establish a prevention program targeted at children and teenagers in school Ministry of Health Continued..

15.  Hold National Youth Camps to promote health and fitness ( for both male and female youth)  Provide reduced rates to enroll obese children in sports facilities  Establish sports and wellness centers for female children and teens  Provide walking events in public areas to promote exercise and well being Organization of Youth Welfare

16.  SDFA should be a FULLY empowered governmental agency to enforce the intent/agenda of the National Health Plans.  Provide regulations that support healthy lifestyles.  Oversee the licensing of food and beverages industry based on preset regulations.  Approves relicensing according to the same criteria  Passes laws prohibiting the manufacturing of unhealthy products.  Oversees and gives final approval of permits to be issued by the Ministry of Commerce of functions related to food and beverages industries. Saudi Food and Drug Administration

17.  Ensure healthy food by prohibiting the use of chemicals and hormones in food products  Establish a system to reward those producers that comply with regulations Ministry of Agriculture

18.  Ensure the schools are compliant with the NDR -Comply with data requirements established by the MOH  Provide students with the “Students Rights” booklet  Provide Health Education in the schools  Ensure there is a Physical Activities Curriculum for all students  School canteens should comply with SFDA regulations for school meals  Teach healthy eating to students and families and provide educational materials School Aged Population Project

19.  Questions? Thank you