|Year : 2013 | Volume
| Issue : 2 | Page : 67-70
Obesity among patients attending primary care centers, Aseer Region, Saudi Arabia
Safar A Al-Saleem, Abdullah M Alshahrani, Yahia M Al-Khaldi
Department of Public Health, Family Medicine, Health Affairs, Aseer Region, Saudi Arabia
|Date of Web Publication||12-Mar-2014|
Safar A Al-Saleem
P.O. Box: WASEL 4809-unit No.1 KHAMIS MUSHAYT 62431-7509, WASEL, Aalami -SP-637725281
Source of Support: None, Conflict of Interest: None
Background: Obesity is one of the most chronic problems which is associated with many serious health problems such as hypertension, diabetes, and heart diseases. Objective: To estimate the magnitude of overweight and obesity among adults attending Primary Health Care Centers (PHCCs) in Aseer region, KSA. Materials and Methods: This cross sectional study was conducted during December 2012 at all PHCCs in Aseer region, Saudi Arabia. A data collecting sheet was designed by the investigators to achieve the objective of the study. It contained age, sex, weight, height, history of hypertension, diabetes, smoking status, and watching TV. Doctors and nurses at PHCCs were instructed regarding using of data collecting sheet. Result: A total of 6 917 adult individuals were assessed during the week of this study. Mean age of participants was 48 years; both genders were equal. Prevalence rates of smoking, diabetes, and hypertension were 6%, 17%, And 12%, respectively. The prevalence of overweight and obesity were 32% and 39%, respectively. Obesity among males and females were 28% and 44%, respectively. Most of patients with hypertension and diabetes were overweight or obese. Conclusion: This survey revealed that prevalence of overweight and obesity are high among adults attending PHCC in Aseer region. Urgent action including health education, health promotion, and treating the affected individuals are mandatory to reduce the magnitude and consequences of this health problem.
Keywords: Aseer region, obesity, overweight, Primary Health Care Centers
|How to cite this article:|
Al-Saleem SA, Alshahrani AM, Al-Khaldi YM. Obesity among patients attending primary care centers, Aseer Region, Saudi Arabia. Saudi J Obesity 2013;1:67-70
|How to cite this URL:|
Al-Saleem SA, Alshahrani AM, Al-Khaldi YM. Obesity among patients attending primary care centers, Aseer Region, Saudi Arabia. Saudi J Obesity [serial online] 2013 [cited 2020 Jul 6];1:67-70. Available from: http://www.saudijobesity.com/text.asp?2013/1/2/67/128632
| Introduction|| |
Obesity is one of the most common chronic health problems in Saudi Arabia. Previous national studies and surveys revealed that overweight and obesity are rising. , Obesity was found to be associated with many serious health problems such as hypertension, diabetes, and heart diseases.  In spite of good evidence regarding the importance of health education and screening for obesity, little effort was observed to control this problem in Saudi Arabia.  Health professionals at Primary Health Care Centers (PHCC) can play vital roles to prevent obesity through health education, health promotion, and screening. , To our knowledge, few studies were conducted on obesity at PHC settings in Saudi Arabia. ,
The aim of this study is to estimate the magnitude of overweight and obesity among attendees of PHCC in Aseer region, Saudi Arabia.
| Materials and Methods|| |
This study was conducted during the last week of December, 2012 at all PHCCs in Aseer region, Saudi Arabia. In order to achieve the objective of this study, a data collecting sheet was designed by the investigators which included the following: Age, gender, weight, height, history of diabetes, hypertension, history of current smoking, and average duration of watching television.
Doctors and nurses at all PHCC centers were instructed how to use the data collecting sheet. Weight and height were checked by the nurses for the nearest 0.1 kg and 0.1 cm, respectively. All attendees of 18 years old and above except pregnant ladies were included in the study. By using the WHO guidelines, body mass index (BMI) was calculated using the following formula (BMI = weight (kg)/height (m) 2 and then weight was classified into the following categories: Underweight, normal, overweight, obesity grade-I, obesity grade-II, and obesity grade-III. 
Data were analyzed using the statistical package for social sciences (SPSS). By using the appropriate statistical tests, P values were considered significant if they were less than 5%.
| Results|| |
This study was conducted in 230 PHCCs in Aseer region, KSA. The total adults who fulfilled the selection criteria were 6 917 individuals. [Table 1] shows the profile of participants in this study. Mean age of participants was 48 years with wide range (18to 86 years), both genders participated equally, rate of smoking, diabetes, and hypertension were 6%, 17%, and 12%, respectively. Screening of participants showed that the prevalence of overweight and obesity were 32% and 37%, respectively. More than one third of participants watch TV for more than three hours daily. Obesity and overweight were more common among diabetics and hypertensive patients. Obesity and overweight were higher among patients between 45 to 64 years old (35% and 41%, respectively). Regarding relationship between gender and weight, it was found that 28% of male have obesity compared to 44% of female [Table 2]. Most of patients with diabetes and hypertension were either overweight or obese.
|Table 1: Obesity and overweight among adults attending PHCC, Aseer Region, 2012|
Click here to view
| Discussion|| |
Magnitude of overweight and obesity
This survey showed that most (69%) of the adult patients attending PHCC settings in Aseer region have either overweight (32%) or obesity (37%) [Table 2]. A large survey in eastern province of Saudi Arabia showed prevalence of overweight and obesity of 35.1% and 43.8%, respectively.  In one national study conducted by Al-Othaimeen et al., obesity in Aseer region was less than this figure (16.2%) 20 years ago  Al-Nozha et al. reported similar national figures (36.6% for overweight and 35.5% for obesity) in 2000 but lower figure of obesity in southern region (29.9%) as compared to this study. 
In one study conducted by AlZahrani et al. which included 600 adult individuals, overweight and obesity were 20% and 39%, respectively.  In a previous study by Al-Humaidi et al., they found that 21.3% and 46.5% of adults attending PHCC in Abha city, Aseer region had overweight and obesity, respectively.  These findings indicate that the magnitude of obesity is increasing and urgent preventive measures to stop this epidemic are essential.
Age groups and obesity
Studying the association between age groups and obesity found that the percentage of obesity is high among older individuals [Table 2]. Prevalence of obesity among individuals less than 30 years was 23% compared to those above 30 years (42%), 45 years and above (46%), and 65 years old and above (35%). Similar trends were observed by Al-Baghli et al.  and Al-Nozha et al.  The above trend could be explained by that as individuals become old, their physical activity decreased and practicing sedentary life is so common.
Gender and obesity
Compared with males, more females were obese (44% vs 28%) with a significant difference (P value less than 0.05%). However, overweight was observed among 35% of males compared to 29% of females as observed in [Table 2]. In one study conducted by AL-Othaimeen et al. ten years ago, the prevalence rates of obesity among males and females were 14.2% and 23.6%, respectively.  In one national study, prevalence rates for overweight among males and females were 42.4% and 31%, respectively, while prevalence rates for obesity among males and females were 26.4% and 44%, respectively. 
These findings indicate that females are at high risk to develop obesity compared to males, which could be explained by that Saudi females staying indoor most of time without practicing any physical activity. In this regard, females who attend to PHCC should be given a priority regarding health education and screening program for obesity.
Obesity, diabetes, and hypertension
Diabetes was reported among 20% of obese compared to 10% among individuals with normal weight, while hypertension was reported among 7% of individuals with normal weight, 12% among patient with overweight and 15% among obese individuals. These differences were very significant (P value less 0.05) [Table 2]. These findings are in agreement with many studies which showed a strong association between high body mass index, diabetes, and hypertension. , Concerning this issue, any adult individual with overweight/obesity should be screened for diabetes and obesity as this triad which is a part of metabolic syndrome is common among Saudi adults as reported by Al-Nozha et al. 
Obesity and watching TV
This study showed that most of the participants (64%) watched TV for 1 to 3 hours per day, while 13% watched TV for four hour or more per day. Studying the association between duration of watching TV and overweight/obesity was insignificant, which could be explained by that all individuals watch TV frequently despite their weight status. In a cohort study by Hu et al., it was found that TV watching was associated with elevated risk of obesity among women.  In this regard, PHCC providers should encourage individuals who suffer from obesity/overweight to restrict watching TV and to be replaced by walking or any other physical activity.
| Conclusion|| |
This survey revealed that prevalence of overweight and obesity are high among adults attending PHCCs in Aseer region.
- Measuring weight, height, and calculating body mass index should be done for all adults attending PHCC at least once per year.
- All individuals with overweight and obesity should be counseled regarding danger/risk of obesity, modification lifestyles including diet and physical activity in addition to referring to concerned specialties as needed.
- All individuals with obesity should be screened for hypertension and diabetes.
- PHCC doctors and nurses should be given training courses in order to introduce preventive and curative measures concerning obesity.
- Urgent action including health education, health promotion, and treating the affected individuals are mandatory to reduce the magnitude and consequences of this health problem.
| References|| |
|1.||Al-Nozha MM, Al-Mazrou YY, Al-Maatouq MA, Arafah MR, Khalil MZ, Khan NB, et al. Obesity in Saudi Arabia. Saudi Med J 2005;26:824-9. |
|2.||Al-Othaimeen AI, Al-Nozha M, Osman AK. Obesity: An emerging problem in Saudi Arabia. Analysis of data from the National Nutrition Survey. East Mediterr Health J 2007;13:441-8. |
|3.||Guh DP, Zhang W, Bansback N, Amarsi Z, Birmingham CL, Anis AH. The incidence of co-morbidities related to obesity and overweight: A systematic review and meta-analysis. BMC Public Health 2009;9:88. |
|4.||Ganbi HH. The impact of obesity and weight reduction program with xenical drug treatment on health status of obese adolescent girls in Saudi Arabia. Journal of American Science 2010;6:944-58. |
|5.||Boardley D, Sherman C, Ambrosetti L, Lewis J. Obesity evaluation and intervention during family medicine well visits. J Am Board Fam Med 2007;20:252-7. |
|6.||Al-Shahrani AM, Al-Khaldi YM. Experience of the health promotion clinics in Aseer region, Saudi Arabia. J Family Community Med 2011;18:130-4. |
|7.||Al-Humaidi MA. Obesity and associated risk of coronary artery disease among patients of primary health care centers in Abha, Saudi Arabia. J Family Community Med 2000;7:25-30. |
|8.||Al Turki YA. Overweight and obesity among attendees of primary care clinics in a university hospital. Ann Saudi Med 2007;27:459-60. |
|9.||World Health Organization (WHO). Obesity: Prevention and managing the global epidemic report on a WHO Consultation. Geneva: WHO; 2000. (WHO) technical report series 894. |
|10.||Al-Baghli NA, Al-Ghamdi AJ, Al-Turki KA, El-Zubaier AG, Al-Ameer MM, Al-Baghli FA. Overweight and obesity in the eastern province of Saudi Arabia. Saudi Med J 2008;29:1319-25. |
|11.||Alzahrani AM, Karawagh AM, Alshahrani FM, Naser TA, Ahmed AA, Alsharef EH. Prevalence and predictors of metabolic syndrome among healthy Saudi adults. Br J Diabetes Vasc Dis 2012;12:78-80. |
|12.||Al-Nozha M, Al-Khadra A, Arafah MR, Al-Maatouq MA, Khalil MZ, Khan NB, et al. Metabolic syndrome in Saudi Arabia. Saudi Med J 2005;26:1918-25. |
|13.||Hu FB, Li TY, Colditz GA, Willett WC, Manson JE. Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women. JAMA 2003;289:1785-91. |
[Table 1], [Table 2]