• Overview
  • Obesity prevalence
  • Population breakdowns
  • Drivers
  • Comorbidities
  • Health systems
  • Actions
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Obesity prevalence

Adults, 2013

Survey type:Measured
Age:15+
Sample size:10735
Area covered:National
References:Saudi Health Interview Survey (SHIS)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 2005

Survey type:Measured
Age:25-64
Sample size:3571
Area covered:National
References:Al-Hamdan, NA; Kutbi, A; Choudhry AJ; Nooh R; Shoukri M; Mujib, SA.WHO Stepwise approach to NCD Surveillance Country-Specific Standard Report Saudi Arabia (2005) Ministry of Health Saudia Arabia in colaboration with WHO, EMRO
Notes:Data for 15-24yrs also available
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 1995-2000

Survey type:Measured
Age:30+
Sample size:17223
Area covered:National
References:Mansour Al-Nozha, et al. (2005). Obesity in Saudi Arabia. Saudi Medical Journal, 26:824 - 829. WHO Infobase.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 1989-1994

Survey type:Measured
Age:18+
Sample size:6253
References:Osman AK, Al-Nozha MM. Risk factors of coronary artery disease in different regions of Saudi Arabia. Eastern Mediterranean health Journal;6:465-474
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Children, 2015

Survey type:Measured
Age:6-16
Sample size:7930
Area covered:Regional
References:Al-Hussaini A, Bashir MS, Khormi M, et al. Overweight and obesity among Saudi children and adolescents: Where do we stand today?. Saudi J Gastroenterol. 2019;25(4):229–235. doi:10.4103/sjg.SJG_617_18
Notes:Region: Riyadh City (urban), WHO 2007 Cut Off
Cutoffs:WHO

Children, 2013-2014

Survey type:Measured
Age:15-18
Sample size:968
Area covered:Subnational (Dammam)
References:Musaiger A.O et al. 2016. Prevalence of overweight and obesity among adolescents in eight Arab countries: comparison between two international standards (ARABEAT-2). Nutr Hosp. 33(5). pp. 1062-1065.
Notes:IOTF cut-offs used NOTE: 2016 data available, sample size (1109). Al-Ghamdi et al. 2018. Prevalence of overweight and obesity based on the body mass index; a cross-sectional study in Alkharj, Saudi Arabia. Lipids in Health and Disease. 17 (134). Doi: 10.1186/s12944-018-0778-5.
Cutoffs:IOTF

Children, 2005

Survey type:Measured
Age:13-17
Sample size:19317
Area covered:National
References:El Mouzan MI, Foster PJ, Al Herbish AS et al. Prevalence of overweight and obesity in Saudi children and adolescents. Ann Saudi Med. 2010 May-Jun; 30(3): 203–208.
Notes:WHO 2007 Cut OFF. Not IOTF Cut off. Comparison with CDC cut off also available
Cutoffs:WHO

Children, 1994-1998

Survey type:Measured
Age:5-17
Sample size:12698
Area covered:National
References:Elhazmi Mohsen AF and Warsy AS. (2002). The prevalence of overweight and obesity in 1 - 18 years-old Saudi Children. Annuals Saudi Medicals, 22(5-6):303 - 307.
Notes:IOTF Cut off. Reference: Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: International survey. BMJ. 2000 May 6;320(7244):1240-3.
Cutoffs:IOTF

Overweight/obesity by education

Children, 2006

Survey type:Measured
Age:6-16
Sample size:1243
Area covered:Riyadh
References:Al Alwan İ, Al Fattani A, Longford N. The Effect of Parental Socioeconomic Class on Children’s Body Mass Indices. Journal of Clinical Research in Pediatric Endocrinology. 2013;5(2):110-115. doi:10.4274/Jcrpe.898.
Notes:Prevalence of overweight and obesity by Fathers Education Obesity and overweight were defined using the WHO 2007 growth standards.
Cutoffs:WHO

Overweight/obesity by age

Adults, 2013

Survey type:Measured
Sample size:10735
Area covered:National
References:Saudi Health Interview Survey (SHIS) 2013. Ministry of Health. http://www.healthdata.org/sites/default/files/files/Projects/KSA/Saudi-Health-Interview-Survey-Results.pdf (last accessed 2 August 2016)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Children, 2006

Survey type:Measured
Sample size:7056
Area covered:Eastern Province
References:Al-Dossary SS, Sarkis PE, Hassan A, Ezz El Regal M, Fouda AE. Obesity in Saudi children: a dangerous reality. East Mediterr Health J. 2010 Sep;16(9):1003-8.
Notes:This study used the Centers for Disease Control and Prevention (CDC) 2000 growth charts to define BMI. The children were classified into 3 weight categories: normal weight (BMI < 85th percentile for age and sex), overweight(BMI between 85th–95th percentiles) and obese (BMI > 95th percentile).
Cutoffs:CDC

Overweight/obesity by region

Boys, 2009-2010

Survey type:Measured
Age:14-19
Sample size:2,908
Area covered:National
References:Al-Hazzaa, Abahussain, Al-Sobayel, Qahwaji, Alsulaiman, and Musaiger. 2014. Prevalence of Overweight, Obesity, and Abdominal Obesity among Urban Saudi Adolescents: Gender and Regional Variations. J Health Popul Nutr. 32(4). pp. 634-645.
Notes:IOTF cut-offs used.
Cutoffs:IOTF

Girls, 2009-2010

Survey type:Measured
Age:14-19
Sample size:2,908
Area covered:National
References:Al-Hazzaa, Abahussain, Al-Sobayel, Qahwaji, Alsulaiman, and Musaiger. 2014. Prevalence of Overweight, Obesity, and Abdominal Obesity among Urban Saudi Adolescents: Gender and Regional Variations. J Health Popul Nutr. 32(4). pp. 634-645.
Notes:IOTF cut-offs used.
Cutoffs:IOTF

Overweight/obesity by socio-economic group

Children, 2006

Survey type:Measured
Age:6-16
Sample size:1243
Area covered:Riyadh
References:Al Alwan &Idot;, Al Fattani A, Longford N. The Effect of Parental Socioeconomic Class on Children’s Body Mass Indices. Journal of Clinical Research in Pediatric Endocrinology. 2013;5(2):110-115. doi:10.4274/Jcrpe.898.
Notes:Prevalence of overweight and obesity by Income (Saudi Riyal/Month). Obesity and overweight were defined using the WHO 2007 growth standards.
Cutoffs:WHO

Insufficient physical activity

Adults, 2016

References:Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1.9 million participants. Lancet 2018 http://dx.doi.org/10.1016/S2214-109X(18)30357-7

Men, 2016

References:Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1.9 million participants. Lancet 2018 http://dx.doi.org/10.1016/S2214-109X(18)30357-7

Women, 2016

References:Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1.9 million participants. Lancet 2018 http://dx.doi.org/10.1016/S2214-109X(18)30357-7

Estimated per-capita fruit intake

Adults, 2017

Survey type:Measured
Age:25+
References:Global Burden of Disease, the Institute for Health Metrics and Evaluation http://ghdx.healthdata.org/
Definitions:Estimated per-capita fruit intake (g/day)

Estimated per-capita processed meat intake

Adults, 2017

Survey type:Measured
Age:25+
References:Global Burden of Disease, the Institute for Health Metrics and Evaluation http://ghdx.healthdata.org/
Definitions:Estimated per-capita processed meat intake (g per day)

Estimated per-capita whole grains intake

Adults, 2017

Survey type:Measured
Age:25+
References:Global Burden of Disease, the Institute for Health Metrics and Evaluation http://ghdx.healthdata.org/
Definitions:Estimated per-capita whole grains intake (g/day)

Mental health - depression disorders

Adults, 2015

References:Prevalence data from Global Burden of Disease study 2015 (http://ghdx.healthdata.org) published in: Depression and Other Common Mental Disorders: Global Health Estimates. Geneva:World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO.
Definitions:% of population with depression disorders

Mental health - anxiety disorders

Adults, 2015

References:Prevalence data from Global Burden of Disease study 2015 (http://ghdx.healthdata.org) published in: Depression and Other Common Mental Disorders: Global Health Estimates. Geneva:World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO.
Definitions:% of population with anxiety disorders

Oesophageal cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, oesophagus, adults ages 20+. ASR (World) per 100,000

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, oesophagus, adults ages 20+. ASR (World) per 100,000

Breast cancer

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, breast, females, ages 20+. ASR (World) per 100,000

Colorectal cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, colorectum, adults, ages 20+. ASR (World) per 100,000

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, colorectum, adults, ages 20+. ASR (World) per 100,000

Pancreatic cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, pancreas, adults, ages 20+. ASR (World) per 100,000

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, pancreas, adults, ages 20+. ASR (World) per 100,000

Gallbladder cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, gallbladder, adults, ages 20+. ASR (World) per 100,000

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, gallbladder, adults, ages 20+. ASR (World) per 100,000

Kidney cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, kidney, adults, ages 20+. ASR (World) per 100,000

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, kidney, adults, ages 20+. ASR (World) per 100,000

Cancer of the uterus

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, cervix uteri, females, ages 20+. ASR (World) per 100,000

Raised blood pressure

Adults, 2015

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A875?lang=en
Definitions:Age Standardised estimated % Raised blood pressure 2015 (SBP>=140 OR DBP>=90).

Men, 2015

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A875?lang=en
Definitions:Age Standardised estimated % Raised blood pressure 2015 (SBP>=140 OR DBP>=90).

Women, 2015

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A875?lang=en
Definitions:Age Standardised estimated % Raised blood pressure 2015 (SBP>=140 OR DBP>=90).

Raised cholesterol

Adults, 2008

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A885
Definitions:% Raised total cholesterol (>= 5.0 mmol/L) (age-standardized estimate).

Men, 2008

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A885
Definitions:% Raised total cholesterol (>= 5.0 mmol/L) (age-standardized estimate).

Women, 2008

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A885
Definitions:% Raised total cholesterol (>= 5.0 mmol/L) (age-standardized estimate).

Raised fasting blood glucose

Men, 2014

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A869?lang=en
Definitions:Age Standardised % raised fasting blood glucose (>= 7.0 mmol/L or on medication).

Women, 2014

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A869?lang=en
Definitions:Age Standardised % raised fasting blood glucose (>= 7.0 mmol/L or on medication).

Diabetes prevalence

Adults, 2017

References:Reproduced with kind permission of IDF, International Diabetes Federation. IDF Diabetes Atlas, 8th edition. Brussels, Belgium: International Diabetes Federation, 2017. http://www.diabetesatlas.org
Definitions:Diabetes age-adjusted comparative prevalence (%).

Health systems

Economic classification: High Income

Health systems summary

Saudi Arabia has a national health care system that is provided and financed by the Ministry of Health. Full and free at point of service care is available to all citizens (as well as expats working within the public sector), with services provided for at primary, secondary and tertiary level. Free healthcare is also provided to the approximately 2 million pilgrims visiting the holy cities (Mecca & Medina), putting an immense strain on the healthcare budget. This public system also struggles with staffing, with most health professionals being expatriates.

To complement the national system, there is cooperative health insurance provided by private employers and the government (for public workers only). This is compulsory for all working non-Saudi nationals and Saudi nationals who work in the private sector. Citizens also have the choice to have private health insurance schemes to enter the private healthcare system.

Indicators

Where is the country’s government in the journey towards defining ‘Obesity as a disease’?Defined as disease
Where is the country’s healthcare provider in the journey towards defining ‘Obesity as a disease’?Some progress
In practice, how is obesity treatment largely funded?Not known
Is there specialist training available dedicated to the training of health professionals to prevent, diagnose, treat and manage obesity?Yes
Have any taxes or subsidies been put in place to protect/assist/inform the population around obesity?Yes
Are there adequate numbers of trained health professionals in specialties relevant to obesity in urban areas?Partial
Are there adequate numbers of trained health professionals in specialties relevant to obesity in rural areas?No
Are there any obesity-specific recommendations or guidelines published for adults?Yes
Are there any obesity-specific recommendations or guidelines published for children?Yes

Perceived barriers to treatment

  • Lack of political will, interest and action
  • Lack of treatment facilities
  • Lack of training for HCP's and lack of trained HCP's
  • Lack of treatment guidelines or pathway
  • Poor availability of pharmaceuticals
  • Cultural norms and traditions
  • Lack of knowledge of potential treatment options
  • Lack of opportunity for physical activity

Summary of stakeholder feedback

Stakeholders reported that a lot of work have been done around obesity prevention and control in recent years, with obesity being recognised as a disease by many.

There is said to be a range of treatment options available that are government funded. Demand, however, is high in the public sector and so many of those seeking treatment obtain support via the private system as an out of pocket expense. Demand in the public system is said to be so high that people only get treatment when there have comorbidities, and even then, it is on a case by case basis. Bariatric surgery and obesity medication is also covered by the cooperative health insurance for those that meet the criteria (BMI ≥ 45 kg/m² for surgery) but this is a recent change.

It was generally agreed that one of the main ways in which people enter the system is via referral when they have comorbidities and their obesity is affecting their health. However, treatments are more readily available in urban areas, with patients in rural areas commonly referred to the cities.

Stakeholders noted that government and association guidelines exist but suggested that these are not yet fully implemented within the health system and at times they did not match insurance criteria. For example, government guidelines recommended surgical intervention for those with a BMI ≥ 35 kg/m² with comorbidities, but cooperative health insurance only covers surgery when BMI ≥ 45 kg/m².

It was reported that there is limited specialist obesity training available. There appears to be a focus on bariatric surgery, with trainees funded to train. Away from this, there is one bariatric surgery fellowship program and a bariatric medicine fellowship program, but they are both located in Riyadh. Stakeholders called for more training that encouraged multidisciplinary working.

Based on interviews/survey returns from 6 stakeholders

Last updated: June 2020

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