A new Study on Lebanese Childhood

Obesity is the new Black Plague of Arab world. Prevention among children and teenagers is particularly important because  70–80% of obese adolescents will remain obese as adults¹. The prevalence is comparable with those reported for the American population and the high socioeconomic status in Lebanon affects the adoption of unhealthy nutritional habits. Ignoring mediterranean regime, well-off teenagers are more often going on the fast food and are less active (computer, TV, console game). For Jean-Michel Borys, recently interviewed, “there is a globalization of the food market with very aggressive marketing targeting children”, promoting an “obesogenic environement”.

Some figures on childhood obesity

Accurate and comprehensive data are lacking in countries of MENA. Moreover, lack of uniformity in reference standards and reporting systems renders comparisons difficult. Nevertheless in September, 2010, a new study² summarizes the prevalence of obesity among children and adolescents in the region during 1990–2007. The highest prevalence of childhood overweight were reported from Bahrain and Kuwait (more than 30% owing some sources). Indeed, in spite of different reference standards, over the past decade, childhood obesity is dangerously increasing in all the countries of MENA.

In Lebanon, a study³ on 2.104 children and teenagers 3 to 19 years old, shows that 22.5% of boys were overweight, 16.5% for girls, and, respectively, 7.5% and 3.2% were obese. Lebanon is a striking example of such a problem in MENA emerging countries: in Qatar, a study⁴, reveals similar prevalence rates (on 12-17 years old population): 28.6% of boys were overweight, 18.9% of girls and respectively 7.9% and 4.7% were obese.

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Reported prevalence of overweight and obesity among children in different Middle East countries and standards used to define cut-offs⁵

Prevention to Fight Obesity Time Bomb

Michelle Obama gets involved to tackle childhood obesity, reports Newsweek. And The New York Times points that Beyoncé has launched a special clip (very American…) called ”Move your Body!” to support her fight (at the end of the clip, we can see her crunching an apple). “There is no viable treatment option for childhood obesity; consequently, the best option currently available to address this problem remains prevention”⁶. To encourage better and healthy behaviors, public policies must consider the whole aspects and media is crucial.

In 1985 Dietz & Gortmaker in Pediatrics established for the first time a correlation between children’s media consumption and their body weight: on 12-17 years old population, the prevalence of obesity increased by 2% for each additional hour of television viewed. And American children spend an average of a daily five-and-a-half-hours using media (TV, video, game or computers) and see about 40,000 ads a year on TV alone⁷. There is a globalization of the food market with very aggressive marketing targeting children.

Time spent using media has two immediate consequences : children are a marketing target and they are less active.

In Arab world, Western media representations contrast with traditional models. The Arabic feminine curves traditionally mean fertility, albeit new media pictures reflect thin and spindly women. For Chakar et Salameh⁸, “the prevalence of obesity was almost triple in boys than in girls. It is possible that the Western feminine self-image and fear of obesity are more marked in Lebanese girls than in boys. In fact, it has been demonstrated that girls as young as 5 years of age care more about their self-image and associate it to weight status.”

As dramatic consequence, a new market (that we have already talked about) fuels into Arab world : slimming pills.

There is no remedy for obesity

Most women are seeking out “slimming medications” (appetite suppressors, fat burners or fat absorption inhibitors) to be slender like famous movie stars and models, in spite of the warnings against the harmful side effects (welling in the stomach, anemia, low calcium levels to inflammation, diarrhea, colon problems, heart palpitations, sterility or nervous disorders). The lack of regulation of these pills used in self-medication without the monitoring of a professional could lead to disaster. A man died on Wednesday after taking diet pills smuggled from Lebanon or Jordan.

The socioeconomic growth led to make too quick and too clean a break with old habits making an “obesogenic” environement.  Sedentary lifestyle promotes less physical activities and bad eating habits (over-eating an junk food): kids are sitting ducks. Recent data on childhood obesity in Lebanon underlined this dangerous paradigm. Next Monday, May 9th, the Samaritan Lebanon Community Hospital will host the Third Annual Summit on Childhood Obesity. Only prevention will tackle obesity with efficiency: dietary awareness, physical activity. The public health policy must be global and comprehensive, including individual privacy:  the traditional representation of Arab women contrasts with new media stars and models. Public policies have to upset the mindset.

And the frantic dances of Beyoncé would go unheeded when we know that the Saudi women are still denied the right to physical exercise!

1. Whitaker RC, Wright JA, Pepe MS. and al.“Predicting obesity in young adulthood from childhood and parental obesity”. The New Journal of England Medicine, 1997.  quoted in Chakar & Salameh [↩]
2. P. Mirmiran, R. Sherafat-Kazemzadeh, S. Jalali-Farahani, F. Azizi, “Childhood obesity in the Middle East: a review “, Eastern Mediterranean Health Journal, Volume 16, n°9, September 2010. [↩]
3. Abla Mehio Sibai, Nahla Hwalla, Nada Adra, Boushra Rahal, “Prevalence and Covariates of Obesity in Lebanon: Findings from the First Epidemiological Study”, Obesity Research, Vol. 11 No. 11, November 2003, see sources. [↩]
4. Bener, Abdulbari,“Prevalence of obesity, overweight, and underweight in Qatari adolescents”, Food & Nutrition Bulletin, Volume 27, Number 1, March 2006 , pp. 39-45, see sources. [↩]
5. P. Mirmiran, R. Sherafat-Kazemzadeh, S. Jalali-Farahani, F. Azizi, “Childhood obesity in the Middle East: a review “, Eastern Mediterranean Health Journal, Volume 16, n°9, September 2010. [↩]
6. E. Ben-Sefer, M. Ben-Natan, M. Ehrenfeld, “Childhood obesity: current literature, policy and implications for practice”, International Nursig Review, 2009, p.169 [↩]
7. The Role of Media in Childhood Obesity, Henry J. Kaiser Family Foundation, February 2004, see sources [↩]
8. Hilda Chakar, Pascale R Salameh, op. cit., p.650 [↩]