Special report: Tackling childhood obesity in the UAE

While young Emiratis are determined to be fit for life, nutritionists warn diet must be taken seriously. Silvia Razgova / The National

Doctors and nutrition experts in the UAE have noted a significant rise in obese children in Abu Dhabi. Inactivity, poor diets and a lack of nutritional knowledge are cited as a few of the root causes. Ayesha Al Khoori investigates the damaging effects of obesity on children both physically and psychologically and how the roles of parents are vital to a child’s health regimen.

Contents

1- Childhood obesity on the rise in Abu Dhabi

2- UAE parents warned against pressuring obese children

3- Parents play a vital role in a child’s health regimen, say UAE experts

4- Case study: Change in diet leads to change in life for UAE youngster

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Childhood obesity on the rise in Abu Dhabi

ABU DHABI // Nutrition experts have noticed a significant rise in obese children in the capital.

Inactivity, easy access to unhealthy food, and lack of knowledge in families about the dangers of obesity are the main reasons, experts said.

Dr Hiba Aboultaif, clinical dietician at Harley Street Medical Centre in the capital, said healthy eating and leisure activities could limit weight gain in children.

“I see minimum of 10 overweight [patients] per month. There are many reasons that lead to having an overweight or an obese child, like inactivity and sedentary lifestyle – playing video games instead of running and exercising, easy access to unhealthy food establishments, eating tied to leisure activities many of which are sedentary, media influences, larger portion sizes, genetics, and absence of parental attention and care,” she said.

Dr Ghina Hamoui, dietician at Cosmesurge and Emirates Hospital, said she sees on average 10 to 15 overweight children per week, some as young as 7 years old.

“The main reason for a child to gain weight is less physical exercise at school and lack of activities at home. When we are not active, we eat less healthy, like skipping meals, and have more fast food, and definitely more high salt, high sugar food,” she said.

Dr Mohammed Zaki, director of nutrition at Lotus Medical Centre, said he had noticed a “horrible rise” in obesity in the past few years.

He said his patients range between ages three to 18, with children younger than the age of 13 being more likely to be obese.

A gradual diet plan for the child usually ends in good results of weight loss, he said.

“We can handle all these cases by starting with talks with the child and family, and make them know of the dangers of obesity in the future and how to avoid it. Then we have to make the child psychologically ready to follow a diet plan to have good health,” he said.

“When the family, with the nutritionist, help each other to reach the child’s best weight, it will make the matter easier. We have to choose a diet plan which suits the child.”

Dr Aboultaif said along with an individualised eating schedule, physical activity is also crucial in reducing the child’s weight.

“I ask parents to encourage their kids to get engaged in at least 30 minutes of physical activity each day, and try to support positive parent-child relation in a way not to let the parents exert too much force because that may lead to children being less able to self-regulate and more likely to overeat when the opportunity is available,” she said.

Dr Hamoui advises parents to not push their children to lose weight, as that will lead to emotional problems.

“A child shouldn’t lose weight unless he’s very obese, and even with obese kids we advise a very slow weight loss. One kilo per month is more than enough, because that totals to 10 to 12 kilos per year and since kids are growing, the extra weight will disappear,” she said.

“I urge the parents not to be tough on kids, preventing them from eating their favourite foods or forcing them to follow strict diet plans and punishing them if they don’t lose weight. Usually these kids turn into emotional eaters.”

In order for the child’s growth not to be affected by weight loss, Dr Aboultaif said exact food quantities must meet the child’s needs.

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UAE parents warned against pressuring obese children

ABU DHABI // The rise in obesity rates in children could lead to more youngsters suffering from emotional issues including depression, anxiety, social phobia and eating disorders, experts have said.

Pressure on children from parents or schools to lose weight, frustration from failed diets, and failure to keep up with sports in schools triggers the child’s emotional and mental problems, said Dr Hala El Hagrasi, consultant paediatrician in Burjeel Hospital.

Figures over a year ago revealed one child in three in Abu Dhabi was overweight, and despite appeals made then for parents to feed their children healthy food and encourage them to exercise this number, according to paediatricians, has almost certainly risen.

Dr El Hagrasi said 2 per cent of her overweight patients have emotional issues and suffer from social stigma, self-esteem issues, depression and emotional eating.

“Obese children have lower self-esteem than the rest. This is a result of being ashamed about their bodies. Lack of self-confidence can lead to poorer academic performance at school,” Dr El Hagrasi said.

Dr Veena Luthra, consultant psychiatrist at the American Centre for Psychiatry and Neurology in the capital, said: “Obese children may see themselves as outcasts.”

She added that they “tend to become sad and clinically depressed and withdraw into themselves”.

Emotional issues related to weight start at an early age.

“Children face teasing by peers and bullying in school because of their weight. This leads to loss of confidence and low self-esteem. Obese people feel stigmatised by others in all areas of their life including family, friends, employers, co-workers, teachers, and peers,” she said.

Overweight children are often labelled as lazy, weak willed and unsuccessful, said Dr Luthra, and media often played a role in “favouring thin people”.

She said physicians in medical centres also feel the need to be careful around overweight children and the patients feel stigmatised because of their weight.

“Health-centre staff need sensitivity training in dealing with these patients because it causes patients to lose motivation with weight loss attempts and even delay health prevention visits that can lead to serious health problems in the future,” she said.

“Healthcare providers should not blame patients for their obesity, these patients frequently feel disrespected by doctors and nurses and feel that all their medical problems are attributed to their weight.”

Dr Dolly Habbal, a clinical psychologist at Gulf Diagnostic Centre Hospital, said obesity and emotional issues were intertwined and led to a vicious cycle, causing the child to suffer emotionally.

“Although obesity is a result of unhealthy lifestyle, it could lead to feelings of sadness and anxiety. Schoolchildren suffering from obesity are at a higher rate of developing psychological symptoms that their slimmer peers.

“Issues such as depression, inability to learn, emotional disturbances, relationship problems and low self-confidence will evolve.”

Early identification of risk of developing health issues in children enabled an early intervention, Dr Habbal said.

“Obesity is both a mind and body interaction. Dealing with obesity requires adapting new habits that fosters a healthier lifestyle but don’t attempt radical changes to the child’s diet.

A dietician’s role was crucial in developing a safe plan for losing weight, Dr Habbal added. She said it was also important to seek a psychologist’s help with the child’s emotional state like stress and depression, if needed.

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Parents play a vital role in a child’s health regimen, say UAE experts

ABU DHABI // Parents and physicians all have a role to play in a child’s health regimen, experts have said, so that children feel encouraged and supported in their weight-loss journey.

Parents should create an environment where youngsters feel good about themselves, said Dr Hala El Hagrasi, consultant paediatrician at Burjeel Hospital.

“Parents can introduce children to hobbies, sports, and neighbourhood activities. Parents need to support and encourage physical activities by going with their children to exercise and making it a fun experience.”

Parents should also help children make better food options, she said.

“Involve them in menu planning and have them munch on fruits and veggies between meals rather than fatty, sugary, and salty snacks,” she said.

Parents should encourage healthy eating habits and physical activity to improve a child’s confidence in their weight loss, said Dr Veena Luthra, consultant psychiatrist at the American Centre for Psychiatry and Neurology in Abu Dhabi.

“Parents play an important role and should support the [child] with healthy eating habits, encourage physical activity and improve self-confidence by focusing on the child’s strengths and helping them do well in some area,” she said. A nutritionist was also needed to “normalise eating patterns”, Dr Luthra said.

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Change in diet leads to change in life for UAE youngster

ABU DHABI // Umm Saif said her eldest daughter, Shahad, 12, had always been overweight.

“She was a big baby. She loved food and ... ate all that I gave her – vegetables, fruit, and meat. She loved it all,” Umm Saif said.

“I always made sure she was having proper healthy meals.”

But Shahad always found a way to have junk food without her mother’s knowledge.

Umm Saif said her daughter had tried many diets while growing up, but had never lost any weight.

“She noticed she was different than other girls. She was always asking me why she looked different, taller, fatter, and it broke my heart,” Umm Saif said. She was also constantly teased at school. Umm Saif said it made her daughter resentful and caused her to lose interest in her schoolwork.

“Eventually, Shahad no longer wanted to eat. In her mind, she thought that was better.”

After this incident, when Shahad was at her heaviest, 64kg, Umm Saif decided it was time to seek medical help.

They visited a nutritionist who explained to Shahad why she was overweight and how it would affect her future life.

“Shahad was immediately convinced that it was better for her to eat regular food, with no excessive chocolate and sugary juices.

“She did have a hard time sticking to small portions and one chocolate bar a week, but she slowly started seeing the difference in her health,” Umm Saif said.

Shahad is now in the normal BMI range, her mother said.