There are remedies (albeit not easy ones for the individuals involved), as suggested by the research. However, and this is very important, the current public health approaches that the Saudi government has taken, as Mabrey et al. (2010) note, have focused fairly narrowly on medical approaches. This focus includes research that has been conducted on metabolic syndrome (which is caused primarily by being overweight). This is caused by clear-cut factors and has a number of possible poor consequences.
Mabrey et al. (2010) note that metabolic syndrome is on average 10 to 15% higher in the GCC states than in the rest of world and that females are disproportionately affected by metabolic syndrome. These researchers are among those who note that a strictly medical approach to such medical problems is far from sufficient. For while metabolic syndrome itself can be identified and described in purely medical terms, such an approach does nothing to explain why rates of metabolic syndrome are higher in this region or why they are higher among Saudi females than males.
Mabrey et al. (2010) note that any truly effective preventative strategies "will require identifying socio-demographic and environmental correlates" and this will be especially true for the factors that influence women. This is not only because females are more likely to be overweight or obese than are men but also because cultural factors are likely to be more important for females than for males. Saudi teenagers (like all other populations) can reduce their weight by reversing certain behaviors, including increasing exercise and changing their diets, but this is only true if there is cultural "permission" for individuals to do so.
Some of the traits that are associated with being overweight or obese are generally much less known than conditions like metabolic syndrome (which is considered to be a precursor to Type II Diabetes) (Al-Qahtani et al., 2006). These can be particularly damaging to girls and women because they affect females' concept of their gender identity. Females in Saudi Arabia are very much affected by cultural and religious attitudes about what is properly female. When they deviate from such standards, they may suffer significant emotional and psychological harm, which is all too likely in turn to produce greater stress, which may result in increased weight. This may occur either because individuals who are stressed may eat more as a method of soothing themselves (Resnick, 1997). It also may result because stress increases the body's production of certain hormones that themselves may increase weight (Jeffrey, 1996).
One of the conditions associated with being overweight or obese for females that may cause considerable psychological distress for the individuals affected is hirsutism, or excessive facial and body hair. This is something that Saudi females would be ashamed of. Shame always makes it harder to seek help (in this case to seek help for the underlying condition, which is obesity). This is likely to be especially true in a culture in which shame is a significant method of cultural control.
Al-Ruhaily et al. (2008) found that there has been a substantial include in PCOS, or polycystic ovarian syndrome, a condition that is caused by obesity, especially high fat deposits in the abdomen. One of the symptoms associated with PCOS is increase in body hair. There are other causes of hirsutism, including disturbances in the adrenal system (although this too can be the result of obesity) but the majority of women in the above study had as a cause of their increased facial hair their PCOS and thus their obesity. This is a condition that is common in Western populations, but that has been absent in Saudi Arabian women and especially in Saudi Arabian adolescents until recently. While this symptom is not dangerous on its own, it is a proxy for an underlying condition that is potentially dangerous and that, moreover, is associated with high rates of infertility (Batton-Smith, 2000).
One of the most obvious cultural and social ways in which Saudi females are affected by obesity in terms of their gender in ways that cannot affect men is the relationship between obesity and female fertility and pregnancy. Obesity affects not just the individual herself but also has effects on the next generation, for overweight and obese women who become pregnant are much more likely to suffer ill effects than are women of healthier weights. This is in addition, as noted above, to the fact that obesity can prevent a woman from becoming pregnant when she wants to.
El-Gilany (2010) found that overweight women were significantly more likely to suffer from pregnancy-induced hypertension, gestational diabetes, pre-eclamptic toxemia, urinary tract infections, and cesarean delivery. Their babies were more likely to suffer from macrosomia, low 1-minute Apgar scores and admission to neonatal care units (El-Gilany, 2010).
While it is slightly tangential, it is worth noting here that there is another practice that many Saudi women engage in during pregnancy that is both related to Western influence and to unhealthy body image. Alghamdi (2010) found that many Saudi women used dermal bleaching agents to lighten their skin and so to make themselves look more European or generally Western. The practice of bleaching skin, like that of adopting eating and other lifestyle habits that lead to obesity, reflect changing standards of body-image and even of femininity itself among Saudi women. As Saudi teens and women become more and more a part of the global society, they are increasingly affected by Western standards of beauty.
This is an ironic state, for just as Saudi women (like women in other non-Western countries), for the more that Saudi women are affected by Western ideals of femininity and beauty, many of them find themselves farther and farther away from being able to achieve such standards on a personal level since many of the traits of Western life that they are being exposed to and are adopting (primarily Western diet) are making them far more likely to become obese (Garn & LaVelle, 1985).
Saudi Arabian female adolescents are among the populations that are most affected in the world by rising rates of obesity. This fact has enormous and potentially terribly dire consequences for these teenagers in terms of both their physical and mental health (Cronke, Roche, Chumlera, & Kent, 1982). These poor consequences are all-too-likely to follow these teenagers for the rest of their lives (Serdula, 1993). Moreover, obesity in adolescence can negatively affect the babies of obese teens, thus directly affecting the next generation, and after birth, this next generation is more likely to be obese if they have a family member (such as their mother) who is also obese (Rimm & Rimm, 1976).
Finally, the costs of treating an obese population can be immense (Abraham & Nordsieck, 1960; Dietz, 1981; Pi-sunyer,1993). Treatment for Type II diabetes alone can be stupendously high, and Type II diabetes is directly caused by obesity. A reduction in the rates of Type II diabetes alone (discounting for the moment the rest of the diseases that are affected by obesity such as cancer and heart disease) would allow for significant health savings, which would benefit Saudi society as a whole.
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