Womens Obesity and its relevance to Socio-economic Development in the State of Qatar.

Over the last 30 years, the state of Qatar has witnessed major socio-economic developments leading to significant changes in standards of living and life style. The change into a more affluent society has lead to many unhealthy dietary habits. These have contributed to the large magnitude of diseases among women in Qatar. Among these are obesity, diabetes mellitus and cardiovascular diseases.

Obesity, a condition in which excess fats accumulate in fat tissues in the body, has increased dramatically in Qatar, especially among females, over the past 25 years. A study conducted in 1989 showed that 63.7% of adult females (18 years and above) were obese (Based on BMI (Body Mass Index) equal or above 25) with a 50% increase in 25 years. This percentage is higher than that reported in other countries in the gulf region. This fact has lead to the following thesis: The socio-economic development due to immense oil revenue has caused an increase in obesity rates among women in Qatar.

Obesity developed as food consumption patterns changed and the personal income grew. Before the discovery of oil, fish, rice and dates were the most commonly consumed food in the gulf especially among Bedouins. Meat tended to be consumed only when guests were invited or by the upper social classes. However, in the last three decades, the economic development resulted in an increase in purchasing power. Consumption of meat and rice in Qatar has been very high, and women have been consuming high levels of fat, sugar and sweets but inadequate quantities of vegetables and fruits. Although fats make excellent fuel by providing the body with huge amounts of the energy, this also means that a person must work harder and expend more energy to use up the fat stored in his body. These energy-dense foods that are stockpiled with calories may lead to increase the incidence of obesity among women in Qatar.

In some cases, obesity can be caused by genetic disorders such as Cushing's Syndrome and Hypothyroidism. Cushing's syndrome is a hormonal disorder caused by prolonged exposure of the body's tissues to high levels of the hormone cortisol. Hypothyroidism on the other hand is a disease caused by insufficient production of the thyroid hormone. Although these genetically determined diseases are widely spread and are considered to be a major cause for obesity in many parts of the world, the increase in obesity rates among females in Qatar is not associated with the increase in genetic diseases. This is due to the low rates of such inherited diseases in this country and in the gulf region in general. A recent research included 30810 infants in Saudi Arabia revealed that only 0.079% of infants had an abnormal thyroid function. These trends indicate that the low rates of genetically determined diseases is not the direct reason for the increase in the incident of obesity among women in Qatar.

By the 21st century, Qatar and other countries of the Arabian Gulf aimed to reinforce the region's position as the leading international financial centre of the Middle East and bring about more western investments in the country. Immigrant populations from western countries came to the region introducing new food habits. These food patterns characterized by "junk" food have spread widely throughout the region in a short period of time and numbers of fast food chains increased dramatically. For instance, hundreds of McDonald's, Burger King, Pizza Hut branches have been built since 1993. Epidemiological data from developing and developed countries concluded that with the westernization of the diet, many chronic diseases would emerge, first as obesity, followed by diabetes, CHD and cardiovascular diseases. As a result, many women replace healthy foods with fast foods which mainly consist of saturated and trans-fats, but low content of massive portion sizes and fibres. Thus dietary changes from traditional high fiber diets towards the affluent fast food diet may increase the incidence of diet related non-communicable diseases among women in Qatar.

Moreover, obesity has been attributed to the adoption of sedentary life style. Several researchers investigated the levels of physical exercise among women in Qatar and its relevance to obesity. Some people may wonder: Is there a significant relationship between the lack of exercise and its direct affect on obesity with the socioeconomic development? In fact, this case is discussed below.

Primarily, women in the gulf region including Qatar are heading to occupy office jobs that do not require much movement but insure a high salary. Such jobs require sitting in front of the computer's monitor for more than 6 hours a day. Besides this, internal networks within companies make it easier for employees to send reports, data and many other documents with a single click of the mouse.

Secondly, the low percentage of females who practice exercise could be attributed to cultural barriers. While many females in western regions find it convenient to walk and exercise in public places such as parks and streets, few women in Qatar would exercise in such places. Furthermore, gulf society in general obliges females to serve their families and children first before considering their own health status or fitness. Another reason attributed to women’s lack of exercise is the shortage of private places for women to practice. Finally, the traditional, long comfortable and wide clothes worn by women have prevented them from noticing their gradual gain in weight. Musaiger (1994) found that more than half of the women in Qatar (56.5%) did not practice any type of exercise; 27.5% practiced exercise infrequently while only 16.5% of women practiced exercise regularly. Most of these were non-Qatari. These facts are strongly associated with the high prevalence of obesity among women in Qatar (63.7%). 

The rapid development in transportation due to the increase in petroleum exports has also contributed to the lack of physical exercise and movement. Before the discovery of oil, the majority of people used to travel to their destinations by walking or riding camels and horses. After several decades, specifically in the 1950s and the 1960s, bicycles and motor cycles were widely used among the Qatari society. Nevertheless, by the 1970s, the country witnessed an immense increase in numbers of cars and vehicles. The less a person moves the more fats he/she will accumulate in the liver and under layers of skin, and the faster the development of obesity.

After the tremendous increase in families' income and the fact that Qatari women need or have the right to go to work, many women workers consider the choice of alternative childcare inexpensive and easily accessible. Non-parental childcare has a destructive effect on children’s development and health status. Although research showed that qualified alternative childcare during infancy can have positive effects, this paper outlines the use of housemaids instead of qualified caregivers in Qatar.  Hala B. Roumani, a worker in Gulf Montessori Centre, outlines the destructive consequences of using unqualified maids as child carers and the way it interferes with the child's health condition. Since most babysitters are illiterate in Arabic and limited in health care knowledge, they may provide a child with any type of food, ignoring the fact that this food is typically inappropriate to ones' medical health. As an example, most children below 10 years are seen in malls and shopping centers with their house maids. When it comes to eating lunch or dinner, maids try to satisfy a child's needs by simply buying him/her an ice-cream from KFC or a happy meal from McDonald's. If this child suffers from obesity, eating fried food on a regular basis would eventually lead to serious chronic diseases such as diabetes mellitus and cardiovascular diseases.  The risk of female's obesity in childhood and its continuation to adulthood is a major dilemma. A survey carried out by the National Center for Health Statistics Standards revealed that the behavioral and cultural attitudes involved in obesity operate early in life. By the tracking of body mass and obesity from childhood through adulthood, results indicated that most of obese adults were overweight during their childhood.

An interesting story I have read recently outlines the destructive consequences of unqualified childcare, and the way it relates to a child's psychological and medical health. A girl from Doha, Sanah, suffered from obesity her entire childhood.  Born in 1979, Sanah had an ultimate problem with obesity. Their house maid, who was responsible for taking care of this child, found it easier to satisfy the girl's demands by simply buying her lots of chocolate, sweets and fast food. Children in the neighborhood and at school teased her all the time, and gradually, she started avoiding sitting with people or interacting with children her own age. The only solution to getting rid of depression and loneliness was to eat. By the age of twenty, Sanah discovered that she developed type II diabetes. Complications developed rapidly threatening her life. In 1994, after having suffered for 20 years, Sanah was killed by a heart-attack.

Obesity may also be contributed to stress and negative emotions. Feelings of sadness, anxiety or stress often lead women to eat more than they normally do. The rapid economic and social development in Qatar has put people under pressure to adapt to industrialization and urbanization. And because of the inflation in prices of goods like rice, meat, and sugar, life has become more and more expensive. Parents are working in full time jobs. More females are working to support the family's income. This new stressful life causes depression and therefore changes the daily food patterns and activity habits. Many women find it difficult sometimes to overcome stress or recover from sudden or emotionally draining events (e.g., losing a job, or facing a serious medical problem, disability to support the family financially). Gradually, they begin eating too much of the wrong foods or forgoing exercise. After a while, these turn into habits and changing them becomes a difficult challenge.

Some physicians proclaim that high levels of education in Qatar that have resulted from the economic development and improvement in standard life conditions have decreased obesity rates. Women nowadays are more health educated and are more capable of making decisions related to food and daily consumed nutrients. However, this might be limited to western countries. Concerning Qatar, the increasing levels of education did not have any significant association with decreasing obesity. A recent research by Musaiger revealed that there was no significant association between levels of education and obesity. In fact, the percentage of obesity in highly educated females was higher (60.5%) than ones with low education levels. Highly educated women usually occupy full time jobs and can barely find time to cook or choose to buy healthy food. Also, they tend to eat more sweets and fats to provide themselves with sufficient energy whenever they are overwhelmed with work. College students are  good examples of how demanding pressures can lead to them neglecting their own health . Although most of them are well aware of the importance of having a healthy diet, they tend not to eat healthy and especially during final examinations. "No time to think about healthy food, studying is more important" they claim.

 From the perspective of a pre-medical student in Weill Cornell Medical College in Qatar, I find it extremely challenging to obtain a balanced healthy diet along with high academic standards. Personally, although I am fully aware of the significance of a healthy life style, whenever I feel overworked, fast food would be the shortest and the effortless in terms of daily meals. In addition, accommodating time for exercise can be difficult when a person is under stress.

Women obesity is significantly associated with the socio-economic development in the Arab countries of the gulf. Dense-fat foods, the lack of physical exercise, unqualified childcare and stress  have resulted from the new sedentary lifestyle and have eventually contributed to the high levels of obesity.