Obesity is the disease of the century which threatens the world. Studies show that one billion people worldwide are at risk of obesity and 300 million people suffer from obesity. In an exclusive interview with Arabstoday, specialist therapeutic nutrition and dietary specialist Dr Mona Radames warns against take-away meals and a sedentary lifestyle as well as unhealthy cooking methods which are widespread in the Arab world, adding that obesity causes many diseases. Arabstoday: Why did you choose therapeutic nutrition and diet as your specialty? MR: I grew up in a medical family. My father is a famous physician and my mother is also a doctor, so I fell in love with the medical profession in childhood and it was my goal to be a doctor from the beginning. I reached a crossroads when I had to choose a specialisation, and therapeutic nutrition and obesity treatment was my first option. I was aware that obesity has an upper hand over most of the diseases that surround us and we can protect ourselves by eating healthy food and the proper regulation of food, moreover we can also treat many diseases through proper nutrition. Obesity is considered a risk factor and the key to all problems and diseases, and from here my journey began with the study of therapeutic nutrition in order to treat my obese patients through food rather than medicine. Arabstoday: What is the percentage of obesity in Egypt and the Arab world? MR: Obesity is a problem throughout the whole world, not just in Arab societies, as studies have shown that there are approximately one billion people in the world at risk of obesity in one form or another and 300 million people suffer obesity. Unfortunately in our Arab world, studies have confirmed that the Gulf countries are most exposed to obesity. Studies have also shown that the Gulf states in particular have expanded the amount of fast-food international chains and cafes they have selling high-calorie meals. The Gulf citizens have taken to this style of eatery and visit them several times a day. They are far-removed from the traditional Arab kitchen which depends on grilled meat, not fried as well as salads and vegetables. Arabstoday: What are the main reasons that lead to obesity in Egypt and the Arab world? MR: Of course, fast food and unhealthy cooking methods, fried foods and sweets and other alternatives to the Arab kitchen which mainly depends on vegetables as the main meal, as well as technological progress and a modern life-style. Everything has become easier with less effort and the amount of time spent in sedentary positions while watching TV, playing video games and working at a computer for example, has increased. A fast pace of life and psychological stress, and spending the whole day away from home, leads to thetemptation of eating fatty meals, as well as neglecting breakfast. This new lifestyle in our Arab societies is responsible for obesity. Arabstoday: Are there psychological reasons leading to obesity? MR: The psychological factor plays a large role in obesity. There was a study done for a conference about the relationship between obesity and frustration and depression, which proved that there is a close relationship between them. Many people who are exposed to tension and mood swings, especially women, resort to sugary food in particular to discharge tension and emotions which leads to obesity, which in turn leads to more depression and therefore it is a vicious circle. Arabstoday: There have been suggestions that dieting can cause depression, what is your opinion? MR: On the contrary, obesity is caused by depression, especially in women. The latest statistics in our Arab countries confirm that the main reason behind divorce is the increased weight in ladies and their inability to reduce weight to please their husbands. The depression that occurs with dieting may be due to using a random diet which is not suited to the individual. Thus, women find themselves deprived of food but without results, and here the cycle of depression begins. Women should be under the supervision of a nutrition specialist and follow up with them weekly, to avoid depression. Arabstoday: Is obesity inherited? MR: Undoubtedly, genes have the upper hand in obesity; there are genetic factors responsible for the occurrence of this disease as well as the control of the number of fat cells and the ability of the body to store fat and insulin secretions, etc. It has been proven by studies and statistics that one parent with obesity increases the possibility of one of the children having obesity by 40 percent, while if both parents have obesity the statistic goes up to 80 percent. Arabstoday: But does this mean that there is no escape from this problem for children? MR: We can avoid the problem of obesity in children by educating them about proper food and avoiding bad eating habits. Parents should teach their children from the beginning, that fruit is better than sweets and candies, and a glass of fruit juice is healthier than a bottle of soft drinks. Arabstoday: What diseases are caused by obesity? MR: Obesity is considered the chief culprit in the pathogenesis of many diseases. When a patient goes to different doctors, we find that the doctor always records the need to reduce weight in parallel with medical therapy. This is particularly prevalent with orthopaedic specialists and doctors who treat rheumatism. It it is proven that every kilogramme added to the normal weight of a person represents an additional burden of 4 kgs to his knees, joints and feet, and each and every one kilo added in the stomach area represents an additional burden of 5 kgs on the spine . Obesity is responsible for all diseases of the heart and arteries and increases the level of cholesterol in the blood. The treatment of obesity is the starting point to solve problems of the heart and arteries. Losing weight by at least 15 percent of total body weight is necessary for every heart patient, and also those with type II diabetes who depend on pills for their treatment. A proper diet is very important in the control of diabetes. Many cases of infertility in women are due to weight gain, so an obstetrics and gynaecology doctor will advise a woman to reduce weight as a start to solve her problems with infertility. Arabstoday: When should an obese person resort to operations to get rid of excess weight? MR: At first, I would like to point out that liposuction and stapling surgeries carry risks. Everyone thinks that this is a final solution to his problem but this is not the case. These surgical procedures are specifically for those who are excessively obese, by that I mean with a body mass of more than 40, and even those must only resort to such operations after trying all the other methods to reduce their weight such as diet and exercise, and the use of special devices such as ultrasound which is the most modern way to remove fat without risk. In the event that all these fail, then surgery is the final resort, but bearing in mind that the patient must resort to a proper diet after the operation. Arabstoday: Are there those at risk of obesity above others? MR: Of course there are people more susceptible to obesity than others. There are many factors involved, for example age; the younger the person is, the chances of weight loss are higher, because the rate at which we burn calories is reduced as we age. Also the number of fat cells in the human body varies from person to person. The more fat cells a person has, the more likely they are to gain weight.. Moreover, different personal habits play a role such as the amount a person moves around, how lazy they are, the way they eat and tendencies towards certain foods such as sweets and sugars. All of these factors vary from person to person, and constitute a person\'s disposition towards obesity. Arabstoday: Is it possible to follow a diet without a doctor? MR: Following a diet without consulting a specialist is a big mistake, but unfortunately it is common. Many women who come to my clinic tell me about their weight loss, journey, and how they had followed diets suggested by friends and had symptoms such as weakness, hair loss, feeling dizzy and other symptoms. A programme for weight loss should only be done after a comprehensive medical examination after which the doctor can design an appropriate plan for that specific person, in order to reach their ideal weight while maintaining sound health. I remember a funny saying by a famous American nutritionist:: “if there was a diet to suit everyone, we should sell it in the supermarkets!” Arabstoday: What is the ideal weight for women? MR: In recent years, the ideal weight for a woman is based on the well-known weight and height ration: height in cms equals the ideal weight in kilo. But modern studies and research has shown that this method is not a true reflection of the desired weight for women, so Body Mass Index (BMI) appeared to determine the degree of obesity: BMI is the body mass divided by the square of a person\'s height and the results are then compared according to a table: · Underweight = less than18 · Normal weight = 18-24.9 · Overweight or Obese = 30-39.9 · Excessive Obesity = 40 or more Women can undoubtedly reach the ideal weight through nutrition alone, but this is not the best option, nutrition is one of the cornerstones of the system of an ideal weight, which also includes exercise and good eating habits. Arabstoday: Some pregnant women diet to maintain their weight. Is this harmful? MR: There is no harm in following a diet for pregnant women as long as it is has been devised by a nutritionist and on a scientific basis. Pregnant women have special requirements to maintain their health and the health of the foetus and should not follow any random diet because it might expose them and their child to many problems. In all cases, a pregnant woman should be aware that during pregnancy, a weight-gain of about 12 kilograms is normal - whether she was overweight or not prior to conceiving. In the case of a woman who was underweight prior to conceiving, she is allowed to gain 16 kilograms throughout the period of pregnancy, and must consult a nutritionist throughout the nine months. Finally Arabstoday asked Dr Radames for her top tips for women wishing to reduce weight while maintaining her family’s health 1. Involve the whole family. It is unreasonable to have calorific food on the table for some members of the family, while asking the rest of the family to eat healthy and low calorie foods. 2 - Keep in the refrigerator, healthy, ready-to-eat food which family members can access when hungry, such as washed and sliced ?? carrots or some fresh fruit. 3 - Don\'t give up hope if you fail to follow out the diet prepared for you. Make up for it the next day and start afresh without looking back at the slip-up of the previous day. 4- Use stairs, rather than riding in elevators. Park your car ahead of your destination so that you can walk for a while. Share household tasks that require physical effort. 5 - Replace white bread with brown, natural juices or water instead of rizzy drinks, and cold cuts of meat instead of preserved meats. 6 - Drink green tea.. The latest studies by the American Association for Obesity have shown that green tea contains substances that act to increase the rate calories are burned. 7 - Make sure to eat foods rich in natural fibre found in vegetables and fresh fruits, which fill the abdomen and give a feeling of satisfaction and help in the digestion process.
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