The its associated co-morbidities. [69] Obesity becomes a globally

The obesity epidemic has more than doubled since 1980, and in 2008, where around 1.5 billion adults, 20 and older, were overweight and of these over 200 million men and approximately 300 million women were obese. This means that more than one in ten of the world’s adult population was obese in 2008. 12 Thus, obesity has been considered a world epidemic and serious public health problem, since it is associated with other various diseases. 12, 66 Obesity is a significant public health crisis with increasing prevalence in the developed as well as developing nations worldwide. This growing incidence represents a pandemic that needs urgent attention to avoid obesity-related morbidity and mortality. 67

Obesity is a chronic health problem affecting continuously increasing numbers of people worldwide. 68 Obesity is a rapidly growing chronic health problem worldwide, with its associated co-morbidities. 69 Obesity becomes a globally fast growing public health problem. Presence of obesity is suitable media for the development of multiple health risks, including diabetes mellitus, hypertension, heart disease and certain forms of cancer. 64

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The increasing prevalence of obesity constitutes a major public health challenge in both developed and developing nations because of the continuously enlarged burden of obesity and associated disorders on subject’s health. 70 Existence of obesity is associated not only with local but also with systemic adverse effects. Increased adiposity amplifies the hazards of many serious medical disorders including cardiovascular disease, hypertension, 71 type 2 diabetes (T2DM), dyslipidemia, obstructive sleep apnea, arthritis, cancer 72 and is estimated to reduce average life expectancy. 73

The prevalence of obesity epidemic had a dramatic increase over years among all ages, ethnic groups, races, all socioeconomic classes and in both women and men. It is estimated globally that there are more than 1 billion overweight adults in the world, with at least 300 million of them are obese, 19 Waxman, 2003. 18 About 25-30% of female population and about 13-18% of male population are affected with obesity, 19 that is associated with increased mortality and morbidity rates. 20 The prevalence of obesity has nearly doubled in adults during the past 2 decades, from 15% to an estimated 27%, with nearly 74% of the women and 46.1% of the men suffer from abdominal obesity. 21  The prevalence of obesity is increasing worldwide at an alarming rate in both developing and developed countries. It has become a serious epidemic health problem, estimated to be the fifth leading cause of mortality at global level 74

The region of Middle East and North Africa had the seventh (among the 21 regions of the Global Burden of Disease Study) highest prevalence of obesity in men, and the second highest in women between 1980 and 2008. 75 The total population of Saudi Arabia is reaching about 30 million. There is increasing longevity, adoption of Western-style eating habits and rapid lifestyle transition, which all are associated with marked increase in non-communicable disorders. Obesity is considered a relatively new phenomenon in Saudi Arabia; it has a continuously progressive rate especially among the young adults. Nearly about 28.9% of the Saudi population is suffering from obesity. 76 Numerous obesity-related studies in Saudi Arabia concluded that all age groups are affected with this disorder, and reported that one third of adult population, one fifth of adolescents, and one tenth of children are suffering from obesity in Saudi Arabia. 77, 78, 79, 80, 81, 82 Previous studies reported that the prevalence of obesity in Saudi Arabia has a wide range; from 14% in children to about 83% in adults. 83, 84 This wide variation could be due to the differences in criteria used to define obesity and to the differences in age, sex, and health status. 85

The prevalence of obesity and overweight in Saudi Arabia male and female is even higher than that reported in the USA, Australia, the UK, and Italy for comparable age groups. 86 Saudi Arabia is one of Middle East countries with a shocking level of obesity. Saudi Arabia lies within the top-ten nations with the highest rates of BMI. 87 According to a moderately recent published report, The Kingdom of Saudi Arabia has one of the fastest-growing obesity rates in the world. Adding to that; about 70-75% of Saudi adults are overweight, and around a third are obese. 88 WHO also reported that overweight and obesity prevalence in KSA are 72.5 % and 35.6 % for males and females respectively 36

According to epidemiological studies and surveys, overweight and obesity were found to affect large percentage of the adults in Saudi Arabia 77, 78, 89, 90, El-Hazmi and Warsy (1997) reported earlier that in the total Saudi population; the prevalence of overweight and obesity is (27.23 % versus 25.20 %) and (13.05% versus 20.26%) for male and female groups respectively. The prevalence of obesity varies in the different regions in KSA, but overall, is frequent in all areas. A high proportion of the populations in the Central and Western regions are obese (16.03 % versus 24.4 %) and (16.65 versus and 21.8 %) for males and females respectively. 91 Al-Shammari et al., reported that the prevalence of obesity in Saudi male adults in Riyadh is about 28.6 % while 34.8% were overweight. 92

 The prevalence of obesity in the Western region is the highest especially among male population. 91 Earlier reports documented regional high prevalence of obesity in males in Riyadh ranging from 18 -28%, 93, 94, 95 and 45% in the highlanders. 96 Earlier reports also documented high prevalence of obesity in females in Riyadh = 44.1%, 97 Eastern Province = 27%, 98 Central Province = 29.7%, 95 and highlanders in the Western Province of Saudi Arabia = 67.6%. 96 In a study (2009-2011) to measure the prevalence of obesity among military personnel in KSA, has found that 40.9% of the participants were overweight, 29% obese, and 42.4% had central obesity. 99 During the last few decades, the Kingdom of Saudi Arabia (KSA) experienced rapid socio-cultural changes caused by the accelerating economy in the Arabian Gulf region. That was associated with major changes in the food choices and eating habits which, progressively, became more and more “Westernized”. Such “a nutritional transition” has been claimed for the rising rates of overweight and obesity which were recently observed among Saudi population.