'Curse of affluence' causing obesity crisis in wealthy Middle East

MANAMA, Bahrain -- Each evening, a warbling call rises from hundreds of mosques across this tiny island kingdom. Come pray, the muezzins sing, and celebrate the holy month of Ramadan.

More often than not, the appeal is drowned out by a more pressing one -- a plaintive "let's eat" -- emitted by the stomachs, and children, of those Muslims who've spent the day fasting. Instead of the mosque, many head straight to the nearest buffet table.

The Muslim holy month of Ramadan, with its dawn-to-dusk fasting, sounds like the ultimate crash diet. But in Bahrain, and across this deeply devout region, day-long abstinence is followed each night by binge eating that contributes to one of the world's fastest-growing obesity crises.

More than 60 per cent of the just over 1 million people who live on this island are either overweight or obese, according to government statistics, meaning that Bahrainis -- slim and fit as a nation just a few scant decades ago -- are now nearly on par with notoriously ballooning beltlines in the United States.

It's not just Bahrainis. Gulf Arabs from Kuwait to Dubai to Saudi Arabia, all countries that had thin and active populations 30 years ago, are now stereotyped by their neighbors as idle and overweight. Call it the curse of affluence: As their oil-based economies boomed and their societies became richer, Gulf Arabs adopted more sedentary lifestyles and fattier diets heavily laced with the Western fast food that they've come to crave.

Matters only get worse each year during Ramadan, a period during which patience and sacrifice are supposed to be paramount as Muslims mark the time when the Koran was revealed by God. Health-care professionals here say many Bahrainis routinely gain five to 10 pounds during the month, much of it due to oversized iftar (Arabic for "breaking the fast") meals.

"It should be a good chance to lose weight, but it's the opposite. People eat like hell -- they feast like animals once they're done fasting," laughed Khalifa Bin Dayna, himself sporting a bit of a Ramadan belly two weeks into the holy month.

He said that while it was traditional for Muslims to end the fast with light foods such as soup, yogurt and dates, many now chomp straight into the main courses -- red meats and deep-fried foods such as falafel -- as soon as the sun sets.

Partly as a result, these are boom times for Bin Dayna, a German-trained surgeon who recently brought cutting-edge stomach-stapling surgery to Bahrain. He said he's performed the radical procedure five times this month already and has a waiting list 35 names long of people happy to pay upward of $10,000 for the procedure.

While the traditional Bahraini diet consists primarily of rice and fresh fish, the island's growing affluence and integration with the Western business world has predictably brought with it a plethora of Western fast-food chains.

McDonalds, KFC, Dairy Queen and Hardee's all have multiple outlets in Manama, Bahrain's otherwise sleepy capital, and delivery motorcycles from all four chains, plus a host of local restaurants specializing in hamburgers, pizza and shawarmas buzz around the island as soon as the sun goes down.

The delivery bikes speak to an equally pressing health problem for Bahrainis: chronic inactivity. This is a country that idolizes and caters to the automobile. Telling someone, even a doctor, that you're going to walk somewhere draws puzzled, sympathetic looks.

Much of that attitude can be attributed to the sweltering heat, which this week has flirted regularly with a lethargy-inducing 40 degrees. But the island's new affluence again plays a role. Many Bahrainis have one or more servants, usually from the Indian subcontinent, whom they rely on for even the most basic tasks.

"In Bahrain, we use cars to travel even short distances. We never walk anywhere. Because of the very hot and humid weather, there's always an excuse not to walk," said Khairya Moosa, the head nutritionist at the country's Ministry of Health.

Another, less obvious, factor seen as driving weight gain is the traditional style of dress to which most Gulf Arabs still adhere. Men usually sport the dishdasha, a formless, flowing white robe, while many women throughout the region wear the black, head-to-toe abaya.

The dishdasha is ideally suited to the hot Gulf climate while, for religious reasons, the abaya (which is mandatory for women in Saudi Arabia) intentionally disguises the shape of the female body. But health experts say that the loose clothing also leads both sexes to take a "why bother" approach to body shape and physical fitness.

"If you wear the abaya, it's very easy to drift into gaining weight," said nutritionist Aliaa Al-Moayed. "There's no belt you have to tighten."

(Distributed by Scripps Howard News Service, www.scrippsnews.com.)