HealthLumen, London, UK.
Sharik Association for Health Research, Riyadh, Saudi Arabia.
Obes Facts. 2023;16(6):559-566. doi: 10.1159/000533301. Epub 2023 Aug 8.
Obesity is a major risk factor for type 2 diabetes (T2DM) and liver disease, and obesity-attributable liver disease is a common indication for liver transplant. Obesity prevalence in Saudi Arabia (SA) has increased in recent decades. SA has committed to the WHO "halt obesity" target to shift prevalence to 2010 levels by 2025. We estimated the future benefits of reducing obesity in SA on incidence and costs of T2DM and liver disease under two policy scenarios: (1) SA meets the "halt obesity" target; (2) population body mass index (BMI) is reduced by 1% annually from 2020 to 2040.
We developed a dynamic microsimulation of working-age people (20-59 years) in SA between 2010 and 2040. Model inputs included population demographic, disease and healthcare cost data, and relative risks of diseases associated with obesity. In our two policy scenarios, we manipulated population BMI and compared predicted disease incidence and associated healthcare costs to a baseline "no change" scenario.
Adults <35 years are expected to meet the "halt obesity" target, but those ≥35 years are not. Obesity is set to decline for females, but to increase amongst males 35-59 years. If SA's working-age population achieved either scenario, >1.15 million combined cases of T2DM, liver disease, and liver cancer could be avoided by 2040. Healthcare cost savings for the "halt obesity" and 1% reduction scenarios are 46.7 and 32.8 billion USD, respectively.
SA's younger working-age population is set to meet the "halt obesity" target, but those aged 35-59 are off track. Even a modest annual 1% BMI reduction could result in substantial future health and economic benefits. Our findings strongly support universal initiatives to reduce population-level obesity, with targeted initiatives for working-age people ≥35 years of age.
肥胖是 2 型糖尿病（T2DM）和肝脏疾病的主要危险因素，肥胖相关的肝脏疾病是肝移植的常见指征。近年来，沙特阿拉伯（SA）的肥胖患病率有所增加。沙特阿拉伯已承诺实现世界卫生组织（WHO）的“遏制肥胖”目标，即在 2025 年前将肥胖患病率降至 2010 年的水平。我们估算了在两种政策情景下，降低沙特肥胖率对 T2DM 和肝脏疾病发病率和成本的未来影响：（1）沙特阿拉伯达到“遏制肥胖”目标；（2）从 2020 年到 2040 年，人口体重指数（BMI）每年降低 1%。
我们在 2010 年至 2040 年之间，为沙特的劳动年龄人群（20-59 岁）开发了一个动态微观模拟模型。模型输入包括人口人口统计学、疾病和医疗保健成本数据，以及与肥胖相关的疾病相对风险。在我们的两个政策情景中，我们操纵了人口 BMI，并将预测的疾病发病率和相关医疗保健成本与“无变化”基线情景进行了比较。
<35 岁的成年人有望达到“遏制肥胖”目标，但≥35 岁的成年人则不然。女性的肥胖率预计会下降，但 35-59 岁的男性肥胖率会上升。如果沙特劳动年龄人口达到任何一种情景，到 2040 年，T2DM、肝脏疾病和肝癌的联合病例数预计将超过 115 万例。“遏制肥胖”和 1%降低 BMI 情景的医疗保健成本节约分别为 467 亿美元和 328 亿美元。
沙特年轻的劳动年龄人口有望达到“遏制肥胖”目标，但 35-59 岁的人口则不然。即使每年 BMI 适度降低 1%，也可能带来巨大的未来健康和经济效益。我们的研究结果强烈支持实施针对全体人口的减少肥胖的措施，并针对≥35 岁的劳动年龄人群实施有针对性的措施。
