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Peer-reviewedCC BY-NCDiabetes, metabolic syndrome and obesity : targets and therapy

Management of Obesity in Special Populations and Limited-Resource Settings: An Egyptian Medical Position Statement.

  • Mona A Hegazy1
  • Amr Mattar2
  • Maissa Mohamed Shawky3
  • Dina Soliman4
  • Maha Mowafy5
  • Yasmine Mohamed NourEldin6
  • Ahmed Madbouli Noweir7
  • Mohamed Kamal Aboulghate8
  • Mostafa Elshazli9
  • May AbdelMoneim Hassaballa10
  • Shereen Abdelghaffar11
  • Heba Morad Bahgat12
4 more authors
  • Noha Sabry13
  • Hesham Salah Eldin Taha14
  • Inass Shaltout15
  • Mona Yousry16
16 affiliations
  1. 1Hepatology and Gastroenterology Division, Faculty of Medicine, Cairo University, Cairo, Egypt.
  2. 2Department of Anaesthesia & SICU and Pain Management Kasr Alainy School of Medicine, Cairo University Cairo Egypt.
  3. 3School of Medicine, Cairo University, Cairo, Egypt.
  4. 4Department of Anesthesiology, SICU and Pain, Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt.
  5. 5Family Medicine Department Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt.
  6. 6Clinical Nutrition Department Shifa Hospitals Group Cairo Egypt.
  7. 7Public Health and Nutrition High Institute of Public Health, Alexandria, Egypt.
  8. 8Department of Anesthesiology Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt.
  9. 9Department of General Surgery Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt.
  10. 10Department of Internal Medicine & Nephrology Cairo University, Cairo, Egypt.
  11. 11Department of Pediatric Diabetes and Endocrinology Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt.
  12. 12Department of Internal Medicine, Diabetes and Endocrinology Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt.
  13. 13Department of Psychiatry Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt.
  14. 14Department of Cardiology Faculty of Medicine, Cairo University, Cairo, Egypt.
  15. 15Department of Internal Medicine and Diabetes Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt.
  16. 16Internal Medicine, Diabetes Mellitus, and Endocrinology Division Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt.
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Abstract

Background

Obesity/adiposity-based chronic disease is a chronic progressive relapsing disease linked to several comorbidities, with rising prevalence in Egypt. Limited local guidelines and healthcare challenges necessitate evidence-based, culturally adapted strategies.Methods

The Egyptian Medical Association for the Study of Obesity convened a clinical multidisciplinary panel to develop consensus recommendations. Evidence was synthesized from literature, prioritizing resource-limited settings and special situations.Result

Assessment: Move beyond Body Mass Index to include waist circumference, waist/height ratio, body composition, and screening for obesity-related complications and diseases. Lifestyle Interventions: a-Nutrition: Mediterranean/dietary approach to stop hypertension diets, slow eating, and supervised fasting (eg Ramadan and Christian). b-Activity: Culturally tailored approaches (eg prayer-time movement and Arabic apps). c-Behavior: Cognitive-behavioral therapy and family-inclusive support. Pharmacotherapy: Use of approved agents (orlistat, naltrexone/bupropion, liraglutide, semaglutide, and tirzepatide) according to obesity-related complications and diseases and age group. Avoid GLP-1, GLP-1/GIP analogues in patients with medullary thyroid cancer, and all agents during pregnancy. Bariatric Surgery: Indicated for body mass index ≥40 kg/m² (or ≥35 with obesity-related complications and diseases), with lifelong micronutrient supplementation. Special Populations: a-Adolescents: Focus on growth, not only weight-loss; consider pharmacotherapy in different age groups. b-Elderly: Prioritize muscle preservation; avoid weight loss unless obesity-related complications and diseases exist. c-Pregnancy: No weight loss; delay postpartum interventions until lactation is established. Policy Actions: Mandate food labeling, tax sugar-sweetened beverages, and integrate obesity services into primary healthcare.Conclusion

These recommendations provide a pragmatic framework for obesity/adiposity-based chronic disease management in Egypt, emphasizing affordable, patient-centered care, and clinical multidisciplinary collaboration and policy support.

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Cite

BibTeXRIS
BibTeX
@article{hegazy2026management,
  title = {{Management of Obesity in Special Populations and Limited-Resource Settings: An Egyptian Medical Position Statement.}},
  author = {Mona A Hegazy and Amr Mattar and Maissa Mohamed Shawky and Dina Soliman and Maha Mowafy and Yasmine Mohamed NourEldin and Ahmed Madbouli Noweir and Mohamed Kamal Aboulghate and Mostafa Elshazli and May AbdelMoneim Hassaballa and Shereen Abdelghaffar and Heba Morad Bahgat and Noha Sabry and Hesham Salah Eldin Taha and Inass Shaltout and Mona Yousry},
  journal = {Diabetes, metabolic syndrome and obesity : targets and therapy},
  year = {2026},
  month = oct,
  doi = {10.2147/dmso.s629991},
  url = {https://europepmc.org/article/MED/42974480},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - Management of Obesity in Special Populations and Limited-Resource Settings: An Egyptian Medical Position Statement.
AU  - Mona A Hegazy
AU  - Amr Mattar
AU  - Maissa Mohamed Shawky
AU  - Dina Soliman
AU  - Maha Mowafy
AU  - Yasmine Mohamed NourEldin
AU  - Ahmed Madbouli Noweir
AU  - Mohamed Kamal Aboulghate
AU  - Mostafa Elshazli
AU  - May AbdelMoneim Hassaballa
AU  - Shereen Abdelghaffar
AU  - Heba Morad Bahgat
AU  - Noha Sabry
AU  - Hesham Salah Eldin Taha
AU  - Inass Shaltout
AU  - Mona Yousry
PY  - 2026
DA  - 2026/10/29
JO  - Diabetes, metabolic syndrome and obesity : targets and therapy
DO  - 10.2147/dmso.s629991
UR  - https://europepmc.org/article/MED/42974480
AB  - Background  Obesity/adiposity-based chronic disease is a chronic progressive relapsing disease linked to several comorbidities, with rising prevalence in Egypt. Limited local guidelines and healthcare challenges necessitate evidence-based, culturally adapted strategies.Methods  The Egyptian Medical Association for the Study of Obesity convened a clinical multidisciplinary panel to develop consensus recommendations. Evidence was synthesized from literature, prioritizing resource-limited settings and special situations.Result  Assessment: Move beyond Body Mass Index to include waist circumference, waist/height ratio, body composition, and screening for obesity-related complications and diseases. Lifestyle Interventions: a-Nutrition: Mediterranean/dietary approach to stop hypertension diets, slow eating, and supervised fasting (eg Ramadan and Christian). b-Activity: Culturally tailored approaches (eg prayer-time movement and Arabic apps). c-Behavior: Cognitive-behavioral therapy and family-inclusive support. Pharmacotherapy: Use of approved agents (orlistat, naltrexone/bupropion, liraglutide, semaglutide, and tirzepatide) according to obesity-related complications and diseases and age group. Avoid GLP-1, GLP-1/GIP analogues in patients with medullary thyroid cancer, and all agents during pregnancy. Bariatric Surgery: Indicated for body mass index ≥40 kg/m² (or ≥35 with obesity-related complications and diseases), with lifelong micronutrient supplementation. Special Populations: a-Adolescents: Focus on growth, not only weight-loss; consider pharmacotherapy in different age groups. b-Elderly: Prioritize muscle preservation; avoid weight loss unless obesity-related complications and diseases exist. c-Pregnancy: No weight loss; delay postpartum interventions until lactation is established. Policy Actions: Mandate food labeling, tax sugar-sweetened beverages, and integrate obesity services into primary healthcare.Conclusion  These recommendations provide a pragmatic framework for obesity/adiposity-based chronic disease management in Egypt, emphasizing affordable, patient-centered care, and clinical multidisciplinary collaboration and policy support.
SN  - 1178-7007
ER  -