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Aim: To describe the dietetic practices of the treatment of obesity in Saudi Arabia and compare this with best practice criteria and the practice in Australia. Methods: Anonymous questionnaires were completed by dietitians in Saudi Arabia. The topics included barriers to obesity management, demand and level of service and strategies and approaches used for weight management. Best practice scores were based on those used to assess Australian dietitians. Results: A total of 253 dietitians participated in the survey. Of these, 175 (69%) were involved in the management of obesity. The best practice score for Australian dietitians was slightly greater than the scores of Saudi dietitians (median 43 vs 39). There was also a significant correlation between the best practice score and years of experience (r = 0.26, P < 0.001). The most common assessment approaches were assessment of body mass index (87%) and exercise habits (81%), while the most common strategies for obesity management were: dietary total fat reduction (92%) and increase incidental daily activity (92%). The major barrier for establishment of a weight management clinic reported by 49% of participants was inadequate resources. Conclusion: Saudi Arabian dietetic practice for the management of obesity does incorporate most best practice recommendations, but some specific elements are rarely used. [ABSTRACT FROM AUTHOR]

Background and Objectives: Body mass index (BMI) is the most widely used measure to define obesity and predict its complications, such as diabetes and hypertension, but its accuracy and usefulness in Saudi subjects is unknown. This study aimed to assess the validity of standard BMI cut-point values in the Saudi population., Subjects and Methods: 197 681 adults participated in a cross-sectional study to detect diabetes and hypertension in the Saudi Eastern province in 2004/2005, with blood pressure, fasting blood sugar, height and weight measurements taken. Sensitivities, specificities, areas under the curves, predictive values, likelihood ratios, false positive, false negatives and total misclassification ratios were calculated for various BMI values determined from receiver operating characteristic (ROC) curves. The significance of the association between risk factors and BMI was assessed using regression analysis., Results: For the definition of overweight, ROC curve analysis suggested optimal BMI cut-offs of 28.50 to 29.50 in men and 30.50 to 31.50 in women, but the levels of sensitivity and specificity were too low to be of clinical value and the overall misclassification was unacceptably high across all the selected BMI values (>0.80). The relationship between BMI and the presence of diabetes and/or hypertension was not improved when a BMI of 25 was used. Using regression analyses, the odds ratios for hypertension and/or diabetes increased significantly from BMI values as low as 21-23 with no improvement in the diagnostic performance of BMI at these cutoffs., Conclusion: In Saudi population, there is an increased risk of diabetes and hypertension relative to BMI, starting at a BMI as low as 21 but overall there is no cutoff BMI level with high predictive value for the development of these chronic diseases, including the WHO definition of obesity at BMI of 30.