By Willa Thayer Jul 8, 2005, 5:45 GMT
Cairo - Although health awareness and the availability of sound nutritional guidance is increasing in Egypt, many women still find it difficult to overcome economic and cultural barriers to maintain a healthy weight.
About 75 per cent of overweight people in Egypt are women, says Dr. Sherif Azmi, a nutritionist at the Nasser Health Institute. As obesity impacts on up to 45 per cent of the population, about 20 million women are carrying excess weight.
Azmi attributes obesity among women to a diet of starchy foods, a tendency to eat large meals at night and the fact that "Women spend a lot of time at home and they tend not to work out - partly because of the religious issue."
But reducing the intake of carbohydrates and exercising pose challenges in Egypt.
Ashgaan Ahmed, a retired headmistress in her 50s, would love to lose 15 kilogrammes, having recently been diagnosed with diabetes. However, she was distraught to find that the diet her doctor has given her will cost a minimum of five dollars a day.
In a country where salaries of 60 dollars a month are common for civil servants, it come as no surprise that "the mainstay of most meals is pasta, potatoes or a pot of vegetables stuffed with rice," says Ahmed.
Exercise is likewise costly. "In the west, people have a choice of 100 different types of sports. My only option is walking," Ahmed says.
The dearth of public parks in Cairo requires a frustrating search for sidewalk not occupied by parked cars or which are so broken as to be impassable. Joining a sports club is out of the question for Ahmed financially.
While wealthier women may be able to overcome the economic barriers to losing weight, they still face cultural ones.
Samia Allouba, who owns several fitness centres in Cairo, says women often have little time to exercise. Mothers bear the brunt of the country's exam-driven education system that leaves much of the instruction to parents, she pointed out.
But newer cultural trends also play a role.
"About 10 to 12 years ago when the veil was becoming more common, some women began asking about classes or gym hours just for ladies," says Allouba, who has been in the business for 24 years. "Others said that they were stopping exercising all together since they were taking on the veil."
But all is not doom and gloom. Although Allouba noticed a slight drop in her female clientele about a decade ago when wearing a veil became more common, the numbers soon rebounded.
Her centres began advising veiled women when fewer men were using the gym. About two years ago, she began offering a handful of classes for women only.
Even so, the fact that on any given evening, one is likely to see a handful of veiled women, from teenagers to 50 year-olds exercising alongside men, suggests that some women are unwilling to be encumbered by the veil.
For those with serious weight problems, help is at hand - provided they have the financial means.
Deena Boraie, an administrator in her 40s at an elite university tells eagerly of her success losing 60 kilogrammes following laparoscopic band surgery.
That surgery, in which a band is inserted in the abdomen that reduces the size of the stomach, cost the equivalent of 5,000 dollars in 2002. Boraie counts herself lucky to have had health insurance to pay for the operation.
Having gone from plump to seriously overweight some to decades ago, Boraie says that she "couldn't have lost the weight without the help of the operation."
A healthy diet rigorously adhered to for nearly two years, coupled with the stomach-shrinking band brought her success. Ironically, part of the solution to Boraie's problem ultimately came at the hands of the medical establishment, given the prejudice she claims to have faced owing to her obesity.
"If I'd had cancer, the doctors would have missed it because they were so focused on the fact that I was overweight."
Boraie attributes much of her weight gain to a serious but undiagnosed bout of post-partum depression. Her repeated pleas for a nutrition plan that addressed her busy lifestyle as a single mother and mobile professional went unheeded.
Instead, the advice she received from nutritionists and doctors over the years, boiled down to admonitions of "eat less".
Boraie has not integrated sports into her new, healthy lifestyle and says she was never encouraged to be active. Asked what she needed to make that change, Boraie says, "I love dancing, I'm a sociable creature, what I need is someone to exercise with - maybe it's a cultural thing."
For all the challenges Egypt presents to maintaining a healthy weight, the social factor may yet be the untapped key to spreading health consciousness in a society characterized by close-knit families and tight social networks.
And that's something that nutritionist Azmi has picked up on as well. His patients "always bring their relatives or friends to the clinic to seek advice, even if they're from other parts of the country," he says.
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