Background: Overweight and obesity are major risk factors for numerous communicable and non-communicable health conditions. Some of those diseases which can be prevented are cardiovascular diseases, diabetes, and chronic kidney disease. In Arab countries, prevalence of overweight and obesity is double what it is globally, making obesity a top public health concern. This study seeks to investigate the regional burden of high BMI-

attributable disease and compare it with global data, to shed light on this public health issue and inform future policies.

Methods: Data from the Global Burden of Disease (GBD) Study 2021, including global and Arab countries statistics, were systematically extracted and analysed. A high body mass index (BMI) was defined as a value of 25 kg/m² or greater. Trends for nine major causes of high BMI-attributable deaths, disability-adjusted life years (DALYs), and years of life lost from mortality (YLLs) were analysed by age and sex, from 1990 to 2021.

Results: In Arab countries, the top causes of high BMI-attributable age-standardised deaths, DALYs, and YLLs in 2021 were cardiovascular diseases, diabetes and kidney diseases, and neoplasms (replacing chronic respiratory diseases in 1990). There was a notable increase in the disease burden attributable to high BMI between 1990 and 2021, with a consistently higher burden compared to global data. Mortality caused by cardiovascular diseases and diabetes and kidney diseases in Arab countries was higher in females than males, compared to global mortality data.

Conclusions: The considerable disease burden attributable to high BMI in Arab countries highlights the necessity for integrated, population-level interventions aimed at holistically preventing high BMI in this region. Longitudinal and qualitative research on perceptions and drivers of trends in high BMI within Arab countries are necessary to gain context and add to the evidence base, allowing for the development of suitable and effective interventions.