The Dubai municipality has come up with a novel way to promote a balanced diet and exercise in the city: slim down, and the reward will be worth your weight in gold. Or rather, you will receive 1 g of gold for every kg shed. Earlier this week it was estimated that more than 15 000 people had signed up, with the final numbers expected to be more since registration closed yesterday. Already this is more than the 9666 people who took part in a similar scheme last year.

An initiative like this is especially important in Dubai. The United Arab Emirates (UAE) has been ranked as the fifth most obese nation in the world, according to a 2012 report published in the BMC Public Health journal. More than 66% of men and 60% of women in the UAE are overweight or obese, according to the Lancet‘s Global Burden of Disease Study 2013.

Obesity is inextricably linked with elevated risks of cardiovascular disease, type 2 diabetes, metabolic syndrome, various cancers, sleep apnoea, osteoarthritis, and gallstones. Patients presenting with these illnesses place a massive strain on hospitals and the time of doctors. Roughly one in five people has diabetes in the Persian Gulf region, according to doctors and the International Diabetes Federation. And, more than 34.6m people in the Middle East and north Africa have the disease. This accounts for 10.9% of diabetics worldwide, costing governments in the region more than $12bn (£7bn; €9bn) in treatment each year.

Bariatric surgery, which is usually recommended as a last resort, is gaining popularity in the UAE. The National reported that, according to Dubai based doctors, children as young as 12 are being booked in for weight loss surgery, and, while statistics are difficult to come by because of patient confidentiality and privacy laws, there are increasing numbers of young people being brought in for such operations.

Obesity does have genetic factors, and may be caused by diseases like hypothyroidism and Cushing’s syndrome. However, overeating and sedentary lifestyles are undoubtedly large contributors to obesity in the Middle East. Searing desert temperatures are not conducive to outdoor exercise, with temperatures reaching up to 50 degrees Celsius. A thriving tourism industry ensures that Dubai is a city with a voracious appetite for fine dining and a shopping mall, food court culture.

All this means that the government’s unusual initiative is a welcome move. “Dubai aims to be one of the healthiest cities in the world,” says Walid Al Shaibani, coordinator of the campaign. “To achieve this big goal we need to change our food habits and promote physical activities reducing lifestyle related diseases such as obesity, high cholesterol, and diabetes.”

The scheme does have its share of pitfalls. Last year, less than half the participants completed the program. The “biggest loser” lost 26 kg over a period of around three weeks—such rapid weight loss may not always be advisable. These incentives are definitely not substitutes for regularly eating well and exercising. However, the program is certainly generating awareness and creating a buzz in the local newspapers. And, for those who register, outdoor exercise activities and health awareness workshops will be laid on to help instruct participants on how to lose weight correctly. There is no harm done if, spurred on by the gleam of gold, people do achieve a healthier weight, and hopefully adopt a healthier lifestyle too.

After all, it is high time the scourge of obesity is addressed before the groaning healthcare system cracks under the weight of the problem.

Lavanya Malhotra has just finished her first year of medicine at the University of Cambridge.

Competing interests: I, Lavanya Malhotra, declare that I have read and understood the BMJ policy on declaration of interests and I have no relevant interests to declare.