Correlates of eating disorder pathology in Saudi Arabia: BMI and body dissatisfaction

Abstract

Background Saudi Arabia is undergoing rapid sociocultural changes, which may have led to an increase of body mass index and eating disorder pathology. The aim of this study is to investigate whether body dissatisfaction, self-esteem, having lived abroad, cultural orientation, perceived stress, media use, and socioeconomic status are correlates of eating disorder pathology with body mass index as a covariate. Additional aims are to investigate if cultural orientation is associated with symptomatology and if stress is a covariate in the association between eating disorder pathology and Western orientation. Method Self-report measures were administered in a convenience Saudi community sample (N = 1225) between April 2017 and May 2018. Hierarchical multiple linear regression analyses with eating disorder pathology as dependent variable were performed to establish the associations among the variables. Results After adjusting for the effect of BMI, only body dissatisfaction and eating disorder pathology were moderately associated. Eating disorder pathology and body dissatisfaction were more severe among Saudi citizens with a higher BMI. Discussion Several explanations for the lack of associations of westernization, self-esteem, and stress with eating disorder pathology are reviewed and discussed. The majority of this convenience sample existed of young unmarried Saudi females of high socioeconomic status. Of the total sample, 35% displayed eating disorder pathology which may be a reflection of the high rates of excess weight.

Psychometric properties of the Arabic version of the Intuitive Eating Scale-2 (IES-2) in a sample of community adults

“…The lifestyle in Arab cultures is closely attached to food, with most of the social and religious celebrations being accompanied by the consumption of large amounts of food [ 41 ]. In addition, the vast majority of Arab people are Muslims, a religion that supports restrictive eating [ 101 ]. All these peculiarities might have affected the factorial validity of the proposed model of the IES-2 in our sample.…”

The Saudi-Arabic adaptation of the Body Shape Questionnaire (BSQ34): Psychometrics and norms of the full version and the short version (BSQ8C)

“…Furthermore, it is recommended to validate the Saudi-Arabic BSQ34 among Saudis with excess weight, like the Body Uneasiness Test has been validated among patients with excess weight in other cultures (Marano et al, 2007). This is of relevance since almost half of the Saudi population suffers from excess weight and a high BMI is associated with more severe body-shape dissatisfaction in Saudi Arabia (Melisse et al, 2022). Moreover, it would also be of interest to investigate general psychopathology, as body-shape dissatisfaction was associated with increased levels of psychological symptoms (Murray et al, 2013;Gailledrat et al, 2016;Pritchard et al, 2021;Turk et al, 2021).…”

“…Furthermore, the sample consisted of men and women, which is quite unique in Saudi society. As Saudi Arabia is socially a rather reclusive society ( Melisse et al, 2022 ), being able to investigate such a large and diverse sample was a rare opportunity. Furthermore, as there was no effect of age, gender, and level of education, it may be concluded that both versions of the BSQ are widely applicable across Saudi Arabia to screen for or assess the severity of body-shape dissatisfaction.…”

“…Though use of the EDE-SC appeared most suitable since bias appeared to be reduced due to its investigator-based nature ( Cooper and Fairburn, 1987 ), the shape concern subscale has the highest internal consistency ( Burke et al, 2017 ) and there are no other standardized measures available to measure body-shape dissatisfaction in Saudi Arabia. Fourthly, since data collection ended, there have been several cultural changes in Saudi Arabia, such as transformations to empower women and modernize the relatively conservative Saudi society ( Melisse et al, 2022 ). Nowadays, women no longer have to wear a traditional abaya which might influence body image and therefore rates of body-shape dissatisfaction ( Dittmar, 2005 ).…”

“…Even though body-shape dissatisfaction is prevalent, its consequences are often underestimated. For instance, Saudis who are dissatisfied with their bodies have an increased risk for unhealthy dietary habits ( Stice and Shaw, 2002 ), which may result in developing eating disorder symptoms, as a strong association was found between body-shape dissatisfaction and eating disorder symptoms in Saudi Arabia ( Melisse et al, 2022 ). Furthermore, eating disorder symptoms are associated with psychological symptoms in Saudi Arabia ( AlHadi et al, 2022 ), and body-shape dissatisfaction is associated with psychological symptoms in other cultures ( Rodríguez-Cano et al, 2006 ; Rich and LeClere, 2011 ; Murray et al, 2013 ; Gailledrat et al, 2016 ; Pritchard et al, 2021 ; Turk et al, 2021 ).…”