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Alyami MM, Al-Dossary SA. Assessing disordered eating behaviours and attitudes: Factor structure and measurement invariance of the Arabic version of the eating attitudes test (EAT-26) in Saudi Arabia. J Eat Disord 2024; 12:185. [PMID: 39563423 DOI: 10.1186/s40337-024-01137-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2024] [Accepted: 10/26/2024] [Indexed: 11/21/2024] Open
Abstract
BACKGROUND The factorial structure of the Eating Attitudes Test (EAT-26) has been found to be inconsistent across studies and samples. This study aimed to resolve inconsistencies in the factorial structure of the Arabic version of the EAT-26 by identifying the best-fitting model and test its measurement invariance across sexes and BMI categories in a large non-clinical Saudi sample. METHODS 1,734 Saudi adults (Mage 26.88 and SD 9.13), predominantly female, completed an online survey. Several existing models were tested (e.g., original 26-item three-factor model, second order 26-item three-factor model, 20-item four-factor model, and 16-item four-factor model) using confirmatory factor analysis (CFA). Fit indices including the CFI, SRMR, and RMSEA were used to identify the best-fitting model for Arabic version of the EAT-26. Multi-group confirmatory factor analysis (MGCFA) was used to test measurement invariance. RESULTS The original three-factor model and two other common models demonstrated poor fit (e.g., CFI = 0.727; SRMR = 0.0911; RMSEA = 0.085 [90% CI 0.082-0.087] for the original three-factor model). Instead, a 16-item, four-factor structure [(Self-Perceptions of Body Weight), (Dieting), (Awareness of Food Contents), and (Food Preoccupation)] showed acceptable fit ([CFI = 0.904; SRMR = 0.0554; RMSEA = 0.073 [90% CI 0.068- 0.077]). Internal consistency was good (α and ω = 0.88), and measurement invariance was supported across sex (male and female) and BMI categories (underweight, normal weight, overweight, and obese). CONCLUSIONS These findings underscore the need for culturally relevant validation of the EAT-26 among Arabic-speaking populations, as the revised factorial structure diverged from previously established models. Future research should further examine this revised 16-item, four-factor structure in clinical settings.
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Affiliation(s)
- Mohsen M Alyami
- Department of Psychology, College of Education, University of Ha'il, Ha'il, Saudi Arabia.
| | - Saeed A Al-Dossary
- Department of Psychology, College of Education, University of Ha'il, Ha'il, Saudi Arabia
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Alhuwaydi AM. A cross-sectional evaluation of binge-eating behavior and its correlation with anxiety disorders among adolescents in Northern Saudi Arabia: implications for future generations. Front Psychiatry 2024; 15:1384218. [PMID: 39575197 PMCID: PMC11578955 DOI: 10.3389/fpsyt.2024.1384218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 10/18/2024] [Indexed: 11/24/2024] Open
Abstract
Background and aim Binge-eating behavior and anxiety disorders pose a significant public health issue worldwide, as it has severe implications for both the physical and mental health of the adolescent population. The present study evaluated the prevalence of binge-eating behavior, anxiety disorders, and associated factors among the northern Saudi adolescent population. Furthermore, we assessed the correlation between binge eating and anxiety. Methods The present population-based cross-sectional study was carried out among adolescents in the Aljouf region of Saudi Arabia from June 2023 to December 2023. A total of 384 eligible participants were selected using the convenience sampling method. The present study used a pretested Arabic version of the binge eating scale (BES) and Hamilton Anxiety Scale (HAM-A) to assess the binge-eating behavior and anxiety disorders among the target population. The Spearman correlation test determined the strength and direction of the correlation between BES and HAM-A scores. Furthermore, logistic regression analysis was applied to find the associated factors for binge-eating behavior among the study participants. Results Of the 384 participants, moderate and severe binge-eating behaviors were found among 11.2% and 8.3% of the respondents, respectively. Regarding the severity of anxiety as assessed by the HAM-A scale, mild, moderate, and severe anxiety were shown among 12.8%, 9.6%, and 7.5% of the participants, respectively. Also, the study found a positive correlation between binge eating and anxiety scores, with a correlation coefficient of 0.26 and a p-value of 0.001. Furthermore, being female (p = 0.001), moderate (p = 0.004), and severe anxiety (P = 0.001) were significantly associated with binge-eating behavior. Conclusion The present research findings advocate for the implementation of targeted interventions and support services aimed at decreasing binge-eating behavior and anxiety, thereby promoting the overall well-being of adolescents and building stronger future generations. Moreover, it is recommended that optional courses about binge eating be incorporated into the curricula of schools and universities.
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Affiliation(s)
- Ahmed M. Alhuwaydi
- Department of Internal Medicine, Division of Psychiatry, College of Medicine, Jouf University, Sakakah, Saudi Arabia
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Melisse B, van Furth E, Hoek HW. Systematic review of the epidemiology of eating disorders in the Arab world. Curr Opin Psychiatry 2024; 37:388-396. [PMID: 39149886 PMCID: PMC11426976 DOI: 10.1097/yco.0000000000000960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
PURPOSE OF REVIEW The Arab world is dealing with modernization and sociocultural changes both associated with eating disorders. The present review provides an update of 'Eating disorders in the Arab world: a literature review', which was published in 2020. RECENT FINDINGS There are 22 recent epidemiological studies on eating disorders in five different countries in the Arab world. A large-scale national mental health survey reported a 12-month eating disorder prevalence of 3.2% and an eating disorder lifetime prevalence of 6.1%. Binge-eating disorder was the most common eating disorder (12-month prevalence = 2.1%, lifetime prevalence = 2.6%), 1.6% was at high risk for binge-eating disorder. Overall, between 23.8 and 34.8% was at high risk for any eating disorder. Body-shape dissatisfaction, a high BMI and separated/widowed/single marital status were associated with eating disorder pathology. SUMMARY Although there is still a lack of studies compared to the western world, the number of epidemiological studies on eating disorders in the Arab world is growing and there is an increase in studies using appropriate assessment-tools and norms. It is recommended to offer specialized treatment and to implement preventive programs.
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Affiliation(s)
- Bernou Melisse
- American Center for Psychiatry and Neurology, Al-Manhal, Abu Dhabi, Abu Dhabi, United Arab Emirates
- Co-Eur, P.O. box 30514. 3503AH, Utrecht, the Netherlands
- Utrecht University, Department of Clinical Psychology, Utrecht
- Tilburg University, Department of Medical and Clinical Psychology, Postbus 90153, 5000 LE Tilburg
| | - Eric van Furth
- GGZ Rivierduinen Eating Disorders Ursula
- Department of Psychiatry, Leiden University Medical Center, Leiden
| | - Hans W. Hoek
- Parnassia Psychiatric Institute the Netherlands, The Hague
- Groningen University, Department of Psychiatry, Groningen, the Netherlands
- Columbia University New York, Department of Epidemiology, Mailman School of Public Health, New York, New York, USA
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Alsaud JS, Aljuaylan N, Alsaloom DS, Alsakaker A, Alfayez JS, Alshehi R. Investigating the Prevalence of Eating Disorders, Factors Contributing to Eating Disorders and Weight Control Methods: A Cross-Sectional Study on the Residents of Qassim Region, Saudi Arabia. Cureus 2024; 16:e71039. [PMID: 39512977 PMCID: PMC11540888 DOI: 10.7759/cureus.71039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2024] [Indexed: 11/15/2024] Open
Abstract
Background: Eating disorders significantly affect quality of life, body image, self-esteem, and relationships. Previous studies have mainly focused on Western populations, leaving a gap in our understanding of the cultural, social, and environmental factors in non-western populations. This cross-sectional study aimed to investigate the prevalence of eating disorders and its risk factors and examine the common methods for weight control used by affected individuals within the Qassim region of Saudi Arabia. Materials and methods: Recognizing the importance of understanding the landscape of eating disorders in this population, we used diagnostic criteria from the validated Arabic version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to assess the severity and patterns of eating disorders. Data were collected remotely over one year using a self-administered questionnaire distributed at schools, colleges, parks, and malls. The questionnaire covered demographics, weight control methods, and diagnostic criteria. This study included 404 undiagnosed cases (n = 404) to provide a comprehensive overview of the prevalence and severity of eating disorders in this region. Statistical significance was set at p < 0.05. Results: Of the participants, 12 (2.9%) reported having a diagnosed eating disorder, and the severity levels varied across different disorders. Anorexia nervosa exhibited predominantly moderate severity (264, 65.3%), with lower percentages classified as low (119, 29.5%) or high severity (21, 5.2%). Avoidant/restrictive food intake disorder demonstrated a varied distribution, with 131 (32.4%) classified as high severity, whereas bulimia nervosa was predominantly of low severity (242, 59.9%). Binge eating disorders were observed in a significant proportion of patients with moderate severity (203, 50.2%). Conclusion: There is an urgent need for heightened awareness, early detection, and intervention strategies tailored to the diverse spectrum of eating disorders in this region. Furthermore, understanding common methods that affect individuals' utilization of food and the severity and distribution of different disorders provides valuable insights into tailored interventions and support systems that promote healthier relationships between food and body image within the community.
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Affiliation(s)
| | - Norah Aljuaylan
- Research and Studies Unit, Patients Friends Association in Unayzah Governorate, Qassim, SAU
| | | | | | | | - Roba Alshehi
- Research and Studies Unit, Patients Friends Association in Unayzah Governorate, Qassim, SAU
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Alrasheed AA, AbuDujain NM, Almohammedi S, Alrayes R, Alajlan F, Abdulqader O, Albarrak M, Alharbi KH, Almigbal TH, Batais MA. Obesity in Saudi Medical Students and Alignment with Eating Disorders: A Stratified Random Cross-Sectional Investigation. Healthcare (Basel) 2024; 12:1281. [PMID: 38998816 PMCID: PMC11241181 DOI: 10.3390/healthcare12131281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 06/22/2024] [Accepted: 06/25/2024] [Indexed: 07/14/2024] Open
Abstract
As a result of the increasing global incidence of obesity and related diseases, this study aims to investigate the prevalence of obesity and its correlation with eating disorder (ED) screening among medical students to develop effective prevention strategies and provide better outcomes for these students. We conducted a quantitative analytical cross-sectional study at the College of Medicine at King Saud University between November 2023 and February 2024. A stratified random sampling technique was utilized, enrolling a net number of 415 participants. Participants were asked several questions, including demographic information, weight, height, and past medical history, and were given a validated screening tool for EDs. Participants' mean age was 21.4 ± 1.67 years, and 17.6% were considered obese. The prevalence of positive screening for EDs was 27.7%; it was more common in females (p = 0.013) and those who earned more than 1000 SAR per month (p = 0.011). Female students also exhibited almost twice the odds of having EDs than males (AOR = 1.957; 95% CI = 1.218-3.146; p = 0.006). Furthermore, non-obese students showed decreased odds of having EDs compared with obese students by at least 48% (AOR = 0.517; 95% CI = 0.287-0.929; p = 0.027). Our study revealed a concerning prevalence of ED symptoms and obesity among medical students, suggesting profound implications. Therefore, multicenter studies are needed to assess the generalizability of the results and apply the findings to targeted national campaigns and interventions tailored specifically to medical students.
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Affiliation(s)
- Abdullah A Alrasheed
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh 11495, Saudi Arabia
| | - Nasser M AbuDujain
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh 11495, Saudi Arabia
| | - Samar Almohammedi
- College of Medicine, King Saud University, Riyadh 11495, Saudi Arabia
| | - Rahaf Alrayes
- College of Medicine, King Saud University, Riyadh 11495, Saudi Arabia
| | - Fahad Alajlan
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh 11495, Saudi Arabia
| | - Osama Abdulqader
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh 11495, Saudi Arabia
| | - Majd Albarrak
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh 11495, Saudi Arabia
| | - Khalid H Alharbi
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh 11495, Saudi Arabia
| | - Turky H Almigbal
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh 11495, Saudi Arabia
| | - Mohammed A Batais
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh 11495, Saudi Arabia
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Yu Z, Guo M, Yu B, Wang Y, Yan Z, Gao R. Anorexia nervosa and bulimia nervosa: a Mendelian randomization study of gut microbiota. Front Microbiol 2024; 15:1396932. [PMID: 38784806 PMCID: PMC11111991 DOI: 10.3389/fmicb.2024.1396932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 04/24/2024] [Indexed: 05/25/2024] Open
Abstract
Background Anorexia nervosa (AN) and bulimia nervosa (BN) poses a significant challenge to global public health. Despite extensive research, conclusive evidence regarding the association between gut microbes and the risk of AN and BN remains elusive. Mendelian randomization (MR) methods offer a promising avenue for elucidating potential causal relationships. Materials and methods Genome-wide association studies (GWAS) datasets of AN and BN were retrieved from the OpenGWAS database for analysis. Independent single nucleotide polymorphisms closely associated with 196 gut bacterial taxa from the MiBioGen consortium were identified as instrumental variables. MR analysis was conducted utilizing R software, with outlier exclusion performed using the MR-PRESSO method. Causal effect estimation was undertaken employing four methods, including Inverse variance weighted. Sensitivity analysis, heterogeneity analysis, horizontal multivariate analysis, and assessment of causal directionality were carried out to assess the robustness of the findings. Results A total of 196 bacterial taxa spanning six taxonomic levels were subjected to analysis. Nine taxa demonstrating potential causal relationships with AN were identified. Among these, five taxa, including Peptostreptococcaceae, were implicated as exerting a causal effect on AN risk, while four taxa, including Gammaproteobacteria, were associated with a reduced risk of AN. Similarly, nine taxa exhibiting potential causal relationships with BN were identified. Of these, six taxa, including Clostridiales, were identified as risk factors for increased BN risk, while three taxa, including Oxalobacteraceae, were deemed protective factors. Lachnospiraceae emerged as a common influence on both AN and BN, albeit with opposing effects. No evidence of heterogeneity or horizontal pleiotropy was detected for significant estimates. Conclusion Through MR analysis, we revealed the potential causal role of 18 intestinal bacterial taxa in AN and BN, including Lachnospiraceae. It provides new insights into the mechanistic basis and intervention targets of gut microbiota-mediated AN and BN.
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Affiliation(s)
- Zongliang Yu
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Manping Guo
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Postdoctoral Research Station, China Academy of Chinese Medical Sciences, Beijing, China
- Postdoctoral Works Station, Yabao Pharmaceutical Group Co., Ltd., Yuncheng, China
| | - Binyang Yu
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yiming Wang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zian Yan
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Rui Gao
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Scotto Di Rinaldi S, Sudres JL, Rousseau A, Bouchard JP. [Anorexia nervosa, a familiar and complex pathology]. SOINS; LA REVUE DE REFERENCE INFIRMIERE 2023; 68:20-23. [PMID: 38070976 DOI: 10.1016/j.soin.2023.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Anorexia nervosa affects people of all ages, and has the highest mortality rate of all psychiatric disorders, following medical complications inherent in the disease or suicide. Early and appropriate treatment is crucial to prevent the risk of chronic disease, which may affect one in two anorexics. Severe undernutrition linked to a complex psychopathology calls for the necessary theoretical and clinical knowledge on the part of the caregiver, applied to the dynamics of care, ideally conceived in a transdisciplinary way and involving nursing teams.
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Affiliation(s)
- Stéphane Scotto Di Rinaldi
- Service de pédopsychiatrie Espace-Arthur, Hôpital Salvator, AP-HM, 13009 Marseille, France; Centre d'études et de recherches en psychopathologie et en psychologie de la santé (CERPPS), EA 7411, Université Toulouse Jean-Jaurès, Maison de la recherche, 31058 Toulouse, France
| | - Jean-Luc Sudres
- Centre d'études et de recherches en psychopathologie et en psychologie de la santé (CERPPS), EA 7411, Université Toulouse Jean-Jaurès, Maison de la recherche, 31058 Toulouse, France; DU Art-thérapies et DU Musicothérapie, formation continue, Université Toulouse Jean-Jaurès, Toulouse, France; Clinique Castelviel, hôpital de jour L'Oasis, 31180 Castelmaurou, France
| | - Amélie Rousseau
- Centre d'études et de recherches en psychopathologie et en psychologie de la santé (CERPPS), EA 7411, Université Toulouse Jean-Jaurès, Maison de la recherche, 31058 Toulouse, France
| | - Jean-Pierre Bouchard
- Statistics and Population Studies Department, Faculty of Natural Sciences, University of the Western Cape, Bellville, 7535, Cape-Town, South Africa; Psychologie-criminologie-victimologie (PCV), 33000 Bordeaux, France.
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Melisse B, van Furth EF, de Beurs E. The Saudi-Arabic adaptation of the Body Shape Questionnaire (BSQ34): Psychometrics and norms of the full version and the short version (BSQ8C). Front Psychol 2022; 13:1046075. [PMID: 36532987 PMCID: PMC9754054 DOI: 10.3389/fpsyg.2022.1046075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 10/24/2022] [Indexed: 09/29/2023] Open
Abstract
INTRODUCTION Saudi Arabia experiences elevated levels of body-shape dissatisfaction which might be related to the increased thin ideal. Studies on body-shape dissatisfaction are scarce, mainly because adapted assessment tools are unavailable. This study describes the Saudi-Arabic adaptation of the Body Shape Questionnaire (BSQ34), preliminary examines the psychometric properties and provides normative data. METHODS The BSQ34 was administered in a convenience community sample (N = 867) between April 2017 and May 2018. Receiver-operating-characteristic curve analysis was used to establish discriminant validity, in a subsample (N = 602) in which the Eating Disorder Examination-Shape concern, was administered, the factor structure investigated with confirmatory-factor analyses and T-scores and percentile scores were determined. RESULTS The BSQ34 discriminated well between low and high levels of body-shape dissatisfaction (area-under-the-curve value = 0.93), had high internal consistency and a unidimensional factor structure, and 23.9% appeared at risk for body-shape dissatisfaction. Analyses were repeated for the shortened BSQ8C, which yielded similar results. DISCUSSION The results indicated that the BSQ34 and BSQ8C appeared suitable measurement tools to screen for body-shape dissatisfaction in a Saudi convenience community sample, mainly comprised young, unmarried, and highly educated women. The BSQ34 supplies more information on the type of concerns respondents have, which is worthwhile when the measure is used in a clinical setting; the BSQ8C is recommended as a short screener. As body-shape dissatisfaction is viewed as a risk factor for the development of eating disorder symptoms, screening for body-shape dissatisfaction with reliable tools is important to detect individuals at risk for eating disorder symptoms and may suggest subsequent preventive steps.
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Affiliation(s)
- Bernou Melisse
- Novarum Center for Eating Disorders and Obesity, Amstelveen, Netherlands
- Section Clinical Psychology, Leiden University, Leiden, Netherlands
- GGZ Rivierduinen, Leiden, Netherlands
| | - Eric F. van Furth
- GGZ Rivierduinen, Leiden, Netherlands
- Department of Psychiatry, Leiden University Medical Center, Leiden, Netherlands
| | - Edwin de Beurs
- Section Clinical Psychology, Leiden University, Leiden, Netherlands
- Research Department, Arkin Mental Health Institute, Amsterdam, Netherlands
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