Prevalence and Associated Predictors and Determinants of Disordered Eating Behaviours (DEBs) Among Female Adolescents in Saudi Arabia

Background
Adolescence is associated with increased vulnerability to diet-related problems. Disordered eating behaviours (DEBs), in particular, are concerned with body image and weight dissatisfaction and can influence intake and growth. Literature on DEBs is scarce in Arab populations, especially in Saudi Arabia. The overall aim of this thesis was to assess the prevalence of DEBs in Saudi adolescents and to explore determinants contributing to these behaviours.
Methods
A systematic review assessing the evidence on the prevalence of DEBs in Saudi Arabia was followed by a sequential mixed-methods study comprising a quantitative survey and qualitative interviews. A survey of 416 female students aged 12–19 years in four Riyadh schools used the EAT-26 questionnaire to explore DEBs prevalence. In-depth interviews with 18 adolescents classified as high-risk of DEBs investigated the main determinants causing DEBs.
Results
The review found that DEBs rates nationwide ranged from 10.2% to 65.5%, with the eastern region having the highest prevalence. Older students had a higher prevalence than younger students, and males reported more DEBs than females. EAT-26 scores indicated that 29.6% of students reported a high-risk of DEBs. Age was a significant predictor of DEBs risk, with the older age group (16–19 years) reporting higher risk than the younger age group (12–15 years) (P=0.017). Interviews concluded that negative cognitions, conscious imitation/copying behaviours, bullying, comparisons, and negative comments were common determinants of DEBs. Some participants indicated that biological and familial variables may increase the risk of DEBs.
Conclusion
This thesis represents the first research exploring the prevalence and primary determinants of DEBs in Saudi female adolescents in Riyadh. The relatively high risk in this age group, and the importance of peers and family members as well as cognition, suggests that interventions to reduce risk need to address both individual factors and social pressures.