Exploring Weight Stigma in Saudi Arabia: A Nationwide Cross-Sectional Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Sampling and Sample Size
2.3. Participant Recruitment
2.4. Survey and Outcome Measures
3. Statistical Analysis
4. Results
4.1. Demographics and Response Rate
4.2. Prevalence of WS
4.3. Associations among WS, Lifestyle, and Basic Nutritional Knowledge
4.4. Associations between WS and Current Weight Management-Related Variables
4.5. Factors Associated with Higher Weight Stigma
5. Discussion
5.1. Results Summary
5.2. WS Prevalence
5.3. WS and Obesity
5.4. WS and Bariatric Surgery
5.5. WS and Waterpipe Smoking
5.6. WS and Nutrition Knowledge
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Demographic Characteristics | Female n (%) | Male n (%) | Total n (%) |
---|---|---|---|
Age Group | |||
18–19 | 120 (47.1) | 135 (52.9) | 255 (5.4) |
20–29 | 827 (53.1) | 729 (46.9) | 1556 (33.0) |
30–39 | 469 (46.5) | 540 (53.5) | 1009 (21.4) |
40–49 | 577 (55.3) | 467 (44.7) | 1044 (22.2) |
50–59 | 260 (46.8) | 295 (53.2) | 555 (11.8) |
60+ | 105 (36.2) | 185 (63.8) | 290 (6.2) |
Region | |||
Aljouf | 180 (49.9) | 181 (50.1) | 361 (7.7) |
Northern Borders | 181 (50.1) | 180 (49.9) | 361 (7.7) |
Tabuk | 182 (50.3) | 180 (49.7) | 362 (7.7) |
Hail | 179 (49.9) | 180 (50.1) | 359 (7.6) |
Madinah | 184 (50.3) | 182 (49.7) | 366 (7.8) |
Qassim | 181 (50.1) | 180 (49.9) | 361 (7.7) |
Makkah | 181 (50.3) | 181 (50.0) | 362 (7.7) |
Riyadh | 183 (50.3) | 181 (49.7) | 364 (7.7) |
Eastern Region | 180 (50.0) | 180 (50.0) | 360 (7.6) |
Baha | 181 (49.7) | 183 (50.3) | 364 (7.7) |
Asir | 184 (50.3) | 182 (49.7) | 366 (7.8) |
Jazan | 181 (50.1) | 180 (49.9) | 361 (7.7) |
Najran | 181 (50.0) | 181 (50.0) | 362 (7.7) |
Sex | |||
Female | - | - | 2358 (50.1) |
Male | - | - | 2351 (49.9) |
Educational Level | |||
High School or Less | 894 (49.9) | 899 (50.1) | 1973 (38.1) |
Undergraduate Diploma | 238 (41.2) | 339 (58.8) | 577 (12.3) |
Bachelor’s Degree | 1145 (54.5) | 957 (45.5) | 2102 (44.6) |
Postgraduate Degree (Master’s/PhD) | 80 (33.9) | 156 (66.1) | 236 (5.0) |
Variable | Lower WS * n (%) | Higher WS n (%) | Chi-Square p-Value |
---|---|---|---|
Sex | |||
Male | 1351 (57.5) | 1000 (42.5) | <0.001 |
Female | 1174 (49.8) | 1184 (50.2) | |
Age Group | |||
18–19 | 135 (52.9) | 120 (47.1) | 0.023 |
20–29 | 859 (55.2) | 697 (44.8) | |
30–39 | 554 (54.9) | 455 (45.1) | |
40–49 | 510 (48.9) | 534 (51.1) | |
50–59 | 303 (54.6) | 252 (45.4) | |
60+ | 164 (56.6) | 126 (43.4) | |
Region | |||
Jouf | 199 (55.1) | 162 (44.9) | <0.001 |
Northern Border | 165 (45.7) | 196 (54.3) | |
Tabuk | 193 (53.3) | 169 (46.7) | |
Hail | 223 (62.1) | 136 (37.0) | |
Madinah | 206 (56.3) | 160 (43.7) | |
Qassim | 213 (59.0) | 148 (41.0) | |
Riyadh | 185 (3.9) | 179 (49.2) | |
Eastern Region | 196 (54.4) | 164 (45.6) | |
Baha | 205 (56.3) | 159 (43.7) | |
Asir | 181 (49.5) | 185 (50.5) | |
Jazan | 212 (58.7) | 149 (41.3) | |
Najran | 160 (44.2) | 202 (55.8) | |
Education Level | |||
High School or Less | 966 (53.9) | 827 (46.1) | 0.591 |
Undergraduate Diploma | 308 (53.4) | 269 (46.6) | |
Bachelor’s Degree | 1114 (53.0) | 988 (47.0) | |
Postgraduate Degree (Master’s/PhD) | 136 (57.6) | 100 (42.4) |
Variable | Lower WS n (%) | Higher WS n (%) | Chi-Square p-Value |
---|---|---|---|
Overall Health | |||
Great | 795 (61.1) | 507 (38.9) | <0.001 |
Very Good | 902 (54.7) | 748 (45.3) | |
Good | 526 (49.3) | 540 (50.7) | |
Normal | 265 (44.7) | 328 (55.3) | |
Bad | 37 (37.8) | 61 (62.2) | |
Trouble Sleeping | |||
Yes | 1023 (46.4) | 1161 (53.2) | <0.001 |
No | 1502 (59.5) | 1023 (40.5) | |
Risk of Depression | |||
Yes | 196 (35.4) | 357 (64.6) | <0.001 |
No | 2329 (56.0) | 1827 (44.0) | |
Sedentary Lifestyle | |||
1–2 h | 455 (62.4) | 274 (37.6) | <0.001 |
3–4 h | 655 (54.0) | 557 (46.0) | |
5–6 h | 623 (52.1) | 572 (47.9) | |
More than 6 | 791 (50.3) | 781 (49.7) | |
Smoking Cigarette | |||
Daily Smoker | 227 (53.9) | 237 (46.1) | 0.017 |
Occasional (Social) Smoker | 129 (45.4) | 115 (54.6) | |
Nonsmoker | 2118 (54.2) | 1792 (45.8) | |
Smoking Waterpipe | |||
Daily Smoker | 96 (55.8) | 76 (44.2) | 0.005 |
Occasional (Social) Smoker | 184 (45.9) | 217 (54.1) | |
Nonsmoker | 2244 (54.3) | 1981 (45.7) | |
Nutritional Knowledge Score | |||
0 out of 4 | 974 (50.4) | 960 (49.6) | 0.001 |
1 out of 4 | 515 (54.2) | 436 (45.8) | |
2 out of 4 | 500 (58.8) | 351 (41.2) | |
3 out of 4 | 359 (55.0) | 294 (45.0) | |
4 out of 4 | 177 (55.3) | 143 (44.7) |
Variable | Lower WS n (%) | Higher WS n (%) | Chi-Square p-Value |
---|---|---|---|
BMI Category * | |||
Underweight | 189 (66.8) | 94 (33.2) | <0.001 |
Normal | 1331 (67.5) | 641 (32.5) | |
Overweight | 682 (47.7) | 749 (52.3) | |
Obese | 323 (31.6) | 700 (68.4) | |
Weight Misclassification | |||
No | 1516 (55.5) | 1217 (44.5) | 0.003 |
Yes | 1009 (51.1) | 967 (48.9) | |
Current Weight Management Action | |||
Lose Weight | 720 (38.5) | 1149 (61.5) | >0.001 |
Manage the Current Weight | 722 (70.1) | 308 (29.9) | |
Gain Weight | 217 (59.3) | 149 (40.7) | |
Nothing | 866 (60.0) | 578 (40.0) | |
Received Doctor Advice About Your Weight | |||
Yes | 308 (35.4) | 563 (64.6) | <0.001 |
No | 2216 (56.8) | 1621 (42.2) | |
Had Bariatric Surgery | |||
Yes | 77 (28.5) | 193(71.5) | <0.001 |
No | 2448 (55.1) | 1991 (44.9) |
Variable | Df | Sig. | Odds Ratio | 95% C.I. for EXP (B) | |
---|---|---|---|---|---|
Lower | Upper | ||||
Age | 1 | 0.000 | 0.989 | 0.984 | 0.994 |
Region $ | 12 | 0.000 | |||
Jouf | 1 | 0.183 | 1.247 | 0.901 | 1.727 |
Northern Border * | 1 | 0.000 | 1.980 | 1.431 | 2.739 |
Tabuk * | 1 | 0.029 | 1.432 | 1.037 | 1.977 |
Madinah | 1 | 0.145 | 1.274 | 0.920 | 1.764 |
Qassim | 1 | 0.454 | 1.132 | 0.819 | 1.565 |
Macca * | 1 | 0.036 | 1.413 | 1.022 | 1.954 |
Riyadh * | 1 | 0.042 | 1.400 | 1.013 | 1.936 |
Eastern Region | 1 | 0.086 | 1.331 | 0.961 | 1.845 |
Baha * | 1 | 0.047 | 1.391 | 1.005 | 1.925 |
Asir * | 1 | 0.001 | 1.695 | 1.227 | 2.342 |
Jazan | 1 | 0.163 | 1.263 | 0.910 | 1.754 |
Najran * | 1 | 0.000 | 2.119 | 1.529 | 2.938 |
Overall Health (with Bad as the reference category) | 4 | 0.004 | |||
Great | 1 | 0.200 | 0.732 | 0.454 | 1.180 |
Very Good | 1 | 0.446 | 0.833 | 0.521 | 1.332 |
Good | 1 | 0.760 | 0.929 | 0.579 | 1.490 |
Normal | 1 | 0.616 | 1.131 | 0.699 | 1.833 |
Trouble Sleeping (Yes) * | 1 | 0.000 | 1.371 | 1.199 | 1.567 |
Sedentary Lifestyle (with 1–2 h as the reference category) | 3 | 0.000 | |||
3–4 h * | 1 | 0.000 | 1.511 | 1.229 | 1.858 |
5–6 h * | 1 | 0.000 | 1.500 | 1.218 | 1.848 |
More than 6 * | 1 | 0.000 | 1.527 | 1.246 | 1.871 |
Smoking Waterpipe (with Nonsmoker as the reference category) | 2 | 0.013 | |||
Daily Smoker * | 1 | 0.004 | 1.803 | 1.208 | 2.691 |
Occasional (Social) Smoker * | 1 | 0.043 | 1.429 | 1.012 | 2.018 |
Nutritional Knowledge Score (with 0 out of 4 as the reference category) | 4 | 0.000 | |||
1 out of 4 * | 1 | 0.005 | 0.782 | 0.659 | 0.929 |
2 out of 4 * | 1 | 0.000 | 0.614 | 0.511 | 0.737 |
3 out of 4 * | 1 | 0.042 | 0.813 | 0.665 | 0.993 |
4 out of 4 * | 1 | 0.021 | 0.734 | 0.563 | 0.955 |
BMI Categories (with Underweight as the reference category) | 3 | 0.000 | |||
Normal | 1 | 0.194 | 1.211 | 0.907 | 1.618 |
Overweight * | 1 | 0.000 | 2.372 | 1.740 | 3.232 |
Obese * | 1 | 0.000 | 3.930 | 2.837 | 5.444 |
Current Weight Management Action (with Nothing as the reference category) | 3 | 0.000 | |||
Lose Weight * | 1 | 0.000 | 1.756 | 1.496 | 2.062 |
Manage the Current Weight * | 1 | 0.002 | 0.747 | 0.621 | 0.897 |
Gain Weight | 1 | 0.161 | 1.205 | 0.928 | 1.565 |
Doctor Advice About Your Weight (Yes) * | 1 | 0.000 | 1.553 | 1.305 | 1.849 |
Had Bariatric Surgery (Yes) * | 1 | 0.000 | 2.075 | 1.529 | 2.815 |
Risk of Depression (At Risk) * | 1 | 0.000 | 1.683 | 1.358 | 2.087 |
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Althumiri, N.A.; Basyouni, M.H.; AlMousa, N.; AlJuwaysim, M.F.; Alhamdan, A.A.; Al-Qahtani, F.S.; BinDhim, N.F.; Alqahtani, S.A. Exploring Weight Stigma in Saudi Arabia: A Nationwide Cross-Sectional Study. Int. J. Environ. Res. Public Health 2021, 18, 9141. https://doi.org/10.3390/ijerph18179141
Althumiri NA, Basyouni MH, AlMousa N, AlJuwaysim MF, Alhamdan AA, Al-Qahtani FS, BinDhim NF, Alqahtani SA. Exploring Weight Stigma in Saudi Arabia: A Nationwide Cross-Sectional Study. International Journal of Environmental Research and Public Health. 2021; 18(17):9141. https://doi.org/10.3390/ijerph18179141
Chicago/Turabian StyleAlthumiri, Nora A., Mada H. Basyouni, Norah AlMousa, Mohammed F. AlJuwaysim, Adel A. Alhamdan, Faisal Saeed Al-Qahtani, Nasser F. BinDhim, and Saleh A. Alqahtani. 2021. "Exploring Weight Stigma in Saudi Arabia: A Nationwide Cross-Sectional Study" International Journal of Environmental Research and Public Health 18, no. 17: 9141. https://doi.org/10.3390/ijerph18179141
APA StyleAlthumiri, N. A., Basyouni, M. H., AlMousa, N., AlJuwaysim, M. F., Alhamdan, A. A., Al-Qahtani, F. S., BinDhim, N. F., & Alqahtani, S. A. (2021). Exploring Weight Stigma in Saudi Arabia: A Nationwide Cross-Sectional Study. International Journal of Environmental Research and Public Health, 18(17), 9141. https://doi.org/10.3390/ijerph18179141