Associations Between Restrained, Emotional, and External Eating Behaviors and Obesity Among Saudi Adults: A...

Obesity has reached alarming levels globally and across the Middle East. In Saudi Arabia, approximately one-third of Saudi adults have obesity, representing a major public health concern. Understanding behavioral factors underlying obesity is essential; therefore, this study aimed to investigate the association between eating styles and obesity indicators among Saudi adults and to examine gender differences in these associations.

This cross-sectional study included 997 adult (405 males and 592 females) aged ≥ 18 years residing in Saudi Arabia. Data were collected using a self-administered questionnaire covering sociodemographic characteristics, anthropometric measures, health status. Eating behaviors were assessed using the validated Dutch Eating Behavior Questionnaire (DEBQ), which measures restrained, emotional, and external eating styles. Regression models were used to examine gender differences in mean eating style scores and to assess associations between eating styles, categorical BMI, and body fatness.

The mean age of participants was 37.05 ± 13.39 years. Significant gender differences were observed in BMI, body fatness, and physical activity levels. Females demonstrated higher restrained eating scores compared with males (β = -0.14; 95% CI: -0.24, -0.04; p = 0.008). Participants with obesity exhibited higher emotional eating scores, while external eating was more prevalent among underweight participants. Body fatness was significantly associated with emotional and external eating but not restrained eating.

BMI status appears to be associated with specific eating styles, particularly unhealthy eating behaviors. These findings highlight the importance of behavioral-focused nutritional interventions that support eating regulation rather than emphasizing weight loss alone.