Understanding eating disorders in the Middle East: body dissatisfaction and westernization in Saudi Arabia and Turkey
Year: 2025
Type: article
Study design: Observational Study
Abstract: Body dissatisfaction is one of the maintaining factors of eating disorders and a well-known risk factor for their development. It was assumed that body dissatisfaction did not afflict non-Western countries. However, body dissatisfaction is reported in non-Western countries, and to what extent westernization is associated with body dissatisfaction and subsequent eating disorders is unknown. The purpose of the present study is to examine the association between Western acculturation and body dissatisfaction in Saudi Arabia and Turkey, and to determine the measurement invariance of the Body Shape Questionnaire. The Body Shape Questionnaire and the adapted version of the Acculturation Rating Scale for Mexican–Americans II were administered to convenience samples in Saudi Arabia (n = 746) and Turkey (n = 363). A hierarchical multiple linear regression analysis was conducted with body dissatisfaction as the dependent variable and cultural orientation as the independent variable. Citizenship status, BMI, and sex were included as covariates. A multi-group CFA compared the item intercepts of the Body Shape Questionnaire in the two non-Western samples with a Dutch community sample (n = 1651). The Body Shape Questionnaire scores differed (p = 0.036) between individuals who had lived abroad in a Western country (M = 88.2, SD = 38.1) for at least six months and those who had not (M = 82.0, SD = 36.5). The BMI, but not cultural orientation, was associated with body dissatisfaction (B = 2.4, R = 0.4, R square = 0.18; p < 0.001). The multi-group CFA indicated that the Body Shape Questionnaire had a single-factor structure, and the item intercepts were similar across samples (CFI = 0.92; RMSEA = 0.059; RMSEA 90% CI 0.50-0.68; SRMR = 0.07). Future research should evaluate preventative programs targeting westernization-driven sedentary lifestyles. The Body Shape Questionnaire can be utilized across cultures and may help further the understanding of body dissatisfaction and eating disorders in the Middle East. Body dissatisfaction, or being unhappy with one’s body shape or size, is an important maintaining and risk factor for eating disorders. It was assumed that body dissatisfaction was only prevalent in Western countries. However, research shows that body dissatisfaction is also present in non-Western countries. It remains unclear, however, whether this increase is associated with Western cultural influences. The present study examined the association between Western acculturation and body dissatisfaction in two non-Western countries: Saudi Arabia and Turkey. The current study also investigated whether a screening tool for body dissatisfaction was interpreted similarly over these two countries compared to a Western sample. The results showed that body mass index was associated with body dissatisfaction, but cultural orientation was not. In addition, statistical analyses supported that the Body Shape Questionnaire had the same single-factor structure, and the items were interpreted similarly across all cultural groups, indicating that it is a valid tool for use in various settings and may help further our understanding of body image and eating disorders in the Middle East.
Source: Journal of Eating Disorders
Authors: Bernou Melisse, Hayriye Gulec, Lot Sternheim
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $2,190
OpenAlex ID: W4416780240