Eating Disorders in United Arab EmiratesUAE It prevalence

Eating Disorders in United Arab Emirates(UAE) It prevalence and determents among Emirati young females Alla Mansour Mohamed Supreme Council for Family Affaires in Sharjah- Health Promotion Department

Introduction Eating concerns and disorders lie continuum ranging from mild dissatisfaction with one’s body shape to serious eating disorders. Body Dissatisfacti on Dieting Behavior Disordered Eating Clinically Significant Eating Disorder

Etiology Multifactorial determinants of eating disorders: Intrapersonal Familial Sociocultural • • • Communication patterns • Parental Expectations • Weight concerns • Dieting behaviors of siblings • Family • Norms • Food availibilty • Peer norms and behaviors • Abuse experience • Media introverted Low self esteem Age Obsession and perfectionist • Genetics • Gender

Introduction • Worldwide concern • Disordered Eating disorders (DED) and body dissatisfaction (BD) are in raising among adolescent female in Western countries. • Recently, high prevalence of DED confirmed among Arab females in Arab countries.

Introduction • This is the first study in the UAE where in-depth interviews were conducted and culture specific determinants of DEA were identified. • (Tsai, et al. , 2011) (Musaiger, et al. , 2013)

Study objectives: 1 - Identify current prevalence of DEA in Sharjah. 2 - Identify prevalence of BD among Emirati adolescent school girls in Sharjah. 3 - Evaluate the relationship between occurrence of vomiting and DEA. 4 - Identify the specific determinants to DEA among Emirati adolescent schools girls in Sharjah through unstructured individualized interviews.

Method • Cross-sectional study • Sample size: 508 students. • A random stratification sampling technique used for classes selections. • One section of each grade from the grades 10, 11, 12 in each school were selected randomly. • All students in that section that meet the inclusion criteria included in the study.

Method Only government schools Inclusion + Exclusion Criteria • • • Age (14 -18) Grade (10, 11, 12) Gender (female) Location (Sharjah) School type (public) Nationality (Emirati) Free of medical conditions Signed consent form Students who do not meet the inclusion criteria excluded from the study. 1 - Emiratis girls are commonly in government schools. 2 - Socioeconomic factor have no significant relationship with Eating disorder. Boys excluded 1 - Girls have higher eating disorder occurrence rate based on the literature. (Eapen, Mabrouk, & Bin-Othman, 2006; Neumark-Stainer&Hannan, 2000; Musaiger, et al. , 2013; Radmanovic-Burgic, et al. , 2011)

Measurement tools •

BFR Scale Figure 1, The BFR sclae conducted by Harris CV, et al, 2007.

Results and discussion Prevalence of DEA in Sharjah Body dissatisfaction and EAT -26 results Body dissatisfaction and BMI Self-Induced vomiting and EAT 26 Eating disorders determinants in the Sharjah

• The results confirm the first hypotheses that DEA is at the rise among adolescent schools girls in Sharjah as compared to previous literature. (1) Prevalence of DEA among Female Adolescents in Sharjah (N=508) 38% Without DEA 62% With DEA

Precentage The Precentage of DEA in UAE 40 35 30 25 20 15 10 5 0 37. 8 37. 4 19. 2 2014 2013 years 2006 In 8 years, an increase of 18. 6%.

The percentage of DEA among adolescents girls in Arab countries Country Percentage Kuwait ( 2013) 42. 8 % Jordan ( 2013) 42. 7% UAE ( 2014) 37. 8 % Syria ( 2013) 32% Oman ( 2002) 29. 4% Saudi Arabia ( 1999) 24. 6% Egypt ( 2011) 11. 2%

Body dissatisfaction and EAT-26 results Figure 3: Correlation between EAT 26 Results and Actual-Desired Discrepancy (N= 508). Body Satisfaction and EAT-26 Scores 57. 8 60 44. 9 38. 6 28. 6 Percentages 50 40 Non- DEA 30 13. 5 16. 5 20 10 0 P-value< 0. 05 Desire to lose weight Body Satisfaction Satisfied with Desire to gain current weight DEA

Body dissatisfaction and BMI • Significant relationship. • Overweight and obese participants have the highest body satisfaction discrepancy. • In line with other researches stating that BD is significantly correlated with overweight and obesity. • (Radmanovic-Burgic, Gaveic, & Burgic, 2011; Mousa, Mashal, Al-Domi, & Jibril, 2010; Madanat, Brown, & Hawks, 2007)

Self-Induced vomiting and EAT 26 NONE (1) Non-DEA and Occurrence of Vomiting Most of the time Usually All the time (2) DEA and Occurrence of Vomiting NONE Most of the time Usually All the time 2% 1% 9% 4% 9% 8% 74% 92% P-value< 0. 05

Figure 5: Unstructured Interviews Answers (N=52) 76. 90% 73. 10% 77. 00% 76. 00% 75. 00% 71. 07% 74. 00% 73. 00% 72. 00% 71. 00% 70. 00% 69. 00% Family Media Bullied at either home or school or both

Recommendation 1. Increasing the awareness of DEA among families and teachers rather than adolescents. 2. Further investigation is required for bulimia or selfinduced vomiting for the same age group. 3. Authorities should initiate programs regarding to ED in high schools. 4. In depth studies to further investigate ED in UAE are needed.

Conclusion • The study shows a high prevalence of eating disorder and body dissatisfaction among schools girls in Sharjah. • The major leading factors to these conditions are family, media, and bullying. • Future studies should emphasis in educational campaigns in schools and within families targeting eating disorders to prevent further decline in health of the young generation in UAE.

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