Emotional eating, body mass index, and sex differences: a national cross-sectional study of Saudi adults
13 affiliations
- 1Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- 2Department of Food Science and Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh, 11451 Saudi Arabia
- 3Performance, Exercise, and Health Sciences Unit, King Fahad Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- 4Department of Biology, College of Science, King Khalid University, Asir, Abha Saudi Arabia
- 5Endocrinology & Diabetes Center, King Fahad Hospital, Al-Ahsa, Saudi Arabia
- 6Nutrition Unit, Dhahran Eye Specialist Hospital, Eastern Health Cluster, Dhahran, Saudi Arabia
- 7Department of Community Health, College of Applied Medical Sciences, Northern Border University, Arar, Saudi Arabia
- 8Department of General Studies, Al-Qurayyat Technical College, Technical and Vocational Training Corporation (TVTC), Al-Qurayyat, Saudi Arabia
- 9Hail Health Cluster, Hail General Hospital, Hail, Saudi Arabia
- 10Department of Basic Science, Preparatory Year Deanship, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
- 11Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, 11451 Saudi Arabia
- 12Department of Social Sciences, College of Arts, University of Hail, Hail, Saudi Arabia
- 13Editome: Precision Gene Editing Unit, King Fahad Medical Research Center, King Abdulaziz University, Jeddah, 21589 Saudi Arabia
Abstract
Background: Emotional eating (EE), eating in response to emotions rather than physiological hunger, is associated with higher energy-dense food intake and greater body weight. Population-scale estimates of EE prevalence, its association with body mass index (BMI), and how these differ by sex are scarce in the Middle East, limiting region-specific prevention efforts.
Methods: In this cross-sectional study spanning all 13 administrative regions of Saudi Arabia, 4,412 adults (2,648 women and 1,764 men), aged 18–65, completed an online survey including the validated Arabic Emotional Eating Scale (subscales: sadness/irritability, exhaustion, excitement, distress), and self-reported height and weight. High EE was defined as a total score at or above the 75th percentile. Differences by sex, BMI category, and age group were tested non-parametrically; the EE-BMI association was analyzed using generalized linear models with a gamma distribution and log link, adjusted for sociodemographic, behavioral, and clinical factors.
Results: Approximately 25% of participants met the high-EE criterion, with marked regional variation (ranging from 17.1% in Qassim to 31.4% in Northern Borders). EES scores varied significantly across sex, BMI categories, and age groups (all p < 0.001). EE was associated with higher BMI (Exp(B) = 1.001, 95% CI 1.000–1.001), although statistically significant, the observed effect sizes were small in magnitude. Thus, prevents overinterpretation of statistical significance. Among EES subscales, the most pronounced association was observed for the distress subscale (Exp(B) = 1.004, 95% CI 1.002–1.005). The EE–BMI association was consistent across all subscales among women (all p < 0.001), whereas no significant associations were observed among men; sex × emotional eating interaction terms confirmed that the association differed significantly by sex (all p < 0.001).
Conclusion: In this national sample, higher emotional eating, particularly distress-related eating, was associated with higher BMI among women but not men, suggesting sex-specific patterns that warrant further research in diverse populations. The observed significant regional differences in EE prevalence and the higher EES scores among women suggest the need for regionally personalized, sex-sensitive interventions that reflect local dietary behaviors and social norms. National longitudinal prospective studies including clinically measured anthropometrics are needed to further establish the relationship between EE and obesity-related outcomes in this population.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12889-026-28366-1.
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BibTeX
@article{alghamdi2026emotional,
title = {{Emotional eating, body mass index, and sex differences: a national cross-sectional study of Saudi adults}},
author = {Rehab Y. Alghamdi and Arwa S. Almasaudi and Hayat Alzahrani and Nehal S. Alsharif and Eram Albajri and Albatul S. Almousa and Sarah A. Al-Sultan and Mona A. Mousa Alamir and Nasser O. Alsubaie and Abdulsalam E. Alkuwaykibi and Marzouqah F. Alshammari and Malak M. Alanazi and Alaa A. Haridi and Lugain T. Marashli and Aref Alsehaimi and Soaad Alsulami},
journal = {BMC Public Health},
year = {2026},
month = aug,
doi = {10.1186/s12889-026-28366-1},
url = {https://doi.org/10.1186/s12889-026-28366-1},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Emotional eating, body mass index, and sex differences: a national cross-sectional study of Saudi adults
AU - Rehab Y. Alghamdi
AU - Arwa S. Almasaudi
AU - Hayat Alzahrani
AU - Nehal S. Alsharif
AU - Eram Albajri
AU - Albatul S. Almousa
AU - Sarah A. Al-Sultan
AU - Mona A. Mousa Alamir
AU - Nasser O. Alsubaie
AU - Abdulsalam E. Alkuwaykibi
AU - Marzouqah F. Alshammari
AU - Malak M. Alanazi
AU - Alaa A. Haridi
AU - Lugain T. Marashli
AU - Aref Alsehaimi
AU - Soaad Alsulami
PY - 2026
DA - 2026/08/17
JO - BMC Public Health
DO - 10.1186/s12889-026-28366-1
UR - https://doi.org/10.1186/s12889-026-28366-1
AB - Background: Emotional eating (EE), eating in response to emotions rather than physiological hunger, is associated with higher energy-dense food intake and greater body weight. Population-scale estimates of EE prevalence, its association with body mass index (BMI), and how these differ by sex are scarce in the Middle East, limiting region-specific prevention efforts. Methods: In this cross-sectional study spanning all 13 administrative regions of Saudi Arabia, 4,412 adults (2,648 women and 1,764 men), aged 18–65, completed an online survey including the validated Arabic Emotional Eating Scale (subscales: sadness/irritability, exhaustion, excitement, distress), and self-reported height and weight. High EE was defined as a total score at or above the 75th percentile. Differences by sex, BMI category, and age group were tested non-parametrically; the EE-BMI association was analyzed using generalized linear models with a gamma distribution and log link, adjusted for sociodemographic, behavioral, and clinical factors. Results: Approximately 25% of participants met the high-EE criterion, with marked regional variation (ranging from 17.1% in Qassim to 31.4% in Northern Borders). EES scores varied significantly across sex, BMI categories, and age groups (all p < 0.001). EE was associated with higher BMI (Exp(B) = 1.001, 95% CI 1.000–1.001), although statistically significant, the observed effect sizes were small in magnitude. Thus, prevents overinterpretation of statistical significance. Among EES subscales, the most pronounced association was observed for the distress subscale (Exp(B) = 1.004, 95% CI 1.002–1.005). The EE–BMI association was consistent across all subscales among women (all p < 0.001), whereas no significant associations were observed among men; sex × emotional eating interaction terms confirmed that the association differed significantly by sex (all p < 0.001). Conclusion: In this national sample, higher emotional eating, particularly distress-related eating, was associated with higher BMI among women but not men, suggesting sex-specific patterns that warrant further research in diverse populations. The observed significant regional differences in EE prevalence and the higher EES scores among women suggest the need for regionally personalized, sex-sensitive interventions that reflect local dietary behaviors and social norms. National longitudinal prospective studies including clinically measured anthropometrics are needed to further establish the relationship between EE and obesity-related outcomes in this population. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12889-026-28366-1.
SN - 1471-2458
ER -