The Social Problems of Morbidly Obese Patients on a Community Level: A Cross-Sectional Study in Saudi Arabia

Figures & data

Table 1 Pearson Correlation Coefficients for the Questionnaire Items

Item Number	Correlation Coefficient
1	**0.660
2	**0.809
3	**0.636
4	**0.710
5	**0.763
6	**0.888
7	**0.760
8	**0.703
9	**0.743
10	**0.832
11	**0.719
12	**0.636
13	**0.778
14	**0.872
15	**0.834
16	**0.780
17	**0.618
18	**0.920
19	**0.887
20	**0.801

Notes: Pearson correlation coefficient value ranged between 0.618 and 0.920, and the overall Cronbach’s alpha measure for the whole questionnaire was 0.859. This gives an indication of high internal consistency coefficients, and it indicates high and sufficient validity and stability of the questionnaire tool. **p≤0.01.

Table 2 Demographic Characteristics of Study Participants

Variable	Frequency (%)
Gender
Female	221 (59.1%)
Age categories
15 to less than 20 years	25 (6.7%)
20 to less than 25 years	48 (12.8%)
25 to less than 30 years	55 (14.7%)
30 to less than 35 years	71 (19.0%)
35 to less than 40 years	73 (19.5%)
40 years and more	102 (27.3%)
Residence
Capital (Riyadh)	297 (79.4%)
Other cities	77 (20.6%)
Educational level
Illiterate	12 (3.2%)
Reads and Writes	7 (1.9%)
Primary	11 (2.9%)
Intermediate	38 (10.2%)
Secondary	113 (30.2%)
Bachelor’s degree	178 (47.6%)
Postgraduate	15 (4.0%)
Marital status
Single	108 (28.9%)
Married	245 (65.5%)
Divorced	14 (3.7%)
Separated	2 (0.5)
Widow	5 (1.3%)
If you are married, then do you have children?
Yes	216 (81.2%)
Employment Status
Employed	202 (54.0%)
Unemployed	116 (31.0%)
Student	56 (15.0%)
Profession
Soldier	38 (10.2%)
Doctor	7 (1.9%)
Teacher	44 (11.8%)
Professor	7 (1.9%)
Engineer	4 (1.1%)
Administrative work	102 (27.3%)
Not applied	164 (43.9%)
Other	8 (2.1%)
Nature of work
Office	89 (23.8%)
Field	40 (10.7%)
Office and Field	72 (19.3%)
Not applied	173 (46.3%)
Income category (per month)
Less than 3000 SR.	115 (30.7%)
3000 to less than 5000 SR.	51 (13.6%)
5000 to less than 7000 SR.	34 (9.1%)
7000 to less than 9000 SR.	42 (11.2%)
9000 to less than 11,000 SR.	47 (12.6%)
11,000 SR. and more	85 (22.7%)

Abbreviation: SR, Saudi Riyal.

Table 3 Participants’ Clinical Profile

Variable	Frequency (%)
Does any of your family members suffer from obesity?
Yes	262 (70.1%)
If yes, which of your family members is suffering from obesity?
Mother	115 (43.9%)
Father	51 (19.5%)
Brother	146 (55.7%)
Sister	138 (52.7%)
Husband	20 (7.6%)
Wife	4 (1.5%)
Son	25 (9.5%)
Daughter	33 (12.6%)
Body Mass Index (BMI)
From 35 kg/m^2 to less than 40 kg/m^2	74 (19.8%)
40 kg/m^2 and above	300 (80.2%)
Time of diagnosis
Less than one year	34 (9.1%)
One year to less than three years	62 (16.6%)
Three years to less than five years	57 (15.2%)
Five years and more	221 (59.1%)
Do you have any diseases that accompanying Obesity?
Yes	221 (59.1%)
Do you have difficulty in movement?
Yes	100 (26.7%)
Comorbidities
Diabetes mellitus	80 (21.4%)
Hypertension	74 (19.8%)
Sleep apnea	67 (17.9%)

Table 4 Obesity Treatment Attempts and Reasons for Choosing Surgery as a Management Option

Variable	Frequency (%)
Have you attempted to treat obesity before being referred to obesity surgery clinics?
Yes	331 (88.5%)
Obesity management procedure
Diet under medical supervision	112 (33.8%)
Diet without medical supervision	96 (29.0%)
Sport	15 (4.5%)
Diet and exercise	108 (32.6%)
Reason for choosing surgery for obesity treatment (more than one answer could be chosen)
Health problems related to obesity	315 (84.2%)
Avoiding being ridiculed for my body shape	143 (38.2%)
I am about to get married	40 (10.7%)
Late childbearing due to obesity	46 (12.3%)
Getting a suitable job	43 (11.5%)

Figure 1 Social problems that patients face at the community level.

Table 5 Mean Social Problem Score Stratified by Participants Characteristics

Variable	Mean (SD)	P-value
Gender
Male	56.1 (22.1)	0.422
Female	57.8 (18.9)
Age categories
15 to less than 20 years	50.1 (20.1)	0.160
20 to less than 25 years	59.3 (22.3)
25 to less than 30 years	58.5 (20.5)
30 to less than 35 years	60.5 (19.2)
35 to less than 40 years	57.5 (21.6)
40 years and more	54.2 (18.5)
Residence
Capital (Riyadh)	56.8 (20.8)	0.602
Other cities	58.1 (18.1)
Educational level
Illiterate	52.6 (16.1)	0.184
Reads and Writes	58.1 (22.6)
Primary	59.7 (22.8)
Intermediate	59.8 (22.0)
Secondary	58.9 (20.0)
Bachelor’s degree	56.5 (19.9)
Postgraduate	56.5 (20.6)
Marital status
Single	57.1 (21.4)	0.576
Married	56.6 (19.6)
Divorced	63.2 (21.4)
Separated	74.0 (31.1)
Widow	54.2 (23.6)
If you are married, then do you have children?
No	53.5 (20.7)	0.171
Yes	57.8 (19.6)
Employment Status
Employed	56.3 (19.8)	0.254
Unemployed	59.5 (20.1)
Student	54.7 (22.1)
Profession
Soldier	60.8 (19.7)	0.767
Doctor	48.3 (24.5)
Teacher	56.8 (18.8)
Professor	53.1 (27.3)
Engineer	56.0 (15.4)
Administrative work	55.2 (20.2)
Not applied	57.9 (20.5)
Other	59.0 (20.8)
Nature of work
Office	55.2 (21.1)	0.635
Field	57.9 (19.0)
Office and Field	55.8 (19.2)
Not applied	57.0 (20.4)
Income category (per month)
Less than 3000 SR.	60.5 (21.6)	0.009***
3000 to less than 5000 SR.	57.8 (20.9)
5000 to less than 7000 SR.	60.4 (18.5)
7000 to less than 9000 SR.	52.8 (19.3)
9000 to less than 11,000 SR.	60.3 (21.3)
11,000 SR and more	51.0 (16.9)
Body Mass Index (BMI)
From 35 kg/m^2 to less than 40 kg/m^2	52.2 (20.8)	0.020*
40 kg/m^2 and above	58.3 (19.9)
Time of diagnosis
Less than one year	53.4 (17.2)	0.214
One year to less than three years	53.2 (21.5)
Three years to less than five years	58.5 (19.4)
Five years and more	58.3 (20.4)
Do you have any diseases that accompanying Obesity?
No	55.1 (19.1)	0.127
Yes	58.4 (20.9)
Do you have difficulty in movement?
No	54.5 (21.7)	0.002**
Yes	63.2 (19.0)
Have you attempt to treat Obesity before being referred to Obesity surgery clinics?
No	53.8 (19.4)	0.266
Yes	57.5 (20.3)

Notes: *p<0.05, **p<0.01, ***p<0.001.

Table 6 Binary Logistic Regression Analysis

Variable	Odds Ratio^§ (95% CI)^a	Odds Ratio^§ (95% CI)^b	Odds Ratio^§ (95% CI)^c
Gender
Male (Reference category)	1.00	1.00	1.00
Female	1.12 (0.74–1.69)	0.83 (0.54–1.28)	0.79 (0.49–1.26)
Age categories
15 to less than 20 years (Reference category)	1.00	1.00	1.00
20 to less than 25 years	1.21 (0.66–2.22)	1.23 (0.66–2.30)	1.25 (0.64–2.44)
25 to less than 30 years	1.14 (0.64–2.02)	1.06 (0.58–1.94)	1.00 (0.52–1.94)
30 to less than 35 years	1.58 (0.93–2.67)	1.49 (0.88–2.53)	1.42 (0.80–2.50)
35 to less than 40 years	1.04 (0.62–1.73)	1.41 (0.83–2.39)	1.59 (0.91–2.77)
40 years and more	0.72 (0.46–1.14)	0.56 (0.33–0.93)*	0.50 (0.28–0.89)*
Residence
Capital (Riyadh) (Reference category)	1.00	1.00	1.00
Other cities	1.10 (0.67–1.82)	0.81 (0.47–1.40)	1.00 (0.92–1.08)
Educational level
Illiterate (Reference category)	1.00	1.00	1.00
Reads and Writes	0.32 (0.09–1.21)	0.66 (0.17–2.47)	0.58 (0.12–2.69)
Primary	1.34 (0.30–6.07)	0.79 (0.15–4.15)	1.18 (0.23–6.18)
Intermediate	1.21 (0.36–4.02)	1.69 (0.51–5.64)	1.71 (0.49–5.97)
Secondary	–	1.04 (0.51–2.11)	1.61 (0.79–3.29)
Bachelor’s degree	1.63 (1.04–2.54)*	1.07 (0.67–1.71)	0.95 (0.57–1.59)
Postgraduate	0.92 (0.61–1.38)	1.08 (0.70–1.65)	0.93 (0.59–1.49)
Marital status
Single (Reference category)	1.00	1.00	1.00
Married	0.98 (0.64–1.50)	0.91 (0.58–1.42)	0.82 (0.51–1.33)
Divorced	1.35 (0.46–3.96)	2.05 (0.70–5.98)	3.09 (1.06–9.06)*
Separated	1.00 (0.06–16.11)	2.00 (0.12–32.24)	2.96 (0.18–47.75)
Widow	0.67 (0.11–4.01)	0.49 (0.06–4.47)	0.73 (0.08–6.63)
If you are married, then do you have children?
No (Reference category)	1.00	1.00	1.00
Yes	1.36 (0.90–2.05)	0.73 (0.37–1.44)	1.01 (0.63–1.62)
Employment Status
Employed (Reference category)	1.00	1.00	1.00
Unemployed	1.22 (0.79–1.90)	1.13 (0.71–1.80)	1.34 (0.82–2.19)
Student	0.71 (0.40–1.27)	1.03 (0.56–1.87)	0.98 (0.51–1.88)
Profession
Soldier (Reference category)	1.00	1.00	1.00
Doctor	0.39 (0.08–2.05)	0.79 (0.15–4.15)	0.48 (0.06–4.07)
Teacher	1.11 (0.59–2.08)	0.72 (0.36–1.45)	0.73 (0.34–1.58)
Professor	0.39 (0.08–2.05)	0.79 (0.15–4.14)	1.18 (0.23–6.18)
Engineer	0.33 (0.03–3.20)	0.66 (0.07–6.42)	0.98 (0.10–9.52)
Administrative work	1.00 (0.63–1.58)	0.83 (0.51–1.35)	0.75 (0.44–1.29)
Nature of work
Office (Reference category)	1.00	1.00	1.00
Field	1.77 (0.90–3.48)	1.08 (0.54–2.15)	0.71 (0.32–1.60)
Office and Field	1.00 (0.60–1.67)	0.85 (0.49–1.48)	0.89 (0.49–1.62)
Income category (per month)
Less than 3000 SR. (Reference category)	1.00	1.00	1.00
3000 to less than 5000 SR.	1.05 (0.58–1.89)	1.10 (0.59–2.05)	1.01 (0.51–1.98)
5000 to less than 7000 SR.	1.30 (0.64–2.64)	0.95 (0.45–2.01)	1.46 (0.68–3.12)
7000 to less than 9000 SR.	0.81 (0.42–1.54)	0.78 (0.38–1.57)	0.78 (0.36–1.70)
9000 to less than 11,000 SR.	1.28 (0.69–2.36)	1.73 (0.93–3.22)	1.62 (0.84–3.12)
11,000 SR. and more	0.59 (0.36–0.97)*	0.42 (0.23–0.75)*	0.24 (0.11–0.52)
Body Mass Index (BMI)
From 35 kg/m^2 to less than 40 kg/m^2 (Reference category)	1.00	1.00	1.00
40 kg/m^2 and above	1.73 (1.03–2.90)*	1.34 (0.77–2.34)	1.59 (0.84–2.99)
Time of diagnosis
Less than one year (Reference category)	1.00	1.00	1.00
One year to less than three years	0.63 (0.36–1.09)	0.86 (0.48–1.55)	0.74 (0.38–1.44)
Three years to less than five years	1.13 (0.64–1.99)	1.31 (0.73–2.34)	1.06 (0.56–2.01)
Five years and more	1.46 (0.96–2.21)	1.17 (0.75–1.82)	1.60 (0.98–2.62)
Do you have any diseases that accompanying Obesity?
No (Reference category)	1.00	1.00	1.00
Yes	1.53 (1.01–2.32)*	1.57 (1.00–2.46)*	1.51 (0.93–2.47)
Do you have difficulty in movement?
No (Reference category)	1.00	1.00	1.00
Yes	1.52 (0.90–2.60)	1.80 (1.05–3.12)*	1.95 (1.08–3.50)*
Have you attempt to treat obesity before being referred to Obesity surgery clinics?
No (Reference category)	1.00	1.00	1.00
Yes	1.62 (0.85–3.09)	1.53 (0.74–3.15)	1.56 (0.70–3.49)

Notes: *p<0.05; ^§Dependent variable: having social problems related to obesity on the community level, ^aCut-off point for social problems is the mean score (score= 57.1), ^bCut-off point for social problems is the upper tertile score (score=65.8), ^cCut-off point for social problems is the upper quartile score (score=73.0).