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Introduction Maladaptive eating behaviors are emerging as the most significant determinants of obesity with a promising role in intervention. In the absence of a standardized tool to assess eating variations, an Eating Error Score (EES) tool was devised which comprised five zones for evaluating the severity of obesogenic behaviors as well as the specific area(s) with the highest susceptibility. This pilot study was aimed at evaluating the effectiveness of the EES in quantitating the eating behavior errors associated with excess weight and identifying the most affected zones. Methods The EES questionnaire was designed to explore potential disturbances in five zones of eating behavior related to the impetus to eat (Munger), meal choices and attentiveness to cravings (Impulsive), consumption speed (Speed feeding), cues to stop ingestion (Indulgent) and the social aspect of eating (Relationship). The questionnaire was conducted on adults with varying body mass index (BMI) attending governmental outpatient clinics. The correlation between EES and BMI was determined through Pearson Coefficient. Results A total of 204 participants completed the EES questionnaire. There were 72 males and 132 females with a mean BMI of 27.63 ± 6.16 kg/m2 and with nearly equal distribution between normal weight (37.2%), overweight (32.4%), and obese (29.4%) individuals. Nearly 75% of our cohort had a moderate total EES, and the remainder was equally distributed between the mild and severe ranges. A weak but significant correlation was observed between total EES and BMI (r=0.275, p<0.001) suggesting increasing obesogenic styles in participants with excess weight. In addition, a similar weak but significant correlation was noted between Body Mass Index and the Munger and Impulsive zones (r=0.266 and 0.258 and p<0.001, respectively) suggesting more severe maladaptive eating behaviors in these areas. No correlation was found with the Speed feeding, Indulgent, and Relationship zones. Conclusion The EES may be a useful tool for assessing the extent of maladaptive eating behaviors, which predispose individuals to weight gain and sabotage their weight loss efforts. Undoubtedly, the utility of the tool needs to be corroborated in large population studies. Further, identifying the specific operant zones may show promise as many of these habits are potentially modifiable and can be targeted for weight control, most notably those associated with the Munger and Impulsive zones.
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BACKGROUND: Obesity is the single most burdensome lifestyle disease, which has reached epidemic proportions. This study aimed to examine the eating behavior patterns and beliefs in a group of adolescents living in the United Arab Emirates (UAE). PROCEDURE: A questionnaire was administered to adolescents (aged 11 and 18 years) attending outpatients' clinics at governmental health facilities. Informed consent was obtained, and the questionnaire was available in English or Arabic languages. RESULTS: In all, 36 adolescent subjects participated in our study with 12 males and 24 females. UAE nationals constituted 72% of our participants and 28% were of other ethnic backgrounds; 75% were overweight to obese with 17% normal and 8% underweight. The majority of patients were healthy with only 6 patients suffering chronic medical diseases. We uncovered that in less than half of our cohort, the decision to eat came directly from the individuals themselves, but it was more influenced by their families. Food consumption was largely in response to physical hunger with the sensation perceived in the upper abdomen by one-third and the remainder localizing it to various other areas. Excessive caloric intake with frequent meals and snacks was also reported. Our study subjects decided what to consume mainly based on what appeared appetizing, followed by availability and cravings and to a lesser extent based on health recommendations. Excessive speed of food ingestion was self-reported in the majority of participants. Moreover, almost half of the adolescents were unable to turn down food offerings from their close family members and over one-fourth were unable to refuse food from other persons. Common symptoms reported included dysphoric mood, disordered sleep, decreased energy and concentration difficulties as well as low self-esteem. CONCLUSION: Our study uncovered certain eating behaviors in the cohort of adolescents, which may be important in promoting weight gain. These included misconceived hunger signals, excessive frequency, amount and speed of food consumption as well as more focus on food taste, inattentiveness to cravings and a strong social influence on food intake decisions. The findings of our study aim to shed some light on the eating patterns among adolescents and encourage research to investigate eating behaviors on an expanded scale evaluating ethnic, gender and age-related differences.
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BACKGROUND: The prevalence of sellar masses (SMs) is reported in Europe and North America but only limited data are available from the Middle East and North Africa (MENA) region. OBJECTIVES: Assess the prevalence and characteristics of SMs in Al Ain city, United Arab Emirates. DESIGN: Retrospective, descriptive multicenter study. SETTING: Three endocrine centers in Al Ain. PATIENTS AND METHODS: All patients diagnosed with SMs in the city of Al Ain, Emirate of Abu Dhabi, between 2011 and 2016 were evaluated. Cases were identified using ICD 9 and 10 codes and demographic and clinical data were collected. The prevalence rate was calculated for patients alive and residing in Al Ain city until 31 December 2016. MAIN OUTCOME MEASURES: Clinical presentations and prevalence rate. SAMPLE SIZE: 272. RESULTS: The mean (SD) age on presentation was 40.8 (14.3) years (range: 6-114 years, median: 40.0). The 170 (61.8%) females and 128 (46.5%) were native citizens of the United Arab Emirates. Two hundred and forty five (90%) patients had pituitary adenomas (PAs) while 27 (10%) had non-pituitary sellar lesions. The four most common SMs were prolactinoma (n=139, 51.1%), nonfunctioning adenoma (NFA) (n= 69, 25.4%), somatotroph adenoma (n=32, 11.8%) and craniopharyngioma (n=15, 5.5%). Patients with prolactinoma, corticotroph adenoma, and Rathke's cleft cyst had small sellar masses (<1 centimeter) while the majority of patients with other SMs had macroadenomas. Hypogonadism and growth hormone deficiency was present in 41.8% and 20.5% of the patients, respectively. Of 268 patients with available data, 82 patients underwent surgery while 25 patients received radiotherapy. At the end of 2016, 197 patients were residing in Al Ain city. The overall prevalence of SMs was 25.7/100 000 with PAs constituting most of these masses (n=177) for a prevalence of 23.1/100 000. CONCLUSIONS: This is the first study of SMs in the United Arab Emirates and the MENA region. Prolactinoma and NFA were the two most common SMs. Further studies are needed to explore the reasons for the lower prevalence of SMs in our region compared with other countries. LIMITATIONS: Retrospective design, relatively small sample size. CONFLICT OF INTEREST: None.
