The association of BMI, lifestyle behaviors, and knowledge of acute cholecystitis of adults: a cross-sectional study

Abstract

Objective Acute cholecystitis is a common biliary disorder with rising prevalence in Saudi Arabia, yet the relationship between body mass index (BMI), lifestyle behaviors, and public knowledge about the condition remains underexplored. This study assessed these associations to inform preventive and educational strategies. Methods A cross-sectional survey was conducted among 385 adults aged 18–80 years residing in Abha, Saudi Arabia, who voluntarily agreed to participate. Data were collected using a validated, self-administered online questionnaire covering socio-demographics, lifestyle behaviors, and four knowledge domains. Knowledge levels were categorized using a validated scoring system in which correct responses were summed and classified as low, moderate, or high based on predetermined cutoff scores. BMI was calculated from self-reported height and weight. Results Participants were predominantly female (76.1%), The mean age of participants was 33 ± 14 years, and their mean BMI was 27.5 ± 5 kg/m 2 , indicating a generally young sample with a high prevalence of overweight and obesity. Knowledge was moderate in most respondents (53.2%), high in 43.9%, and low in 2.9%. Risk factor and symptom knowledge scored highest (mean = 2.40/3), while dietary risk knowledge scored lowest (mean = 2.13/3). BMI correlated positively with lifestyle score (r = 0.310, p = 0.041), dietary risk knowledge (r = 0.280, p = 0.047), and risk factor knowledge (r = 0.360, p = 0.008). Lifestyle scores correlated significantly with all knowledge domains (r = 0.390–0.450, p < 0.01). Although the correlation coefficients were modest (r ≤ 0.40), they still indicate meaningful but limited shared variance, suggesting that BMI and lifestyle factors contribute only partially to differences in knowledge. Most participants favoured periodic check-ups (26.2%) and laparoscopic surgery (25.5%) as preferred treatments. Conclusion Adults in Abha generally demonstrate moderate awareness of acute cholecystitis, with notable gaps in dietary risk and prevention knowledge. Higher BMI and healthier lifestyle behaviors are associated with greater knowledge in certain domains. Future studies should employ representative sampling methods and multivariable analytical approaches to better examine independent relationships between lifestyle factors and disease awareness.