1
|
Belloli A, Saccaro LF, Landi P, Spera M, Zappa MA, Dell’Osso B, Rutigliano G. Emotion dysregulation links pathological eating styles and psychopathological traits in bariatric surgery candidates. Front Psychiatry 2024; 15:1369720. [PMID: 38606413 PMCID: PMC11006956 DOI: 10.3389/fpsyt.2024.1369720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 03/18/2024] [Indexed: 04/13/2024] Open
Abstract
Objectives Approximately one-third of bariatric surgery patients experience weight regain or suboptimal weight loss within five years post-surgery. Pathological eating styles and psychopathological traits (e.g., emotion dysregulation) are recognized as potential hindrances to sustain weight loss efforts and are implicated in obesity development. A comprehensive understanding of these variables and their interplays is still lacking, despite their potential significance in developing more effective clinical interventions for bariatric patients. We investigate the prevalence of and interactions between pathological eating styles and psychopathological traits in this population. Materials and methods 110 bariatric surgery candidates were characterized using the Binge Eating Scale (BES), Hamilton Depression/Anxiety Scales (HAM-D/A), Barratt Impulsiveness Scale (BIS-11), Experiences in Close Relationships (ECR), Difficulties in Emotion Regulation Scale (DERS). We analyzed these variables with multiple logistic regression analyses and network analysis. Results Patients with pathological eating styles showed more pronounced anxiety/depressive symptoms and emotion dysregulation. Network analysis revealed strong connections between BES and DERS, with DERS also displaying robust connections with HAM-A/D and ECR scales. DERS and attention impulsivity (BIS-11-A) emerged as the strongest nodes in the network. Discussion Our findings demonstrate the mediating role of emotion dysregulation between pathological eating styles and psychopathological traits, supporting existing literature on the association between psychopathological traits, insecure attachment styles, and pathological eating behaviors. This research emphasizes the significance of emotion regulation in the complex network of variables contributing to obesity, and its potential impact on bariatric surgery outcomes. Interventions focusing on emotion regulation may thus lead to improved clinical outcomes for bariatric patients.
Collapse
Affiliation(s)
- Arianna Belloli
- Department of Psychiatry, Azienda Socio Sanitaria Territoriale (ASST) Fatebenefratelli-Sacco, Milan, Italy
- Department of Psychology, Sigmund Freud University, Milan, Italy
| | - Luigi F. Saccaro
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Psychiatry, Geneva University Hospital, Geneva, Switzerland
| | - Paola Landi
- Department of Psychiatry, Azienda Socio Sanitaria Territoriale (ASST) Fatebenefratelli-Sacco, Milan, Italy
| | - Milena Spera
- Department of Psychiatry, Azienda Socio Sanitaria Territoriale (ASST) Fatebenefratelli-Sacco, Milan, Italy
| | - Marco Antonio Zappa
- Department of General Surgery, Azienda Socio Sanitaria Territoriale (ASST) Fatebenefratelli-Sacco, Milan, Italy
| | - Bernardo Dell’Osso
- Department of Psychiatry, Azienda Socio Sanitaria Territoriale (ASST) Fatebenefratelli-Sacco, Milan, Italy
| | - Grazia Rutigliano
- Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| |
Collapse
|
2
|
Carbone EA, Aloi M, Rania M, de Filippis R, Quirino D, Fiorentino TV, Segura-Garcia C. The relationship of food addiction with binge eating disorder and obesity: A network analysis study. Appetite 2023; 190:107037. [PMID: 37714336 DOI: 10.1016/j.appet.2023.107037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 09/05/2023] [Accepted: 09/07/2023] [Indexed: 09/17/2023]
Abstract
Food addiction (FA) has been associated with binge eating disorder (BED) and obesity at varying levels of severity and treatment outcomes. Despite much debate and scientific interest in FA, the mechanisms that underlie its co-occurrence with both conditions are not yet well understood. In order to understand this relationship, this study explores FA in a clinical sample of individuals with BED and obesity using network analysis (NA). A total of 303 patients (151 with BED and 152 with obesity) completed a battery of tests that investigated eating psychopathology, eating behaviours, emotional dysregulation, depression and FA. Two different NAs were conducted to investigate the interaction between these variables and FA. The BED and obesity groups were comparable in age (38 ± 14 vs. 42 ± 13 years), body mass index (38.8 ± 8.5 vs 42.4 ± 7.8), sex and demographics. According to the expected influence values, binge eating severity and depression were identified as the central nodes in both networks. In the BED group, binge eating severity was the central node and showed strong connections to both FA and grazing. In contrast, in the obesity group, depression was the central node, but its connections were weak, with only marginal associations to FA. These results suggest that FA represents an important and distinct construct of the two populations. In patients with BED, FA is intimately connected to other loss-of-control-related eating behaviours, such as binge eating and grazing. Conversely, in those with obesity, depression explains the relationship of FA with pathological eating behaviours. The presence of FA seems to be a distinguishing characteristic in the psychopathology of patients suffering from obesity with and without BED, and this could have implications for the prevention, treatment and management of these disorders.
Collapse
Affiliation(s)
- Elvira Anna Carbone
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy
| | - Matteo Aloi
- Department of Clinical and Experimental Medicine, University of Messina, 98125, Messina, Italy; Department of Health Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy
| | - Marianna Rania
- Center for Clinical Research and Treatment of Eating Disorders, University Hospital Mater Domini, 88100, Catanzaro, Italy
| | - Renato de Filippis
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy
| | - Daria Quirino
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy
| | - Teresa Vanessa Fiorentino
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy
| | - Cristina Segura-Garcia
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy; Center for Clinical Research and Treatment of Eating Disorders, University Hospital Mater Domini, 88100, Catanzaro, Italy.
| |
Collapse
|
3
|
Huang L, Zhao K, Zhu H, Li X, Yang Y, Hou C, Zhu S, Xu Q. Family characteristics in adolescents with overweight or obesity: a network analysis. Front Pediatr 2023; 11:1282117. [PMID: 38034834 PMCID: PMC10686212 DOI: 10.3389/fped.2023.1282117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/09/2023] [Indexed: 12/02/2023] Open
Abstract
Background Rates of overweight and obesity continue to grow in adolescents. Overweight and obesity in adolescence are associated with numerous immediate and long-term adverse health conditions. Throughout adolescence, parents and the family have an important and central influence on adolescents' health and lifestyle. The home environment may be a major factor in shaping children's weight. However, our current understanding of the interplay between family-related variables in adolescents with overweight or obesity is limited and fragmented. This study aimed to assess the relationship between family-related variables in adolescents who are overweight or obese using network analysis and inform future health promotion for family-based intervention. Methods Participants (n = 488) were recruited from middle schools in Nanjing from October 2022 to March 2023. Participants, together with their parents, completed a questionnaire at school about the family food environment, family size, family APGAR index, family physical activity facilities, parental mental health, rearing behavior, parental weight status, drinking history, marital satisfaction, and sociodemographic characteristics. Results The network split into three distinct communities of items. Network analysis showed that parental mental health and paternal rearing styles-rejection were the most central nodes in the network. In contrast, maternal weight status was the most peripheral and least connected nodes. Conclusion Family-related variables constituted a connected network in adolescents with overweight or obesity. The pattern of network node connections supports that interventions could prioritize targeting changing parental mental health and paternal rearing styles in adolescents with overweight or obesity.
Collapse
Affiliation(s)
- Lidong Huang
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Kang Zhao
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Hanfei Zhu
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Xiaonan Li
- Child Healthcare Department, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Yiqing Yang
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Caiyun Hou
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Shuqin Zhu
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Qin Xu
- School of Nursing, Nanjing Medical University, Nanjing, China
| |
Collapse
|
4
|
Monteleone AM, Cascino G, Salerno L, Albano G, Barone E, Cardi V, Lo Coco G. The interplay between emotion regulation, interpersonal problems and eating symptoms in individuals with obesity: A network analysis study. J Affect Disord 2023; 324:61-67. [PMID: 36565965 DOI: 10.1016/j.jad.2022.12.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 12/13/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION A complex and bidirectional relationship between eating and psychological symptoms in individuals with obesity has been proposed. This study aims to identify the specific processes playing a role in this association, using a data-driven approach. METHODS Two hundred ninety-four adults with obesity, including 106 (36 %) with binge-eating disorder, were consecutively admitted to a specialized public center. They completed self-report questionnaires to assess emotion regulation, interpersonal problems, self-esteem, binge-eating symptoms, and expectancies regarding eating behaviors. To assess the interplay among eating and psychological variables, a network analysis was used. The bridge function analysis was also performed to identify the bridge nodes among three communities (eating symptoms, interpersonal and emotional problems). RESULTS The network was stable. Limited access to emotion regulation strategies, eating helps manage negative affect, and non-assertiveness were the nodes with the highest strength centrality. Lack of emotional clarity, non-assertiveness, socially inhibition, and binge-eating were the nodes with the highest bridge strength. LIMITATIONS The main limitation of the study is the cross-sectional nature of the findings which prevents to infer causality regarding the association between symptoms in the network. DISCUSSION An interplay between eating symptoms and affective and interpersonal factors characterizes individuals with obesity. Across the variety of psychological problems associated with obesity, the present study suggests specific psychological variables and their connections that could be addressed to improve treatment outcome.
Collapse
Affiliation(s)
| | - Giammarco Cascino
- Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', Section of Neurosciences, University of Salerno, Salerno, Italy
| | - Laura Salerno
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | - Gaia Albano
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | - Eugenia Barone
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Valentina Cardi
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of General Psychology, University of Padova, Padova, Italy
| | - Gianluca Lo Coco
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| |
Collapse
|
5
|
Dicker-Oren SD, Gelkopf M, Greene T. The dynamic network associations of food craving, restrained eating, hunger and negative emotions. Appetite 2022; 175:106019. [PMID: 35500722 DOI: 10.1016/j.appet.2022.106019] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Food craving, restrained eating, hunger, and negative emotions may predict and reinforce one another. However, less is known about how they interact together as a complex system in daily life. Therefore, we used a dynamic network approach to examine the associations between food craving, restrained eating, hunger and negative emotions in daily life. METHODS Food craving, restrained eating, hunger and negative emotions were measured using ecological momentary assessment three times a day over ten days in a community sample in Israel (n = 123). A two-step multilevel vector auto-regression network analysis was used to estimate temporal, contemporaneous and between-persons networks. RESULTS In the temporal network, restrained eating was the most central predictor of eating behaviors and negative emotions, predicting food craving and hunger as well as sadness and loneliness. Food craving was also predicted by hunger and stress, and hunger predicted loneliness. In the contemporaneous network, food craving was associated with hunger and feeling bored, and higher anger was associated with lower restrained eating. Stress and sadness were central negative emotions in the models. DISCUSSION This study suggests possible temporal and contemporaneous relationships between food craving, restrained eating, hunger and negative emotions, emphasizing their complex interactions in daily life. Restrained eating and stress should be investigated as potential targets for interventions addressing food craving and overeating.
Collapse
Affiliation(s)
- S D Dicker-Oren
- The Department of Community Mental Health, University of Haifa, Haifa, Israel.
| | - M Gelkopf
- The Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - T Greene
- The Department of Community Mental Health, University of Haifa, Haifa, Israel
| |
Collapse
|
6
|
Burgermaster M, Rodriguez VA. Psychosocial-Behavioral Phenotyping: A Novel Precision Health Approach to Modeling Behavioral, Psychological, and Social Determinants of Health Using Machine Learning. Ann Behav Med 2022; 56:1258-1271. [PMID: 35445699 DOI: 10.1093/abm/kaac012] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The context in which a behavioral intervention is delivered is an important source of variability and systematic approaches are needed to identify and quantify contextual factors that may influence intervention efficacy. Machine learning-based phenotyping methods can contribute to a new precision health paradigm by informing personalized behavior interventions. Two primary goals of precision health, identifying population subgroups and highlighting behavioral intervention targets, can be addressed with psychosocial-behavioral phenotypes. We propose a method for psychosocial-behavioral phenotyping that models social determinants of health in addition to individual-level psychological and behavioral factors. PURPOSE To demonstrate a novel application of machine learning for psychosocial-behavioral phenotyping, the identification of subgroups with similar combinations of psychosocial characteristics. METHODS In this secondary analysis of psychosocial and behavioral data from a community cohort (n = 5,883), we optimized a multichannel mixed membership model (MC3M) using Bayesian inference to identify psychosocial-behavioral phenotypes and used logistic regression to determine which phenotypes were associated with elevated weight status (BMI ≥ 25kg/m2). RESULTS We identified 20 psychosocial-behavioral phenotypes. Phenotypes were conceptually consistent as well as discriminative; most participants had only one active phenotype. Two phenotypes were significantly positively associated with elevated weight status; four phenotypes were significantly negatively associated. Each phenotype suggested different contextual considerations for intervention design. CONCLUSIONS By depicting the complexity of psychological and social determinants of health while also providing actionable insight about similarities and differences among members of the same community, psychosocial-behavioral phenotypes can identify potential intervention targets in context.
Collapse
Affiliation(s)
- Marissa Burgermaster
- Department of Nutritional Sciences, College of Natural Sciences, University of Texas at Austin, Austin, TX, USA.,Department of Population Health, Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | - Victor A Rodriguez
- Department of Biomedical Informatics, Columbia University, New York, NY, USA.,College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA
| |
Collapse
|
7
|
Zeiler M, Philipp J, Truttmann S, Waldherr K, Wagner G, Karwautz A. Psychopathological Symptoms and Well-Being in Overweight and Underweight Adolescents: A Network Analysis. Nutrients 2021; 13:4096. [PMID: 34836351 PMCID: PMC8624115 DOI: 10.3390/nu13114096] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/08/2021] [Accepted: 11/12/2021] [Indexed: 12/24/2022] Open
Abstract
Overweight and underweight adolescents have an increased risk of psychological problems and reduced quality of life. We used a network analysis approach on a variety of psychopathology and well-being variables to identify central factors in these populations. The network analysis was conducted on data of 344 overweight adolescents (>90th BMI-percentile) and 423 underweight adolescents (<10th BMI-percentile) drawn from a large community sample (10-19 years) including behavioral and emotional problems (Youth Self-Report), eating disorder risk (SCOFF) and well-being variables (KIDSCREEN). Additionally, psychopathology and well-being scores of overweight and underweight individuals were compared with 1.560 normal weight adolescents. Compared to their normal weight peers, overweight adolescents showed elevated psychopathology and eating disorder risk as well as reduced well-being. Underweight adolescents reported increased levels of internalizing problems but no increased eating disorder risk or reduced well-being. The network analysis revealed that anxious/depressed mood and attention problems were the most central and interconnected nodes for both overweight and underweight subsamples. Among underweight individuals, social problems and socially withdrawn behavior additionally functioned as a bridge between other nodes in the network. The results support psychological interventions focusing on improving mood, coping with negative emotions and tackling inner tension.
Collapse
Affiliation(s)
- Michael Zeiler
- Eating Disorder Unit, Department for Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (J.P.); (S.T.); (G.W.); (A.K.)
| | - Julia Philipp
- Eating Disorder Unit, Department for Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (J.P.); (S.T.); (G.W.); (A.K.)
| | - Stefanie Truttmann
- Eating Disorder Unit, Department for Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (J.P.); (S.T.); (G.W.); (A.K.)
| | - Karin Waldherr
- Department for Research and Development, Ferdinand Porsche FernFH-Distance Learning University of Applied Sciences, 2700 Wiener Neustadt, Austria;
| | - Gudrun Wagner
- Eating Disorder Unit, Department for Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (J.P.); (S.T.); (G.W.); (A.K.)
| | - Andreas Karwautz
- Eating Disorder Unit, Department for Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (J.P.); (S.T.); (G.W.); (A.K.)
| |
Collapse
|
8
|
Hilbert A, Herpertz S, Zipfel S, Tuschen-Caffier B, Friederich HC, Mayr A, de Zwaan M. Psychopathological Networks in Cognitive-Behavioral Treatments for Binge-Eating Disorder. PSYCHOTHERAPY AND PSYCHOSOMATICS 2021; 89:379-385. [PMID: 32694245 DOI: 10.1159/000509458] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 06/09/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Network approaches to psychopathology posit that mental disorders emerge from interrelated symptoms, and thus connectivity among symptoms are assumed to negatively predict the treatment response and decrease with efficacious treatment. OBJECTIVE This study uniquely sought to elucidate the network structure, its change, and its predictive value in cognitive-behavioral therapy (CBT) for binge-eating disorder (BED). METHODS In a multicenter randomized trial of face-to-face and Internet-based guided self-help CBT, 178 individuals with full syndrome and subsyndromal BED, eating disorder and general psychopathology, and body mass index (BMI) were subjected to Gaussian Graphical Network and Exploratory Graph Analyses before and after treatment and at 6-month follow-up. RESULTS At pretreatment, 3 network communities of: eating disorder psychopathology; general psychopathology; and restraint and BMI were identified, with the latter community included in the first thereafter. Eating disorder-related impairment and self-esteem were the most central symptoms, while BMI and binge eating had the lowest centrality. Network connectivity significantly increased from pre- to posttreatment, with the greatest increases in strength centrality found in binge eating and shape concern, but it did not predict remission from binge eating. CONCLUSIONS With decreasing symptom severity, CBT resulted in a greater integration and connectivity of the psychopathology network in BED, suggesting an increased patient understanding of relations between binge eating and other symptoms. Network connectivity was not a negative prognostic indicator of treatment outcome. These results indicate a need for further research on the predictive value of network variables in the explanation of therapeutic change for patients with BED.
Collapse
Affiliation(s)
- Anja Hilbert
- Integrated Research and Treatment Center AdiposityDiseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany,
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL University, Bochum, Germany
| | - Stephan Zipfel
- Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Brunna Tuschen-Caffier
- Department of Clinical Psychology and Psychotherapy, University of Freiburg, Freiburg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, Medical University Hospital Heidelberg, Heidelberg, Germany
| | - Andreas Mayr
- Department of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| |
Collapse
|
9
|
Godoy-Izquierdo D, Lara R, Ogallar A, Rodríguez-Tadeo A, Ramírez MJ, Navarrón E, Arbinaga F. Psychosocial and Diet-Related Lifestyle Clusters in Overweight and Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6461. [PMID: 34203684 PMCID: PMC8296278 DOI: 10.3390/ijerph18126461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 05/31/2021] [Accepted: 06/03/2021] [Indexed: 11/17/2022]
Abstract
This study explored intraindividual multidimensional profiles integrating psychosocial factors, namely, body image and satisfaction, weight-related self-stigma, positivity, and happiness, and behavioural-lifestyle factors, namely, adherence to a healthy diet, among Spanish adults with overweight or obesity. We further aimed to investigate the association of excess weight (i.e., measured body mass index, BMI) with the abovementioned multidimensional configurations. A convenience sample of 100 adult individuals (60% females) with excessive weight (69% overweight; 31% obesity) was recruited. They completed self-reports regarding the study variables, and their weight and height were measured. With a perspective centered on the individual, a cluster analysis was performed. Three distinct intraindividual psychosocial and diet-related profiles were identified: a group of healthy individuals with excess weight (46%); a group of individuals who were negatively affected by their excessive weight and showed the most distressed profile (18%); and a group of dysfunctional individuals who seemed to be excessively unrealistic and optimistic regarding their excessive weight and unhealthy lifestyles, but were troubled by their weight (36%). Furthermore, individuals in the affected cluster had higher obesity (mean BMI ± SD = 32.1 ± 3.7) than those in the clusters of healthy (28.0 ± 3.0) and dysfunctional individuals (28.1 ± 3.3) (p < 0.05). The results showed that there are specific psychosocial and lifestyle profiles in the adult population with excess weight and that there are relationships among psychological, behavioural, and body-composition factors. For clinical application purposes, it is important to account for the heterogeneity within individuals who are obese and to individualize the interventions, with a focus from weight change to the individual's overall well-being.
Collapse
Affiliation(s)
- Débora Godoy-Izquierdo
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Campus Universitario de Cartuja, Universidad de Granada, 18071 Granada, Spain;
- Grupo de Investigación Psicología de la Salud y Medicina Conductual (CTS-267), Centro de Investigación Mente, Cerebro y Comportamiento, Facultad de Psicología, Campus Universitario de Cartuja, Universidad de Granada, 18071 Granada, Spain; (R.L.); (M.J.R.); (E.N.)
| | - Raquel Lara
- Grupo de Investigación Psicología de la Salud y Medicina Conductual (CTS-267), Centro de Investigación Mente, Cerebro y Comportamiento, Facultad de Psicología, Campus Universitario de Cartuja, Universidad de Granada, 18071 Granada, Spain; (R.L.); (M.J.R.); (E.N.)
- Departamento de Psicología Social, Facultad de Psicología, Campus Universitario de Cartuja, Universidad de Granada, 18071 Granada, Spain
| | - Adelaida Ogallar
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Campus Universitario de Cartuja, Universidad de Granada, 18071 Granada, Spain;
- Grupo de Investigación Psicología de la Salud y Medicina Conductual (CTS-267), Centro de Investigación Mente, Cerebro y Comportamiento, Facultad de Psicología, Campus Universitario de Cartuja, Universidad de Granada, 18071 Granada, Spain; (R.L.); (M.J.R.); (E.N.)
| | - Alejandra Rodríguez-Tadeo
- Departamento Ciencias de la Salud, Instituto de Ciencias Biomédicas, Anillo Envolvente del Pronaf y Estocolmo, Universidad Autónoma Ciudad Juárez, Ciudad Juárez 32300, Chihuahua, Mexico;
| | - María J. Ramírez
- Grupo de Investigación Psicología de la Salud y Medicina Conductual (CTS-267), Centro de Investigación Mente, Cerebro y Comportamiento, Facultad de Psicología, Campus Universitario de Cartuja, Universidad de Granada, 18071 Granada, Spain; (R.L.); (M.J.R.); (E.N.)
| | - Estefanía Navarrón
- Grupo de Investigación Psicología de la Salud y Medicina Conductual (CTS-267), Centro de Investigación Mente, Cerebro y Comportamiento, Facultad de Psicología, Campus Universitario de Cartuja, Universidad de Granada, 18071 Granada, Spain; (R.L.); (M.J.R.); (E.N.)
| | - Félix Arbinaga
- Departamento de Psicología Clínica y Experimental, Facultad de Educación, Psicología y Ciencias del Deporte, Campus Universitario El Carmen, Universidad de Huelva, 21071 Huelva, Spain;
| |
Collapse
|
10
|
Manasse SM, Michael ML, Lin M, Gillikin L, Zhang F, Forman EM, Juarascio A. Can a Short Screening Tool Discriminate Between Overeating and Binge Eating in Treatment-Seeking Individuals with Obesity? Obesity (Silver Spring) 2021; 29:706-712. [PMID: 33759384 PMCID: PMC8142689 DOI: 10.1002/oby.23128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 12/18/2020] [Accepted: 01/03/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Existing screening tools are inadequate in differentiating binge eating from normative overeating in treatment-seeking individuals with overweight or obesity, as these individuals tend to overendorse loss-of-control (LOC; the hallmark characteristic of binge eating) on self-report measures. In order for treatment centers to efficiently and accurately identify individuals who would benefit from specialized treatment, it is critical to develop effective brief screening tools. This study examined the sensitivity and specificity of a self-report screener designed to be used by an outpatient treatment center on a large scale. METHODS Participants were treatment-seeking individuals (N = 364) with overweight or obesity who were administered the screener and who completed a subsequent interview assessing for LOC and binge eating. RESULTS Discriminant analyses revealed that the screener achieved 77.6% sensitivity and 77.0% specificity in predicting clinician-assessed LOC and 75.2% sensitivity and 74.1% specificity in predicting "full-threshold" binge eating (i.e., ≥12 objectively large binge-eating episodes within the past 3 months). Post hoc analyses indicated that male participants were more likely to be misclassified with the screener. CONCLUSIONS The self-report screener demonstrated satisfactory predictive ability, which is notable given the challenges of discriminating between LOC and normative overeating. However, room for improvement remains. In particular, the inclusion of additional screener items that more fully capture the binge-eating experience in males is warranted.
Collapse
Affiliation(s)
- Stephanie M. Manasse
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, Pennsylvania, USA
| | - Megan L. Michael
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, Pennsylvania, USA
| | - Mandy Lin
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, Pennsylvania, USA
| | - Lindsay Gillikin
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, Pennsylvania, USA
| | - Fengqing Zhang
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Evan M. Forman
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, Pennsylvania, USA
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Adrienne Juarascio
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, Pennsylvania, USA
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| |
Collapse
|
11
|
Eik-Nes TT, Vrabel K, Raman J, Clark MR, Berg KH. A Group Intervention for Individuals With Obesity and Comorbid Binge Eating Disorder: Results From a Feasibility Study. Front Endocrinol (Lausanne) 2021; 12:738856. [PMID: 34803910 PMCID: PMC8597950 DOI: 10.3389/fendo.2021.738856] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 09/30/2021] [Indexed: 11/13/2022] Open
Abstract
PURPOSE A common challenge among a subgroup of individuals with obesity is binge eating, that exists on a continuum from mild binge eating episodes to severe binge eating disorder (BED). BED is common among bariatric patients and the prevalence of disordered eating and ED in bariatric surgery populations is well known. Conventional treatments and assessment of obesity seldom address the underlying psychological mechanisms of binge eating and subsequent obesity. This study, titled PnP (People need People) is a psychoeducational group pilot intervention for individuals with BED and obesity including patients with previous bariatric surgery. Design, feasibility, and a broad description of the study population is reported. MATERIAL AND METHODS A total of 42 patients were from an obesity clinic referred to assessment and treatment with PnP in a psychoeducational group setting (3-hour weekly meetings for 10 weeks). Of these, 6 (14.3%) patients had a previous history of bariatric surgery. Feasibility was assessed by tracking attendance, potentially adverse effects and outcome measures including body mass index (BMI), eating disorder pathology, overvaluation of shape and weight, impairment, self-reported childhood difficulties, alexithymia, internalized shame as well as health related quality of life (HRQoL). RESULTS All 42 patients completed the intervention, with no adverse effects and a high attendance rate with a median attendance of 10 sessions, 95% CI (8.9,9.6) and 0% attrition. Extent of psychosocial impairment due to eating disorder pathology, body dissatisfaction and severity of ED symptoms were high among the patients at baseline. Additionally, self-reported childhood difficulties, alexithymia, and internalized shame were high among the patients and indicate a need to address underlying psychological mechanisms in individuals with BED and comorbid obesity. Improvement of HRQoL and reduction of binge eating between baseline and the end of the intervention was observed with a medium effect. CONCLUSION This feasibility study supports PnP as a potential group psychoeducational intervention for patients living with BED and comorbid obesity. Assessments of BED and delivery of this intervention may optimize selection of candidates and bariatric outcomes. These preliminary results warrant further investigation via a randomized control trial (RCT) to examine the efficacy and effectiveness of PnP.
Collapse
Affiliation(s)
- Trine T. Eik-Nes
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
- Stjørdal Community Mental Health Centre, Levanger Hospital, Levanger, Norway
- *Correspondence: Trine T. Eik-Nes,
| | | | - Jayanthi Raman
- Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Melinda Rose Clark
- Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Kjersti Hognes Berg
- Stjørdal Community Mental Health Centre, Levanger Hospital, Levanger, Norway
| |
Collapse
|
12
|
Levallius J, Monell E, Birgegård A, Clinton D, Forsén Mantilla E. Binge Eating and Addictive-Like Behaviours in Males and Females. Psychol Rep 2020; 125:148-166. [PMID: 33174818 DOI: 10.1177/0033294120971750] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Binge eating is a common behaviour that is strongly linked to both obesity and eating disorder. There is evidence that binge eating commonly co-occurs with other problematic and addictive-like behaviours; however, this has not been explored systematically. The present study aimed to examine the relationship between binge eating, body weight, disordered eating behaviours and associated addictive-like behaviours, with particular attention paid to gender differences. METHOD A community sample (N = 500; 75% female, Mage = 32.5 years) reported disordered eating behaviours (i.e. binge eating, purging, restriction of eating, compulsive exercise), body mass index (BMI), food addiction, starvation addiction, exercise dependence, tobacco use and alcohol consumption. RESULTS 42% of females and 21% of males reported binge eating during the past four weeks. Binge eating was significantly associated with all investigated behaviours in females, and with purging, compulsive exercise and overweight/obesity in males. Controlling for BMI, self-starvation predicted binge eating in males (OR = 1.07), while food addiction (OR = 1.73) and alcohol dependence (OR = 1.11) predicted binge eating in females. CONCLUSIONS The multiple associations between binge eating and addictive-like behaviors supports broad screening and generalized prevention efforts. Prevention efforts should reflect gender differences.
Collapse
Affiliation(s)
- Johanna Levallius
- Department of Medical Epidemiology and Biostatistics, Center for Eating Disorders Innovation, Karolinska Institutet, Stockholm, Sweden
| | - Elin Monell
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Andreas Birgegård
- Department of Medical Epidemiology and Biostatistics, Center for Eating Disorders Innovation, Karolinska Institutet, Stockholm, Sweden
| | - David Clinton
- Department of Medical Epidemiology and Biostatistics, Center for Eating Disorders Innovation, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden; Institute for Eating Disorders, Oslo, Norway
| | - Emma Forsén Mantilla
- Department of Medical Epidemiology and Biostatistics, Center for Eating Disorders Innovation, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| |
Collapse
|
13
|
Godoy-Izquierdo D, González-Hernández J, Rodríguez-Tadeo A, Lara R, Ogallar A, Navarrón E, Ramírez MJ, López-Mora C, Arbinaga F. Body Satisfaction, Weight Stigma, Positivity, and Happiness among Spanish Adults with Overweight and Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4186. [PMID: 32545437 PMCID: PMC7344457 DOI: 10.3390/ijerph17124186] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/29/2020] [Accepted: 06/10/2020] [Indexed: 12/16/2022]
Abstract
Although previous evidence suggests that happiness is lower among individuals with obesity, research on the correlates of subjective well-being (SWB) is warranted to increase our knowledge. We aim to explore excess weight (i.e., measured and self-reported body mass index (BMI)), body image and satisfaction, self-stigma, positivity, and happiness among Spanish adults with overweight or obesity. We further aim to investigate the predictors of SWB in this sample. A convenience sample of 100 individuals with excess weight completed self-reports on the study variables and were weighed and their height measured. On average, the participants reported body perceptions revealing minor excessive weight, moderate body satisfaction, low-to-moderate weight-related stigma, and elevated positivity and happiness. BMI and gender/sex independently affected these variables, but there were no significant interaction effects. Furthermore, individuals with overweight or obesity with higher body satisfaction and elevated positivity were more likely to report being happy, independent of their age, gender/sex, weight, and weight-related stigma. Mediation effects were found for body satisfaction and positivity in the relationship between weight and happiness. Moreover, positive orientation suppressed the pervasive influence of stigma on SWB. Our findings confirm the key role of body image dimensions and weight-related stigma for happiness and add support to the relevance of positivity for overall well-being of individuals with excess weight. These results may inform obesity management actions focused on inclusive aesthetic models, combating social stigmatization and enhancing positivity for a flourishing and fulfilling life.
Collapse
Affiliation(s)
- Débora Godoy-Izquierdo
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Universidad de Granada, Campus Universitario de Cartuja, 18071 Granada, Spain; (J.G.-H.); (A.O.)
- Grupo de Investigación Psicología de la Salud y Medicina Conductual (CTS-267), Centro de Investigación Mente, Cerebro y Comportamiento, Facultad de Psicología, Universidad de Granada, Campus Universitario de Cartuja, 18071 Granada, Spain; (R.L.); (E.N.); (M.J.R.); (C.L.-M.)
| | - Juan González-Hernández
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Universidad de Granada, Campus Universitario de Cartuja, 18071 Granada, Spain; (J.G.-H.); (A.O.)
- Grupo de Investigación Psicología de la Salud y Medicina Conductual (CTS-267), Centro de Investigación Mente, Cerebro y Comportamiento, Facultad de Psicología, Universidad de Granada, Campus Universitario de Cartuja, 18071 Granada, Spain; (R.L.); (E.N.); (M.J.R.); (C.L.-M.)
| | - Alejandra Rodríguez-Tadeo
- Departamento Ciencias de la Salud, Instituto de Ciencias Biomédicas, Universidad Autónoma Ciudad Juárez, Anillo Envolvente del Pronaf y Estocolmo, Ciudad Juárez 32300, Chihuahua, Mexico;
| | - Raquel Lara
- Grupo de Investigación Psicología de la Salud y Medicina Conductual (CTS-267), Centro de Investigación Mente, Cerebro y Comportamiento, Facultad de Psicología, Universidad de Granada, Campus Universitario de Cartuja, 18071 Granada, Spain; (R.L.); (E.N.); (M.J.R.); (C.L.-M.)
- Departamento de Psicología Social, Facultad de Psicología, Universidad de Granada, Campus Universitario de Cartuja, 18071 Granada, Spain
| | - Adelaida Ogallar
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Universidad de Granada, Campus Universitario de Cartuja, 18071 Granada, Spain; (J.G.-H.); (A.O.)
- Grupo de Investigación Psicología de la Salud y Medicina Conductual (CTS-267), Centro de Investigación Mente, Cerebro y Comportamiento, Facultad de Psicología, Universidad de Granada, Campus Universitario de Cartuja, 18071 Granada, Spain; (R.L.); (E.N.); (M.J.R.); (C.L.-M.)
| | - Estefanía Navarrón
- Grupo de Investigación Psicología de la Salud y Medicina Conductual (CTS-267), Centro de Investigación Mente, Cerebro y Comportamiento, Facultad de Psicología, Universidad de Granada, Campus Universitario de Cartuja, 18071 Granada, Spain; (R.L.); (E.N.); (M.J.R.); (C.L.-M.)
| | - María J. Ramírez
- Grupo de Investigación Psicología de la Salud y Medicina Conductual (CTS-267), Centro de Investigación Mente, Cerebro y Comportamiento, Facultad de Psicología, Universidad de Granada, Campus Universitario de Cartuja, 18071 Granada, Spain; (R.L.); (E.N.); (M.J.R.); (C.L.-M.)
| | - Clara López-Mora
- Grupo de Investigación Psicología de la Salud y Medicina Conductual (CTS-267), Centro de Investigación Mente, Cerebro y Comportamiento, Facultad de Psicología, Universidad de Granada, Campus Universitario de Cartuja, 18071 Granada, Spain; (R.L.); (E.N.); (M.J.R.); (C.L.-M.)
- Seneca Foundation & Departmen of Human Development and Family Science, University of Missouri-Columbia, Gentry Hall, Columbia, MO 65211, USA
| | - Félix Arbinaga
- Departamento de Psicología Clínica y Experimental, Facultad de Educación, Psicología y Ciencias del Deporte, Universidad de Huelva, Campus Universitario El Carmen, 21071 Huelva, Spain
| |
Collapse
|