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Escandón-Nagel N, Peró-Cebollero M, Grau A, Soriano J, Feixas G. Overvaluation of weight and shape in obesity: a comparative study between people with and without binge eating disorder. Front Psychol 2024; 15:1414455. [PMID: 38979078 PMCID: PMC11229786 DOI: 10.3389/fpsyg.2024.1414455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 06/10/2024] [Indexed: 07/10/2024] Open
Abstract
Introduction The overvaluation of weight and shape is a diagnostic criterion in eating disorders, except in binge eating disorder (BED), where it has received less attention. This aspect is also not usually analyzed in people with overweight or obesity without an eating disorder. This research aims to identify the indicators of symptomatology, as well as those of self-construction and cognitive structure, that are associated with overvaluation in obesity, either alone or in conjunction with BED. Method A sample of 102 overweight or obese participants was accessed. The sample was divided into four groups: one without overvaluation or BED (n = 33); a second with overvaluation and without BED (n = 21); a third with BED, but without overvaluation (n = 15), and a fourth with BED and overvaluation (n = 33). The groups completed instruments regarding eating symptomatology, anxiety, depression, and stress. In addition, they were administered the Repertory Grid Technique, a semi-structured interview to evaluate the cognitive structure involved in the construal of the self and others. Results The factors of overvaluation and the presence of BED independently explained eating symptomatology, and the latter also showed a tendency to influence anxiety, depression, and stress. In terms of cognitive structure, weight polarization was explained by overvaluation, while BED was associated with a high presence of cognitive conflicts. In self-construction, BED was the factor that explained the differences, particularly in Self-Ideal discrepancy. Discussion The results highlight the importance of overvaluation in obesity, even in the absence of BED. Its evaluation and treatment are recommended. Furthermore, in the case of BED, it is also advisable to evaluate the overvaluation of weight and shape since it can be a severity specifier.
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Affiliation(s)
- Neli Escandón-Nagel
- Departament of Psychology, Facultad de Ciencias de la Salud, Universidad Católica de Temuco, Temuco, Chile
| | - Maribel Peró-Cebollero
- Departament de Psicología Social i Psicología Quantitativa, Facultat de Psicología, Institut de Neurociències de la Universitat de Barcelona, Universitat de Barcelona Institute of Complex Systems, Universitat de Barcelona, Barcelona, Spain
| | | | - José Soriano
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Guillem Feixas
- Department of Clinical Psychology and Psychobiology, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
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Guglielmi V, Dalle Grave R, Leonetti F, Solini A. Female obesity: clinical and psychological assessment toward the best treatment. Front Endocrinol (Lausanne) 2024; 15:1349794. [PMID: 38765954 PMCID: PMC11099266 DOI: 10.3389/fendo.2024.1349794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 04/19/2024] [Indexed: 05/22/2024] Open
Abstract
Obesity is a heterogeneous condition which results from complex interactions among sex/gender, sociocultural, environmental, and biological factors. Obesity is more prevalent in women in most developed countries, and several clinical and psychological obesity complications show sex-specific patterns. Females differ regarding fat distribution, with males tending to store more visceral fat, which is highly correlated to increased cardiovascular risk. Although women are more likely to be diagnosed with obesity and appear more motivated to lose weight, as confirmed by their greater representation in clinical trials, males show better outcomes in terms of body weight and intra-abdominal fat loss and improvements in the metabolic risk profile. However, only a few relatively recent studies have investigated gender differences in obesity, and sex/gender is rarely considered in the assessment and management of the disease. This review summarizes the evidence of gender differences in obesity prevalence, contributing factors, clinical complications, and psychological challenges. In addition, we explored gender differences in response to obesity treatments in the specific context of new anti-obesity drugs.
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Affiliation(s)
- Valeria Guglielmi
- Unit of Internal Medicine and Obesity Center, Department of Systems Medicine, Policlinico Tor Vergata, University of Rome Tor Vergata, Rome, Italy
| | - Riccardo Dalle Grave
- Department of Eating and Weight Disorders, Villa Garda Hospital, Garda, VR, Italy
| | - Frida Leonetti
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Anna Solini
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy
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Goldstein SP, Olson KL, Thomas JG. Association of weight and shape concern with weight change and weight-related behaviors in behavioral weight loss treatment. J Behav Med 2023; 46:1049-1056. [PMID: 37740874 PMCID: PMC10577101 DOI: 10.1007/s10865-023-00451-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 09/13/2023] [Indexed: 09/25/2023]
Abstract
Weight and shape concern (WSC) is a facet of negative body image that is common among individuals with overweight/obesity seeking behavioral weight loss treatment (BWL), but remains understudied. This secondary analysis evaluates associations between WSC, weight change, and weight-related behaviors among individuals in a 24-week BWL. Adults (n = 32) with body mass index 25-50 kg/m2 completed a baseline WSC questionnaire, measured weight at 12 and 24 weeks, measured physical activity via accelerometer, and completed 24-hour dietary recalls. Adherence to self-monitoring dietary intake and weight were assessed. A series of linear mixed models were used to evaluate associations between baseline WSC and weight change, as well as weight-related behaviors. Results revealed no significant effect of WSC on weight change. There were significant WSC x time interactions, such that those rating WSC "very important" decreased self-weighing and the "low importance" group decreased their caloric intake during treatment. The "pretty important" group had greater minutes of activity than the "low importance" group. Findings indicated that WSC may impact weight-related behaviors that contribute to BWL success. This trial was pre-registered on ClinicalTrials.gov (NCT03739151).
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Affiliation(s)
- Stephanie P Goldstein
- Department of Psychiatry and Human Behavior, The Miriam Hospital/Weight Control and Diabetes Research Center, Warren Alpert Medical School of Brown University, 196 Richmond St, Providence, RI, 02903, USA.
| | - KayLoni L Olson
- Department of Psychiatry and Human Behavior, The Miriam Hospital/Weight Control and Diabetes Research Center, Warren Alpert Medical School of Brown University, 196 Richmond St, Providence, RI, 02903, USA
| | - J Graham Thomas
- Department of Psychiatry and Human Behavior, The Miriam Hospital/Weight Control and Diabetes Research Center, Warren Alpert Medical School of Brown University, 196 Richmond St, Providence, RI, 02903, USA
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Zhu B, Gostoli S, Benasi G, Patierno C, Petroni ML, Nuccitelli C, Marchesini G, Fava GA, Rafanelli C. The Role of Psychological Well-Being in Weight Loss: New Insights from a Comprehensive Lifestyle Intervention. Int J Clin Health Psychol 2021; 22:100279. [PMID: 34868322 PMCID: PMC8606336 DOI: 10.1016/j.ijchp.2021.100279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 10/19/2021] [Indexed: 12/30/2022] Open
Abstract
Background/Objective Although the literature suggested that impaired psychological well-being (PWB) is associated with obesity, evidence on the role of PWB in weight outcomes is limited and inconclusive. This research aimed to investigate the joint role of PWB in achieving clinically significant weight loss (CWL; loss of 5% of the initial weight) through a comprehensive lifestyle intervention for obesity using a broad-based evaluation. Method This study is a prospective cohort of 96 patients with obesity attending a comprehensive lifestyle intervention for weight loss. Data on weight, lifestyle, PWB, and distress, were collected before and after the intervention. Results 30.5% of the participants achieved CWL at the end of treatment. A more pronounced increase in autonomy (odds ratio = 0.80 [95% CI: 0.68, 0.93], p ≤ .01) and somatization (odds ratio = 0.83 [95% CI: 0.70, 0.98], p ≤ .05) from pre- to post-treatment were independently associated with a lower probability of CWL. Conclusions Unbalanced dimensions of PWB, in particular exceedingly high autonomy, may contribute to a poor weight loss outcome. This study paves the way for the addition of psychotherapeutic strategies geared to euthymia in comprehensive lifestyle intervention.
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Affiliation(s)
- Boheng Zhu
- Department of Psychology "Renzo Canestrari", University of Bologna, Italy.,Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, China
| | - Sara Gostoli
- Department of Psychology "Renzo Canestrari", University of Bologna, Italy
| | - Giada Benasi
- Department of Psychology "Renzo Canestrari", University of Bologna, Italy
| | - Chiara Patierno
- Department of Psychology "Renzo Canestrari", University of Bologna, Italy
| | - Maria Letizia Petroni
- Department of Medical and Surgical Sciences, IRCCS-S. Orsola-Malpighi Hospital, University of Bologna, Italy
| | - Chiara Nuccitelli
- Unit of Metabolic Diseases and Clinical Dietetics, IRCCS-S. Orsola-Malpighi Hospital, University of Bologna, Italy
| | - Giulio Marchesini
- Department of Medical and Surgical Sciences, IRCCS-S. Orsola-Malpighi Hospital, University of Bologna, Italy
| | - Giovanni Andrea Fava
- Department of Psychiatry, University at Buffalo, State University of New York, USA
| | - Chiara Rafanelli
- Department of Psychology "Renzo Canestrari", University of Bologna, Italy
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Lydecker JA, Cotter EW, Grilo CM. Distinctiveness and significance of body dissatisfaction and overvaluation among Latinx/Hispanic and White men and women. Int J Eat Disord 2021; 54:354-364. [PMID: 33247450 PMCID: PMC7956228 DOI: 10.1002/eat.23413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 11/04/2020] [Accepted: 11/04/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To examine the distinctiveness and significance of two body image constructs, dissatisfaction with weight and shape and overvaluation of weight and shape, with respect to eating disorder psychopathology, weight, and depression in White and Latinx/Hispanic men and women. METHODS Participants were White (n = 1,941) and Latinx/Hispanic (n = 568) adults living in the United States who completed an online battery of established measures of body image, eating disorder psychopathology and behaviors, and depression. RESULTS Two body image constructs, dissatisfaction with weight and shape and overvaluation of weight and shape, were related to each other but showed some important distinctions in their associations with eating- and weight-related variables. Significantly greater proportions of White than Latinx/Hispanic individuals reported co-occurring dissatisfaction and overvaluation, and significantly greater proportions of Latinx/Hispanic than White individuals reported dissatisfaction alone. Ethnicity moderated the association of dissatisfaction and overvaluation with body mass index (BMI), and the association of overvaluation with depression. Ethnicity also had a main effect on binge-eating frequency. CONCLUSIONS Dissatisfaction and overvaluation were distinct among both Latinx/Hispanic and White individuals. However, associations with eating- and weight-related variables varied between ethnicities, suggesting a need for further research on the influence of cultural variables on body image and eating disorder psychopathology.
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Affiliation(s)
| | | | - Carlos M. Grilo
- Department of Psychiatry, Yale School of Medicine, New Haven, CT,Department of Psychology, Yale University, New Haven, CT
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Seo CL, Lee JH. Attentional Bias to High-Calorie Food in Binge Eaters With High Shape/Weight Concern. Front Psychiatry 2021; 12:606296. [PMID: 33762976 PMCID: PMC7982957 DOI: 10.3389/fpsyt.2021.606296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 01/29/2021] [Indexed: 12/13/2022] Open
Abstract
Individuals with high shape/weight concern (SWC) place disproportionate emphasis on shape and weight in evaluating their self-worth, making them more vulnerable to body-related cues. Binge eaters (BE), who are obsessed with devouring high-calorie foods, would show severe symptomatology, especially when they have clinically high SWC. The present study attempted to elucidate how SWC influences binging based on attentional patterns toward high-calorie food cues. A total of 120 participants were selected and divided into four groups: (1) BE with high SWC, (2) BE with low SWC, (3) healthy controls (HC) with high SWC, and (4) HC with low SWC. BE and SWC status were respectively determined using the Eating Disorder Diagnostic Scale (DSM-5) and the Eating Disorder Examination Questionnaire. All participants completed the same free-viewing task, measuring initial fixation latency and total fixation duration. BE with high SWC showed attentional bias toward high-calorie food cues in terms of significantly faster initial fixation latency and longer total fixation duration, whereas BE with low SWC and the HC groups did not show any differences. The results revealed that SWC level makes unique contributions to BE's initial orienting bias toward and difficulty disengaging from high-calorie food cues. This may indicate that BE with high SWC merely worry about eating high-calorie food in a cognitive way, but not controlling actual binging behavior. The current study of attentional bias elucidated the role of SWC as a potential maintenance factor of being concerned and binging in BE.
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Affiliation(s)
- Chai Lee Seo
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Jang-Han Lee
- Department of Psychology, Chung-Ang University, Seoul, South Korea
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