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Lin CY, Latner JD, Rozzell-Voss KN, Huang PC, Tsai YC, Pakpour AH, Weng HC. Association of quality of life with internet use and weight stigma across individuals with obesity and those without obesity: Role of self-perception. Acta Psychol (Amst) 2024; 244:104203. [PMID: 38442432 DOI: 10.1016/j.actpsy.2024.104203] [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: 07/25/2023] [Revised: 02/12/2024] [Accepted: 02/28/2024] [Indexed: 03/07/2024] Open
Abstract
Weight status, weight stigma, and internet use are important factors impacting quality of life (QoL). However, little is known regarding how these factors interact in their association with QoL, and it is important to understand how self-perceived obesity and body mass index (BMI)-defined obesity may differentially impact QoL. We aimed to assess the associations between weight status (obesity vs. non-obesity, including both self-perceived and BMI-defined), weight stigma, internet use, and QoL. Cross-sectional data from the Taiwan Social Change Survey (N = 1604; mean age = 49.22; 52.93 % women) were used. All participants were classified as having obesity or not having obesity according to both self-perceived (self-perceived as 'too fat') and BMI-defined (≧27 kg/m2 as obesity) weight status. Results showed that the group with obesity (both BMI-defined and self-perceived) had significantly more internet time and lower physical QoL than the group without obesity. Those with self-perceived obesity, but not those with BMI-defined obesity, sought health information via the internet and used social media significantly more than the group without obesity. More internet time was associated with worse physical and mental QoL for the group with obesity regardless of BMI-defined or self-perceived status. Moreover, weight stigma was associated with worse mental QoL for the group with self-perceived obesity, but not for the group with BMI-defined obesity. Accordingly, being a person with obesity (self-defined, or based upon BMI) was associated with more internet time and poorer QoL. People with self-perceived obesity may have increased experience of weight stigma and greater internet use, factors that may contribute to their impaired QoL.
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Affiliation(s)
- Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Faculty of Health and Life Sciences, INTI International University, Nilai, Malaysia.
| | - Janet D Latner
- Department of Psychology, University of Hawaii, Honolulu, HI, USA.
| | | | - Po-Ching Huang
- School of Physical Therapy, Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Rd., Taoyuan 333323, Taiwan.
| | - Yu-Cheng Tsai
- Department of Pediatrics, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.
| | - Amir H Pakpour
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
| | - Hui-Ching Weng
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Foster T, Eaton M, Probst Y. The relationship between internalised weight bias and biopsychosocial outcomes in children and youth: a systematic review. J Eat Disord 2024; 12:38. [PMID: 38491402 PMCID: PMC10941429 DOI: 10.1186/s40337-023-00959-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 12/20/2023] [Indexed: 03/18/2024] Open
Abstract
OBJECTIVE To synthesise the evidence on the relationships between internalised weight bias (IWB) and biopsychosocial health outcomes in individuals ≤ 25 years. METHODS A systematic review was conducted by searching five scientific databases up to May 2022 to retrieve studies that investigated associations between IWB and biopsychosocial outcomes. Articles with participants ≤ 25 years, at least one validated measure of IWB, one measure of a biopsychosocial outcome, and were observational were included. Excluded articles involved systematic literature reviews, case study reports, intervention studies, meta-analyses, grey literature, pilot, and feasibility studies. Quality assessment was carried out using the American Dietetic Association Quality Criteria Checklist. The protocol was registered with PROSPERO, ID number CRD42022323876. RESULTS Two hundred and sixty-six articles were identified. Nineteen were eligible for inclusion, (15 cross-sectional and 4 prospective). The Weight Bias Internalization Scale and the Weight Self-Stigma Questionnaire were the most used tools to assess IWB with large heterogeneity in tool types used to assess biopsychosocial measures. IWB had positive associations with psychopathology, eating disorder symptomology, higher BMI, being female, and experiences of weight stigma. It was negatively associated with quality of life, body image, physical activity, social ability, self-esteem, and socioeconomic status. DISCUSSION IWB associated with adverse biopsychosocial outcomes in children and youth populations. IWB may be more clinically relevant in assessing at-risk children and youth than physical weight due to its psychosocial aspects and ability to expand beyond the scope of BMI. Research would benefit from better assessment tools designed for children and youth that accurately measure IWB. Future research should focus on increased diversity and longitudinal study designs with children and youth-specific populations.
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Affiliation(s)
- Tiarna Foster
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW, Australia
| | - Melissa Eaton
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW, Australia
| | - Yasmine Probst
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW, Australia.
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Kleppang AL, Abildsnes E, Haraldstad K, Stea TH. Changes in health-related quality of life and sleep habits after a 6-month non-randomised cluster-controlled trial among children with overweight or obesity. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02375-0. [PMID: 38396227 DOI: 10.1007/s00787-024-02375-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/08/2024] [Indexed: 02/25/2024]
Abstract
Being overweight or obese can have severe negative psychological impacts and reduce health-related functioning. To improve health-related quality of life (HRQoL) and sleep habits for children with overweight or obesity, it is important to design and implement effective interventions. The aim of this study was to evaluate the effects of a 6-month family-based lifestyle intervention on HRQoL and sleep habits in Norwegian children with overweight or obesity in a primary-care setting. This 6-month, non-randomised, cluster-controlled trial included Norwegian children aged 5-13 years with overweight or obesity and their parents. A questionnaire was filled out by the parents. A total of 33 and 52 children in the control group and 41 and 78 children in the intervention group answered the HRQoL and sleep habits questions, respectively, and were included. The intervention group received individual family counselling and participated in physical activity groups and nutrition courses. The Children's Sleep Habits Questionnaire (CSHQ) and Kidscreen-10 index were used to assess sleep habits and HRQoL. At baseline, the mean average scores for HRQoL were 50.0 [standard deviation (SD) 8.1] for the intervention group and 49.0 (SD 10.1) for the control group. For sleep habits at baseline, the mean average scores were 45.2 (SD 11.8) for the intervention group and 46.0 (SD 11.9) for the control group. No significant changes in HRQoL and sleep habits after the intervention were revealed. Overall, the family-based lifestyle intervention targeting overweight and obese children in a primary-care setting showed no significant effect on HRQoL or sleep quality.
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Affiliation(s)
- Annette Løvheim Kleppang
- Faculty of Health and Sport Sciences, Department of Health and Nursing Science, University of Agder, Post-Box 422, 4604, Kristiansand, Norway.
- Department of Public Health and Sport Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway.
| | - Eirik Abildsnes
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kristin Haraldstad
- Faculty of Health and Sport Sciences, Department of Health and Nursing Science, University of Agder, Post-Box 422, 4604, Kristiansand, Norway
| | - Tonje Holte Stea
- Faculty of Health and Sport Sciences, Department of Health and Nursing Science, University of Agder, Post-Box 422, 4604, Kristiansand, Norway
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Christensen Pacella KA, Forbush KT. Weight bias internalization is positively associated with insomnia symptom severity in young women with disordered eating. Sleep Health 2024; 10:60-64. [PMID: 38016909 PMCID: PMC10922884 DOI: 10.1016/j.sleh.2023.10.014] [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: 03/21/2023] [Revised: 10/04/2023] [Accepted: 10/24/2023] [Indexed: 11/30/2023]
Abstract
OBJECTIVE Social stigma has been associated with disparities in sleep heath; however, one type of stigma that has been less evaluated is weight bias internalization. Previous studies have shown inconsistent results linking weight bias internalization and sleep problems and few have examined associations with insomnia. METHODS Women with disordered eating (N = 173, Mage=20.22, SD=1.70, range=18-25) completed questionnaires measuring insomnia symptoms, weight bias internalization, alcohol use, and dysphoria. Linear regression tested associations between weight bias internalization and insomnia symptom severity, after adjusting for demographic variables, alcohol use, and dysphoria. RESULTS Weight bias internalization, alcohol use, and dysphoria were significantly positively associated with insomnia symptom severity above-and-beyond demographic variables. CONCLUSIONS Although effect sizes were small, weight bias internalization was associated with greater insomnia symptom severity. Results add to the growing literature examining the associations of stigma with sleep health.
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Affiliation(s)
| | - Kelsie T Forbush
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
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Weng HC, Chang SM, Hsu JC, Yang YN, Lin CY. Age and gender differences in misperceptions of body shape in a Taiwanese population. J Eat Disord 2023; 11:110. [PMID: 37400881 DOI: 10.1186/s40337-023-00837-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 06/23/2023] [Indexed: 07/05/2023] Open
Abstract
OBJECTIVES Most studies of body size perception have been performed in adolescents, and most focus on gender differences in accurate perception of body size. This study investigated misperceptions of body sizes among males and females at different stages of adulthood in Taiwan. DESIGNS In-person home interviews were used to proportionally and randomly select 2095 adult men and women to answer the East Asian Social Survey. Participants were divided into 18-39, 40-64, and 65 + age groups. The main variables analyzed were self-perceived body size and standardized BMI. RESULTS Women, unlike men, were more likely to misperceive their body size as being overweight (OR = 2.92; p < .001). People with higher self-perceived social status were less likely to misperceive themselves as overweight (OR = 0.91; p = .01). People with college educations were 2.35 times more likely to overestimate their body size as being heavier than they were (p < .001) and less likely to underestimate it as being thinner than they were (OR = 0.45; p < .001). Women 18-35 and 36-64 years old were 6.96 and 4.31 times more likely (p < .001) to misperceive themselves as being overweight than women 65 or older, who were more likely to misperceive themselves as being too thin. There were no significant differences in body size misperceptions among the three age groups of adult men (p > .05). We found no different significant discrepancies between self-perceived body size and actual BMI between the older men and women (p = .16). However, younger and middle-aged men were 6.67 and 3.1 times more likely to misperceive themselves as being too thin than women in their same age groups (OR = 0.15 and OR = 0.32, respectively). CONCLUSIONS Age and gender affect self-perceptions of body size in Taiwan. Overall, women are more likely than men to misperceive themselves as being too big, and men are more likely than women to misperceive themselves as too thin. Older women, however, were more likely to misperceive themselves as being too thin. Clinicians and health educators should know that people's perceptions and concerns regarding their body size vary by age and gender.
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Affiliation(s)
- Hui-Ching Weng
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan City, Taiwan.
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, 1 University Road, East Dist., Tainan City, 701401, Taiwan.
| | - Sheng-Mao Chang
- Department of Statistics, National Taipei University, New Taipei City, Taiwan
| | - Jason C Hsu
- International PhD Program in Biotech and Healthcare Management, College of Management, Taipei Medical University, Taipei City, Taiwan
- Research Center of Health Care Industry Data Science, College of Management, Taipei Medical University, Taipei City, Taiwan
- Clinical Big Data Research Center, Taipei Medical University Hospital, Taipei Medical University, Taipei City, Taiwan
| | - Yung-Ning Yang
- Department of Pediatrics, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan.
- School of Medicine, I-Shou University, 1, Sec. 1, Syuecheng Rd., Dashu District, Kaohsiung, 84001, Taiwan.
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, 1 University Road, East Dist., Tainan City, 701401, Taiwan
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
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Liu X, Zhang W, Yue W, Sun C, Li W. From Weight Bias Internalization to Health-Related Quality of Life: Self-esteem and Psychopathology in Pre-bariatric Surgery Patients. Obes Surg 2022; 32:3705-3713. [PMID: 36057756 PMCID: PMC9613576 DOI: 10.1007/s11695-022-06261-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 08/24/2022] [Accepted: 08/25/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION It has been reported that people seeking bariatric surgery have poor health-related quality of life (HRQoL). Weight bias internalization (WBI) is prevalent in this population and strongly associated with psychopathology and health status. However, the psychological mechanisms underlying the relationship between WBI and the physical and mental dimensions of HRQoL remain to be clarified. METHODS A preoperative sample of patients with obesity (N = 246; women = 75.2%; Mage = 32.07) completed validated measures as part of a routine preoperative psychological assessment to assess their WBI, self-esteem, anxiety symptoms, depressive symptoms, and HRQoL. RESULTS After controlling for the effects of gender, age, and BMI, WBI was linked to poorer physical and mental HRQoL through low self-esteem and increased psychological distress, including anxiety and depressive symptoms. CONCLUSION In pre-bariatric surgery patients with obesity, high WBI may predict impairments in mental and physical HRQoL by lowering self-esteem, and further increasing anxiety and depressive symptoms. Interventions targeting WBI may be an important aspect to consider in the clinical treatment of pre-bariatric surgery patients. Further longitudinal studies are warranted to determine causality.
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Affiliation(s)
- Xu Liu
- Operating Theater, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, People's Republic of China
| | - Wenjing Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, 250012, People's Republic of China
| | - Wenwen Yue
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, 250012, People's Republic of China
| | - Chaonan Sun
- Operating Theater, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, People's Republic of China
| | - Weihua Li
- Operating Theater, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, People's Republic of China.
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Body Weight, Weight Self-Perception, Weight Teasing and Their Association with Health Behaviors among Chinese Adolescents-The Shanghai Youth Health Behavior Survey. Nutrients 2022; 14:nu14142931. [PMID: 35889888 PMCID: PMC9320621 DOI: 10.3390/nu14142931] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 07/11/2022] [Accepted: 07/14/2022] [Indexed: 01/16/2023] Open
Abstract
Weight-related status has been associated with the physical and psychological health of adolescents. This cross-sectional study evaluated three different kinds of weight-related statuses (Body Mass Index (BMI), weight self-perception and weight teasing from others) among Chinese adolescents and identified their associations with health risk behaviors (lack of healthy dietary behavior, unhealthy dietary behavior, binge eating behavior, lack of physical activity (PA), sedentary behaviors (SB) and sleep disturbance). A stratified random cluster sampling method was used to select 10,070 students aged 11−18 years old from schools in Shanghai. Self-reported questionnaires were collected, weight-related statuses were divided into three categories and six specific health risk behaviors were classified into two groups: positive or negative. Overall, 27.82% of the adolescents were classified as being overweight and obese (35.61% of boys and 18.21% of girls), 43.45% perceived themselves as too heavy and 30.46% experienced weight teasing in the past. Among overweight or obese participants, 50.55% have been teased about their weight, and 77.48% perceived themselves as too heavy. Weight perception and weight teasing were significantly associated with health risk behaviors rather than the actual body weight status based on BMI, especially regarding binge eating behavior (body weight status (BMI): p > 0.05, underweight perception: OR = 1.18, 95%CI 1.03−1.34; weight teasing for more than once a year: OR = 2.00, 95%CI 1.76−2.27). In addition, weight perception and weight teasing were significantly associated with health risk behaviors, mainly in normal and overweight/obese groups but not in underweight groups. Weight teasing and weight self-perception play an independent and stronger role than actual body weight in the health behaviors of adolescents. This calls for more attention and intervention to reduce peer bullying and stigmas on weight among adolescents.
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Nwanaji-Enwerem U, Condon EM, Conley S, Wang K, Iheanacho T, Redeker NS. Adapting the Health Stigma and Discrimination Framework to understand the association between stigma and sleep deficiency: A systematic review. Sleep Health 2022; 8:334-345. [PMID: 35504839 PMCID: PMC9233012 DOI: 10.1016/j.sleh.2022.03.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 02/11/2022] [Accepted: 03/08/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Sleep deficiency and sleep disorders disproportionally affect socially disadvantaged and marginalized individuals and groups. Recent evidence suggests that stigma, a social process characterized by labeling, stereotyping, and prejudice, is associated with sleep characteristics. PURPOSE Guided by the Health Stigma and Discrimination Framework, the purpose of this systematic review is to describe associations between dimensions of stigma and sleep deficiency and to identify future directions for research. METHODS We searched the OVIDPsycINFO, OVIDEMASE, OVIDMEDLINE, and CINAHL databases for empirical research studies that reported relationships between the 3 dimensions of stigma-internalized, perceived, and anticipated-and characteristics of sleep deficiency-duration, continuity/efficiency, timing, alertness/sleepiness, quality, and disorders. RESULTS Of 1717 articles, 15 met our inclusion criteria. The most frequently assessed dimensions of stigma were internalized and perceived stigma. Characteristics of sleep deficiency were measured by self-report and included sleep quality, duration, trouble sleeping, and insomnia symptoms. We found consistent evidence that stigma, whether internalized, perceived, or anticipated, is associated with self-reported characteristics of sleep deficiency. CONCLUSIONS This evidence base can be further strengthened with prospective studies that incorporate both multidimensional measures of stigma and objective measures of sleep characteristics. We outline research implications that can clarify underlying mechanisms and more precisely define the relationships between stigma and sleep and inform interventions to address stigma, improve sleep, and reduce the health inequities that disproportionately affect individuals from socially disadvantaged and marginalized groups.
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Affiliation(s)
| | - Eileen M Condon
- University of Connecticut School of Nursing, Storrs, Connecticut, USA
| | | | - Katie Wang
- Yale School of Public Health, New Haven, Connecticut, USA
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Warnick JL, Darling KE, West CE, Jones L, Jelalian E. Weight Stigma and Mental Health in Youth: A Systematic Review and Meta-Analysis. J Pediatr Psychol 2021; 47:237-255. [PMID: 34791368 DOI: 10.1093/jpepsy/jsab110] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 09/23/2021] [Accepted: 09/29/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE Over the past two decades, there has been a steady increase in research focused on the association between weight-based stigma and mental health outcomes in children and adolescents. The present study is a systematic review and meta-analysis of the associations between weight stigma and mental health in youth. METHODS A systematic search of PubMed, PsychInfo, and Embase databases was conducted in January 2020. Inclusion criteria included the following: (a) examined an association between weight stigma and a mental health outcome, (b) mean sample age <18 (+1 standard deviation) years, (c) written in English, and (d) peer reviewed. Forty eligible articles were identified. The moderating effects of age, sex (percent female), weight status (percent with overweight/obesity), and study quality were examined. RESULTS Overall, meta-analytic findings using a random-effects model indicated a statistically significant moderate association between weight stigma and poorer mental health outcomes (r = .32, 95% confidence interval [0.292, 0.347], p < .001). Age and study quality each moderated the association between weight stigma and mental health. Generally, the study quality was fair to poor, with many studies lacking validated measurement of weight stigma. CONCLUSIONS Although there was a significant association between weight stigma and mental health in youth, study quality hinders the current body of literature. Furthermore, findings highlight the lack of consideration of internalized weight stigma in child populations, the importance of using validated measures of weight stigma, and the need for increased awareness of how these associations affect populations of diverse backgrounds.
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Affiliation(s)
- Jennifer L Warnick
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, USA.,Weight Control and Diabetes Research Center, The Miriam Hospital, USA
| | - Katherine E Darling
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, USA.,Weight Control and Diabetes Research Center, The Miriam Hospital, USA
| | - Caroline E West
- Department of Psychological Sciences, Kent State University, USA
| | - Laura Jones
- Department of Clinical and Health Psychology, University of Florida, USA
| | - Elissa Jelalian
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, USA.,Weight Control and Diabetes Research Center, The Miriam Hospital, USA
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Poorebrahim A, Lin CY, Imani V, Griffiths MD, Pakpour AH. A Prospective Study Examining the Relationship Between Dispositional Mindfulness and Insomnia Among Male Prisoners in Iran: The Mediating Effect of Psychological Distress and Perceived Stress. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-020-00287-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Lin CY, Cheung P, Imani V, Griffiths MD, Pakpour AH. The Mediating Effects of Eating Disorder, Food Addiction, and Insomnia in the Association between Psychological Distress and Being Overweight among Iranian Adolescents. Nutrients 2020; 12:nu12051371. [PMID: 32403387 PMCID: PMC7284879 DOI: 10.3390/nu12051371] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 04/25/2020] [Accepted: 05/08/2020] [Indexed: 12/16/2022] Open
Abstract
With obesity and excess weight remaining a serious concern worldwide, investigating the mechanisms underlying this is of great importance. Psychological distress is a possible trigger contributing to excess weight for adolescents. Moreover, the association between psychological distress and excess weight may be mediated by eating disorder, food addiction, and insomnia. The present study utilized parallel mediation analysis to assess the aforementioned associations and possible mediation effects among Iranian adolescents. Through stratified and clustered sampling, adolescents (N = 861; mean ± SD age = 15.9 ± 3.2; 372 males) participated and were followed for a one-year period. Excess weight (standardized body mass index, z-BMI); psychological distress (Depression, Anxiety, and Stress Scale-21); eating disorder attitudes (Eating Attitude Test-26); food addiction (Yale Food Addiction Scale for Children); and insomnia (Insomnia Severity Index) were assessed. Eating disorder attitudes, food addiction, and insomnia were significant mediators in the association of psychological distress and z-BMI. Additionally, psychological distress had direct effects on z-BMI. Given that eating disorder attitudes, food addiction, and insomnia showed mediated effects in the temporal association of psychological distress and excess weight, healthcare providers are encouraged to design programs on improving these three mediators to help adolescents overcome excess weight problems.
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Affiliation(s)
- Chung-Ying Lin
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong; (C.-Y.L.); (P.C.)
| | - Pauline Cheung
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong; (C.-Y.L.); (P.C.)
| | - Vida Imani
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz 5166/15731, Iran;
| | - Mark D. Griffiths
- Nottingham Trent University, International Gaming Research Unit, Psychology Department, Nottingham NG1 4FQ, UK;
| | - Amir H. Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin 3419759811, Iran
- Department of Nursing, School of Health and Welfare, Jönköping University, SE-551 11 Jönköping, Sweden
- Correspondence: ; Tel.: +98-28-33239259
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