Social anxiety and disordered overeating: an association among overweight and obese individuals

Cardiometabolic Risk Factors among Women with Eating Disorders in Saudi Arabia

Objective

To assess selected cardiometabolic risk factors among Saudi women with eating disorders.

Methods

An epidemiological, cross-sectional study included women aged between 18 and 50 years with eating disorders (EDs). Women with chronic diseases, pregnant, or lactating were excluded. The weight and height were measured for the calculation of the body mass index (BMI). Fasting blood samples were drawn for the analysis of blood sugar, glycated haemoglobin, lipid profile, albumin, haemoglobin, and C-reactive levels. The atherogenic dyslipidemia index (AIP) was also calculated.

Results

Patients (n = 100) were enrolled. Fasting blood glucose levels were critically low among women with anorexia nervosa (AN) and bulimia nervosa (BN) but normal among those with binge eating disorders (BEDs). All women with ED suffered from anaemia based on their haemoglobin levels as well as dyslipidemia, hypoalbuminaemia, and high C-reactive protein levels. Women with AN had low cardiovascular (CV) risks based on their normal AIP values. However, women with BN and BED had intermediate CV risks. On average, women with AN suffered from severe thinness and those with BN had normal BMIs, whereas those with BED were overweight. Women (90%) with BN and BED were overweight and/or obese.

Conclusion

Women with ED had a high risk of cardiovascular diseases defined by their hypoalbuminaemia, dyslipidemia, anaemia, and high AIP levels. Dietitians and psychiatrists are advised to collaborate in assessing the potential risk of having eating disorders to provide counselling sessions to women on healthy balanced diets and their effect on health.

Multiple mediation of the association between childhood emotional abuse and adult obesity by anxiety and bulimia - a sample from bariatric surgery candidates and healthy controls

Bulimia, which means a person has episodes of eating a very large amount of food (bingeing) during which the person feels a loss of control over their eating, is the most primitive reason for being overweight and obese. The extended literature has indicated that childhood emotional abuse has a close relationship with adverse mood states, bulimia, and obesity. To comprehensively understand the potential links among these factors, we evaluated a multiple mediation model in which anxiety/depression and bulimia were mediators between childhood emotional abuse and body mass index (BMI). A set of self-report questionnaires, including the Childhood Trauma Questionnaire (CTQ), Beck Anxiety Inventory, Beck Depression Inventory (BDI), and Eating Disorder Inventory (EDI), was sent out. Clinical data from 37 obese patients (age: 29.65 ± 5.35, body mass index (BMI): 37.59 ± 6.34) and 37 demographically well-matched healthy people with normal body weight (age: 31.35 ± 10.84, BMI: 22.16 ± 3.69) were included in the investigation. We first performed an independent t-test to compare all scales or subscale scores between the two groups. Then, we conducted Pearson correlation analysis to test every two variables' pairwise correlation. Finally, multiple mediation analysis was performed with BMI as the outcome variable, and childhood emotional abuse as the predictive variable. Pairs of anxiety, bulimia, and depression, bulimia were selected as the mediating variables in different multiple mediation models separately. The results show that the obese group reported higher childhood emotional abuse (t = 2.157, p = 0.034), worse mood state (anxiety: t = 5.466, p < 0.001; depression: t = 2.220, p = 0.030), and higher bulimia (t = 3.400, p = 0.001) than the healthy control group. Positive correlations were found in every pairwise combination of BMI, childhood emotional abuse, anxiety, and bulimia. Multiple mediation analyses indicate that childhood emotional abuse is positively linked to BMI (β = 1.312, 95% CI = 0.482-2.141). The model using anxiety and bulimia as the multiple mediating variables is attested to play roles in the relationship between childhood emotional abuse and obesity (indirect effect = 0.739, 95% CI = 0.261-1.608, 56.33% of the total effect). These findings confirm that childhood emotional abuse contributes to adulthood obesity through the multiple mediating effects of anxiety and bulimia. The present study adds another potential model to facilitate our understanding of the eating psychopathology of obesity.

Unveiling the links between physical activity, self-identity, social anxiety, and emotional eating among overweight and obese young adults

Introduction

Emotional eating not only contributes to physical obesity but also leads to the experience of guilt and shame, exacerbating emotional problems. Increasing physical activity, adopting a balanced diet, and seeking psychological support help improve emotional eating issues in overweight or obese young adults, enhancing overall mental and physical well-being.

Methods

This study investigates the correlation between physical activity, self-identity, social anxiety, and emotional eating among 373 overweight and obese college students aged 18-26 in central China. By utilizing AMOS v.26, a structural equation model was constructed to examine the hypotheses.

Results

The findings reveal that physical activity significantly influences self-identity and social anxiety, which, in turn, significantly impact emotional eating. Moreover, self-identity and social anxiety serve as mediators in the relationship between physical activity and emotional eating. These results emphasize the role of physical activity in mitigating emotional eating among young individuals struggling with overweight and obesity.

Discussion

Consequently, the government and relevant agencies are urged to address the issue of obesity among young adults and provide support for their engagement in physical activity.

Changes in Food Consumption, BMI, and Body Composition in Youth in the US during the COVID-19 Pandemic

Rates of childhood overweight/obesity have risen for decades; however, data show the prevalence increased at a faster rate during the COVID-19 pandemic. Pandemic-associated increases in youth's body mass index (BMI; kg/m2) have been attributed to decreases in reported physical activity; few studies have examined changes in food intake. We therefore examined changes in total energy, nutrient consumption, BMI, BMIz, and adiposity longitudinally over 3 years, comparing healthy youth aged 8-17 years assessed twice prior to the pandemic, to youth seen once before and once during the pandemic. The total energy intake and percent macronutrient consumption were assessed using a standardized, laboratory-based, buffet-style meal. Height and weight were measured and adiposity was collected via dual energy X-ray absorptiometry. Generalized linear model univariate analyses investigated differences between groups. One-hundred-fifteen youth (15.6 + 2.8 years 47.8% female; 54.8% White) from the Washington D.C., Maryland, and Virginia greater metropolitan area participated. In this secondary analysis, neither changes in total energy intake (p = 0.52) nor changes in nutrient consumption were significantly different between the two groups (ps = 0.23-0.83). Likewise, changes in BMI, BMIz, and adiposity (ps = 0.95-0.25) did not differ by group. Further research should investigate food intake and body composition, comparing youth with and without overweight/obesity to better identify those at greatest risk of excess weight gain during the pandemic.

The interaction between affective lability and eating expectancies predicts binge eating

Both affective lability and eating expectancies have been found to predict binge eating. There is the additional possibility that the joint effect of affective lability and eating expectancies incurs further risk: perhaps expectancies for affective relief from eating operate more strongly in those experiencing frequent, rapid shifts in emotion. In the current study, we tested whether such a joint effect predicts binge eating prospectively in college students. We assessed affective lability, eating expectancies, and binge eating in 358 college students at two time points during the first year of college (e.g., December and April). The interaction of affective lability and eating expectancies in December predicted binge eating 4 months later in April. The influence of eating expectancies on binge eating was stronger at higher levels of affective lability. Findings offer support to the hypothesis that risk factors may transact to further elevate risk for eating disorder behaviors.Clinical implicationsThe interaction of affective lability and eating expectancies predicts binge eatingRisk factors may interact to further increase binge eatingIdentification of co-occurring risk factors may have vital treatment implications.

Untangling the associations between generalized anxiety and body dissatisfaction: The mediating effects of social physique anxiety among collegiate men and women

Researchers disagree on which types of anxiety influence body dissatisfaction and how gender (cisgender men vs. cisgender women) may impact these associations. Specifically, little is known about how generalized anxiety and social physique anxiety combine to predict body dissatisfaction in men and women. The purpose of the present study was to explore a moderated mediation model in which the relationships between generalized anxiety and body dissatisfaction (drive for thinness and drive for muscularity) were mediated by social physique anxiety and moderated by gender. Data from 423 U.S. college students (n = 259 women) were analyzed using multigroup structural equation modeling. Generalized anxiety was positively associated with social physique anxiety, and this association was significantly stronger for men than for women. Neither social physique anxiety nor generalized anxiety were associated with drive for muscularity. Social physique anxiety was positively and significantly associated with drive for thinness equally for men and women and emerged as a significant mediator. These results highlight gender differences/similarities in body image and suggest drive for thinness and social physique anxiety may have a common factor of generalized anxiety. When helping clients who suffer with body dissatisfaction, clinicians and researchers may wish to focus on generalized anxiety (and not just social physique anxiety).

The boundary conditions by which body-esteem leads to eating disorders risk among adolescents

Adolescents are believed to be susceptible to eating disorders (EDs) due to their serious fear of appearance evaluation from society. Related to this, low body-esteem has been found to be common among individuals with EDs. The present study mainly aimed to explore how emotional intelligence (EI), gender, and body size influence the relationship between body-esteem and EDs risk among adolescents. 128 middle school students classified as obese and 128 age-and gender-matched normal weight controls were included. All participants were asked to fill out self-report measures of body-esteem, EI, and EDs risk. The results showed that (1) both gender and body size directly influenced body-esteem and EDs risk; (2) EI acted as a moderator between body-esteem and EDs risk; and (3) both gender and body size interacted with EI and body-esteem to influence EDs risk. These findings contribute to our understanding of boundary conditions by which low body-esteem leads to EDs among adolescents, and help us to correspondingly conduct targeted intervention of adolescents' EDs.

1-Boc-Piperidine-4-Carboxaldehyde Prevents Binge-Eating Behaviour and Anxiety in Rats

BACKGROUND

Piperidines are biogenic amines studied mainly in toxicology because they were initially found as alkaloids from peppers and insect venoms. Piperidines are also produced in the human body, and their actions seem to be related to wakefulness/sleep and other cognitive phenomena. Piperidines have been minimally characterized for therapeutic applications. In this context, 1-Boc-piperidine-4-carboxaldehyde (1-Boc-piperidine) is a piperidine-derivative molecule with no mechanism of action reported, although its uses include the synthesis of GPR119 selective agonists that have been patented as anti-obesity drugs.

OBJECTIVES

The aim of this work was to study the effects of 1-Boc-piperidine on binge-eating behaviour and anxiety in Wistar rats.

METHODS

In experimental protocol 1, binge-eating behaviour was induced in animals that received pre-treatment (i.p.) with (i) vehicle (methanol 10%; 1 mL/kg), (ii) 1-Boc-piperidine (1 µmol kg-1), or (iii) 1-Boc-piperidine (10 µmol kg-1). In experimental protocol 2, mildly stressed animals were evaluated in the elevated plus maze under the acute effects of the pre-treatments applied in experimental protocol 1.

RESULTS AND CONCLUSIONS

1-Boc-piperidine decreased, in a dose-dependent manner, the intake of calories from a succulent hyper-caloric food in a binge-eating protocol in female rats, whereas the acute exposition to this piperidine exerted an anxiolytic effect in the male rat. In both effects, the mechanism of action remains to be characterized.

A rational emotive behavior therapy-based intervention for binge eating behavior management among female students: a quasi-experimental study

BACKGROUND

Binge eating behavior is highly likely to progress to an eating disorder, with female students particularly at risk.

OBJECTIVE

This study aimed to verify the effect of a binge eating behavior management program, based on rational emotive behavior therapy (REBT), on binge eating behavior and related cognitive and emotional factors among female college students.

METHOD

The study, conducted from November 1 to December 2, 2016, involved a pretest-posttest design and nonequivalent control group. The sample included 24 and 22 first- to third-year students, from a college in South Korea, in the experimental and control groups, respectively. Data were collected using self-esteem, covert narcissism, perfectionism, body dissatisfaction, anxiety, depression, and binge eating scales and analyzed via frequency analysis, χ² tests, t tests, and analysis of covariance.

RESULTS

The results indicated that the REBT-based binge eating behavior management program exerted positive effects on participants' self-esteem, reducing covert narcissism, body dissatisfaction, anxiety, depression, and binge eating. However, there was no significant difference in perfectionism, although the experimental group's mean score decreased from pretest to posttest.

CONCLUSIONS

Based on the results, the program was considered to be effective, and is expected to be useful in preventing the development of eating disorders among female college students by treating binge eating behavior and related cognitive and emotional factors. This intervention could ultimately contribute to the improvement of female college students' health and quality of life.

Social and early life adversity and chronic health conditions among Tunisian adults

Early life adversities (ELAs) are shown as significant risk factors for chronic health conditions (CHCs). ELAs include multiple types of abuse such as the social abuse (peer, community, and collective violence). The purpose is to describe the relationship between childhood social abuse and chronic conditions in adulthood among a sample of adults in Tunisia and to investigate the role of obesity and tobacco use as mediators of this association. A cross-sectional study was conducted in Tunisia, from January to June 2016 using the Arabic Adverse Childhood Experiences International Questionnaire (ACE-IQ). Items of social abuse (peer violence, witnessing community violence, and exposure to collective violence) were analyzed. A total of 2,120 adults were enrolled. After adjustment for age, gender, and intrafamilial ELA, social adversities were associated significantly with the selected CHC. Experiencing more than two social ELA increase the risk of occurrence of hypertension and coronary diseases. After accounting for the indirect effect of body mass index, statistically significant partial mediation effects were observed for the cumulative number of social ELA as the exposure variable and chronic diseases as the outcome variable (p ≤ .001; % mediated = 44.5%). These findings support an association between many chronic health disorders and childhood social abuse, independently of intrafamilial ACEs.

Risk factors and temporal patterns of disordered eating differ in adolescent boys and girls: Testing gender-specific appearance anxiety models

Adolescent dieting and disordered eating (DE) are risks for clinical eating disorders. In this five-wave longitudinal study, we tested gender-specific models linking early risk factors to temporal patterns of DE, considering appearance anxiety as a mediator. Participants were 384 Australian students (age 10 to 13; 45% boys) who reported their purging and skipping meals, experience with appearance-related teasing, media pressure, and appearance anxiety. Parents reported pubertal maturation and height/weight was measured. Gender differences in temporal patterns of DE were found and predictive models were tested using latent-variable growth curve and path models. Boys’ DE was generally stable over time; girls showed stability in purging but an average increase in skipping meals. Peer teasing, media pressure, and pubertal maturation were associated with more elevated initial DE in girls, and pubertal maturation was associated with a steeper increase in DE. For boys, body mass index had a direct positive association with DE. Appearance anxiety was associated with more DE, but there was only one significant indirect effect via anxiety, which was for boys’ pubertal maturation. Findings support the dominant role of social interactions and messages, as well as pubertal maturation, for girls’ DE and the prominence of physical risk factors for explaining boys’ DE.

Binge eating and social anxiety in treatment-seeking adolescents with eating disorders or severe obesity

PURPOSE

Binge eating is a common behavior in children and adolescents who suffer from either eating disorders (EDs) or from severe obesity. The purpose of the current study was to explore the association between social anxiety and binge eating and compare prevalence rates of social anxiety between youth with severe obesity or EDs who did or did not engage in binge eating.

METHODS

Retrospective data on treatment-seeking youth's (n = 490) eating behaviors and social anxiety at assessment were analyzed.

RESULTS

Results indicate that those who engage in binge eating have higher rates of social anxiety; frequency of binges does not predict severity of social anxiety, though social anxiety predicts presence of binge eating. Adolescents with EDs had higher rates of social anxiety than those with obesity, and for both groups, rates of social anxiety were highest in those who binge.

CONCLUSIONS

Clinicians who treat youth with EDs and with obesity should be aware of the relationship between binge eating and social anxiety and of the need for treatment to address both these disorders.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

Wanting to eat matters: Negative affect and emotional eating were associated with impaired memory suppression of food cues

OBJECTIVE

Previous studies have linked emotional eating with negative affect and decreased inhibitory control. However, studies on inhibitory control have generally focused on motor inhibition. How to stop higher-level cognitive processes, such as food-related memory retrieval or voluntary thoughts, received few direct investigation in field of food intake or food-related decision making. The current study, adopting Anderson and Green's Think/No-Think paradigm, aimed to investigate the relationship between emotional eating, negative affect and food-related memory suppression.

METHOD

Sixty-one young females participated in the current study, during which they finished food specific Think/No-Think task. Their positive and negative affect and eating style were measured using Positive Affect and Negative Affect Schedule and Dutch Eating Behavior Question. The reward value of the food item used in the Think/No-Think task was measured using liking and wanting ratings.

RESULTS

As hypothesized, negative affect and emotional eating were associated with decreased memory suppression of palatable food cues. Further analysis showed that higher emotional eating was associated with greater wanting only among the food items which were previously suppressed however remembered later.

DISCUSSION

The current study presents the first evidence that negative affect and emotional eating were associated with impaired memory suppression of palatable food cues, and it provided insight into the interaction between reward valuation for the food cues and hippocampal memory mechanisms during retrieval suppression.

Association between food insecurity and emotional eating in Latinos and the mediating role of perceived stress

OBJECTIVE

To examine the association between food insecurity and emotional eating (EE) in US Latinxs and explore the mediating role of perceived stress.

DESIGN

Cross-sectional analysis. Food insecurity was measured with the six-item US Department of Agriculture Household Food Security Scale; EE with the Three-Factor Eating Questionnaire R18-V2; and perceived stress with Cohen's Perceived Stress Scale-10. Covariates included age, sex, education, marital status, household size and country of birth. Mediation was tested using the Baron and Kenny method and the mediated proportion was calculated. Analyses included multivariable linear regression and multinomial logistic regression.

SETTING

A largely Latinx city in Massachusetts, USA. Participants were recruited from a community health centre serving a large portion of this Latinx community.

PARTICIPANTS

Latinx individuals (n 580), aged 21-84 years.

RESULTS

Overall, 34·4 % were food insecure and 33·8 % experienced High EE. Food insecurity was associated (adjusted OR; 95 % CI) with higher odds of High EE (1·96; 1·28, 3·02) but not Low EE (1·27; 0·82, 1·99). Food insecurity was associated (β; 95 % CI) with higher perceived stress (5·69; 4·20, 7·19). Perceived stress was associated (adjusted OR; 95 % CI) with High EE (1·09; 1·06, 1·12) but not Low EE (1·00; CI 0·97, 1·02). When perceived stress was added in the main effects model, food insecurity was no longer associated (OR; 95 % CI) with High EE (1·31; 0·83, 2·07) and explained 69·9 % of the association between food insecurity and High EE.

CONCLUSIONS

The association between food insecurity and high EE among Latinxs may be largely mediated by perceived stress. Longitudinal studies are needed.

The relative importance of social anxiety facets on disordered eating in pediatric obesity

PURPOSE

Children with obesity demonstrate increased risk for eating disorders and internalizing psychopathology. Research in adults indicates unique facets of social anxiety differentially relate to eating pathology. These associations remain understudied in pediatric samples. The current study evaluated associations between social anxiety and disordered eating, and tested the relative importance of distinct social anxiety constructs-fear of negative evaluation, social anxiety in general situations, and social anxiety in new situations-for disordered eating in weight-loss treatment-seeking youth with obesity.

METHODS

One-hundred and thirty-five youth (M_age 12.6 years; Range 8-17 years; M_BMIz = 2.6) from a multidisciplinary outpatient pediatric obesity clinic completed questionnaires assessing dimensions of social anxiety and the Children's Eating Attitudes Test (ChEAT). Dominance analyses were used to evaluate the relative importance of social anxiety facets associated with ChEAT subscales.

RESULTS

Social anxiety subscales did not correlate with Dieting scores. Dominance analyses indicated Fear of Negative Evaluation (FNE) evinced complete dominance, thus, emerging as the most important predictor relative to other social anxiety components for Body/Weight Concern and Food Preoccupation. General dominance weights for FNE accounted for more than twice the shared and unique variance, relative to other independent variables within the Body/Weight Concern and Food Preoccupation models, respectively.

CONCLUSIONS

Unique facets of social anxiety differentially relate to disordered eating in youth with obesity. Findings suggest nuanced assessment of anxiety constructs, such as FNE, in pediatric obesity treatment settings may aid in identifying youth at risk for disordered eating attitudes and behaviors.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

Linking body esteem to eating disorders among adolescents: A moderated mediation model

This study explored the roles of social appearance anxiety and emotional intelligence in the relationship between body esteem and eating-disorder risk among adolescents. A total of 2509 high-school students were sampled to participate in the study. Statistical methods mainly involved descriptive statistics, Bootstrapping, and structural equation modeling analyses. The results showed that social appearance anxiety partially mediated the relationship between body esteem and eating-disorder risk among adolescents; meanwhile, emotional intelligence moderated the effects of body esteem on social appearance anxiety and eating-disorder risk among adolescents.

Disordered Eating Among Individuals with Excess Weight: a Review of Recent Research

PURPOSE OF REVIEW

The purpose of this review was to examine different forms of disordered eating among individuals with excess weight, including their rates, correlates, and psychosocial treatments.

RECENT FINDINGS

Binge eating/binge eating disorder, loss of control eating, emotional eating, and food addiction are all fairly prevalent among individuals with excess weight. They appear to share many of the same correlates, including broader eating disorder psychopathology, body/shape/weight concerns, depression, anxiety, and low self-esteem. Behavioral, cognitive-behavioral, and third-wave (e.g., acceptance, mindfulness) therapies appear effective in improving binge eating, loss of control eating, emotional eating, associated features (e.g., weight and shape concerns), and psychological distress (e.g., depression). Certain forms of disordered eating are elevated among individuals with excess weight, and psychosocial interventions have been found effective in improving symptomatology. Empirical research examining the efficacy of treatments for food addiction is lacking, and greatly needed given both its rate and controversy.

Chewing and swallowing in obese individuals referred to bariatric surgery/gastroplasty - a pilot study

ABSTRACT Objective: to describe the chewing and swallowing pattern of obese individuals indicated for bariatric surgery/gastroplasty before the procedure, using standardized clinical protocols. Methods: a cross-sectional descriptive case-control study that presents preliminary data for a larger investigation. Eight participants matched for age and sex were divided into two groups (four in the research group and four as controls) and submitted to clinical speech therapy assessment using the “Questionnaire on eating behavior and the anatomofunctional conditions of the stomatognathic system” from the Expanded Protocol of Orofacial Myofunctional Evaluation with Scores (OMES-E) and the maximum tongue pressure test. Results: when compared to controls, participants from the research group exhibited a predominantly unilateral chewing preference; reported that they just “swallowed food”; repeated swallowing of liquid and solid foods, with facial muscle tension; increased cheek volume and the presence of flaccidity; shorter meal and chewing times; increased tension of the lips, mentalis and facial muscles at rest and during swallowing; predominance of insufficient ability with associated movements and/or tremors during lip, tongue, jaw and cheek movements; and lack of knowledge regarding speech therapy. Conclusion: orofacial myofunctional dysfunctions were more frequent in patients from the research group when compared to controls. A need to increase the number of participants in this case series and conduct a post-surgery reassessment, in order to provide a longitudinal description of the chewing and swallowing pattern, was verified.

Looking beyond the mirror: Psychological distress; disordered eating, weight and shape concerns; and maladaptive eating habits in lawyers and law students

Research indicates that, in comparison to professionals and University students in other disciplines, lawyers and law students may be at greater risk of experiencing high levels of psychological distress. There is also a large body of literature supporting an association between stress, anxiety and depression and unhealthy eating. This article reports on the results of a study of Australian legal professionals and law students that evidence a positive association between psychological distress; disordered eating, weight and shape concerns; and maladaptive eating habits in lawyers and law students. Additionally, this study confirms a positive link between frequency of exercise and subjective physical well-being, that in turn is associated with enhanced emotional well-being. Based on the results of this study, we suggest simple yet effective strategies law firms and law schools might adopt to support the mental health of their staff and students.

Social anxiety in the eating disorders: a systematic review and meta-analysis

Social anxiety disorder is one of the most common comorbid conditions in eating disorders (EDs). The aim of the current review and meta-analysis is to provide a qualitative summary of what is known about social anxiety (SA) in EDs, as well as to compare levels of SA in those with EDs and healthy controls. Electronic databases were systematically searched for studies using self-report measures of SA in ED populations. In total, 38 studies were identified, 12 of which were included in the meta-analyses. For both anorexia nervosa (AN) and bulimia nervosa, there were significant differences between ED groups and HCs, with medium to large effect sizes. Findings from the qualitative review indicate that levels of SA are similar across the ED diagnoses, and SA improves with treatment in AN. In addition, high levels of SA are associated with more severe ED psychopathology, but not body mass index. These findings add to the wider literature on socio-emotional functioning in EDs, and may have implications for treatment strategies.

The effects of parental feeding styles, children’s self-efficacy and social anxiety on adolescent obesity

ABSTRACT Objective To examine the effect of parental feeding styles and children’s self-efficacy and social anxiety on adolescent obesity. Methods The samples of this descriptive and cross-sectional study were collected by using a simple sampling method. The study group was composed of 649 Turkish secondary schools students and their parents. Three secondary schools were selected from both rural and urban areas of the province. Data of the study were collected with the child-parent socio-demographic data collection form, the parenting feeding style questionnaire, the middle school self-efficacy scale and the social anxiety scale for the adolescent. To analyze the data of the study, we used percentages, mean, correlation, and regression analysis. Results The average age of the students was 11.58+1.21 years and percentages of female students 55.0%. The factors that significantly affect male adolescent obesity were fear of social situations in general, interpersonal relations, preventive healthcare self-efficacy, and strict dietary control, respectively. The factors affect male adolescent obesity at the rate of 35.0%. The factors that significantly affect female adolescent obesity were fear of social situations in general, preventive healthcare self-efficacy, emotional feeding, social evasion and distress in new situations, and tolerant dietary control, respectively. These factors affect female adolescent obesity at the rate of 32.8%. Conclusion It is indicated that the obesity of children is affected by self-efficacy levels, social anxiety, and the parental feeding style.

Non-invasive Prefrontal/Frontal Brain Stimulation Is Not Effective in Modulating Food Reappraisal Abilities or Calorie Consumption in Obese Females

Background/Objectives: Previous studies suggest that non-invasive transcranial direct current stimulation (tDCS) applied to the prefrontal cortex modulates food choices and calorie intake in obese humans.

Participants/Methods: In the present fully randomized, placebo-controlled, within-subject and double-blinded study, we applied single sessions of anodal, cathodal, and sham tDCS to the left dorsolateral prefrontal cortex (DLPFC) and contralateral frontal operculum in 25 hungry obese women and investigated possible influences on food reappraisal abilities as well as calorie intake. We hypothesized that tDCS, (i) improves the ability to regulate the desire for visually presented foods and, (ii) reduces their consumption.

Results: We could not confirm an effect of anodal or cathodal tDCS, neither on the ability to modulate the desire for visually presented foods, nor on calorie consumption.

Conclusions: The present findings do not support the notion of prefrontal/frontal tDCS as a promising treatment option for obesity.

Modification of the medical exclusion criterion in DSM-5 social anxiety disorder: Comorbid obesity as an example

BACKGROUND

The DSM 5 modified the medical exclusion criterion from DSM-IV, which now allows for a diagnosis of social anxiety disorder (SAD) to be given if the fears are related only to the medical condition (e.g., obesity) yet cause significant impairment or distress.

METHODS

To examine this modification, the current study compared bariatric surgery candidates with DSM-IV SAD (n=135), modified SAD (clinically significant social fears related to obesity only; n=40), and no history of Axis I disorders (n=616) on variables related to pre-surgical problematic eating behaviors, body image dissatisfaction, functional impairment, and other characteristics related to bariatric surgery. Participants were referred by their surgeon for a psychiatric evaluation as part of the clearance process, and completed a comprehensive, semi-structured diagnostic interview and self-report measures.

RESULTS

There were several differences between those with DSM-IV SAD and modified SAD compared to those with no disorder (e.g., on binge and emotional eating), but the two SAD groups did not differ from each other on any of the comparisons.

LIMITATIONS

Results may not generalize to individuals suffering from obesity in the general population or those seeking other types of weight loss treatment. Because they were seeking psychiatric clearance, they also may have underreported symptoms/problems for fear that they would not get cleared.

CONCLUSIONS

Overall, the modified SAD group more closely resembled the DSM-IV SAD group rather than the no disorder group, providing further support for diagnosing SAD even when the social fears are related to obesity only.

Severe obesity, emotions and eating habits: a case-control study

BACKGROUND

Obesity has a multifaceted etiology that involves genetic, biological and behavioral factors, body growth, eating habits, energy expenditure and the function of adipose tissue. The present study aimed to expand upon knowledge about the relationships among obesity, emotions and eating habits in severely obese individuals using a case-control method.

METHODS

The subject group consisted of 112 individuals (81 females and 31 males) receiving a permanent disability pension primarily for obesity. The control subjects were randomly selected from the same area and were receiving a disability pension for a different primary illness. The controls were matched with the subjects by the place of residence, sex, age, the time since the pension was granted and occupation. Psychiatric interviews were conducted on all participants. The results were analyzed using the chi-squared test (χ²-test) and the percent distribution. The subject and control groups were compared using the t-test for paired variables. Conditional logistic regression analysis was also conducted.

RESULTS

The emotional state of eating was significantly associated with quarrels and feelings of loneliness. The subjects suffered from night eating syndrome, which was associated with an increased risk of early retirement. Binge eating syndrome was observed more frequently in the study group. The subjects reported feeling increased hunger compared with the controls. A significant percentage of the subjects had a body mass index of ≥ 40. No differences in eating habits were observed between the groups.

CONCLUSION

This study provides information on the relationship between emotions and eating habits in obesity, which is a rarely studied topic. We believe that our study provides a novel and necessary overview of the associations among severe obesity, emotions and eating habits.

Social appearance anxiety and dietary restraint as mediators between perfectionism and binge eating: A six month three wave longitudinal study

Binge eating is related to perfectionism and restrained eating. However, the mechanisms underlying these relationships are not well understood. It is possible that social anxiety, specifically social appearance anxiety (i.e., the fear of overall appearance evaluation), influences the relationship between binge eating, perfectionism, and dietary restraint. In the current study (N = 300 women), we tested the relationship between dietary restraint, social appearance anxiety, concern over mistakes (a component of perfectionism), and binge eating in prospective data (three time points: at baseline, at two month, and at six month follow up). We found that social appearance anxiety, dietary restraint, and concern over mistakes each predicted binge eating at baseline. Only social appearance anxiety prospectively predicted binge eating when accounting for all variables. Further, in the tested model, social appearance anxiety mediated the relationship between concern over mistakes and binge eating across six months. On the contrary, dietary restraint did not mediate the relationship between concern over mistakes and binge eating in the tested model. The finding that social appearance anxiety served as a mediator between concern over mistakes and binge eating, but that dietary restraint did not, implies that social appearance anxiety may be a more salient prospective predictor of binge eating than dietary restraint. Intervening on social appearance anxiety may be important in the treatment and prevention of binge eating.

The relation of anxiety, depression, and stress to binge eating behavior

This study aimed to extend the literature by examining several psychological factors (i.e. depression, anxiety, and stress) in relation to binge eating. Data were collected via online surveys from a community sample of men and women of diverse backgrounds. The main study hypotheses were supported, indicating a unique relation between anxiety and binge eating, and between stress and binge eating, independent of the impact of depression. Gender differences are discussed. The results of this study suggest a need for a more detailed examination of negative affect in binge eating. Furthermore, the role of anxiety may be important for future research.

Edmonton Obesity Staging System Prevalence and Association with Weight Loss in a Publicly Funded Referral-Based Obesity Clinic

OBJECTIVES

To determine the distribution of EOSS stages and differences in weight loss achieved according to EOSS stage, in patients attending a referral-based publically funded multisite weight management clinic.

SUBJECTS/METHODS

5,787 obese patients were categorized using EOSS staging using metabolic risk factors, medication use, and severity of doctor diagnosis of obesity-related physiological, functional, and psychological comorbidities from electronic patient files.

RESULTS

The prevalence of EOSS stages 0 (no risk factors or comorbidities), 1 (mild conditions), 2 (moderate conditions), and 3 (severe conditions) was 1.7%, 10.4%, 84.0%, and 3.9%, respectively. Prehypertension (63%), hypertension (76%), and knee replacement (33%) were the most common obesity-related comorbidities for stages 1, 2, and 3, respectively. In the models including age, sex, initial BMI, EOSS stage, and treatment time, lower EOSS stage and longer treatment times were independently associated with greater absolute (kg) and percentage of weight loss relative to initial body weight (P < 0.05).

CONCLUSIONS

Patients attending this publicly funded, referral-based weight management clinic were more likely to be classified in the higher stages of EOSS. Patients in higher EOSS stages required longer treatment times to achieve similar weight outcomes as those in lower EOSS stages.

A weighty issue: explaining the association between body mass index and appearance-based social anxiety

Research has indicated that individuals who are overweight or obese are more likely to experience mental health difficulties. One line of research has indicated that body mass index (BMI) is positively associated with appearance-based social anxiety, rather than social anxiety more generally. However, there is a lack of research that has attempted to explain this association. Thus, the current study recruited an undergraduate sample (N=90) and aimed (a) to replicate previous research by examining the associations between BMI, social anxiety, and appearance-based social anxiety and (b) to extend previous research by examining two potential mediators in the relationship between BMI and appearance-based social anxiety suggested in the literature (i.e., body image dissatisfaction and emotional eating). Analyses indicated that BMI was not associated with social anxiety but positively associated with appearance-based social anxiety. The association between BMI and appearance-based social anxiety was only mediated by body image dissatisfaction, and the model of these relationships emerged as the best fitting model relative to a plausible alternative model. The findings replicate and extend previous research on weight status and psychological factors and highlight the need for future longitudinal research on BMI, appearance-based social anxiety, and body image dissatisfaction so that interventions for obesity and weight loss maintenance programs can be ultimately enhanced.

Negative Social Evaluative Fears Produce Social Anxiety, Food Intake, and Body Dissatisfaction: Evidence of Similar Mechanisms through Different Pathways

Social anxiety and eating disorders are highly comorbid, suggesting there are shared vulnerabilities that underlie the development of these disorders. Two proposed vulnerabilities are fear of negative evaluation and social appearance anxiety (i.e., fear of negative evaluation regarding one's appearance). In the current experimental study (N=160 women) we measured these fears: (a) through a manipulation comparing fear conditions, (b) with trait fears, and (c) state fears. Results indicated that participants in the fear of negative evaluation condition increased food consumption, whereas participants in the social appearance anxiety condition and high in trait social appearance anxiety experienced the highest amounts of body dissatisfaction. Participants in the fear of evaluation and social appearance anxiety conditions experienced elevated social anxiety. These results support the idea that negative evaluation fears are shared vulnerabilities for eating and social anxiety disorders, but that the way these variables exert their effects may lead to disorder specific behaviors.