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Yurtdaş Depboylu G, Fındık BE. Relationships among alexithymia, psychological distress, and disordered eating behaviors in adolescents. Appetite 2024; 200:107536. [PMID: 38825016 DOI: 10.1016/j.appet.2024.107536] [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: 01/26/2024] [Revised: 05/16/2024] [Accepted: 05/30/2024] [Indexed: 06/04/2024]
Abstract
This cross-sectional study aimed to evaluate the relations between psychological distress, alexithymia, disordered eating behaviors (DEBs), and body mass index (BMI) and to assess if psychological stress would mediate the influence of alexithymia on DEBs in adolescents. A total of 1609 high school students (58.9% females) aged 14-18 years were included in the study. Data were collected using a self-administered questionnaire. DEBs including emotional eating, cognitive restraint, and uncontrolled eating were assessed with the Three-Factor Eating Questionnaire, psychological distress was assessed with the Depression Anxiety Stress Scale and alexithymia was assessed with the Toronto Alexithymia Scale. Anthropometric measurements were performed. Psychological distress was found to be positively associated with alexithymia, emotional eating, uncontrolled eating, and cognitive restraint (p < 0.01). Both direct and indirect effects of alexithymia on emotional eating and uncontrolled eating were significant. Psychological distress partially mediated the relationship between alexithymia and uncontrolled eating (β = 0.05) and emotional eating (β = 0.04), while it fully mediated the relationship between alexithymia and cognitive restraint (β = 0.05). BMI z score was not correlated with alexithymia and psychological distress. Emotional eating (β = 0.16) and cognitive restraint (β = 0.34), but not uncontrolled eating, significantly were associated with BMI z score. This study demonstrated that alexithymia and psychological distress are positively associated with DEBs in adolescents. It also showed that psychological distress plays a mediating role between alexithymia and DEBs. Moreover, it showed that emotional eating and cognitive restraint are positively associated with the BMI z score. These results suggest that interventions aimed at improving adolescents' psychological well-being and their ability to identify and describe their emotions may reduce DEBs in adolescents, thereby preventing obesity in adolescents.
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Affiliation(s)
- Gamze Yurtdaş Depboylu
- Faculty of Health Sciences, Department of Nutrition and Dietetics, İzmir Katip Çelebi University, İzmir, Turkey.
| | - Berfin Esin Fındık
- Faculty of Health Sciences, Department of Nutrition and Dietetics, İzmir Katip Çelebi University, İzmir, Turkey.
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Kollin SR, Gratz KL, Lee AA. The role of emotion dysregulation in self-management behaviors among adults with type 2 diabetes. J Behav Med 2024; 47:672-681. [PMID: 38671288 PMCID: PMC11291593 DOI: 10.1007/s10865-024-00483-5] [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: 11/01/2023] [Accepted: 02/27/2024] [Indexed: 04/28/2024]
Abstract
Suboptimal disease self-management among adults with type 2 diabetes is associated with greater risk of diabetes related health complications and mortality. Emotional distress has been linked with poor diabetes self-management; however, few studies have examined the role of emotion dysregulation in diabetes management. The purpose of this study was to examine the relations between different facets of emotion dysregulation and diabetes self-management behaviors among a sample of 373 adults with type 2 diabetes. Separate median regression and binary logistic regression models were used to examine the association of emotion dysregulation facets and each diabetes self-care behavior (i.e., medication nonadherence, diet, exercise, self-monitoring of blood glucose (SMBG), foot care, and smoking). Generally, greater difficulties in emotion regulation were associated with poorer self-management behaviors. However, several facets of emotion dysregulation were linked with better self-management behaviors. Addressing emotion dysregulation among adults with type 2 diabetes has the potential to improve diabetes related self-management.
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Affiliation(s)
- Sophie R Kollin
- Department of Psychology, University of Mississippi, 304 University Circle, Oxford, 38677, MS, England
| | - Kim L Gratz
- Lyra Health, Burlingame, CA, USA
- Department of Psychology, University of Toledo, Toledo, OH, USA
| | - Aaron A Lee
- Department of Psychology, University of Mississippi, 304 University Circle, Oxford, 38677, MS, England.
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Debeuf T, Verbeken S, Boelens E, Volkaert B, Tanghe A, Michels N, Braet C. Emotion Regulation Training as an Add-on in the Treatment of Obesity in Young Adolescents: A Randomized Controlled Superiority Trial. Behav Ther 2024; 55:839-855. [PMID: 38937054 DOI: 10.1016/j.beth.2023.12.005] [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: 02/04/2022] [Revised: 12/18/2023] [Accepted: 12/20/2023] [Indexed: 06/29/2024]
Abstract
In an inpatient treatment center for pediatric obesity, the effectiveness of an emotion regulation (ER) training on top of the multidisciplinary obesity treatment (MOT) was tested by means of an RCT. The ER training was evaluated on primary outcomes: ER and emotional eating, and secondary outcomes: well-being and weight loss, taking into account pre, post, and follow-up measurements. Of the 115 10- to-14-year old adolescents with obesity (52.2% girls), 65 were allocated to the ER training. Physicians measured their height and weight objectively (4 times). Participants also filled out questionnaires on ER competencies (ER abilities and ER strategies), emotional eating and well-being (3 times). Significant pre-post interactions were found for "emotional awareness," "problem solving," and "evoking a positive mood." Moreover, the positive effects of the ER training on emotion regulation strategies were maintained at follow-up. Concerning well-being, no significant pre-post interaction effects were found but a significant interaction effect was found when comparing pre with follow-up. Analyses show a significant main effect of time on weight loss, but this was not qualified by a Time × Condition interaction effect. The current RCT study shows limited but promising effects of adding an ER training to the MOT. Further research should investigate whether the positive short-term effects will be maintained.
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Chen J, Mangieri L, Mar S, Piantadosi S, Marcus D, Davis P, Anger B, Land BB, Bruchas MR. Endogenous opioids facilitate stress-induced binge eating via an insular cortex-claustrum pathway. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.06.10.598168. [PMID: 38915527 PMCID: PMC11195079 DOI: 10.1101/2024.06.10.598168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
Stress has been shown to promote the development and persistence of binge eating behaviors. However, the neural circuit mechanisms for stress-induced binge-eating behaviors are largely unreported. The endogenous dynorphin (dyn)/kappa opioid receptor (KOR) opioid neuropeptide system has been well established to be a crucial mediator of the anhedonic component of stress. Here, we aimed to dissect the basis of dynorphinergic control of stress-induced binge-like eating behavior. We first established a mouse behavioral model for stress-induced binge-like eating behaviors. We found that mice exposed to stress increased their food intake of familiar palatable food (high fat, high sugar, HPD) compared to non-stressed mice. Following a brain-wide analysis, we isolated robust cFos-positive cells in the Claustrum (CLA), a subcortical structure with highly abundant KOR expression, following stress-induced binge-eating behavior. We report that KOR signaling in CLA is necessary for this elevated stress-induced binge eating behavior using local pharmacology and local deletion of KOR. In vivo calcium recordings using fiber photometry revealed a disinhibition circuit structure in the CLA during the initiation of HPD feeding bouts. We further established the dynamics of endogenous dynorphinergic control of this behavior using a genetically encoded dynorphin biosensor, Klight. Combined with 1-photon single-cell calcium imaging, we report significant heterogeneity with the CLA population during stress-induced binge eating and such behavior attenuates local dynorphin tone. Furthermore, we isolate the anterior Insular cortex (aIC) as the potential source of endogenous dynorphin afferents in the CLA. By characterizing neural circuits and peptidergic mechanisms within the CLA, we uncover a pathway that implicates endogenous opioid regulation stress-induced binge eating.
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Affiliation(s)
- Jingyi Chen
- Center for the Neurobiology of Addiction, Pain and Emotion;Departments of Anesthesiology, Pharmacology, and Bioengineering, University of Washington, Seattle, WA, USA
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
| | - Leandra Mangieri
- Center for the Neurobiology of Addiction, Pain and Emotion;Departments of Anesthesiology, Pharmacology, and Bioengineering, University of Washington, Seattle, WA, USA
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
| | - Sophia Mar
- Center for the Neurobiology of Addiction, Pain and Emotion;Departments of Anesthesiology, Pharmacology, and Bioengineering, University of Washington, Seattle, WA, USA
- Department of Pharmacology, University of Washington, Seattle, WA, USA
| | - Sean Piantadosi
- Center for the Neurobiology of Addiction, Pain and Emotion;Departments of Anesthesiology, Pharmacology, and Bioengineering, University of Washington, Seattle, WA, USA
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
| | - David Marcus
- Center for the Neurobiology of Addiction, Pain and Emotion;Departments of Anesthesiology, Pharmacology, and Bioengineering, University of Washington, Seattle, WA, USA
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
| | - Phoenix Davis
- Center for the Neurobiology of Addiction, Pain and Emotion;Departments of Anesthesiology, Pharmacology, and Bioengineering, University of Washington, Seattle, WA, USA
| | - Bennett Anger
- Center for the Neurobiology of Addiction, Pain and Emotion;Departments of Anesthesiology, Pharmacology, and Bioengineering, University of Washington, Seattle, WA, USA
| | - Benjamin B Land
- Center for the Neurobiology of Addiction, Pain and Emotion;Departments of Anesthesiology, Pharmacology, and Bioengineering, University of Washington, Seattle, WA, USA
- Department of Pharmacology, University of Washington, Seattle, WA, USA
| | - Michael R Bruchas
- Center for the Neurobiology of Addiction, Pain and Emotion;Departments of Anesthesiology, Pharmacology, and Bioengineering, University of Washington, Seattle, WA, USA
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
- Department of Pharmacology, University of Washington, Seattle, WA, USA
- Department of Bioengineering, University of Washington, Seattle, WA, USA
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Fitterman-Harris HF, Han Y, Osborn KD, Faulkner LM, Williams BM, Pennesi JL, Levinson CA. Comparisons between atypical anorexia nervosa and anorexia nervosa: Psychological and comorbidity patterns. Int J Eat Disord 2024; 57:903-915. [PMID: 38288579 PMCID: PMC11018480 DOI: 10.1002/eat.24147] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 01/12/2024] [Accepted: 01/12/2024] [Indexed: 04/16/2024]
Abstract
OBJECTIVE Literature comparing "atypical" anorexia nervosa (atypical AN) and anorexia nervosa (AN) suggests these diagnoses share significant similarities in eating disorder (ED) pathology and psychiatric comorbidities. This study evaluated potential differences in ED pathology, psychiatric comorbidity, associated mechanisms (i.e., ED fears and perfectionism), and demographic factors (i.e., ethnicity and age) between individuals with atypical AN and AN. METHOD Data from seven protocols were combined for a total 464 individuals diagnosed with atypical AN (n = 215) or AN (n = 249). Between-group differences in ED severity and behaviors, psychiatric comorbidities, ED fears, perfectionism, and demographic factors were assessed using t-tests, Wilcoxon rank-sum tests, and Fisher's exact test. RESULTS Participants with atypical AN reported higher levels of overvaluation of weight and shape than those with AN. Participants with AN scored higher on food-related fears (anxiety about eating, food avoidance behaviors, and feared concerns) and fears of social eating, as well as obsessive-compulsive symptoms. Participants with AN were more likely to identify as Asian or Pacific Islander. No other statistically significant differences were found between groups for overall ED severity, ED behaviors, psychiatric comorbidities, general ED fears, perfectionism, or demographic factors. DISCUSSION Overall, results support previous literature indicating limited differences between individuals with atypical AN and AN, though individuals with atypical AN reported more overvaluation of weight and shape and those with AN reported higher food and social eating fears and obsessive-compulsive symptoms. Relatively few overall differences between atypical AN and AN highlight the importance of exploring dimensional conceptualizations of AN as an alternative to the current categorical conceptualization. PUBLIC SIGNIFICANCE This study assessed differences among individuals with atypical anorexia nervosa and anorexia nervosa in eating disorder severity and behaviors, comorbid psychiatric diagnoses, associated mechanisms, and demographic factors. Few differences emerged, though participants with atypical anorexia nervosa reported more overvaluation of weight and shape, while those with anorexia nervosa reported more food and social eating fears and higher obsessive-compulsive symptoms. Results support exploration of these diagnoses as a spectrum disorder.
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Affiliation(s)
| | - Yuchen Han
- Department of Bioinformatics and Biostatistics, University of Louisville
| | - Kimberly D. Osborn
- Department of Psychological and Brain Sciences, University of Louisville
- School of Community Health Sciences, Counseling and Counseling Psychology, Oklahoma State University
| | - Loie M. Faulkner
- Department of Psychological and Brain Sciences, University of Louisville
| | - Brenna M. Williams
- Department of Psychological and Brain Sciences, University of Louisville
| | - Jamie-Lee Pennesi
- Department of Psychological and Brain Sciences, University of Louisville
| | - Cheri A. Levinson
- Department of Psychological and Brain Sciences, University of Louisville
- Department of Pediatrics – Division of Child and Adolescent Psychiatry, University of Louisville
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Zhang H, Liu Z, Zheng H, Xu T, Liu L, Xu T, Yuan TF, Han X. 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. BMC Public Health 2024; 24:653. [PMID: 38429770 PMCID: PMC10905949 DOI: 10.1186/s12889-024-18015-w] [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: 10/17/2023] [Accepted: 02/06/2024] [Indexed: 03/03/2024] Open
Abstract
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.
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Affiliation(s)
- Hongwei Zhang
- Department of Bariatric & Metabolic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ziqi Liu
- Shanghai Key Laboratory of Psychotic Disorders, Brain Health Institute, National Center for Mental Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Psychology, Anhui Provincial Children's Hospital, Children's Hospital of Fudan University Anhui Hospital, National Children's Regional Medical Center, Hefei, China
| | - Hui Zheng
- Shanghai Key Laboratory of Psychotic Disorders, Brain Health Institute, National Center for Mental Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ting Xu
- Department of Anesthesiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lin Liu
- Department of Anesthesiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tao Xu
- Department of Anesthesiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Ti-Fei Yuan
- Shanghai Key Laboratory of Psychotic Disorders, Brain Health Institute, National Center for Mental Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu, China.
| | - Xiaodong Han
- Department of Bariatric & Metabolic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Duarte A, Martins S, Lopes L, Silva MJ, Augusto C, Santos R, Rosário R. Is the association between sleep and socio-emotional development mediated by weight in toddlers aged 12 to 36 months? Front Psychol 2023; 14:1190081. [PMID: 38125855 PMCID: PMC10731978 DOI: 10.3389/fpsyg.2023.1190081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 11/14/2023] [Indexed: 12/23/2023] Open
Abstract
Introduction Childhood is an important stage for socio-emotional development. Understanding the associations of lifestyle habits with the healthy development of social and emotional skills is crucial for better interventions early in life. This study aims to analyze the association between sleep and socio-emotional development in toddlers aged 12 to 36 months and examine whether weight mediated these associations. Methods This study is part of a cluster randomized controlled trial developed in Portuguese childcare centers. A sample of 344 children (176 females) enrolled in the study. Participants' anthropometrics were measured while at childcare centers using standardized procedures. Body mass index (BMI) was computed as the body weight/height2 (kg/m2) ratio. Sleep quality was collected with the Tayside Children's Sleep Questionnaire, a 10-item scale that evaluates the child's ability to initiate and maintain sleep. Two additional questions regarding sleep duration were added. Parental questionnaires assessed the child's sex and date of birth, socioeconomic status, and total energy intake (TEI). Motor (fine and gross) was assessed using Bayley-III scales and socio-emotional (SE) by the Greenspan Social-Emotional Growth Chart questionnaire. Linear regression models were used to examine the associations between sleep (duration and quality) and SE with adjustments for sex, age, BMI, mothers' education, motor development, and TEI. Mediation analysis was conducted using path analysis. Results SE development was significantly associated with nighttime sleep duration even when adjusted for confounders (β = 0.223; 95% CI: 0.001, 0.004 and β = 0.168; 0.0003, 0.003; respectively). Sleep quality was not significantly associated with SE development, and the weight did not explain the associations between sleep and SE development. Conclusion This study supports that sleep duration is directly associated with SE development in toddlers. From a public health perspective, sleep duration should be prioritized in intervention programs to improve socio-emotional development early in life.
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Affiliation(s)
- Ana Duarte
- The Health Sciences Research Unit: Nursing (UICISA: E), School of Nursing of Coimbra (ESEnfC), Coimbra, Portugal
- Research Centre on Child Studies (CIEC), Institution of Education, University of Minho, Braga, Portugal
| | - Silvana Martins
- The Health Sciences Research Unit: Nursing (UICISA: E), School of Nursing of Coimbra (ESEnfC), Coimbra, Portugal
| | - Luís Lopes
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sports, University of Porto, Porto, Portugal
| | - Maria José Silva
- The Health Sciences Research Unit: Nursing (UICISA: E), School of Nursing of Coimbra (ESEnfC), Coimbra, Portugal
- Nursing Research Centre, School of Nursing, University of Minho, Braga, Portugal
- School of Nursing, University of Minho, Braga, Portugal
| | - Cláudia Augusto
- The Health Sciences Research Unit: Nursing (UICISA: E), School of Nursing of Coimbra (ESEnfC), Coimbra, Portugal
- Nursing Research Centre, School of Nursing, University of Minho, Braga, Portugal
- School of Nursing, University of Minho, Braga, Portugal
| | - Rute Santos
- Research Centre on Child Studies (CIEC), Institution of Education, University of Minho, Braga, Portugal
- Institute of Education, University of Minho, Braga, Portugal
| | - Rafaela Rosário
- The Health Sciences Research Unit: Nursing (UICISA: E), School of Nursing of Coimbra (ESEnfC), Coimbra, Portugal
- Research Centre on Child Studies (CIEC), Institution of Education, University of Minho, Braga, Portugal
- Nursing Research Centre, School of Nursing, University of Minho, Braga, Portugal
- School of Nursing, University of Minho, Braga, Portugal
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Arexis M, Feron G, Brindisi MC, Billot PÉ, Chambaron S. A scoping review of emotion regulation and inhibition in emotional eating and binge-eating disorder: what about a continuum? J Eat Disord 2023; 11:197. [PMID: 37950264 PMCID: PMC10636978 DOI: 10.1186/s40337-023-00916-7] [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: 02/24/2023] [Accepted: 10/18/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Emotional eating is defined as a nonpathological eating behavior, whereas binge-eating disorder (BED) is defined as a pathological eating behavior. While different, both share some striking similarities, such as deficits in emotion regulation and inhibition. Previous research has suggested the existence of an "eating continuum" that might reflect the increased severity of overeating behaviors, that is, from nonpathological overeating to BED. The main aims of this scoping review were to explore in the literature the idea of a continuum between emotional eating and BED and to observe whether deficits in emotion regulation and inhibition follow this continuum in terms of severity. The other aims were to hopefully clarify the ill-defined concept of overeating, to question the potential role of positive emotions and to identify potential knowledge gaps. METHOD A systematic scoping review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Two databases (PubMed/Medline and PsycINFO) were examined in complete accordance with the beforehand sharply defined eligibility and exclusion criteria. The main criteria included adults (≥ 18) with emotional eating, BED or overeating and emotion regulation and inhibition as exposure criteria. RESULTS Thirty-two studies were included in this scoping review. If the results showed a link between emotional eating and BED, with the presence of inhibition and emotion regulation deficits in both eating behaviors, no mention of a continuum between emotional eating and BED was found. CONCLUSION In the absence of research directly comparing emotional eating and BED in the same studies and testing the potential increase in severity of emotion regulation and inhibition deficits along this continuum, there is currently no certainty that a continuum exists between emotional eating and BED. In the end, the idea of a continuum in terms of increased severity of overeating and in terms of emotion regulation and inhibition deficits between emotional eating and BED appears to be a gap in knowledge in the literature. This scoping review highlights the need for further research to identify knowledge gaps.
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Affiliation(s)
- Mahé Arexis
- Centre Des Sciences du Goût Et de L'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne, 21000, Dijon, France
- Université de Franche-Comté, LINC, 25000, Besançon, France
| | - Gilles Feron
- Centre Des Sciences du Goût Et de L'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne, 21000, Dijon, France
| | - Marie-Claude Brindisi
- Centre Des Sciences du Goût Et de L'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne, 21000, Dijon, France
- Centre Spécialisé de L'Obésité Bourgogne, Centre Hospitalier Universitaire Dijon Bourgogne, Dijon, France
| | | | - Stéphanie Chambaron
- Centre Des Sciences du Goût Et de L'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne, 21000, Dijon, France
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Vang M, Sherrard A, Tan CC. Parents' emotion dysregulation and children's emotional overeating: The role of emotion regulation feeding. Eat Behav 2023; 50:101795. [PMID: 37633220 DOI: 10.1016/j.eatbeh.2023.101795] [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: 12/13/2022] [Revised: 08/02/2023] [Accepted: 08/17/2023] [Indexed: 08/28/2023]
Abstract
Parents' use of food to regulate children's emotions (i.e., emotion regulation feeding) has been associated with children's emotional overeating. However, less is known about how parents' emotion regulation feeding acts as a moderator between parents' emotion dysregulation and children's emotional overeating. A total of 216 parents (Mage = 35.84 years, SD = 6.11) of 3- to 5-year-old children were recruited to complete an online survey. Analyses revealed that emotion regulation feeding moderated the association between parents' emotion dysregulation and children's emotional overeating, such that parents with high emotion dysregulation and high emotion regulation feeding had children who engaged in more emotional overeating compared to parents with low emotion regulation feeding. This finding suggests that less adaptive feeding aggravates the association between parents' emotion dysregulation and children's emotional overeating.
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Tian Y, Zhou H, Wang D, Zhang X. Association of Alexithymia With Positive Symptoms in Chinese Chronic Schizophrenia Patients With and Without Obesity. Psychiatry Investig 2023; 20:689-695. [PMID: 37409369 PMCID: PMC10460978 DOI: 10.30773/pi.2023.0004] [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: 01/05/2023] [Revised: 03/19/2023] [Accepted: 04/04/2023] [Indexed: 07/07/2023] Open
Abstract
OBJECTIVE A growing body of research suggests the presence of alexithymia (a form of social cognitive impairment) in patients with schizophrenia (SCZ), which may be related to their psychopathological symptoms. Patients with SCZ exhibit high rates of obesity. Interestingly, studies of the general population have found that alexithymia acts a pivotal role in the development and maintenance of obesity. However, little is known regarding the relationship between obesity, alexithymia, and clinical symptoms in SCZ patients. The study was aim to explore the relationship between obesity, alexithymia, and clinical symptoms in SCZ patients. METHODS Demographic and clinical data were collected from 507 patients with chronic SCZ. Their symptoms were assessed with the Positive and Negative Syndrome Scale (PANSS), and alexithymia was assessed with the Toronto Alexithymia Scale (TAS). RESULTS Compare with nonobese SCZ patients, obese SCZ patients scored higher on PANSS positive symptoms, TAS total score, difficulty identifying feelings, and difficulty describing feelings (all p<0.05). Correlation analysis revealed a significant association between difficulty identifying feelings and positive symptoms in SCZ patients. Further correlation analysis showed that this association was only present in obese SCZ patients (p<0.05). CONCLUSION Obesity may moderate the association between alexithymia and positive symptoms in chronic SCZ patients.
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Affiliation(s)
- Yang Tian
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Huixia Zhou
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Dongmei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Yang H, Zhou X, Xie L, Sun J. The effect of emotion regulation on emotional eating among undergraduate students in China: The chain mediating role of impulsivity and depressive symptoms. PLoS One 2023; 18:e0280701. [PMID: 37319167 PMCID: PMC10270349 DOI: 10.1371/journal.pone.0280701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 05/30/2023] [Indexed: 06/17/2023] Open
Abstract
This study aimed to examine the relationship between difficulties in emotion regulation and emotional eating and the role of impulsivity and depressive symptoms in mediating this chain. Four hundred ninety-four undergraduate students participated in the study. A self-designed questionnaire was used in the survey from February 6 to 13, 2022, to finish our purpose, including the Emotional Eating Scale (EES-R), Depression Scale (CES-D), Short Version of the Impulsivity Behavior Scale (UPPS-P) and Difficulties in Emotion Regulation Scale (DERS). The results showed that 1) difficulties in emotion regulation, impulsivity, depressive symptoms, and emotional eating were correlated; 2) impulsivity and depressive symptoms separately mediated the relationship between difficulties in emotion regulation and emotional eating; 3) impulsivity and depressive symptoms played a chain mediating role between difficulties in emotion regulation and emotional eating. The current study provided a better understanding of the psychologically related pathway of emotional eating. The results would be helpful for prevention and intervention of emotional eating among undergraduate students.
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Affiliation(s)
- Huimin Yang
- School of Nursing, Peking University, Beijing, China
| | - Xinyi Zhou
- School of Nursing, Peking University, Beijing, China
| | - Longjiao Xie
- School of Nursing, Peking University, Beijing, China
| | - Jing Sun
- Department of Community Nursing, School of Nursing, Peking University, Beijing, China
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12
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Ahmadkaraji S, Farahani H, Orfi K, Fathali Lavasani F. Food addiction and binge eating disorder are linked to shared and unique deficits in emotion regulation among female seeking bariatric surgery. J Eat Disord 2023; 11:97. [PMID: 37312144 PMCID: PMC10265849 DOI: 10.1186/s40337-023-00815-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/29/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Problematic eating behaviors can indicate obesity-related problems. Food addiction (FA) is not classified as an official diagnosis. However, given the many commonalities between FA and binge-eating disorder (BED) within the context of obesity, it is imperative to conduct a comparative investigation. The current study aimed to identify overlapping and distinctive features in emotion dysregulation as an underlying mechanism and emotional eating as a clinical feature among four groups of females with obesity seeking bariatric surgery. METHODS Data on emotion dysregulation and emotional eating were derived from the total 128 Females with obesity seeking bariatric surgery (Mage = 38.91 ± 10.59, MBMI = 42.10 kg/m2 ± 4.43) divided into four groups: those with FA (n = 35), BED (n = 35), BED + FA (n = 31) and a control group of individuals with obesity only (OB; n = 27), using well-established measures. RESULTS Regarding descriptive statistics, the BED + FA group showed the highest levels of emotional dysregulation (M = 111.09) and emotional eating (M = 46.80), while the OB group acquired the lowest scores (M = 70.44 and M = 27.29, respectively). Univariate analyses of variance revealed significant differences between the four groups in terms of emotion dysregulation F(3, 124) = 24.63, p < .01 and emotional eating F(3, 124) = 26.26, p < .01. All of the emotion dysregulation domains revealed significant differences too. Pairwise comparisons using Bonferroni post hoc tests did not reveal any significant differences between BED + FA and BED groups, while all of our other hypotheses regarding this matter were confirmed. CONCLUSIONS The study found that individuals with obesity and comorbid BED exhibit greater emotional dysregulation compared to those with OB or FA, indicating a need to assess BED in individuals with obesity. Emotion dysregulation may be linked to increased BED and FA, but those with BED seem more affected by limited access to emotion regulation strategies. These findings support the notion that PEBs are associated with emotion dysregulation and underscore the need for tailored interventions that target emotion regulation skills before and after bariatric surgery.
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Affiliation(s)
- Shahrzad Ahmadkaraji
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health, Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
- Minimally Invasive Surgery Research Center, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | | | - Koosha Orfi
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Fahimeh Fathali Lavasani
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health, Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, Iran.
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13
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Barbuti M, Carignani G, Weiss F, Calderone A, Fierabracci P, Salvetti G, Menculini G, Tortorella A, Santini F, Perugi G. Eating disorders and emotional dysregulation are associated with insufficient weight loss after bariatric surgery: a 1-year observational follow-up study. Eat Weight Disord 2023; 28:49. [PMID: 37266717 DOI: 10.1007/s40519-023-01574-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 05/14/2023] [Indexed: 06/03/2023] Open
Abstract
PURPOSE Subjects with obesity, especially those seeking bariatric surgery, exhibit high rates of mental disorders and marked psychopathological traits. The primary objective of this prospective, non-interventional study was to investigate whether the presence of different psychiatric disorders, attention deficit/hyperactivity disorder (ADHD) symptomatology and emotional dysregulation influenced weight loss at 1-year follow-up after surgery. METHODS Subjects consecutively referred for pre-surgical evaluation at the Obesity Center of Pisa University Hospital were recruited. Psychiatric diagnoses were made through the Mini-International Neuropsychiatric Interview (MINI) and ADHD symptomatology was assessed with the Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS). Emotional dysregulation was investigated through the WRAADDS and self-report questionnaires. After surgery, weight and obesity-related comorbidities were monitored during follow-up. RESULTS Of the 99 participants recruited, 76 underwent surgery and 65 could be reevaluated 1 year after surgery. Subjects with insufficient weight loss (excess body mass index loss ≤ 53%, n = 15) had more frequent lifetime binge eating disorder (BED) and BED-mood disorders comorbidity than subjects with favorable post-surgical outcome. Additionally, they scored higher on both physician-administered and self-report scales assessing emotional dysregulation, which represents a nuclear symptom of ADHD in adults. At the logistic regression analysis, older age, higher preoperative excess body mass index and greater affective instability were predictors of reduced weight loss at 1-year follow-up. CONCLUSION Emotional dysregulation seems to be associated with a worse outcome after bariatric surgery. Further studies with larger samples and longer follow-up are needed to confirm the influence of different psychiatric disorders and psychopathological traits on post-surgical outcome. LEVEL OF EVIDENCE V, prospective descriptive study.
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Affiliation(s)
- Margherita Barbuti
- 2nd Psychiatry Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Via Savi 10, 56126, Pisa, Italy
| | - Giulia Carignani
- 2nd Psychiatry Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Via Savi 10, 56126, Pisa, Italy
| | - Francesco Weiss
- 2nd Psychiatry Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Via Savi 10, 56126, Pisa, Italy
| | - Alba Calderone
- 1st Endocrinology Unit, Department of Clinical and Experimental Medicine, Obesity and Lipodystrophy Research Center, University Hospital of Pisa, Via Paradisa, 2, 56124, Pisa, Italy
| | - Paola Fierabracci
- 1st Endocrinology Unit, Department of Clinical and Experimental Medicine, Obesity and Lipodystrophy Research Center, University Hospital of Pisa, Via Paradisa, 2, 56124, Pisa, Italy
| | - Guido Salvetti
- 1st Endocrinology Unit, Department of Clinical and Experimental Medicine, Obesity and Lipodystrophy Research Center, University Hospital of Pisa, Via Paradisa, 2, 56124, Pisa, Italy
| | - Giulia Menculini
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Piazza Lucio Severi 1, 06132, Perugia, Italy
| | - Alfonso Tortorella
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Piazza Lucio Severi 1, 06132, Perugia, Italy
| | - Ferruccio Santini
- 1st Endocrinology Unit, Department of Clinical and Experimental Medicine, Obesity and Lipodystrophy Research Center, University Hospital of Pisa, Via Paradisa, 2, 56124, Pisa, Italy
| | - Giulio Perugi
- 2nd Psychiatry Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Via Savi 10, 56126, Pisa, Italy.
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14
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Braden A, Barnhart WR, Kalantzis M, Redondo R, Dauber A, Anderson L, Tilstra-Ferrell EL. Eating when depressed, anxious, bored, or happy: An examination in treatment-seeking adults with overweight/obesity. Appetite 2023; 184:106510. [PMID: 36868313 DOI: 10.1016/j.appet.2023.106510] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 01/19/2023] [Accepted: 02/24/2023] [Indexed: 03/05/2023]
Abstract
Emotions that differ in valence are uniquely associated with eating. In our previous study with an online sample of adults with overweight/obesity, eating in response to depression was the type of emotional eating most closely associated with negative psychosocial correlates (Braden et al., 2018). The current study extended this research by examining associations between emotional eating types (eating in response to depression, anxiety, boredom, happiness) and psychological correlates among treatment-seeking adults. The present study was a secondary analysis of adults (N = 63; 96.8% female) with overweight/obesity and self-identified emotional eating who completed a baseline assessment for a behavioral weight loss intervention. Emotional eating in response to depression (EE-depression), anxiety/anger (EE-anxiety/anger), and boredom (EE-boredom) were assessed with the revised Emotional Eating Scale (EES-R), and positive emotional eating (EE-positive) was assessed with the positive emotions subscale of the Emotional Appetite Questionnaire (EMAQ). The Eating Disorder Examination Questionnaire (EDE-Q), Binge Eating Scale (BES), Difficulties in Emotion Regulation Scale (DERS), and Patient Health Questionnaire-9 (PHQ-9; depressive symptoms) were also administered. Frequencies showed the most endorsed emotional eating type was EE-depression (44.4%; n = 28). Four multiple regression analyses examined associations between emotional eating (EE-depression, EE-anxiety/anger, EE-boredom, and EE-positive) and dependent variables (EDE-Q, BES, DERS, and PHQ-9). Results showed that depression was the emotional eating type most closely related to disordered eating, binge eating, and depressive symptoms. Eating in response to anxiety was closely related to emotion regulation difficulties. Positive emotional eating was related to less depressive symptoms. Exploratory analyses showed that lower levels of positive emotional eating were related to higher depressive symptoms among adults with greater emotion regulation difficulties. Researchers and clinicians may consider tailoring weight loss treatment based on unique emotions that trigger eating.
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Affiliation(s)
- Abby Braden
- Department of Psychology, Bowling Green State University, USA.
| | | | - Maria Kalantzis
- Department of Psychology, Bowling Green State University, USA
| | - Rachel Redondo
- Department of Psychology, Bowling Green State University, USA
| | - Aubrey Dauber
- Department of Psychology, Bowling Green State University, USA
| | - LaNaya Anderson
- Department of Psychology, Bowling Green State University, USA
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15
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Doom JR, Young ES, Farrell AK, Roisman GI, Simpson JA. Behavioral, cognitive, and socioemotional pathways from early childhood adversity to BMI: Evidence from two prospective, longitudinal studies. Dev Psychopathol 2023; 35:749-765. [PMID: 35545317 PMCID: PMC9652481 DOI: 10.1017/s0954579421001887] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Childhood adversity is associated with higher adult weight, but few investigations prospectively test mechanisms accounting for this association. Using two socioeconomically high-risk prospective longitudinal investigations, the Minnesota Longitudinal Study of Risk and Adaptation (MLSRA; N = 267; 45.3% female) and the Fragile Families and Child Wellbeing Study (FFCWS; n = 2,587; 48.5% female), pathways between childhood adversity and later body mass index (BMI) were tested using impulsivity, emotion dysregulation, and overeating as mediators. Childhood adversity from 0 to 5 years included four types of adversities: greater unpredictability, threat/abuse, deprivation/neglect, and low socioeconomic status. Parents reported on child impulsivity, emotion dysregulation, and overeating. Height and weight were self-reported and measured at 32 and 37 years in MLSRA and at 15 years in FFCWS. FFCWS results indicated that threat, deprivation, and low socioeconomic status predicted greater impulsivity and emotion dysregulation at 5 years, which in turn predicted greater overeating at 9 years and higher BMI z-score at 15 years. Early unpredictability in FFCWS predicted higher BMI through greater impulsivity but not emotion dysregulation at age 5. MLSRA regression results replicated the threat/abuse → emotion dysregulation → overeating → higher BMI pathway. These findings suggest that different dimensions of early adversity may follow both similar and unique pathways to predict BMI.
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Affiliation(s)
- Jenalee R. Doom
- Department of Psychology, University of Denver, Denver, CO, USA
| | - Ethan S. Young
- Department of Psychology, Utrecht University, Utrecht, The Netherlands
| | | | - Glenn I. Roisman
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | - Jeffry A. Simpson
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
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16
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Chew HSJ, Loong SSE, Lim SL, Tam WSW, Chew NWS, Chin YH, Chao AM, Dimitriadis GK, Gao Y, So BYJ, Shabbir A. Socio-Demographic, Behavioral and Psychological Factors Associated with High BMI among Adults in a Southeast Asian Multi-Ethnic Society: A Structural Equation Model. Nutrients 2023; 15:nu15081826. [PMID: 37111045 PMCID: PMC10144460 DOI: 10.3390/nu15081826] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/31/2023] [Accepted: 04/08/2023] [Indexed: 04/29/2023] Open
Abstract
While various influencing factors of overweight and obesity have been identified, the underlying mechanism remains unclear. We examined the relationships among sociodemographic, behavioral, and psychological factors on anthropometry in a multi-ethnic population with overweight and obesity. Participants (N = 251) were recruited from January to October 2022. Mean age and self-reported BMI were 31.7 ± 10.1 years and 29.2 ± 7.2 kg/m2. Participants were mostly female (52.4%) and overweight (58.2%). Multivariate multiple regression was performed using maximum likelihood estimation. Body mass index was associated with waist circumference, age, sex, race, marital status, education level, residential region, overeating habit, immediate thinking, self-regulation, and physical activity, but not anxiety, depression, or the intention to change eating habits. Final model indicated good fit: χ2 (30, N = 250) = 33.5, p = 0.32, CFI = 0.993, TLI = 0.988, RMSEA = 0.022, and SRMR = 0.041. Direct effects were found between BMI and overeating (β = 0.10, p = 0.004), race (β = -0.82, p < 0.001), marital status (β = -0.42, p = 0.001), and education level (β = -0.28, p = 0.019). Crisps (68.8%), cake (66.8%) and chocolate (65.6%) were identified as the most tempting foods. Immediate thinking indirectly increased overeating habits through poor self-regulation, although sociodemographic characteristics better predicted anthropometry than psycho-behavioral constructs.
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Affiliation(s)
- Han Shi Jocelyn Chew
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Shaun Seh Ern Loong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Su Lin Lim
- Dietetics Department, National University Hospital, Singapore 119074, Singapore
| | - Wai San Wilson Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Nicholas W S Chew
- Department of Cardiology, National University Heart Centre, Singapore 119074, Singapore
| | - Yip Han Chin
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Ariana M Chao
- Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, PA 19104-4217, USA
| | - Georgios K Dimitriadis
- Department of Endocrinology ASO/EASO COM, King's College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK
- Obesity, Type 2 Diabetes and Immunometabolism Research Group, Department of Diabetes, Faculty of Cardiovascular Medicine & Sciences, School of Life Course Sciences, King's College London, London WC2R 2LS, UK
| | - Yujia Gao
- Division of Hepatobiliary & Pancreatic Surgery, Department of Surgery, National University Hospital, Singapore 119074, Singapore
| | - Bok Yan Jimmy So
- Division of General Surgery (Upper Gastrointestinal Surgery), Department of Surgery, National University Hospital, Singapore 119074, Singapore
| | - Asim Shabbir
- Division of General Surgery (Upper Gastrointestinal Surgery), Department of Surgery, National University Hospital, Singapore 119074, Singapore
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17
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Saccaro LF, Rutigliano G, Landi P, Spera M, Kraslavski A, Zappa MA, Mencacci C. Emotional Regulation Underlies Gender Differences in Pathological Eating Behavior Styles of Bariatric Surgery Candidates. WOMEN 2023. [DOI: 10.3390/women3020015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
Almost a third of bariatric surgery patients present suboptimal weight loss or important weight regain in the first five postoperative years. While the reasons underlying this are not fully understood, it is known that pathological eating styles (such as emotional or binge eating) can thwart efforts to maintain weight loss. However, detailed characterization and understanding of these eating styles have yet to be achieved. In particular, research on gender differences in pathological eating styles and psychiatric symptoms before bariatric surgery is lacking. To characterize gender differences in eating styles and their association with clinical symptoms, we prospectively enrolled 110 bariatric surgery candidates, collecting eating styles and clinical scores. Women displayed a higher frequency of emotional eating as compared to men (x2 = 9.07, p = 0.003), while men showed a higher frequency of quantitative eating behavioral style (x2 = 4.58, p = 0.044). Binge eating style was associated with higher Difficulties in Emotion Regulation Scale (DERS), Hamilton Depression Scale (HAM-D), and Hamilton Anxiety Scale (HAM-A) scores (p < 0.05). Emotional eating style was associated with higher HAM-D and HAM-A scores (p < 0.05). The present findings highlight the importance of understanding the role of gender differences in emotion regulation processes involved in the development and maintenance of pathological eating styles in bariatric surgery candidates. This paves the way to gender- and symptoms-specific interventions on eating behaviors to improve surgery long-term outcomes.
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Affiliation(s)
- Luigi F. Saccaro
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Campus Biotech, 9 Chemin des Mines, 1202 Geneva, Switzerland
- Department of Psychiatry, Geneva University Hospital, 1205 Geneva, Switzerland
| | - Grazia Rutigliano
- Institute of Clinical Sciences, Imperial College London, MRI Steiner Unit, Hammersmith Hospital Campus, Du Cane Road, London W12 0NN, UK
- Department of Pathology, University of Pisa, via Savi 10, 56126 Pisa, Italy
| | - Paola Landi
- Dipartimento di Salute Mentale e Dipendenze, ASST Fatebenefratelli-Sacco, 20157 Milan, Italy
| | - Milena Spera
- Dipartimento di Salute Mentale e Dipendenze, ASST Fatebenefratelli-Sacco, 20157 Milan, Italy
| | - Alexandra Kraslavski
- Dipartimento di Salute Mentale e Dipendenze, ASST Fatebenefratelli-Sacco, 20157 Milan, Italy
| | - Marco Antonio Zappa
- UOC di Chirurgia Generale, ASST Fatebenefratelli Sacco, Piazza Principessa Clotilde 3, 20121 Milano, Italy
| | - Claudio Mencacci
- Dipartimento di Salute Mentale e Dipendenze, ASST Fatebenefratelli-Sacco, 20157 Milan, Italy
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18
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Conti C, Di Nardo M, Lanzara R, Guagnano MT, Cardi V, Porcelli P. Improvement in binge eating and alexithymia predicts weight loss at 9-month follow-up of the lifestyle modification program. Eat Weight Disord 2023; 28:30. [PMID: 36947261 PMCID: PMC10033561 DOI: 10.1007/s40519-023-01560-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 11/25/2022] [Indexed: 03/23/2023] Open
Abstract
PURPOSE The aim of this longitudinal study was to examine the extent to which improved levels of binge eating (BE) behaviors, alexithymia, self-esteem, and psychological distress would predict a reduction in body mass at 9-month follow-up, following a lifestyle modification program for weight loss in obese or overweight patients. METHODS A convenience sample of 120 obese or overweight patients were recruited. Body mass index (BMI), binge eating (BES), levels of alexithymia (TAS-20), perceived stress (PSS), depressive symptoms (SDS), and self-esteem (RSE) were assessed during their first medical examination (T1), and after a weight-loss treatment period of 9 months (T2). RESULTS Compared with unimproved patients, improved patients reported a significant decrease in binge eating (p = 0.04) and perceived stress symptoms (p = 0.03), and a significant improvement in self-esteem (p = 0.02) over time. After controlling for gender, self-esteem, depressive symptoms, and perceived stress, baseline BMI (OR = 1.11, 95% CI [1.04,1.19]), ΔBES (OR = 0.99, 95% CI [0.98,0.99]), and ΔTAS-20 (OR = 1.03, 95% CI [1.01,1.05]) significantly and independently predicted a ≥ 5% reduction in body mass from baseline. CONCLUSIONS Our finding supports the suggestion to consider psychological outcomes such as emotional aspects and dysfunctional eating behaviors when planning a weight loss programs to prevent a negative outcome. LEVEL OF EVIDENCE Level III, case-control analytic study.
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Affiliation(s)
- Chiara Conti
- Department of Psychological, Health, and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Maria Di Nardo
- Department of Psychological, Health, and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Roberta Lanzara
- Department of Psychological, Health, and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy.
| | - Maria Teresa Guagnano
- Department of Medicine and Aging, University "G. d'Annunzio" Chieti-Pescara, Chieti, 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, Padua, Italy
| | - Piero Porcelli
- Department of Psychological, Health, and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
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Dehghan M, Sharifi P, Hasani J, Young CA, Langdon D. Healthier living with MS: The key role of self-efficacy and emotion regulation. Mult Scler Relat Disord 2023; 73:104608. [PMID: 36963171 DOI: 10.1016/j.msard.2023.104608] [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: 01/13/2023] [Revised: 02/25/2023] [Accepted: 03/05/2023] [Indexed: 03/08/2023]
Abstract
OBJECTIVES Understanding distress and quality of life (QOL) is important in improving the lives of people with multiple sclerosis (MS), and investigating their antecedents is very important. The present study aimed to examine the role of multiple sclerosis self-efficacy and difficulties in emotion regulation in predicting distress and QOL in people with MS. Also, this study compared types of MS (RRMS, PPMS, and SPMS) in terms of MS self-efficacy, difficulties in emotion regulation, distress, and QOL. METHODS This study included 122 people with three types of MS (RRMS=33, PPMS=62, and SPMS=25). Data were collected by the use of four scales: Quality of Life (QOL), Psychological Distress (DASS), Difficulties in Emotion Regulation (DERS), and Multiple Sclerosis Self-Efficacy (MSSE). Pearson's correlation, path analysis, MANOVA, and Tukey's post hoc test were used for data analysis. RESULTS Findings indicated MS self-efficacy had negative and significant effects on difficulties in emotion regulation and distress and had a positive and significant effect on QOL. Difficulties in emotion regulation had a negative and significant effect on QOL and a positive and significant effect on distress. Also, the indirect effect (through difficulties in emotion regulation) of MS self-efficacy on distress and QOL was significant. In addition, the comparisons showed that differences between RRMS and SPMS in terms of MS self-efficacy and distress were significant. CONCLUSIONS Self-efficacy and emotion regulation are key components in improving the life (reducing distress and increasing QOL) of people with MS, although it depends to some extent on the type of MS disease.
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Affiliation(s)
- Mojtaba Dehghan
- Department of Health Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran.
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20
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Shehata WM, Abdeldaim DE. Emotional eating in relation to psychological stress during COVID-19 pandemic: a cross-sectional study in faculty of medicine, Tanta University, Egypt. BMC Public Health 2023; 23:277. [PMID: 36750824 PMCID: PMC9904530 DOI: 10.1186/s12889-023-15177-x] [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: 07/13/2022] [Revised: 01/18/2023] [Accepted: 01/31/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Stress, anxiety, and depression resulting from the COVID-19 pandemic as well as subsequent restrictive measures had a negative impact on eating behaviors. This study aimed to determine the emotional eating behaviors and the perceived stress level and to assess the relation between them among adults in the faculty of medicine during the late period of lockdown during the COVID-19 pandemic. METHODS This was a cross-sectional study among 580 persons from the faculty of medicine, at Tanta University, Egypt conducted over a period of one month during the last period of partial lockdown (October 2020). A self-administered structured questionnaire consisted of five parts used in the study (sociodemographic factors, COVID-19-related parameters, nutrition-related information during the pandemic, emotional eating scale, and perceived stress scale). RESULTS More than two-fifths of students, employees, and staff (45.2%, 45.5%, and 44.2%, respectively) stated that their weight increased as a result of the lockdown. 50.8% of students, 42.5% of employees, and 54.6% of staff were in the moderate emotional eating groups. Similarly, the majority of students, employees, and staff reported moderate levels of stress(84%, 80.8%, and 76.1% respectively). The total emotional eating score was positively correlated with the total perceived stress scores (r = 0.13, p = 0.001*). CONCLUSION COVID-19 pandemic, particularly during the period of lockdown, had a negative impact on individuals' psychological stress levels and levels of emotional eating behaviors.
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Affiliation(s)
- Walaa M. Shehata
- grid.412258.80000 0000 9477 7793Assistant professor of Public Health and Community Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Doaa E. Abdeldaim
- grid.412258.80000 0000 9477 7793Assistant professor of Public Health and Community Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt
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21
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Abu Dabrh AM, Haga CB, Conrad J, Perlman AI, Allyse MA, Albertie ML, Martinez-Heath M, Ball CT, Willis FB. Nutrition and Emotional Health Education: The Use of Emotional Intelligence and a Plant-Based Diet to Reduce Cardiometabolic Risk. GLOBAL ADVANCES IN INTEGRATIVE MEDICINE AND HEALTH 2023; 12:27536130231215014. [PMID: 38026440 PMCID: PMC10656810 DOI: 10.1177/27536130231215014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 10/09/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023]
Abstract
Background For individuals living with chronic conditions like diabetes mellitus and obesity, there is a need for sustainable behavioral strategies and physiologic tools. These tools support identifying and addressing barriers to healthy eating, reducing body mass index (BMI), and building increased physical resilience in real time. Objective To evaluate whether a 12-week learning management system designed to combine nutritional intervention with education and coaching on improving emotional intelligence (EI) could alter cardiometabolic outcomes. Methods This pre-post prospective study enrolled 37 adult volunteers with BMI greater than 25 to participate in a 12-week learning management system. Primary (BMI, systolic blood pressure, diastolic blood pressure, low-density lipoprotein [LDL], high-density lipoprotein, and fasting glucose levels) and secondary self-reported outcomes were assessed at baseline, 12 weeks, and 6 months after enrollment using Short Form-36, Emotional Quotient Inventory (EQi), and Whole Health Index (WHI). Linear mixed-effects regression models with random effect were used to estimate changes in primary and secondary outcomes. We adjusted for multiple testing using Holm step-down method. Results BMI and LDL were the only primary endpoints lower at program completion and 6-month follow-up compared to baseline levels (-1.63 and -17.77 mg/dL, respectively; P < .001). Secondary outcomes showing statistically significant improvement from baseline to 6-month follow-up included energy/fatigue (Short Form-36), self-regard (EQi), decision-making (EQi), impulse control (EQi), stress management (EQi), Whole Brain - Form A (WHI), Whole Food - Form C (WHI), and Whole Body - Form D (WHI). Conclusion This study provides preliminary evidence that lifestyle programs combining nutritional interventions and EI can have a significant impact on BMI and LDL. Our study highlights the potential importance of both nutrition and EI in programs targeting diet and lifestyle modification.
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Affiliation(s)
| | - Claire B. Haga
- Department of Family Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Jarik Conrad
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL, USA
| | - Adam I. Perlman
- Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Megan A. Allyse
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL, USA
| | - Monica L. Albertie
- Community Outreach and Engagement, Department of Research, Mayo Clinic, Jacksonville, FL, USA
| | | | - Colleen T. Ball
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL, USA
| | - Floyd B. Willis
- Department of Family Medicine, Mayo Clinic, Jacksonville, FL, USA
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22
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Kalantzis MA, Chung Xiann Lim S, Dauber AK, Studer-Perez EI, Silverman ZJ, O'Brien WH. Acculturative stress and eating disorder psychopathology: A meta-analysis. Eat Behav 2023; 48:101694. [PMID: 36621037 DOI: 10.1016/j.eatbeh.2022.101694] [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: 11/05/2021] [Revised: 11/11/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022]
Abstract
The present meta-analysis aims to extend Doris and colleagues' (2015) systematic review and address the comprehensive, quantitative gap in the relation between acculturative stress and eating disorder psychopathology reported by studies in the past 20 years. A total of 14 eligible studies were included in our meta-analysis. Across all study samples, there were 2681 participants. The overall relation between eating disorder psychopathology and acculturative stress measurements was examined. Moderation analyses were run to investigate the substantial heterogeneity detected between studies. Results indicated a small effect size for the relationship between eating pathology behaviors and acculturative stress. These results provide insight for clinicians working with individuals who are experiencing acculturative stress, as well as highlight future research directions.
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Affiliation(s)
- Maria A Kalantzis
- Department of Psychology, Bowling Green State University, United States of America.
| | - Sam Chung Xiann Lim
- Department of Psychology, Bowling Green State University, United States of America
| | - Aubrey K Dauber
- Department of Psychology, Bowling Green State University, United States of America
| | - Emma I Studer-Perez
- Department of Psychology, Bowling Green State University, United States of America
| | - Zachary J Silverman
- Department of Psychology, Bowling Green State University, United States of America
| | - William H O'Brien
- Department of Psychology, Bowling Green State University, United States of America
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23
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Hayes S, Lonergan A, Trompeter N, Bussey K, Hay P, Mitchison D. Longitudinal relationship between experience of sexual harassment and 2-year body image and weight outcomes in adolescence: mediation through self-objectification and psychological distress. Eat Weight Disord 2022; 27:3095-3108. [PMID: 35834106 PMCID: PMC9803756 DOI: 10.1007/s40519-022-01432-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 05/31/2022] [Accepted: 06/08/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The current study investigated the experience of sexual harassment as a risk factor for weight gain and weight/shape concerns in a community sample of adolescents, with potential mediating factors self-objectification and psychological distress. METHOD 1034 Australian adolescents (aged 11 to 19 years) from the EveryBODY longitudinal study of disordered eating pathology participated. Data were collected through online surveys annually for 3 years. Participants completed self-report measures of demographics, sexual harassment, psychological distress, self-objectification, weight/shape concerns and BMI percentile. RESULTS A parallel mediation model adjusting for baseline scores found no direct effect between baseline experiences of sexual harassment and change in BMI percentile or weight/shape concern after 2 years. Experiences of sexual harassment significantly increased self-objectification scores after 1 year in female adolescents. Subsequently, higher self-objectification significantly increased the risk of greater weight/shape concern after 1 year in female adolescents. However, no significant mediating relationship was found in the relationship between sexual harassment and weight/shape concern or BMI percentile for either gender. Psychological distress was found to be a clear risk factor for weight/shape concern in both genders after 1 year. CONCLUSIONS Intervention programmes in schools should focus on developing policies to reduce sexual harassment, self-objectification and distress in adolescents. LEVEL OF EVIDENCE Level IV, longitudinal multiple time series without intervention.
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Affiliation(s)
- Samantha Hayes
- School of Psychology, Western Sydney University, 51 Captain Cook Drive, Kurnell, Sydney, NSW, 2231, Australia.
| | | | - Nora Trompeter
- School of Psychology, Macquarie University, Sydney, NSW, Australia
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Kay Bussey
- School of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Phillipa Hay
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
- Camden and Campbelltown Hospitals, SWSLHD, Campbelltown, NSW, Australia
| | - Deborah Mitchison
- School of Psychology, Macquarie University, Sydney, NSW, Australia
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
- School of Medicine, Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia
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24
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Mikhail ME, Fowler N, Burt SA, Neale MC, Keel PK, Katzman DK, Klump KL. A daily diary study of emotion regulation as a moderator of negative affect-binge eating associations. Int J Eat Disord 2022; 55:1305-1315. [PMID: 35779074 PMCID: PMC9529946 DOI: 10.1002/eat.23768] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 06/19/2022] [Accepted: 06/20/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND While negative affect (NA) typically increases risk for binge eating, the ultimate impact of NA may depend on a person's ability to regulate their emotions. In this daily, longitudinal study, we examined whether emotion regulation (ER) modified the strength of NA-dysregulated eating associations. METHODS Women (N = 311) from the Michigan State University Twin Registry first reported dimensional binge eating symptoms and broad ER difficulties (e.g., limited emotional awareness, difficulty controlling emotional impulses). Participants then rated use of adaptive (cognitive reappraisal, social sharing, situation modification, and acceptance) and maladaptive (rumination, expressive suppression, and self-criticism) ER strategies, emotional eating (EE), objective binge eating (OBE), and NA once daily for 49 consecutive days. RESULTS There were several main effects of ER on binge-eating pathology in both between-person (i.e., comparing women who differed on average) and within-person (i.e., examining fluctuations in variables day-to-day) analyses. Between-person, greater broad ER difficulties, greater maladaptive strategy use, and lower adaptive strategy use were all associated with greater binge-eating pathology. Within-person, greater maladaptive strategy use was associated with greater odds of OBE on that day and on the following day. However, neither broad ER difficulties nor use of specific strategies moderated associations between NA and dysregulated eating in between- or within-person analyses. CONCLUSIONS While ER is independently associated with risk for dysregulated eating, it may not fully mitigate the impact of NA. Additional strategies (e.g., decreasing environmental stressors and increasing social support) may be needed to minimize NA and its impact on dysregulated eating. PUBLIC SIGNIFICANCE Negative affect (NA; e.g., sadness, guilt) increases dysregulated eating risk. Because NA is sometimes unavoidable, we examined whether emotion regulation (ER; i.e., how a person responds to their emotions) might impact whether NA leads to dysregulated eating. Although more effective ER was associated with less dysregulated eating overall, ER did not impact the association between NA and dysregulated eating. Other approaches may therefore be needed to mitigate NA-dysregulated eating associations.
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Affiliation(s)
| | - Natasha Fowler
- Department of Behavioral Neuroscience, Oregon Health and Science University, USA
| | | | - Michael C. Neale
- Departments of Psychiatry, Human Genetics, and Psychology, Virginia Commonwealth University, USA
| | | | | | - Kelly L. Klump
- Department of Psychology, Michigan State University, USA
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25
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Wang Q, Cui S, Barnhart WR, Liu Y, Yu Y, Cui T, He J. Relationships between retrospective parental feeding practices and Chinese university students' current appetitive traits, weight status, and satisfaction with food-related life. Appetite 2022; 175:106061. [PMID: 35469996 DOI: 10.1016/j.appet.2022.106061] [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: 02/05/2022] [Revised: 04/06/2022] [Accepted: 04/12/2022] [Indexed: 11/02/2022]
Abstract
Accumulating evidence suggests that parental feeding practices during childhood are related to adults' eating behaviors and weight status, but research exploring these relationships is largely conducted in Western contexts. However, China, a country that holds the largest world population, has distinct patterns of eating habits and food culture from Western countries. Therefore, the present study aimed to examine relationships between retrospective parental feeding practices (e.g., concern, monitoring, pressure to eat, and restriction) and current body mass index (BMI) and satisfaction with food-related life in a sample of 476 Chinese university students (195 men; Mage = 19.78 years, SD = 1.23). We also examined whether appetitive traits mediated these associations. Retrospective parental feeding practices were significantly related with participants' current BMI (concern: r = 0.26, p < .001; pressure to eat: r = -0.15, p < .001) and satisfaction with food-related life (concern: r = 0.15, p < .001; monitoring: r = 0.12, p = .009; pressure to eat: r = 0.13, p = .006; restriction: r = 0.16, p < .001). Relationships were partially mediated by young adults' current appetitive traits (e.g., enjoyment of food, emotional overeating, satiety responsiveness, slowness in eating). These findings suggest that retrospective parental feeding practices are important correlates of young adults' current weight status and satisfaction with food-related life, and that appetitive traits partially explain these relationships in the Chinese context.
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Affiliation(s)
- Qingyang Wang
- School of Management and Economics, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Shuqi Cui
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Wesley R Barnhart
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA
| | - Yutian Liu
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Yiman Yu
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Tianxiang Cui
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China; Department of Psychology, University of Macau, Macao, China
| | - Jinbo He
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China.
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26
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Felske AN, Williamson TM, Rash JA, Telfer JA, Toivonen KI, Campbell T. Proof of Concept for a Mindfulness-Informed Intervention for Eating Disorder Symptoms, Self-Efficacy, and Emotion Regulation among Bariatric Surgery Candidates. Behav Med 2022; 48:216-229. [PMID: 33052762 DOI: 10.1080/08964289.2020.1828255] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Up to 64% of patients seeking bariatric (weight-loss) surgery report eating disorder (ED) symptoms (addictive-like eating, binge eating, emotional eating, grazing) that can interfere with post-surgical weight loss. This prospective proof-of-concept study aimed to evaluate the impact of a pre-surgical mindfulness-informed intervention (MII) on ED symptoms and potential mechanisms-of-action to inform optimization of the intervention. Surgery-seeking adults attended four, 2-hour, MII sessions held weekly. Participants completed validated questionnaires assessing ED symptoms, eating self-efficacy, emotion regulation, and mindful eating pre-MII, post-MII, and at a 12-week follow-up. The MII consisted of mindfulness training, with cognitive, behavioral, and psychoeducational components. Fifty-six patients (M = 47.41 years old, 89.3% female) participated. Improvements in addictive-like eating, binge eating, emotional eating, and grazing were observed from pre- to post-MII. ED symptom treatment gains were either maintained or improved further at 12-week follow-up. Eating self-efficacy and emotion regulation improved from pre-MII to follow-up. Scores on the mindful eating questionnaire deteriorated from pre-MII to follow-up. In mediation analyses, there was a combined indirect effect of emotion regulation, eating self-efficacy, and mindful eating on grazing and binge eating, and an indirect effect of emotion regulation on emotional eating and addictive-like eating. Participation in the MII was associated with improvements in ED symptoms and some mechanisms-of-action, establishing proof-of-concept for the intervention. Future work to establish the MII's efficacy in a randomized controlled trial is warranted.
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Affiliation(s)
- Ashley N Felske
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | | | - Joshua A Rash
- Department of Psychology, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Jo Ann Telfer
- Calgary Adult Bariatric Surgery Clinic, Alberta Health Services, Richmond Road Diagnostic and Treatment Services, Calgary, AB, Canada
| | - Kirsti I Toivonen
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Tavis Campbell
- Department of Psychology, University of Calgary, Calgary, AB, Canada
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27
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French EN, Eneva K, Arlt JM, Yiu A, Chen EY. Negative mood induction effects on problem-solving task in women with eating disorders: a multi-method examination. J Eat Disord 2022; 10:73. [PMID: 35598002 PMCID: PMC9123706 DOI: 10.1186/s40337-022-00591-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 05/08/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The effects of negative affect on problem-solving and its psychophysiological correlates are poorly understood in eating disorder populations. METHODS This study examined respiratory sinus arrhythmia (RSA) and skin conductance responses of women with Binge Eating Disorder (BED: n = 56), Anorexia Nervosa (AN: n = 12), Bulimia Nervosa (BN: n = 32), and 24 healthy controls (HCs) at baseline, and then during: a negative mood induction task, an adapted Means Ends Problem-Solving (MEPS) task, and recovery. The MEPS task included four interpersonal scenarios: (1) binge-eating as a solution to stress, (2) job loss, (3) rejection by friends, and (4) by a significant other. RESULTS We found that individuals with eating disorders reported less positive mood than HCs and individuals with BN and BED reported more negative mood and greater urges to binge than HCs. After a negative mood induction, women with BED provided significantly less effective problem-solving strategies compared to HCs and women with BN for the binge-eating MEPS scenario. Relative to baseline and the negative mood induction, all participants exhibited significantly higher skin conductance measures throughout the MEPS scenarios and recovery. BED showed significantly lower respiratory sinus arrhythmia (RSA) levels than individuals with BN and HCs throughout the protocol. CONCLUSIONS The multimethod findings suggest individuals with BED are likely to have disorder-specific problem-solving difficulties after a negative mood induction.
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Affiliation(s)
- Elan N French
- Temple Eating Disorders Program, Temple University, 1701 North 13th Street, Philadelphia, PA, 19122, USA
| | - Kalina Eneva
- Temple Eating Disorders Program, Temple University, 1701 North 13th Street, Philadelphia, PA, 19122, USA
| | - Jean M Arlt
- Temple Eating Disorders Program, Temple University, 1701 North 13th Street, Philadelphia, PA, 19122, USA
| | - Angelina Yiu
- Temple Eating Disorders Program, Temple University, 1701 North 13th Street, Philadelphia, PA, 19122, USA
| | - Eunice Y Chen
- Temple Eating Disorders Program, Temple University, 1701 North 13th Street, Philadelphia, PA, 19122, USA.
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28
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Fanton S, Azevedo LC, Vargas DM. Alexithymia in obese adolescents is associated with severe obesity and binge eating behavior. J Pediatr (Rio J) 2022; 98:264-269. [PMID: 34273272 PMCID: PMC9432034 DOI: 10.1016/j.jped.2021.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To study the occurrence of alexithymia in obese adolescents. METHODS Cross-sectional study with 102 obese adolescents. Sociodemographic, clinical, and psychometric data (alexithymia and binge eating) were analyzed The Brazilian version of the Toronto Alexithymia Scale and Binge Eating Scale were used for psychometric data collection. Statistical analysis was performed using the Kolmogorov-Smirnov test, Student's t-test, ANOVA, chi-square, linear regression, and logistic regression. The study was approved by Research Ethics Committee. RESULTS A 22% occurrence of alexithymia was observed. Considering the category "possible alexithymia", half of the participants presented some alexithymic behavior. Adolescents with alexithymia had higher binge eating scores (alexithymia 16,2 versus possible alexithymia 11,7 versus no alexithymia 8,5; ANOVA p < 0,0005) and three times more binge eating behavior than adolescents with no alexithymia or possible alexithymia (alexithymia 36.4% versus 17.2% possible alexithymia versus 11.8% no alexithymia; chi-square = 6,2, p = 0.04). In simple linear regression, alexithymia scores were positively associated with binge eating scores (r2 = 0,4; p = 0,002). Binary logistic regression showed a three times higher probability of an adolescent with severe obesity to meet the criteria for alexithymia. CONCLUSIONS There was a 22% occurrence of alexithymia in obese adolescents. It was positively associated with obesity severity and higher binge eating scores, suggesting a relationship between severe obesity, alexithymia, and binge eating behavior.
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Affiliation(s)
- Susane Fanton
- Universidade de Blumenau, Centro de Ciência da Saúde, Programa de Pós-graduação em Saúde Coletiva, Blumenau, SC, Brazil
| | - Luciane Coutinho Azevedo
- Universidade de Blumenau, Centro de Ciência da Saúde, Programa de Pós-graduação em Saúde Coletiva, Blumenau, SC, Brazil
| | - Deisi Maria Vargas
- Universidade de Blumenau, Centro de Ciência da Saúde, Programa de Pós-graduação em Saúde Coletiva, Blumenau, SC, Brazil.
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29
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Cheng D, Wei M. Modified Dual Pathway Model for Binge Eating: The Role of Emotion Dysregulation. COUNSELING PSYCHOLOGIST 2022. [DOI: 10.1177/00110000221077936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We tested a modification of the dual pathway model using two sequential mediators between body dissatisfaction and binge eating: restricted eating and difficulties in emotion regulation replacing negative affect. A total of 435 college students completed an online survey. Results from path analyses indicated that the relationship between body dissatisfaction and binge eating was not mediated by restricted eating for neither women nor men. However, this relationship was mediated first by restricted eating and then by difficulties in emotion regulation for women only. Moreover, this relationship was mediated by difficulties in emotion regulation for both women and men. A post hoc analysis indicated that the above mediation results were still significant after adding negative affect into the model. No mediations through negative affect were significant. Clinical implications include the conceptualization and intervention of eating concerns within an emotion dysregulation framework.
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Affiliation(s)
- Davelle Cheng
- Department of Psychology, Iowa State University, Ames, IA, USA
| | - Meifen Wei
- Department of Psychology, Iowa State University, Ames, IA, USA
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30
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da Fonseca NKDO, Costa MDA, Gosmann NP, Dalle Molle R, Gonçalves FG, Silva AC, Rodrigues Y, Silveira PP, Manfro GG. Emotional eating in women with generalized anxiety disorder. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2022; 45:e20210399. [PMID: 35156782 PMCID: PMC10597384 DOI: 10.47626/2237-6089-2021-0399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 02/06/2022] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Individuals diagnosed with generalized anxiety disorder (GAD) seek pleasurable foods to avoid their negative emotional experiences. Ineffective regulation of negative emotions may be a risk factor for emotional eating (EE), leading to suffering, dysfunctional behaviors, and weight gain. OBJECTIVES The aim of this study is to understand the relationship between emotional dysregulation and EE, investigating potential mediators such as the intensity of the worry, avoidance of internal experiences, mindfulness, and self-compassion in female patients with anxiety. METHODS In this cross-sectional study, participants from a randomized clinical trial diagnosed with GAD answered the following instruments at baseline: the Difficulties in Emotion Regulation Scale (DERS), the Three Factor Eating Questionnaire (TFEQ-R21), the Penn State Worry Questionnaire (PSWQ), the Action and Acceptance Questionnaire (AAQ), the Five Facet Mindfulness Questionnaire (FFMQ), and the Self-Compassion Scale (SCS). We estimated Pearson correlation coefficients and performed mediation analyses. RESULTS We evaluated 51 female individuals, 34 of whom completed all the questionnaires. Our data showed that EE was positively correlated with emotional dysregulation (r = 0.593; p < 0.001), worry trait (r = 0.402; p = 0.018), and avoidance of internal experiences (r = 0.565; p < 0.001), whereas it was negatively correlated with self-compassion (r = -0.590; p < 0.001) and mindful state (r = -0.383; p = 0.026). Moreover, we demonstrated that self-compassion mediates the relationship between emotional dysregulation and EE (ab product estimate = 0.043, 95% confidence interval [95%CI] 0.003-0.084). CONCLUSION Our findings contribute to the literature by identifying psychological factors that could mediate the association between emotional dysregulation and EE, enabling identification of more effective eating behavior intervention targets for patients with GAD.
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Affiliation(s)
- Natasha Kim de Oliveira da Fonseca
- Programa de Pó́s-Graduação em Psiquiatria e Ciências do ComportamentoUniversidade Federal do Rio Grande do SulPorto AlegreRSBrazil Programa de Pó́s-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
| | - Marianna de Abreu Costa
- Programa de Pó́s-Graduação em Psiquiatria e Ciências do ComportamentoUniversidade Federal do Rio Grande do SulPorto AlegreRSBrazil Programa de Pó́s-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
| | - Natan Pereira Gosmann
- Programa de Pó́s-Graduação em Psiquiatria e Ciências do ComportamentoUniversidade Federal do Rio Grande do SulPorto AlegreRSBrazil Programa de Pó́s-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
| | - Roberta Dalle Molle
- Department of PsychiatryFaculty of MedicineMcGill UniversityMontrealCanada Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Canada.
| | - Francine Guimarães Gonçalves
- Programa de Pó́s-Graduação em Psiquiatria e Ciências do ComportamentoUniversidade Federal do Rio Grande do SulPorto AlegreRSBrazil Programa de Pó́s-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
| | - Alice Cardozo Silva
- UFRGSPorto AlegreRSBrazil Curso de Graduação em Nutrição, UFRGS, Porto Alegre, RS, Brazil.
| | - Ylana Rodrigues
- UFRGSPorto AlegreRSBrazil Curso de Graduação em Nutrição, UFRGS, Porto Alegre, RS, Brazil.
| | - Patrícia Pelufo Silveira
- Department of PsychiatryFaculty of MedicineMcGill UniversityMontrealCanada Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Canada.
- Ludmer Centre for Neuroinformatics and Mental HealthDouglas Mental Health University InstituteMontrealCanada Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, Montreal, Canada.
| | - Gisele Gus Manfro
- Programa de Pó́s-Graduação em Psiquiatria e Ciências do ComportamentoUniversidade Federal do Rio Grande do SulPorto AlegreRSBrazil Programa de Pó́s-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
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31
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Marshall TE, Thomas KS, Weinstein N, Vanderwert RE. Disordered eating behaviours and basic psychological need satisfaction: the mediating role of anxiety symptoms in preadolescents. J Child Adolesc Ment Health 2022; 34:42-52. [PMID: 38504657 DOI: 10.2989/17280583.2023.2277763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
Objective: According to self-determination theory, satisfied basic psychological needs can be a protective factor for psychopathology, including eating disorders and anxiety symptomatology. However, most research has focused on adolescent and adult populations, with less work examining perceived basic psychological need satisfaction from parents in younger samples who report anxiety and disordered eating. This cross-sectional study aimed to investigate whether basic psychological need satisfaction from parents was associated with disordered eating in preadolescents and whether anxiety mediated this relation.Method: A total of 211 preadolescents were recruited from primary schools across south Wales (mean age = 10.27 years, age range = 9-11 years; 49.3% female). Children completed self-report questionnaires on their basic psychological need satisfaction when with parents, as well as disordered eating and anxiety symptoms.Results: It was found that higher needs satisfaction was associated with lower disordered eating and anxiety, with stronger relations found in girls compared with boys. Furthermore, anxiety was found to mediate this relationship.Conclusions: Results suggest that basic psychological needs satisfaction may play an important role in the early emergence of co-occurring disordered eating and anxiety symptoms in boys and girls. The importance of considering anxiety symptoms in future work investigating needs satisfaction in the context of disordered eating and eating disorders is discussed.
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Affiliation(s)
| | - Kai S Thomas
- School of Psychology, Cardiff University, UK
- Cardiff University Centre for Human Developmental Science, Cardiff University, UK
| | - Netta Weinstein
- School of Psychology, Cardiff University, UK
- School of Psychology and Clinical Language Sciences, University of Reading, UK
| | - Ross E Vanderwert
- School of Psychology, Cardiff University, UK
- Cardiff University Centre for Human Developmental Science, Cardiff University, UK
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Cella S, Cipriano A, Aprea C, Cotrufo P. Risk factors for binge eating severity among adolescent girls and boys. A structural equation modeling approach. Appetite 2021; 169:105825. [PMID: 34826528 DOI: 10.1016/j.appet.2021.105825] [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: 02/11/2021] [Revised: 09/29/2021] [Accepted: 11/21/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Parental bonding, low self-esteem, emotion dysregulation, and eating style are correlated with each other and are associated with binge eating among adolescents. However, no studies have yet examined all these variables simultaneously. In the current study, the independent and combined influences of such constructs on binge eating were tested with structural equation modeling. METHOD A sample of 973 students aged between 12 and 16 (M = 14.17, SD = 1.25) years was screened by means of self-report measures assessing parental bonding, self-esteem, emotion dysregulation, eating styles and binge eating severity. RESULTS Self-esteem (β = -0.205) and eating styles (emotional β = 0.313, external β = 0.133, and restrained β = 0.178) had a direct effect on binge eating severity. The model (χ2(22) = 57.679; RMSEA = 0.041; CFI = 0.987; TLI = 0.949; SRMR = 0.024) revealed that the paths from both maternal and paternal care and maternal overprotection to binge eating were mediated through low self-esteem, emotion dysregulation and each eating style, explaining 35% of the variance. DISCUSSION Findings provide support for a comprehensive theoretical-based model of risk factors for binge eating and suggest the possible mechanisms through which the quality of early parental relationships contribute to developing dysfunctional eating patterns. Treatment and prevention efforts should improve self-esteem and emphasize emotion regulation capabilities.
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Affiliation(s)
- Stefania Cella
- Observatory on Eating Disorders, Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy.
| | - Annarosa Cipriano
- Observatory on Eating Disorders, Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Cristina Aprea
- Observatory on Eating Disorders, Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Paolo Cotrufo
- Observatory on Eating Disorders, Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
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Wilfred SA, Lundgren JD. The Double Consciousness Body Image Scale: A body image assessment centering the experiences of Black women. Int J Eat Disord 2021; 54:1771-1781. [PMID: 34272899 DOI: 10.1002/eat.23581] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 07/02/2021] [Accepted: 07/03/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Body image among Black women is poorly understood; emerging research suggests that Black women experience pressures to adhere to a body type not currently captured in commonly used body image measures. This study assessed the psychometric properties and validity of the Double Consciousness Body Image Scale (DCBIS), a new culturally relevant body image assessment for Black women. METHOD Black women living in the United States (n = 198; 73.4% identified as African American; the remainder identified as African, Afro-Latina, Caribbean, Caribbean American, Black descent, or multiple racial identities) completed online surveys assessing behaviors used to modify physical features, pressures to adhere to certain physical features, and eating disorder symptomatology. RESULTS Exploratory factor analysis identified a unitary factor structure focused on pressures to adhere to physical characteristics, as well as behavior manifestation of those pressures. The DCBIS demonstrated good internal consistency (α = .96). The DCBIS demonstrated convergent validity with measures of body image and disordered eating behaviors and attitudes. DISCUSSION The DCBIS is a culturally relevant assessment of body image centering the experiences of Black women living in the context of U.S. culture. Future research is needed to confirm the factor structure of the DCBIS and evaluate its psychometric properties among a broader representation of Black women, globally.
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Affiliation(s)
- Salomé A Wilfred
- Department of Psychology, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Jennifer D Lundgren
- Department of Psychology, University of Missouri-Kansas City, Kansas City, Missouri, USA
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Psychosocial Correlates of Emotional Eating and Their Interrelations: Implications for Obesity Treatment Research and Development. J Prim Prev 2021; 41:105-125. [PMID: 31933059 DOI: 10.1007/s10935-020-00580-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We tested the effects of emotional eating in long-term weight-loss so that both treatment processes and theory could be improved. Women with obesity participated in treatments of either high interpersonal contact and behavioral methods (n = 39) or low interpersonal contact and educational methods (n = 36) through community-based settings. We assessed mood, emotional eating, self-regulation, self-efficacy, and weight. Changes in the psychosocial measures were significantly greater in the high interpersonal contact/behavioral methods group. That group had a mean weight reduction of 6.5% and 6.8% over 6 and 24 months, respectively, which was significantly greater than the 2.9% and 1.8% loss in the low interpersonal contact/educational methods group at the same time points. Using aggregate data, change in eating self-regulation significantly mediated the prediction of reduced anxiety- and depression-related emotional eating over 6 months by improvements in tension and depression, respectively. The emotional eating reductions were significantly associated with weight loss over both 6 and 24 months. Increased physical activity was significantly associated with reduced tension and depression. We also found that the relationship between changes in physical activity and tension was significantly mediated by a change in exercise-related self-efficacy. Increased exercise self-regulation significantly predicted improved eating regulation, with eating-related self-efficacy change being a significant mediator. Our findings suggest an array of psychosocial targets for behavioral weight-management treatments that have large-scale applications.
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The Relationship between Psychological Distress during the Second Wave Lockdown of COVID-19 and Emotional Eating in Italian Young Adults: The Mediating Role of Emotional Dysregulation. J Pers Med 2021; 11:jpm11060569. [PMID: 34204480 PMCID: PMC8235082 DOI: 10.3390/jpm11060569] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/02/2021] [Accepted: 06/14/2021] [Indexed: 12/16/2022] Open
Abstract
This cross-sectional study aims to investigate the impact of psychological distress experienced during the second wave of the COVID-19 pandemic on emotional eating and to assess the mediating role of emotional dysregulation in a sample of Italian young adults (20-35). A total of 437 participants provided demographical data and were assessed using the Depression Anxiety Stress Scale, the Difficulties in Emotion Regulation Scale, and the Emotional Eating subscale of the Dutch Eating Behavior Questionnaire. Correlational analyses were performed to assess the relationship between continuous variables, while ANOVA was conducted to detect differences between males and females for emotional eating. To assess whether demographic and clinical data predicted emotional eating, hierarchical linear regression was performed. Then, a mediation analysis was conducted to assess whether emotional dysregulation was a mediator between psychological distress and emotional eating. Emotional eating was associated with psychological distress and emotional dysregulation. Moreover, higher levels of emotional eating were found in females than in males. Predictors of emotional eating were sex, psychological distress, and emotional dysregulation. Mediation analyses showed that the indirect effect of psychological distress on emotional eating through emotional dysregulation was significant (b = 0.0069; SE = 0.0024; CI = 0.0024-0.0118), confirming that the relationship between psychological distress and emotional eating was mediated by emotional dysregulation, controlling for sex. The model explained 26.8% (R2 = 0.2680) of the variance. These findings may help to plan and develop psychological interventions aimed at addressing emotional eating in young adults by targeting emotional dysregulation.
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Turk F, Kellett S, Waller G. Determining the potential links of self-compassion with eating pathology and body image among women and men: A cross-sectional mediational study. Body Image 2021; 37:28-37. [PMID: 33548664 DOI: 10.1016/j.bodyim.2021.01.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 01/21/2021] [Accepted: 01/21/2021] [Indexed: 11/15/2022]
Abstract
This study examined whether rumination, shame, self-criticism, and perfectionism mediate the previously established link between self-compassion and both eating and body image concerns. A cross-sectional online survey was completed by a community sample of non-clinical adult women (n = 369) and men (n = 201). Participants completed standardised measures of self-compassion (predictor), rumination, external shame, perfectionism and self-criticism (mediating variables), and eating pathology and body image (criterion variables). Path analyses confirmed that higher self-compassion was serially linked to lower eating pathology and body dissatisfaction through comparative self-criticism and external shame. Compared with women, the association between higher self-compassion and lower body dissatisfaction was weaker in men. However, there were no mediating effects of rumination, perfectionism, or internalized self-criticism. Overall results indicate notable similarities between women and men, and emphasise the potential value of targeting external shame during eating disorder prevention and treatment. Longitudinal study of these constructs is warranted in future research.
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Affiliation(s)
- Fidan Turk
- Department of Psychology, University of Sheffield, Sheffield, UK.
| | - Stephen Kellett
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Glenn Waller
- Department of Psychology, University of Sheffield, Sheffield, UK
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Guerrini Usubini A, Cattivelli R, Giusti EM, Riboni FV, Varallo G, Pietrabissa G, Manzoni GM, Consoli S, Bastoni I, Granese V, Volpi C, Villa V, Caretti A, Bottacchi M, Castelnuovo G, Molinari E. The ACTyourCHANGE study protocol: promoting a healthy lifestyle in patients with obesity with Acceptance and Commitment Therapy-a randomized controlled trial. Trials 2021; 22:290. [PMID: 33879183 PMCID: PMC8056547 DOI: 10.1186/s13063-021-05191-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 03/15/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND As treatment of choice in promoting psychological flexibility, Acceptance and Commitment Therapy (ACT) was found to be effective in several conditions, and among different populations, including weight management in individuals with obesity. However, the mechanism of action of psychological flexibility is less known. The aim of the present study is, within the context of a brief ACT intervention for behavioral change and behavioral maintenance of a healthy lifestyle in a sample of inpatients with obesity, to explore the effect of each subcomponent of the psychological flexibility model on treatment processes and outcomes. METHODS A randomized controlled trial will be conducted. Ninety Italian adult inpatients with obesity attending a rehabilitation program for weight loss will be randomly allocated into three experimental conditions targeting respectively each subcomponent of the psychological flexibility model: group Engage focused on values-oriented behaviors, group Openness focused on acceptance and cognitive defusion, and group Awareness focused on being present and aware of thoughts, feelings, and behaviors at every moment. Weight, BMI (kg/m2), the Psychological General Well-Being Inventory (PGWBI), the Outcome Questionnaire-45.2 (OQ-45.2), the Depression Anxiety and Stress Scale (DASS-21), the Difficulties in Emotion Regulation Scale (DERS), the Dutch Eating Behaviors Questionnaire (DEBQ), the Brief Values Inventory (BVI), the Committed Action Questionnaire (CAQ), the Italian-Cognitive Fusion Questionnaire (I-CFQ), the Five Facet Mindfulness Questionnaire (FFMQ), and the Acceptance and Action Questionnaire (AAQ-II) will be assessed at the beginning (time 0), at the end of psychological intervention (time 1), and after 3 (time 2) and 6 months (time 3) and 9 months (time 4) from discharge. During the following month after discharge, outpatients will be monitored in their adherence to a healthy lifestyle, using a wearable device. To assess the effectiveness of the intervention, mixed between-within 3 (conditions) × 4 (times) repeated measure ANOVAs will be conducted to examine changes from time 0 to time 1, 2, 3, and 4 in means of weight, BMI, and means of scores PGWBI, OQ-45.2, DASS, DERS, DEBQ, AAQ-II, BVI, CAQ, I-CFQ, and FFMQ, between three groups. DISCUSSION This study will contribute to clarify the mechanism of action of each subcomponent of the psychological flexibility model and understand its impact on the promotion of a healthy lifestyle. TRIAL REGISTRATION ClinicalTrials.gov NCT04474509 . Registered on July 4, 2020.
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Affiliation(s)
- Anna Guerrini Usubini
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy.
- Department of Psychology, Catholic University of Milan, Milan, Italy.
| | - Roberto Cattivelli
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Emanuele Maria Giusti
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | | | - Giorgia Varallo
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Giada Pietrabissa
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Gian Mauro Manzoni
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
- Department of Psychology, eCampus University, Novedrate, Italy
| | - Simone Consoli
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
| | - Ilaria Bastoni
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
| | - Valentina Granese
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Clarissa Volpi
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
| | - Valentina Villa
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
| | - Annalisa Caretti
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
| | - Michela Bottacchi
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
| | - Gianluca Castelnuovo
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Enrico Molinari
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
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Munguía L, Jiménez-Murcia S, Granero R, Baenas I, Agüera Z, Sánchez I, Codina E, del Pino-Gutiérrez A, Testa G, Treasure J, Fernández-Aranda F. Emotional regulation in eating disorders and gambling disorder: A transdiagnostic approach. J Behav Addict 2021; 10:508-523. [PMID: 33784249 PMCID: PMC8997225 DOI: 10.1556/2006.2021.00017] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/04/2021] [Accepted: 02/22/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS Difficulties in Emotion Regulation (ER) are related to the etiology and maintenance of several psychological disorders, including Eating Disorders (ED) and Gambling Disorder (GD). This study explored the existence of latent empirical groups between both disorders, based on ER difficulties and considering a set of indicators of personality traits, the severity of the disorder, and psychopathological distress. METHODS The sample included 1,288 female and male participants, diagnosed with ED (n = 906) and GD (n = 382). Two-step clustering was used for the empirical classification, while analysis of variance and chi-square tests were used for the comparison between the latent groups. RESULTS Three empirical groups were identified, from the most disturbed ER profile (Subgroup 1) to the most functional (Subgroup 3). The ER state showed a linear relationship with the severity of each disorder and the psychopathological state. Different personality traits were found to be related to the level of emotion dysregulation. DISCUSSION AND CONCLUSION In this study, three distinct empirical groups based on ER were identified across ED and GD, suggesting that ER is a transdiagnostic construct. These findings may lead to the development of common treatment strategies and more tailored approaches.
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Affiliation(s)
- Lucero Munguía
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, 08907Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, 08907Barcelona, Spain
- Ciber Physiopathology, Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, 08907Barcelona, Spain
| | - Roser Granero
- Ciber Physiopathology, Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, 08907Barcelona, Spain
- Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, 08193Barcelona, Spain
| | - Isabel Baenas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907Barcelona, Spain
- Ciber Physiopathology, Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, 08907Barcelona, Spain
| | - Zaida Agüera
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, 08907Barcelona, Spain
- Department of Public Health, Mental Health and Maternal-Child Nursing, School of Nursing, University of Barcelona, 08907Barcelona, Spain
| | - Isabel Sánchez
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907Barcelona, Spain
- Ciber Physiopathology, Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, 08907Barcelona, Spain
| | - Ester Codina
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907Barcelona, Spain
| | - Amparo del Pino-Gutiérrez
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907Barcelona, Spain
- Ciber Physiopathology, Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, 08907Barcelona, Spain
- Department of Public Health, Mental Health and Maternal-Child Nursing, School of Nursing, University of Barcelona, 08907Barcelona, Spain
| | - Giulia Testa
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907Barcelona, Spain
- Ciber Physiopathology, Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, 08907Barcelona, Spain
| | - Janet Treasure
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, 08907Barcelona, Spain
- Ciber Physiopathology, Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, 08907Barcelona, Spain
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Cardoso A, Oliveira S, Ferreira C. Negative and positive affect and disordered eating: The adaptive role of intuitive eating and body image flexibility. CLIN PSYCHOL-UK 2021. [DOI: 10.1111/cp.12224] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Ana Cardoso
- CINEICC – Center for Research in Neuropsychology and Cognitive and Behavioral Intervention Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal,
| | - Sara Oliveira
- CINEICC – Center for Research in Neuropsychology and Cognitive and Behavioral Intervention Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal,
| | - Cláudia Ferreira
- CINEICC – Center for Research in Neuropsychology and Cognitive and Behavioral Intervention Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal,
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40
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O'Loghlen E, Galligan R. Disordered eating in the postpartum period: Role of psychological distress, body dissatisfaction, dysfunctional maternal beliefs and self-compassion. J Health Psychol 2021; 27:1084-1098. [PMID: 33588637 DOI: 10.1177/1359105321995940] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The present cross-sectional study tested the affect regulation model of disordered eating for women in the postpartum period, whereby disordered eating is used to cope with psychological distress. Two hundred and two women who had given birth in the last two years completed an online survey of self-report measures of study variables. Path analyses supported the primary hypothesis: negative affect mediated relationships between body dissatisfaction, dysfunctional maternal beliefs, negative components of self-compassion and disordered eating behaviours, particularly binge eating. Results suggest that negative affect plays a central role in postpartum disordered eating. Interventions to address maladaptive emotion regulation strategies, specifically targeting body image distress and self-critical maternal thoughts may improve eating behaviours for this population.
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Emotional Eating in Adults: The Role of Sociodemographics, Lifestyle Behaviors, and Self-Regulation-Findings from a U.S. National Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041744. [PMID: 33670147 PMCID: PMC7916829 DOI: 10.3390/ijerph18041744] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/04/2021] [Accepted: 02/06/2021] [Indexed: 11/17/2022]
Abstract
Background: Emotional eating, the tendency to overeat in response to negative emotions, has been linked to weight gain. However, scant evidence exists examining the prevalence and correlates of emotional eating among large samples of adults in the United States (U.S.). Hence, we examine the relationship among individual and socioeconomic factors, health behaviors, and self-regulation with emotional eating patterns among U.S. adults. Methods: Cross-sectional analysis of 5863 Family Health Habits Survey participants. Multivariable, ordered, logistic regression was employed to examine the relationship between the frequency of the desire to eat when emotionally upset (never, rarely, sometimes, often, and very often) and the independent variables. Results: Analysis reveals that 20.5% of the sample tended to emotionally eat often or very often. Being female, non-Hispanic White, and of younger age were all related to a higher likelihood of emotional eating. Additionally, inability to delay gratification (impatience) was related to an 18% increased likelihood (95% confidence interval (CI) 1.05–1.33) for emotional eating. Finally, emotional eating was significantly related to more frequent fast-food consumption. Conclusions: Program planners might need to develop targeted interventions aimed at enhancing emotional regulation skills while addressing these less healthful behaviors (e.g., fast-food intake) with the goal of obesity and chronic disease prevention.
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Barnhart WR, Braden AL, Dial LA. Understanding the relationship between negative emotional eating and binge eating: The moderating effects of acting with awareness and non-reactive mindfulness. J Clin Psychol 2021; 77:1954-1972. [PMID: 33561322 DOI: 10.1002/jclp.23123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 01/08/2021] [Accepted: 01/21/2021] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Negative emotional eating and binge eating are positively related, occur in diverse populations, and may be driven by similar mechanisms. Mindfulness facets such as acting with awareness, describe, non-judgement, non-reactive, and observe may moderate the relationship between these maladaptive eating phenotypes. METHOD A cross-sectional study assessed emotional eating-depression (Emotional Eating Scale-Revised, depression subscale), trait mindfulness facets (Five Facet Mindfulness Questionnaire-Short Form), and binge eating severity (Binge Eating Scale) in adults (N = 258). RESULTS Emotional eating-depression was less strongly associated with binge eating severity in participants with higher acting with awareness mindfulness. Emotional eating-depression was more strongly associated with binge eating severity in participants with higher non-reactive mindfulness. CONCLUSIONS Acting with awareness and non-reactive mindfulness may be important treatment targets in concurrent presentations of emotional eating-depression and binge eating.
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Affiliation(s)
- Wesley R Barnhart
- Department of Psychology, Bowling Green State University, Bowling Green, Ohio, USA
| | - Abby L Braden
- Department of Psychology, Bowling Green State University, Bowling Green, Ohio, USA
| | - Lauren A Dial
- Department of Psychology, Bowling Green State University, Bowling Green, Ohio, USA
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Ravichandran S, Bhatt RR, Pandit B, Osadchiy V, Alaverdyan A, Vora P, Stains J, Naliboff B, Mayer EA, Gupta A. Alterations in reward network functional connectivity are associated with increased food addiction in obese individuals. Sci Rep 2021; 11:3386. [PMID: 33564081 PMCID: PMC7873272 DOI: 10.1038/s41598-021-83116-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 01/07/2021] [Indexed: 12/19/2022] Open
Abstract
Functional neuroimaging studies in obesity have identified alterations in the connectivity within the reward network leading to decreased homeostatic control of ingestive behavior. However, the neural mechanisms underlying sex differences in the prevalence of food addiction in obesity is unknown. The aim of the study was to identify functional connectivity alterations associated with: (1) Food addiction, (2) Sex- differences in food addiction, (3) Ingestive behaviors. 150 participants (females: N = 103, males: N = 47; food addiction: N = 40, no food addiction: N = 110) with high BMI ≥ 25 kg/m2 underwent functional resting state MRIs. Participants were administered the Yale Food Addiction Scale (YFAS), to determine diagnostic criteria for food addiction (YFAS Symptom Count ≥ 3 with clinically significant impairment or distress), and completed ingestive behavior questionnaires. Connectivity differences were analyzed using a general linear model in the CONN Toolbox and images were segmented using the Schaefer 400, Harvard-Oxford Subcortical, and Ascending Arousal Network atlases. Significant connectivities and clinical variables were correlated. Statistical significance was corrected for multiple comparisons at q < .05. (1) Individuals with food addiction had greater connectivity between brainstem regions and the orbital frontal gyrus compared to individuals with no food addiction. (2) Females with food addiction had greater connectivity in the salience and emotional regulation networks and lowered connectivity between the default mode network and central executive network compared to males with food addiction. (3) Increased connectivity between regions of the reward network was positively associated with scores on the General Food Cravings Questionnaire-Trait, indicative of greater food cravings in individuals with food addiction. Individuals with food addiction showed greater connectivity between regions of the reward network suggesting dysregulation of the dopaminergic pathway. Additionally, greater connectivity in the locus coeruleus could indicate that the maladaptive food behaviors displayed by individuals with food addiction serve as a coping mechanism in response to pathological anxiety and stress. Sex differences in functional connectivity suggest that females with food addiction engage more in emotional overeating and less cognitive control and homeostatic processing compared to males. These mechanistic pathways may have clinical implications for understanding the sex-dependent variability in response to diet interventions.
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Affiliation(s)
- Soumya Ravichandran
- G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, Ingestive Behavior and Obesity Program, CHS 42-210 MC737818, 10833 Le Conte Avenue, Los Angeles, USA
| | - Ravi R Bhatt
- G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, Ingestive Behavior and Obesity Program, CHS 42-210 MC737818, 10833 Le Conte Avenue, Los Angeles, USA
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, USA
| | - Bilal Pandit
- G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, Ingestive Behavior and Obesity Program, CHS 42-210 MC737818, 10833 Le Conte Avenue, Los Angeles, USA
| | - Vadim Osadchiy
- G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, Ingestive Behavior and Obesity Program, CHS 42-210 MC737818, 10833 Le Conte Avenue, Los Angeles, USA
- David Geffen School of Medicine At UCLA, Los Angeles, USA
| | - Anita Alaverdyan
- G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, Ingestive Behavior and Obesity Program, CHS 42-210 MC737818, 10833 Le Conte Avenue, Los Angeles, USA
| | - Priten Vora
- G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, Ingestive Behavior and Obesity Program, CHS 42-210 MC737818, 10833 Le Conte Avenue, Los Angeles, USA
| | - Jean Stains
- G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, Ingestive Behavior and Obesity Program, CHS 42-210 MC737818, 10833 Le Conte Avenue, Los Angeles, USA
- David Geffen School of Medicine At UCLA, Los Angeles, USA
- Vatche and Tamar Manoukian Division of Digestive Diseases, Los Angeles, USA
| | - Bruce Naliboff
- G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, Ingestive Behavior and Obesity Program, CHS 42-210 MC737818, 10833 Le Conte Avenue, Los Angeles, USA
- David Geffen School of Medicine At UCLA, Los Angeles, USA
- Vatche and Tamar Manoukian Division of Digestive Diseases, Los Angeles, USA
- UCLA Microbiome Center, Los Angeles, USA
| | - Emeran A Mayer
- G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, Ingestive Behavior and Obesity Program, CHS 42-210 MC737818, 10833 Le Conte Avenue, Los Angeles, USA
- David Geffen School of Medicine At UCLA, Los Angeles, USA
- Vatche and Tamar Manoukian Division of Digestive Diseases, Los Angeles, USA
- UCLA Microbiome Center, Los Angeles, USA
- Ahmanson-Lovelace Brain Mapping Center, University of California Los Angeles (UCLA), Los Angeles, USA
| | - Arpana Gupta
- G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, Ingestive Behavior and Obesity Program, CHS 42-210 MC737818, 10833 Le Conte Avenue, Los Angeles, USA.
- David Geffen School of Medicine At UCLA, Los Angeles, USA.
- Vatche and Tamar Manoukian Division of Digestive Diseases, Los Angeles, USA.
- UCLA Microbiome Center, Los Angeles, USA.
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Rumination, mood, and maladaptive eating behaviors in overweight and healthy populations. Eat Weight Disord 2021; 26:273-285. [PMID: 32072571 PMCID: PMC7895787 DOI: 10.1007/s40519-020-00857-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 01/24/2020] [Indexed: 11/04/2022] Open
Abstract
PURPOSE The literature suggests that rumination (i.e., repetitive thinking about 1 or more negative concerns that is perceived as difficult to control) is linked to impaired emotional regulation and increases negative affect. Not only individuals suffering from overweight or obesity, but also healthy individuals might use emotional eating as a coping strategy to deal with negative affect caused by rumination. The aim of the present study was to determine the link between rumination and maladaptive eating strategies in participants with normal weight and overweight/obesity using trait and ecological momentary measures. METHOD In Study 1, 88 individuals from overweight/obese (N = 33) and control group (N = 50) filled in a series of questionnaires assessing trait rumination, and eating behaviors. In Study 2 momentary affect, rumination and eating behavior of 26 participants were assessed using ecological momentary assessment (EMA) methodology. RESULTS In Study 1, the moderated mediation model revealed that emotional eating mediates the link between rumination and uncontrolled eating or snacking, but only in healthy participants and not in the participants with overweight. The results of Study 2 suggest that when both momentary rumination and sad mood are entered into the model predicting momentary daily emotional eating, only rumination remains a significant predictor of emotional eating. This relationship is not modified by the fact that the participants are from healthy controls or the overweight/obese group. DISCUSSION Study 1 provided evidence on the differential role of emotional eating in participants with normal weight and with overweight. Study 2 provided initial insights into the role of momentary mood and momentary repetitive thinking in the use of emotional eating in participants' everyday lives. The differences in group effect in trait and EMA measures indicated also the importance of considering the consciousness of using rumination and emotional eating, while studying those processes in individuals with overweight. LEVEL OF EVIDENCE Level III, case-control analytic study.
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Abdul Basir SM, Abdul Manaf Z, Ahmad M, Abdul Kadir NB, Ismail WNK, Mat Ludin AF, Shahar S. Reliability and Validity of the Malay Mindful Eating Questionnaire (MEQ-M) among Overweight and Obese Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031021. [PMID: 33498903 PMCID: PMC7908380 DOI: 10.3390/ijerph18031021] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/06/2021] [Accepted: 01/18/2021] [Indexed: 01/10/2023]
Abstract
The Mindful Eating Questionnaire is a reliable tool for the assessment of mindful eating behavior among the general population. This study aimed to determine the reliability and validity of The Malay Mindful Eating Questionnaire (MEQ-M) in a sample of overweight and obese adults. This is a cross-sectional survey which involved 144 overweight and obese adults in a selected public university. After linguistic validation of the Malay version of the MEQ, exploratory factor analysis (EFA) with varimax rotation was performed on the scale constructs. The psychometric properties of the MEQ were assessed through Cronbach’s alpha and intraclass correlation coefficient (ICC) analysis. The EFA of the MEQ produced a seven-dimensional model (58.8% of overall variances). The concurrent validity analysis between total MEQ scores and total Mindfulness Attention Awareness Scale (MAAS) scores indicated a weak non-significant correlation (p = 0.679). The internal consistency reliability of the MEQ was reasonable (Cronbach’s α = 0.64). The agreement stability of the MEQ over eight weeks was poor (ICC = 0.10). In conclusion, the psychometric properties of the Malay-translated MEQ are acceptable through construct validity and internal consistency reliability tests. This instrument may be used for assessing mindful eating habits in the Malaysian population, especially among overweight and obese adults.
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Affiliation(s)
- Siti Munirah Abdul Basir
- Dietetic Program and Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Aziz, Kuala Lumpur 50300, Malaysia; (S.M.A.B.); (S.S.)
| | - Zahara Abdul Manaf
- Dietetic Program and Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Aziz, Kuala Lumpur 50300, Malaysia; (S.M.A.B.); (S.S.)
- Correspondence: ; Tel.: +60-392897677
| | - Mahadir Ahmad
- Clinical Psychology & Behavioural Health Program, Center for Community Health Studies (ReACH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Aziz, Kuala Lumpur 50300, Malaysia;
| | - Nor Ba’yah Abdul Kadir
- Centre for Research in Psychology and Human Well-being, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Selangor, Bangi 43600, Malaysia; (N.B.A.K.); (W.N.K.I.)
| | - Wan Nur Khairunnisa Ismail
- Centre for Research in Psychology and Human Well-being, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Selangor, Bangi 43600, Malaysia; (N.B.A.K.); (W.N.K.I.)
| | - Arimi Fitri Mat Ludin
- Biomedical Science Program and Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Aziz, Kuala Lumpur 50300, Malaysia;
| | - Suzana Shahar
- Dietetic Program and Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Aziz, Kuala Lumpur 50300, Malaysia; (S.M.A.B.); (S.S.)
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Understanding eating and drinking behaviours in Pakistani university students: A conceptual model through qualitative enquiry. Appetite 2021; 161:105133. [PMID: 33493609 DOI: 10.1016/j.appet.2021.105133] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 12/24/2020] [Accepted: 01/16/2021] [Indexed: 12/24/2022]
Abstract
Excess weight in Pakistan's university students is on the rise and is driven by their maladaptive eating behaviours. Practitioners in Pakistan have adopted Western conceptual models to understand obesogenic eating behaviours. However, these models provide incomplete explanations as they miss important culturally specific determinants for such eating behaviours. The goals of this study were two-fold: first, to explore Pakistani university students' perception of their obesity-related eating behaviours and attitudes; second, to develop a culturally sensitive model of obesogenic eating behaviours in university students from Pakistan. Semi-structured interviews were used with twenty-four Pakistani university students who were categorised as obese using the Body Mass Index according to Asia-Specific cut-offs. Interviews were transcribed, translated, and then analysed through a Grounded Theory methodology. Six major categories emerged from interviews: (1) Obesogenic Eating Habits (Social Eating, Emotional Eating, and Eating Whatever and Whenever You Want); (2) Beliefs about Food in the Culture; (3) Neither Too Fat nor Too Thin body belief (4) Student Life Attitudes; (5) Student Stressors; (6) Inconsistent Weight-Control Strategies. A model was developed with cultural beliefs about food, attitudes towards student-life, and stressors as important determinants of students' obesogenic eating habits, while inconsistent weight-control strategies contributed to further weight gain. The findings highlight the importance of identifying culturally specific determinants of eating behaviours among university students in Pakistan. This emerging model can be used to guide the development of future quantitative and also longitudinal studies aimed at identifying targets for therapeutic interventions to manage obesogenic eating behaviours in Pakistani university students.
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Favieri F, Marini A, Casagrande M. Emotional Regulation and Overeating Behaviors in Children and Adolescents: A Systematic Review. Behav Sci (Basel) 2021; 11:11. [PMID: 33477932 PMCID: PMC7833366 DOI: 10.3390/bs11010011] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/15/2021] [Accepted: 01/15/2021] [Indexed: 12/19/2022] Open
Abstract
The worldwide prevalence of obesity has dramatically increased, mostly in children and adolescents. The Emotional Eating theoretical model has proposed that the failure in emotional regulation could represent a risk factor for establishing maladaptive overeating behavior that represents an inadequate response to negative emotions and allows increasing body-weight. This systematic review investigates the relationship between overeating and both emotional regulation and emotional intelligence in childhood and adolescence, considering both cross-sectional and longitudinal studies. Moreover, another goal of the review is evaluating whether emotional regulation and emotional intelligence can cause overeating behaviors. The systematic search was conducted according to the PRISMA-statement in the databases Medline, PsychArtcles, PsychInfo, PubMed, Scopus, and Web of Sciences, and allows 484 records to be extracted. Twenty-six studies were selected according to inclusion (e.g., studies focused on children and adolescents without clinical conditions; groups of participants overweight or with obesity) and exclusion (e.g., studies that adopted qualitative assessment or cognitive-affective tasks to measure emotional variables; reviews, commentary, or brief reports) criteria detailed in the methods. Cross-sectional studies showed a negative association between emotional regulation and overeating behavior that was confirmed by longitudinal studies. These findings highlighted the role of maladaptive emotion regulation on overeating and being overweight. The relationship between these constructs in children and adolescents was consistent. The results indicated the complexity of this association, which would be influenced by many physiological, psychological, and social factors. These findings underline the need for further studies focused on emotion regulation in the development of overeating. They should analyze the mediation role of other variables (e.g., attachment style, peer pressure) and identify interventions to prevent and reduce worldwide overweight prevalence.
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Affiliation(s)
- Francesca Favieri
- Department of Psychology, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Andrea Marini
- Department of Dynamic, Clinical and Health Psychology, “Sapienza” University of Rome, 00185 Rome, Italy;
| | - Maria Casagrande
- Department of Dynamic, Clinical and Health Psychology, “Sapienza” University of Rome, 00185 Rome, Italy;
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Mood disorders comorbidity in obese bariatric patients: the role of the emotional dysregulation. J Affect Disord 2021; 279:46-52. [PMID: 33038699 DOI: 10.1016/j.jad.2020.09.128] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 08/25/2020] [Accepted: 09/27/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Obese patients seeking bariatric surgery are known to show high rates of mental disorders, mainly mood and eating disorders. The aim of the present study is to evaluate psychiatric comorbidities, affective temperamental dimensions, emotional dysregulation and impulsivity in a sample of obese bariatric patients, exploring the differences between obese patients with and without mood disorders (MD). METHODS A total of 69 obese patients were consecutively enrolled between March and November 2019 during the presurgical evaluation routinely performed before the bariatric intervention. Sociodemographic and clinical features were collected by psychiatrists during a single consultation. Affective temperaments, emotional dysregulation and impulsivity were also investigated through self-report questionnaires. Epidemiological and clinical variables were compared between patients with and without MD. RESULTS In our sample, almost 3 out of 4 patients presented a lifetime psychiatric disorder, mainly MD (n=33, 48%), binge eating disorder (BED) (n=34, 49%) and anxiety disorders (n=30, 43%). Compared to N-MD patients, those with MD showed higher rates of psychiatric comorbidity with BED, bulimia and panic disorder. In addition, obese patients with MD showed more frequently cyclothymic, depressive and anxious temperaments, and higher mean scores on the psychometric questionnaires assessing emotional dysregulation and impulsivity compared to obese subjects without MD. LIMITATIONS the small sample size, the retrospectively assessment of psychiatric disorders and the self-report questionnaires. CONCLUSIONS A subgroup of obese patients, especially among those with MD, show high emotional dysregulation, affective lability and impulsiveness that could represent suitable substrates for the development of compulsive and addictive eating habits.
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Shriver LH, Dollar JM, Calkins SD, Keane SP, Shanahan L, Wideman L. Emotional Eating in Adolescence: Effects of Emotion Regulation, Weight Status and Negative Body Image. Nutrients 2020; 13:E79. [PMID: 33383717 PMCID: PMC7824438 DOI: 10.3390/nu13010079] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/22/2020] [Accepted: 12/27/2020] [Indexed: 12/16/2022] Open
Abstract
Emotional eating is associated with an increased risk of binge eating, eating in the absence of hunger and obesity risk. While previous studies with children and adolescents suggest that emotion regulation may be a key predictor of this dysregulated eating behavior, little is known about what other factors may be influencing the link between emotional regulation and emotional eating in adolescence. This multi-method longitudinal study (n = 138) utilized linear regression models to examine associations between childhood emotion regulation, adolescent weight status and negative body image, and emotional eating at age 17. Emotion regulation predicted adolescent emotional eating and this link was moderated by weight status (β = 1.19, p < 0.01) and negative body image (β = -0.34, p < 0.01). Higher engagement in emotional eating was predicted by lower emotional regulation scores among normal-weight teens (β = -0.46, p < 0.001) but not among overweight/obese teens (β = 0.32, p > 0.10). Higher scores on emotion regulation were significantly associated with lower emotional eating at high (β = -1.59, p < 0.001) and low (β = -1.00, p < 0.01) levels of negative body image. Engagement in emotional eating was predicted by higher negative body image among overweight/obese teens only (β = 0.70, p < 0.001). Our findings show that while better childhood emotion regulation skills are associated with lower emotional eating, weight status and negative body image influence this link and should be considered as important foci in future interventions that aim to reduce emotional eating in adolescence.
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Affiliation(s)
- Lenka H. Shriver
- Department of Nutrition, University of North Carolina at Greensboro (UNCG), Greensboro, NC 27402, USA
| | - Jessica M. Dollar
- Department of Human Development and Family Studies, UNCG, Greensboro, NC 27402, USA;
| | - Susan D. Calkins
- Office of Research and Engagement, UNCG, Greensboro, NC 27402, USA;
| | - Susan P. Keane
- Department of Psychology, UNCG, Greensboro, NC 27402, USA;
| | - Lilly Shanahan
- Jacobs Center for Productive Youth Development, University of Zurich, 8050 Zurich, Switzerland;
| | - Laurie Wideman
- Department of Kinesiology, UNCG, Greensboro, NC 27402, USA;
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Casu G, Gremigni P, Masheb RM. Emotional overeating questionnaire: a validation study in Italian adults with obesity, overweight or normal weight. Eat Weight Disord 2020; 25:1747-1754. [PMID: 31782027 DOI: 10.1007/s40519-019-00821-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 11/15/2019] [Indexed: 01/07/2023] Open
Abstract
PURPOSE This study aimed at testing the validity and reliability of the Emotional Overeating Questionnaire (EOQ) in a sample of Italian adults with obesity, overweight or normal weight. MATERIALS AND METHODS Participants were 314 Italian adults (72.6% females, aged 18-76 years) with obesity (27.4%), overweight (21.3%), or normal weight (51.3%), who completed the EOQ and measures of binge eating, mental well-being, and mindful eating. Retesting was performed 4 weeks later in a randomly selected subsample of 60 participants. Factor structure of the EOQ was estimated by confirmatory factor analysis (CFA). Reliability was tested with McDonald's ω and ordinal α coefficients for internal consistency and Cohen's weighted Kappa coefficient (Kw) for test-retest reliability. RESULTS Based on CFA, the five negative emotional items formed one factor (EOQ-5) with good reliability (ω = 0.89; ordinal α = 0.88; Kw= 0.71), while the item referring to happiness was dropped. EOQ-5 scores were associated with higher binge eating, lower mental well-being, and lower mindful eating. A cut-off point of two identified individuals at risk for binge eating disorders with 75% sensitivity and 67% specificity. Negative emotional overeating was more frequent in women with obesity than women with normal weight and men with obesity. CONCLUSIONS EOQ-5 is a valid and reliable tool for measuring the frequency of emotional overeating at the Italian community-level. LEVEL OF EVIDENCE Level V, cross-sectional, descriptive study.
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Affiliation(s)
- Giulia Casu
- Department of Psychology, University of Bologna, Viale Berti Pichat, 5, 40127, Bologna, Italy
| | - Paola Gremigni
- Department of Psychology, University of Bologna, Viale Berti Pichat, 5, 40127, Bologna, Italy.
| | - Robin M Masheb
- Department of Psychiatry, Yale School of Medicine, 300 George St, New Haven, CT, 06511, USA
- VA Connecticut Healthcare System, 950 Campbell Ave, West Haven, CT, 06516, USA
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