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Ahola AJ, Suojanen LU, Joki A, Pietiläinen KH. Loneliness and its cross-sectional associations with health, health behaviours, and perceptions in Finnish patients with overweight or obesity taking part in the Healthy Weight Coaching. Prev Med 2024; 185:108032. [PMID: 38851400 DOI: 10.1016/j.ypmed.2024.108032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 06/03/2024] [Accepted: 06/05/2024] [Indexed: 06/10/2024]
Abstract
OBJECTIVE To investigate cross-sectional associations between loneliness and health, health behaviours, and perceptions in Finnish individuals with overweight or obesity (BMI ≥25 kg/m2). METHODS We used baseline data from patients participating, in 2016-2022, in a real-life digital 12-month weight management program known as Healthy Weight Coaching. Patients completed several questionnaires such as those related to loneliness, healthcare resource utilization, physical activity, and life satisfaction. BMI was computed based on self-reported weight and height. In addition to investigating individual health variables, we studied the association between loneliness and factor-analysis-derived health and wellbeing clusters. RESULTS Data were available from 2000 individuals (16.7% men, median age 48 years, median BMI 39.2 kg/m2). Altogether, 11.6%, 42.4%, and 46.0% reported feeling lonely, somewhat lonely, and not lonely, respectively. Feeling lonely was associated with higher BMI, greater healthcare resource utilization, lower life satisfaction, burdensomeness of life, more negative perceptions related to obesity and to the upcoming coaching, lower daytime energy, and reduced 20-min brisk walk results, a measure of functional capacity. Of the five factor-analysis-derived clusters, loneliness was adversely associated with "Life satisfaction" [lonely, 0.337 (0.270-0.421), p < 0.001; somewhat lonely, 0.545 (0.475-0.625), p < 0.001]. Moreover, loneliness associated with "Negative perceptions of obesity/daytime fatigue" [lonely, 4.627 (3.391-6.314), p < 0.001; somewhat lonely 2.021 (1.694-2.412), p < 0.001], and "Obesity/low physical activity" [lonely, 1.474 (1.105-1.966), p = 0.008; somewhat lonely, 1.220 (1.019-1.460), p = 0.030]. CONCLUSIONS Loneliness had several untoward associations with health, health behaviours, and perceptions. Further research should explore the intricate relationship between obesity, loneliness, and physical and psychosocial health. TRIAL REGISTRATION The trial is registered at clinicaltrials.cov (Clinical Trials Identifier NCT04019249).
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Affiliation(s)
- Aila J Ahola
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Laura-Unnukka Suojanen
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Healthy Weight Hub, Abdominal Centre, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Research Program for Population Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Anu Joki
- Healthy Weight Hub, Abdominal Centre, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Kirsi H Pietiläinen
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Healthy Weight Hub, Abdominal Centre, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
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Zhou J, Tang R, Wang X, Li X, Heianza Y, Qi L. Improvement of Social Isolation and Loneliness and Excess Mortality Risk in People With Obesity. JAMA Netw Open 2024; 7:e2352824. [PMID: 38252435 PMCID: PMC10804268 DOI: 10.1001/jamanetworkopen.2023.52824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 12/01/2023] [Indexed: 01/23/2024] Open
Abstract
Importance Individuals with obesity experience markedly higher levels of social isolation and loneliness than those without obesity, but little is known about whether improvement of social isolation or loneliness might attenuate obesity-related excess risk of mortality. Objective To investigate whether improvement of social isolation or loneliness is associated with lower obesity-related excess risk of mortality. Design, Setting, and Participants This cohort study included individuals without cancer or cardiovascular disease (CVD) at baseline from the UK Biobank with follow-up beginning in March 2006 and ending in November 2021. Main Outcomes and Measures All-cause, cancer-related, and CVD-related mortality were estimated. Results A total of 398 972 participants were included in this study (mean [SD] age, 55.85 [8.08] years; 220 469 [55.26%] women; 13 734 [3.44%] Asian, 14 179 [3.55%] multiracial, and 363 685 [91.16%] White participants). Overall, 93 357 (23.40%) had obesity, and 305 615 (76.60%) did not. During a median (IQR) follow-up of 12.73 (12.01-13.43) years, a total of 22 872 incident deaths were recorded. Compared with participants with obesity with an index of 2 or greater for social isolation, the multivariable adjusted hazard ratios (HRs) for all-cause mortality were 0.85 (95% CI, 0.79-0.91) and 0.74 (95% CI, 0.69-0.80) for participants with obesity and a social isolation index of 1 and 0, respectively (P for trend < .001); compared with participants with obesity and an index of 2 for loneliness, the HRs and 0.97 (95% CI, 0.89-1.06) and 0.86 (95% CI, 0.79-0.94) for participants with obesity and a loneliness index of 1 and 0, respectively (P for trend < .001). As the index of social isolation and loneliness went from highest to lowest, the HR for all-cause mortality decreased by 36% and 9%, respectively, in people with obesity compared with people without obesity using the multivariable model. Social isolation was ranked higher than loneliness, depression, anxiety, and lifestyle-related risk factors including alcohol, physical activity, and healthy diet for estimating the risks of all-cause mortality, cancer-related mortality, and CVD-related mortality. Conclusions and Relevance In this cohort study of UK Biobank participants, a lower index of social isolation or loneliness was associated with a decreased risk of all-cause mortality among people with obesity, and improvement of social isolation and loneliness attenuated obesity-related excess risk of all-cause mortality.
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Affiliation(s)
- Jian Zhou
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Rui Tang
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Xuan Wang
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Xiang Li
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Yoriko Heianza
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Lu Qi
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Jeon SE, Ryu S, Lee JY, Kim JM, Kim SW, Kang YS. The Effect of Fear of COVID-19 Infection and Anxiety on Loneliness: Moderated Mediation Effects of Gratitude. Psychiatry Investig 2023; 20:870-879. [PMID: 37794669 PMCID: PMC10555511 DOI: 10.30773/pi.2023.0170] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 07/05/2023] [Indexed: 10/06/2023] Open
Abstract
OBJECTIVE This study was conducted to identify factors related to loneliness during the coronavirus disease-2019 (COVID-19) pandemic and focused on how the fear of COVID-19 infection affects loneliness and the conditional effect of gratitude as a moderator in the relationship among the fear of COVID-19, anxiety, and loneliness. METHODS For the analysis of this study, a survey was conducted among 1,500 individuals aged 19 to 69 years living in three metropolitan areas in South Korea. Questionnaires included sociodemographic data, psychological experience and stress associated with COVID-19, Generalized Anxiety Disorder Scale-7, UCLA Loneliness Scale-3, and Gratitude Questionnaire-6. An analysis was conducted by applying SPSS PROCESS macro models 4 and 7. RESULTS First, anxiety mediated the relationship between the fear of COVID-19 infection and loneliness. Second, the effect of the fear of COVID-19 infection on loneliness through anxiety was moderated by gratitude. The higher the gratitude, the more the fear of COVID-19 infection is buffered in the path to anxiety, and the lower the indirect effect on loneliness. CONCLUSION This suggests that in the context of the COVID-19 pandemic, interventions for psychological problems such as anxiety and loneliness can be carried out through gratitude, a significant protective variable.
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Affiliation(s)
- Seong-Eun Jeon
- Department of Psychology, Chonnam National University, Gwangju, Republic of Korea
| | - Seunghyong Ryu
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
- Mindlink, Gwangju Bukgu Mental Health Center, Gwangju, Republic of Korea
| | - Young-Shin Kang
- Department of Psychology, Chonnam National University, Gwangju, Republic of Korea
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Prell T, Stegmann S, Schönenberg A. Social exclusion in people with diabetes: cross-sectional and longitudinal results from the German Ageing Survey (DEAS). Sci Rep 2023; 13:7113. [PMID: 37130924 PMCID: PMC10152415 DOI: 10.1038/s41598-023-33884-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 04/20/2023] [Indexed: 05/04/2023] Open
Abstract
As social exclusion can be linked to worse health and overall reduced quality of life, we describe social exclusion in people with diabetes and assess whether diabetes can be considered as a risk factor for social exclusion. We analyzed two waves (2014, 2017, N = 6604) from a survey of community-dwelling people aged > 40 using linear regression, group comparison and generalized estimating equations to explore the association between diabetes, social exclusion, socioeconomic, physical and psychosocial variables. In the entire cohort, diabetes was cross-sectionally associated with social exclusion after adjusting for covariates (p = 0.001). In people with diabetes, social exclusion was further associated with self-esteem (p < 0.001), loneliness (p = < 0.001), income (p = 0.017), depression (p = 0.001), physical diseases (p = 0.04), and network size (p = 0.043). Longitudinal data revealed that higher levels of social exclusion were already present before the diagnosis of diabetes, and future social exclusion was predicted by self-esteem, loneliness, depression, and income, but not by diabetes (p = .221). We conclude that diabetes is not a driver of social exclusion. Instead, both seem to co-occur as a consequence of health-related and psychosocial variables.
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Affiliation(s)
- Tino Prell
- Department of Geriatrics, Halle University Hospital, Halle, Germany
| | | | - Aline Schönenberg
- Department of Geriatrics, Halle University Hospital, Halle, Germany.
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The impact of threats to belonging on health, peripheral physiology, and social behavior. ADVANCES IN EXPERIMENTAL SOCIAL PSYCHOLOGY 2022. [DOI: 10.1016/bs.aesp.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Hajek A, König HH. Asymmetric effects of obesity on loneliness among older Germans. Longitudinal findings from the Survey of Health, Ageing and Retirement in Europe. Aging Ment Health 2021; 25:2293-2297. [PMID: 32962423 DOI: 10.1080/13607863.2020.1822285] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The aim of this longitudinal study was to examine whether the onset and the end of obesity was associated with loneliness. METHOD Nationally representative longitudinal data from Germany were taken from the Survey of Health, Ageing and Retirement in Europe (wave 5 to wave 7; n = 10,446 observations in the analytical sample). Using the three item loneliness scale (UCLA), loneliness was measured. According to the WHO thresholds, obesity was defined as BMI ≥ 30 kg/m2. Asymmetric fixed effects (FE) regressions were used. RESULTS Conventional FE regression analysis revealed that changes in obesity status were associated with changes in loneliness (men: β = -.19, p < .05; women: β = .19, p < .05). Asymmetric FE regressions showed that in men the onset of obesity was associated with a decrease in loneliness (β = -.31, p < .05), whereas the end of obesity was not associated with loneliness. Asymmetric FE regressions showed that in women, the onset of obesity was associated with an increase in loneliness (β = .33, p < .01), whereas the end of obesity was not associated with loneliness. CONCLUSION Findings showed that the onset of obesity has different consequences in terms of loneliness for older women and men in Germany, whereas the end of obesity was not associated with changes in loneliness scores. We recommend that future studies should distinguish between the onset and the end of obesity - which comes along with important practical implications. When older women report transitions to obesity, efforts to prevent loneliness may be of importance.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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The Impact of Interpersonal Cognitive Distortions on Satisfaction with Life and the Mediating Role of Loneliness. SUSTAINABILITY 2021. [DOI: 10.3390/su13169293] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Loneliness and cognitive distortions have serious negative effects on life satisfaction and are seen as related to each other. However, what mediates in these relationships has not been adequately analyzed. This study aims to analyze the effect between cognitive distortions and life satisfaction by asserting the mediating role of loneliness. For this purpose, we conducted a cross-sectional study with 978 people over the age of 20 from various parts of Turkey using a general screening model. Firstly, we analyzed the direct effect of interpersonal rejection, interpersonal misperception, and unrealistic relationship expectation, which are sub-dimensions of cognitive distortions, loneliness, and life satisfaction. Secondly, we analyzed the effects of independent, mediation, and interaction (Loneliness X age) variables on satisfaction with life. Thirdly, we applied direct regression analysis between independent, mediating, and dependent variables to conduct the mediation analysis of the study. Also, we examined age as a moderator between loneliness and life satisfaction. The results showed loneliness as an essential determinant between cognitive distortions and life satisfaction. Moreover, in the moderation analysis, we found some age-related differences between loneliness and life satisfaction. According to this, both loneliness and life satisfaction increased with increasing age. However, life satisfaction decreased as loneliness increased in young people. Being able to compensate for loneliness in the aging process is an essential psychological indicator. Although young people have more opportunities than older people, their ability to cope with negative situations such as loneliness is largely undeveloped. These results showed both psychological and sociological problems of loneliness. Therefore, the results can be useful for the prevention of loneliness and the development of intervention programs.
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Oser TK, Roy S, Parascando J, Mullen R, Radico J, Reedy-Cooper A, Moss J. Loneliness in Primary Care Patients: Relationships With Body Mass Index and Health Care Utilization. J Patient Cent Res Rev 2021; 8:239-247. [PMID: 34322576 DOI: 10.17294/2330-0698.1808] [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] [Indexed: 11/04/2022] Open
Abstract
Purpose Rates of loneliness and obesity have increased in recent decades. Loneliness and obesity independently have been found to be risk factors for negative physical and mental health outcomes. This study examined the rates and interrelationships of loneliness, body mass index (BMI), and health care utilization in a primary care setting. Methods A cross-sectional survey of adult patients presenting for outpatient care at 7 family medicine clinical practices in Pennsylvania was conducted. Survey questions included self-reported measures of loneliness, height/weight, number of health care visits, and potential confounders (eg, sociodemographic variables, health status). Bivariate and multivariable linear regression models were used to analyze associations among loneliness, BMI, and health care utilization. Results In all, 464 eligible patients returned surveys for an overall response rate of 26%. Mean (standard deviation) loneliness score was 4.2 (1.7), mean BMI was 30.4 (7.6), and mean number of visits in year prior was 2.7 (3.6). On bivariate analysis, BMI was positively associated with loneliness (effect estimate: 0.50; P=0.03). On multivariable analysis, BMI was negatively associated with attending religious services and self-reported physical health and positively associated with self-reported mental health (P<0.05 for all), but not associated with loneliness. While not associated with loneliness, health care utilization was negatively associated with Hispanic ethnicity, marital status, and self-reported physical health (P<0.05 for all). Conclusions Given the detrimental effects loneliness and obesity have on health outcomes, it might be prudent for health care providers to prioritize health concerns for their patients by assessing loneliness and counseling regarding associated risks, particularly in patients with obesity.
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Affiliation(s)
- Tamara K Oser
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO
| | - Siddhartha Roy
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA
| | - Jessica Parascando
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA
| | - Rebecca Mullen
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO
| | - Julie Radico
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA
| | - Alexis Reedy-Cooper
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA
| | - Jennifer Moss
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA
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Hajek A, König HH. Does obesity lead to loneliness and perceived social isolation in the second half of life? Findings from a nationally representative study in Germany. Geriatr Gerontol Int 2021; 21:836-841. [PMID: 34278676 DOI: 10.1111/ggi.14246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/01/2021] [Accepted: 07/01/2021] [Indexed: 12/15/2022]
Abstract
AIM Little is known about the link between obesity and loneliness as well as perceived social isolation. Therefore, the objective of this longitudinal study is to clarify whether the onset and the end of obesity is associated with changes in perceived social isolation as well as loneliness (stratified by sex) in older age. METHODS Longitudinal data were used from wave 5 (year 2014) and 6 (year 2017) of the German Ageing Survey - a nationally representative sample of community-dwelling individuals aged ≥40 years in Germany. Established tools were used to quantify loneliness and perceived social isolation. A body mass index ≥30 kg/m2 was used to classify individuals as being obese. Asymmetric fixed effects regressions were used. RESULTS Regressions showed that the end of obesity was associated with decreases in perceived social isolation among women (β = -0.24, P = 0.01), but not in men (with significant sex differences). The onset of obesity was not associated with changes in perceived social isolation. Neither the beginning of obesity nor the end of obesity was associated with changes in loneliness. CONCLUSIONS Our findings emphasize the importance of overcoming obesity for women in the second half of life. As most of the existing studies were conducted in Germany, studies from other countries are of importance to understand this association better. Geriatr Gerontol Int 2021; 21: 836-841.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Martinistraße 52, Hamburg, 20246, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Martinistraße 52, Hamburg, 20246, Germany
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Nguyen TT, Lee EE, Daly RE, Wu TC, Tang Y, Tu X, Van Patten R, Jeste DV, Palmer BW. Predictors of Loneliness by Age Decade: Study of Psychological and Environmental Factors in 2,843 Community-Dwelling Americans Aged 20-69 Years. J Clin Psychiatry 2020; 81:20m13378. [PMID: 33176072 PMCID: PMC7953851 DOI: 10.4088/jcp.20m13378] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 07/21/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Loneliness is a prevalent and serious public health problem due to its effects on health, well-being, and longevity. Understanding correlates of loneliness is critical for guiding efforts toward the development of evidence-based strategies for prevention and intervention. Considering that patterns of association between age and loneliness vary, the present study sought to examine age-related differences in risk and protective factors for loneliness. METHODS Correlates of loneliness were examined through a large web-based survey of 2,843 participants (aged 20-69 years) from across the United States from April 10, 2019, through May 10, 2019. Participants completed the 4-item UCLA Loneliness Scale, San Diego Wisdom Scale (with the following subscales measuring components of wisdom: Prosocial Behaviors, Emotional Regulation, Self-Reflection, Acceptance of Divergent Values, Decisiveness, and Social Advising), and other scales measuring psychosocial variables. Multivariate regression analyses were conducted to identify the best model of loneliness and examine potential age-related differences. RESULTS Age demonstrated a nonlinear quadratic relationship with loneliness (Wald statistic = 5.48, P = .019); levels were highest in the 20s and lowest in the 60s with another peak in the mid-40s. Across all decades, loneliness was associated with not having a spouse or partner (P < .001), sleep disturbance (P < .02), lower prosocial behaviors (P < .001), and smaller social network (P < .001). Lower social self-efficacy (P < .001) and higher anxiety (P < .005) were associated with worse loneliness in all age decades, except the 60s. Loneliness was uniquely associated with decisiveness in the 50s (P = .012) and with education (P = .046) and memory complaints (P = .013) in the 60s. CONCLUSIONS Our findings identify several potentially modifiable targets related to loneliness, including several aspects of wisdom and social self-efficacy. Differential predictors at different decades suggest a need for a personalized and nuanced prioritizing of prevention and intervention targets.
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Affiliation(s)
- Tanya T Nguyen
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA
| | - Ellen E Lee
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA
| | - Rebecca E Daly
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, California, USA
| | - Tsung-Chin Wu
- Department of Mathematics, University of California San Diego, La Jolla, California, USA
| | - Yi Tang
- Newcomb-Tulane College, Tulane University, New Orleans, Louisiana, USA
| | - Xin Tu
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, California, USA
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, USA
| | - Ryan Van Patten
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA
| | - Dilip V Jeste
- University of California San Diego, 9500 Gilman Drive #0664, La Jolla, CA 92023-0664.
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
- Department of Neurosciences, University of California San Diego, La Jolla, California, USA
| | - Barton W Palmer
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA
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Hajek A, König HH. Obesity and loneliness. Findings from a longitudinal population-based study in the second half of life in Germany. Psychogeriatrics 2019; 19:135-140. [PMID: 30294939 DOI: 10.1111/psyg.12375] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 08/04/2018] [Accepted: 08/14/2018] [Indexed: 01/22/2023]
Abstract
AIM Little is known about whether changes to obesity are associated with changes in loneliness scores. Therefore, using a longitudinal approach, we aimed to determine whether the onset of obesity (explanatory variable) is associated with changes in loneliness (outcome measure) among older adults. METHODS For the present study, data from wave 2 (2002) to wave 5 (2014) of the German Ageing Survey were analyzed. This is a representative sample of community-dwelling individuals in Germany (≥40 years). A validated six-item scale by Gierveld and van Tilburg was used to quantify loneliness. Obesity was defined as body mass index ≥30 kg/m2 . Fixed effects regressions were used. RESULTS Fixed effects regressions showed that loneliness increased with the onset of obesity among men but not among women. The sex × obesity interaction term was significant (P = 0.02). CONCLUSIONS Findings stress the importance of the onset of obesity for loneliness among older men. Weight management strategies might also be a promising strategy to reduce loneliness scores.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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12
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Pavela G, Kim YI, Salvy SJ. Additive effects of obesity and loneliness on C-reactive protein. PLoS One 2018; 13:e0206092. [PMID: 30439985 PMCID: PMC6237312 DOI: 10.1371/journal.pone.0206092] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 10/06/2018] [Indexed: 12/05/2022] Open
Abstract
Obesity and loneliness are associated with C-reactive protein (CRP), a predictor of cardiovascular disease. It is unknown whether the co-presence of obesity and loneliness is associated with additional risk for clinically elevated CRP. The present study thus examines their independent and combined effects on elevated CRP in older adults. Data come from 10,912 respondents who completed the 2008 and 2010 waves of the Health and Retirement Study. Loneliness was measured using an 11-item Loneliness Scale and body mass index was calculated from technician measured height and weight. Our primary outcome is high sensitivity CRP (hsCRP). Survey-weighted logistic regression models were used to test whether loneliness and BMI category are independent predictors of CRP after adjusting for demographics and other inflammatory-related covariates. In the fully adjusted model for men, obesity (OR = 2.36, p < .0001) was associated with increased odds of hsCRP >3.0. Among females, being overweight (OR = 1.75, p < .0001) or obese (OR = 4.01, p < .0001) were associated increased odds of hsCRP>3.0. Among both men and women, results from fully adjusted models indicated that loneliness was not associated with clinically elevated hsCRP (OR = 1.34, p = .0535; OR = 0.97, p = 0.6776, respectively).
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Affiliation(s)
- Gregory Pavela
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Young-il Kim
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Sarah-Jeanne Salvy
- Department of Medicine, Cedars Sinai Medical Center, Los Angeles, California, United States of America
- * E-mail:
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Hajek A, König HH. The association between obesity and social exclusion in middle-aged and older adults: findings from a nationally representative study in Germany. BMC Geriatr 2018; 18:258. [PMID: 30359233 PMCID: PMC6202845 DOI: 10.1186/s12877-018-0946-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 10/10/2018] [Indexed: 12/24/2022] Open
Abstract
Background There is a lack of studies that focus explicitly on the association between social exclusion and obesity. The aim of the present study was to identify whether social exclusion is associated with obesity in older adults, and whether this association is moderated by sex. Methods Data were derived from wave 5 (2014) of the German Ageing Survey - a representative sample of individuals residing in private households aged 40 and over in Germany. A validated scale developed by Bude and Lantermann was used to assess social exclusion. Individuals with body-mass-index ≥30 kg/m2 were classified as being obese. Multiple linear regressions were applied in this study. Results Linear regressions showed that social exclusion was not associated with obesity in the total sample and in men, whereas women with obesity were less socially excluded than women without obesity (β = −.06, p = .02). The corresponding interaction term (sex x obesity) achieved statistical significance (p = .03). Conclusions Our findings emphasize the negative association between social exclusion and obesity in women, but not men, highlighting the complex interplay between social factors and excess weight in individuals aged 40 and above. Future longitudinal studies are needed to clarify this relationship in further detail.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Miller MM, Allison A, Trost Z, De Ruddere L, Wheelis T, Goubert L, Hirsh AT. Differential Effect of Patient Weight on Pain-Related Judgements About Male and Female Chronic Low Back Pain Patients. THE JOURNAL OF PAIN 2018; 19:57-66. [DOI: 10.1016/j.jpain.2017.09.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 08/12/2017] [Accepted: 09/19/2017] [Indexed: 12/19/2022]
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Floyd K, Veksler AE, McEwan B, Hesse C, Boren JP, Dinsmore DR, Pavlich CA. Social Inclusion Predicts Lower Blood Glucose and Low-Density Lipoproteins in Healthy Adults. HEALTH COMMUNICATION 2017; 32:1039-1042. [PMID: 27463703 DOI: 10.1080/10410236.2016.1196423] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Loneliness has been shown to have direct effects on one's personal well-being. Specifically, a greater feeling of loneliness is associated with negative mental health outcomes, negative health behaviors, and an increased likelihood of premature mortality. Using the neuroendocrine hypothesis, we expected social inclusion to predict decreases in both blood glucose levels and low-density lipoproteins (LDLs) and increases in high-density lipoproteins (HDLs). Fifty-two healthy adults provided self-report data for social inclusion and blood samples for hematological tests. Results indicated that higher social inclusion predicted lower levels of blood glucose and LDL, but had no effect on HDL. Implications for theory and practice are discussed.
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Affiliation(s)
- Kory Floyd
- a Department of Communication , University of Arizona
| | - Alice E Veksler
- b Department of Communication , Christopher Newport University
| | - Bree McEwan
- c Department of Communication , DePaul University
| | - Colin Hesse
- d Department of Speech Communication , Oregon State University
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Jaremka LM, Sunami N, Nadzan MA. Eating moderates the link between body mass index and perceived social connection. Appetite 2017; 112:124-132. [PMID: 28109731 DOI: 10.1016/j.appet.2017.01.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 01/13/2017] [Accepted: 01/17/2017] [Indexed: 10/20/2022]
Abstract
Some studies have demonstrated that heavier people perceive themselves as lacking social connections, whereas others have not. The current study investigated whether eating alters the link between body mass index (BMI) and perceived social connection, providing one explanation for inconsistencies across previous studies. Participants were instructed to refrain from eating or drinking anything except water after 9 p.m. the prior night. Upon arrival at the lab, participants were assigned to the food (n = 63) or no food (n = 110) condition. They also provided a saliva sample that was assayed for ghrelin (an appetite-relevant hormone), and completed a series of questionnaires about their relationships. Participants with a higher BMI felt more socially disconnected than people with a lower BMI, but only among those who had not recently eaten. BMI and perceived social disconnection were unrelated among people who had recently eaten. These results were consistent across multiple measures of perceived social disconnection, and also across the experimental manipulation and continuously measured ghrelin.
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Affiliation(s)
- Lisa M Jaremka
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE 19716, USA.
| | - Naoyuki Sunami
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE 19716, USA
| | - Megan A Nadzan
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE 19716, USA
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Wiederman MW, Hurst SR. Physical Attractiveness, Body Image, and Women's Sexual Self-Schema. PSYCHOLOGY OF WOMEN QUARTERLY 2016. [DOI: 10.1111/j.1471-6402.1997.tb00131.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Recently, Andersen and Cyranowski (1994) presented a self-report measure of women's sexual self-schema, or cognitive view of the self regarding sexuality. In the current study, we investigated potential relationships between women's sexual self-schema and physical attractiveness, body size and shape, and body image. Young adult women ( N = 199) completed questionnaires and were weighed, measured, and rated for facial attractiveness. Results revealed that sexual self-schema was unrelated to body size or shape, general body dissatisfaction, history of teasing about weight, and degree of investment in personal appearance. Sexual self-schema scores significantly correlated with experimenter-rated facial attractiveness, self-rated facial and bodily attractiveness, and degree of social avoidance due to concerns over personal appearance, however. In a multiple regression analysis, only self-rated facial attractiveness and social avoidance were unique predictors. Results are discussed with regard to implications for the development of women's sexual self-schema and directions for future research.
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Mulry G, Kalichman SC, Kelly JA. Substance Use and Unsafe Sex Among Gay Men: Global Versus Situational Use of Substances. ACTA ACUST UNITED AC 2015. [DOI: 10.1080/01614576.1994.11074115] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Smith MJ, Theeke L, Culp S, Clark K, Pinto S. Psychosocial variables and self-rated health in young adult obese women. Appl Nurs Res 2013; 27:67-71. [PMID: 24361145 DOI: 10.1016/j.apnr.2013.11.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 11/04/2013] [Accepted: 11/04/2013] [Indexed: 10/26/2022]
Abstract
AIM The aim of this study is to describe relationships among self-rated health, stress, sleep quality, loneliness, and self-esteem, in obese young adult women. BACKGROUND Obesity has steadily increased among young adults and is a major predictor of self-rated health. METHODS A sample of 68 obese (BMI 30 or higher, mean 35), young (18-34 years, mean 22) adult women were recruited from a health center. Survey data were gathered and analyzed using descriptive and bivariate procedures to assess relationships and group differences. RESULTS Scores reflected stress, loneliness, poor sleep quality, and poor self-esteem. There were positive correlations among stress, loneliness, and sleep quality and, a high inverse correlation between loneliness and self-esteem. Those who ranked their health as poor differed on stress, loneliness, and self-esteem when compared to those with rankings of good/very good. CONCLUSIONS Assessing and addressing stress, loneliness, sleep quality and self-esteem could lead to improved health outcomes in obese young women.
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Affiliation(s)
- Mary Jane Smith
- WVU School of Nursing, PO Box 9600, Health Sciences Center South, Morgantown, WV 26506-9600.
| | - Laurie Theeke
- WVU School of Nursing, PO Box 9600, Health Sciences Center South, Morgantown, WV 26506-9600.
| | - Stacey Culp
- WVU School of Nursing, PO Box 9600, Health Sciences Center South, Morgantown, WV 26506-9600.
| | - Karen Clark
- School of Medicine, Student Health Services, PO Box 9247, Health Sciences Center South, Morgantown, WV 26506-9247.
| | - Susan Pinto
- WVU School of Nursing, PO Box 9600, Health Sciences Center South, Morgantown, WV 26506-9600.
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Chen EY, Fettich KC, McCloskey MS. Correlates of Suicidal Ideation and/or Behavior in Bariatric-Surgery-Seeking Individuals With Severe Obesity. CRISIS 2012; 33:137-43. [DOI: 10.1027/0227-5910/a000115] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Background: Approximately 10% of severely obese bariatric-surgery-seeking individuals report a lifetime history of suicide attempts, a higher rate than in the general community. Being overweight is associated with weight-related stigma, making an individual more vulnerable to social isolation, a potential risk factor for suicidal ideation and/or behavior. Aims: In this cross-sectional study of surgery-seeking adults with severe obesity, we examined whether weight-related stigma increases (1) the likelihood of suicidal ideation and/or behavior or (2) the degree of loneliness; and whether hypotheses (1) and (2) are supported (3) if loneliness mediates the effect of weight-related stigma on suicidal ideation and/or behavior. Methods: Online questionnaires were administered to 301 women and 95 men seeking bariatric surgery. Results: Approximately 30.3% reported having at least a passing thought of suicide, and 5.55% a suicide attempt during their lifetime. The suicide attempt rate appears lower than other bariatric surgery samples, but possibly higher than community and other surgery sample rates. For severely obese surgery-seeking women, weight-related stigma was associated with suicidal ideation and/or behavior, though this was not mediated by loneliness. Conclusions: Future studies are needed to model and compare suicidal ideation and/or behavior in bariatric-surgery-seeking individuals and control groups.
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Affiliation(s)
- E. Y. Chen
- Adult Eating and Weight Disorders Program, Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL, USA
| | - K. C. Fettich
- Adult Eating and Weight Disorders Program, Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL, USA
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - M. S. McCloskey
- Department of Psychology, Temple University, Philadelphia, PA, USA
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Rotenberg KJ, Gruman JA, Ariganello M. Behavioral Confirmation of the Loneliness Stereotype. BASIC AND APPLIED SOCIAL PSYCHOLOGY 2010. [DOI: 10.1207/s15324834basp2402_1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Coplan RJ, Closson LM, Arbeau KA. Gender differences in the behavioral associates of loneliness and social dissatisfaction in kindergarten. J Child Psychol Psychiatry 2007; 48:988-95. [PMID: 17914999 DOI: 10.1111/j.1469-7610.2007.01804.x] [Citation(s) in RCA: 117] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Much of the evidence suggesting that loneliness is a risk factor for socio-emotional adjustment difficulties comes from studies with older children and adolescents. Comparatively less is known about the mental health implications of loneliness in early childhood. The goals of the present study were to provide additional convergent validity of the Loneliness and Social Dissatisfaction Questionnaire for Young Children (Cassidy & Asher, 1992) and explore potential gender differences in relations between loneliness and behavior problems in early childhood. METHODS A multiple source assessment of 139 kindergarten-aged children (M(age) = 64.76 mos., SD = 4.48) was undertaken, including parental ratings, behavioral observations, child interviews, and teacher ratings. RESULTS Overall, loneliness was positively associated with anxiety, aggression, and peer exclusion. However, several gender differences were also observed. CONCLUSIONS Loneliness may be a marker variable for both early internalizing and externalizing problems. However, gender differences in the behavioral associates of loneliness are also evident.
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Affiliation(s)
- Robert J Coplan
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada.
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Heinrich LM, Gullone E. The clinical significance of loneliness: a literature review. Clin Psychol Rev 2006; 26:695-718. [PMID: 16952717 DOI: 10.1016/j.cpr.2006.04.002] [Citation(s) in RCA: 857] [Impact Index Per Article: 47.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2005] [Revised: 02/10/2006] [Accepted: 04/07/2006] [Indexed: 11/22/2022]
Abstract
Satisfying social relationships are vital for good mental and physical health. Accordingly, we recommend that the alleviation and prevention of social relationship deficits be a key focus of clinicians. In this review, we focus on loneliness as a crucial marker of social relationship deficits and contend that loneliness should command clinicians' attention in its own right--not just as an adjunct to the treatment of other problems such as depression. With a particular focus on the adolescent developmental period, this review is organized into five sections: Drawing on developmental and evolutionary psychology theories, the nature of social relationships and the function they serve is first discussed. In the second section, loneliness is introduced as an exemplar of social relationship deficits. Here a definition of loneliness is provided, as well as an explanation of why it may pose a situation of concern. This is followed by a review of the prototypic features of loneliness through examination of its affective, cognitive, and behavioral correlates. The fourth section includes a review of theories related to the antecedent and maintenance factors involved in loneliness. Finally, methodological and theoretical considerations are addressed, and conclusions and proposals for future research directions are put forth.
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Affiliation(s)
- Liesl M Heinrich
- School of Psychology, Psychiatry, and Psychological Medicine, Faculty of Medicine, Nursing, and Health Sciences, Monash University, VIC 3800, Australia.
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La Puma J, Szapary P, Maki KC. Predictors of physician overweight and obesity in the USA: an empiric analysis. ACTA ACUST UNITED AC 2005. [DOI: 10.1108/00346650510625502] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
The study was designed to examine Herman and Polivy's restrained eating theory (Journal of Abnormal Psychology, 84, 666-672, 1975) using two different methods: situational-experimental and dispositional-correlational. Fifty-eight female college students were administered the revised UCLA Loneliness Scale, the Beck Depression Inventory (Short Form), and the Restraint scale. Subsequently, the students were subjected to either a neutral, sad, or loneliness mood induction and then ate cookies under the pretext of participating in a taste test. Consistent with expectation, dieters tended to consume more food in the loneliness than neutral mood condition, whereas nondieters displayed the opposite pattern. A comparable pattern was found in the relation between the revised UCLA Loneliness Scale and food consumption with respect to Restraint; the amount of food consumed increased as a function of loneliness for high restrained eaters, whereas the amount of food consumed decreased as a function of loneliness for low restrained eaters. There were no appreciable effects of the sad mood induction, nor prediction by dispositional depression, regarding the amount of food consumed as a function of dietary restraint. The findings were discussed with respect to the motivational role that loneliness may play in inhibiting and disinhibiting food consumption.
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Affiliation(s)
- K J Rotenberg
- Department of Psychology, Lakehead University, Thunder Bay, Canada
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Rotenberg KJ. Loneliness and the Perception of the Exchange of Disclosures. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 1997. [DOI: 10.1521/jscp.1997.16.3.259] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
The revised UCLA Loneliness Scale (ULS-20) and a four-item short form (ULS-4) are widely used in personality research (Russell, Peplau, & Cutrona, 1980). In an exploratory factor analysis of the ULS-20, we identified eight items that loaded substantially on the first factor. These items were combined to form an alternative short-form measure, the ULS-8. The results of this study indicate that the ULS-8 is reliable, valid, and a better substitute for the ULS-20 than is the ULS-4. Consistent with the previous research, the loneliness measures (ULS-20, ULS-8, ULS-4) were strongly related to socially undesirable personality characteristics, but loneliness was uncorrelated with the six different health-related behaviors (exercise, meal regularity, alcohol use, hard drug use, smoking, and hours of sleep) assessed in this study.
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