The Relationship Between Childhood Onset Obesity and Psychopathology in Adulthood

We administered the Symptom Checklist (Derogatis, 1975; SCL-90-R) to 37 obese subjects in outpatient treatment for obesity. Patients with early onset obesity demonstrated a greater frequency and higher levels of emotional distress and psychiatric symptomatology than patients with late onset obesity. Individuals who developed obesity in childhood showed more psychopathology than those who developed obesity later in life. Overall, these findings support the belief that obesity is characteristically associated with greater internal psychological conflict. These findings further suggest that childhood obesity could serve as a predictor variable for possible future psychological disturbance in obese populations.     

Association between Inhibitory Control Capacity and Body Weight in Overweight and Obese Children and Adolescents: Dependence on Age and Inhibitory Control Component

It has been assumed that overweight individuals show weak inhibitory control capacity leading to a failure to resist external cues for palatable food and that this deficit underlies the recently reported empirical association between obesity and attention deficit/hyperactivity disorder (ADHD). In childhood and adolescence, empirical research on this issue is scarce. Here, the hypothesis is tested that high body weight is associated with weak inhibitory control performance and that this association is moderated by age.

The sample included 177 overweight and obese children and adolescents (BMI: M = 29.2, SD = 4.33; BMI-SDS: M = 2.45, SD = 0.43) between 8 and 15 years. Inhibitory control was assessed by a Go/No-Go task and an Interference Task. A principal component analysis yielded two components: impulsivity (fast but invalid responses) and inattention (highly variable reaction times).

While controlling for age, gender, and maternal education level, we found that more obese children/adolescents showed more inattention. As indicated by a significant interaction effect, exclusively at younger ages, high impulsivity was associated with high body weight.

The results thus confirm a link between low inhibitory control capacity and high body weight and might point to a developmental period with heightened significance of impulsivity for weight gain.     

Mental Health and Obesity: A Meta-Analysis

The relationship between obesity and psychological distress is not clear because research conducted so far is not conclusive, with some studies finding that obese people report less mental health than normal-weight individuals, whilst others find that obesity may work as a protective factor that prevents people with weight problems from developing mental health issues. In this meta-analysis we review research that compares the mental health (measured with SF-36) of class I obese people (Body Mass Index between 30 and 34.99) with normal weight people (Body Mass Index between 18 and 24.99) in non-clinical adult populations. The meta-analysis conducted assumed a random-effects model and a weighted mean effect size was calculated (d), together with its statistical significance and confidence interval. Results reveal that obese women report less mental health than normal weight females (d?=??.26) but that obese men show more mental health than normal weight individuals (d?=?.62). The results give support to the so-called “Jolly Fat” hypothesis.     

Causal attributions of obese men and women in genetic testing: Implications of genetic/biological attributions1

The present study sought to investigate genetic/biological attributions of obesity, their associations with a predisposition to obesity and their crossectional and longitudinal implications for weight regulation in obese individuals presenting for genetic testing and counselling. A total of 421 obese men and women underwent psychological and anthropometric assessment and a mutation screen of the melanocortin-4 receptor gene. At study entry, women revealed more genetic/biological attributions than men on the Revised Illness Perception Questionnaire adapted to obesity (86.2% versus 59.7%). Genetic/biological attributions of obesity were associated in both sexes with a family history of obesity, assessed through Stunkard's Figure Rating Scale. In both sexes, genetic/biological attributions were unrelated to weight regulation beliefs and behaviour (i.e. self-efficacy, controllability beliefs, restrained eating and physical activity), assessed through standardised questionnaires or interview at baseline and at six-month follow-up. In addition, causal attributions and weight regulation beliefs and behaviour were not predictive of body mass index at six-month follow-up. Overall, the results indicate that causal attributions of obesity to genetic/biological factors in obese individuals presenting for genetic screening and counselling are crossectionally and longitudinally unrelated to weight regulation and longer-term weight outcome. Those who attribute their obesity to genetic/biological factors likely have a familial obesity risk.     

Use of an Orientation Session May Help Decrease Attrition in a Pediatric Weight Management Program for Low-Income Minority Adolescents

This study examined predictors of attrition from a pediatric weight-control program in a low-income minority community and the potential usefulness of an orientation session to increase length of treatment. Participants were 342 children and adolescents (M age=13.0 years old; 54% female; 89% African American; M BMI=44.2, M BMI z-score=6.0) and their caregivers who attended FitMatters, a multidisciplinary cognitive-behavioral program focused on long-term participation. Those who attended an orientation session stayed in treatment significantly longer, but attrition was not affected by demographic factors, weight status, or psychological functioning. These results indicate that an orientation session that clearly delineates the structure of a program and expected attitudinal and behavioral requirements for the families may help align expectations, as well as more effectively identify families who are ready to make concerted efforts to change the family lifestyle in support of their obese children's efforts.     

Bi-Directional Relationship Between Self-Regulation and Improved Eating: Temporal Associations With Exercise,Reduced Fatigue,and Weight Loss

ABSTRACT. Severely obese men and women (body mass index ≥ 35 ≤ 55 kg/m²; M_age = 44.8 years, SD = 9.3) were randomly assigned to a 6-month physical activity support treatment paired with either nutrition education (n = 83) or cognitive-behavioral nutrition (n = 82) methods for weight loss. Both groups had significant improvements in physical activity, fatigue, self-regulation for eating, and fruit and vegetable intake. Compared to those in the nutrition education group, participants in the behavioral group demonstrated greater overall increases in fruit and vegetable intake and physical activity. These group differences were associated with changes that occurred after Month 3. Increased physical activity predicted reduced fatigue, β = ?.19, p =.01. A reciprocal relationship between the mediators of that relationship, which were changes in self-regulation and fruit and vegetable intake, was identified. There was significantly greater weight loss over six months in the behavioral nutrition group when contrasted with the nutrition education group. Self-regulation for eating and fruit and vegetable intake were significant predictors of weight loss over both three and six months. Findings enabled a better understanding of psychosocial effects on temporal aspects of weight loss and may lead to more effective behavioral treatments for weight loss.     

The relationship among the transtheoretical model of behavioral change,psychological distress,and diet attitudes in obesity: Implications for primary care intervention

Obesity is prevalent but undertreated in primary care. Family practice volunteer outpatients (N=454) were administered the Stage of Change for Weight (URICA), the Brief Symptom Inventory (BSI), and the Diet Readiness Test (DRT) to assess the relationship between these variables and obesity. The body mass index (BMI) was used to classify obesity revealing 197 patients with elevated BMI's. There was no significant difference between the obese and the nonobese on any of the psychological measures. The obese reported significantly more difficulty setting diet goals and less control over their eating, ate more to emotional situations, and exercised less than the nonobese. The obese sample (46.7%) reported being in the Action stage of change for weight management. Implications for intervention in primary care include targeting attitudes (DRT) and dispelling physician attitudes that obese individuals have increased levels of psychological distress. Addressing Stage of Change for weight management can facilitate tailoring the appropriate intervention when used in concert with the DRT variables.     

Current and vestigial effects of overweight among women: Fear of fat,attitudinal body image,and eating behaviors

College females completed multiple, standardized measures of their fear of fat, attitudinal body image, and binge eating and dieting. Situational weigh-in measures were taken, including latency to get on the scale and anxiety while being weighed. Based on current weight and a structured weight history questionnaire, three groups were constructed: normal-weight subjects without an overweight history (NW; n=24), normal-weight subjects who were formerly overweight (FOW; n=16), and those currently overweight (OW; n=24). Group comparisons revealed, as expected, that OW females, relative to their NW peers, had more weight-related anxieties, more negative body experiences, and more frequent past-year dieting. Consistent with Stunkard's original proposition, the FOW group regarded their bodies as fatter and less affectively satisfying and expressed more weigh-in anxiety than NW participants. Currently normal-weight FOW subjects seldom differed from the currently OW individuals. Clinical and research implications are considered, particularly with regard to the psychological sequelae of weight loss.     

Role of Body Dissatisfaction in Developmental Psychopathology Among the Adolescents with Obesity: A Matched Case Control Study

Body-image is a significant component of self-image, and problems with the same are associated with several behavioural and psychological disorders. Adolescents, who otherwise more concerned about their body-image than any other age group, are at a higher risk for various psychological problems due to obesity. But much of our understanding in this regard comes from studies on the adults. In this backdrop, this study aims to examine the role of body dissatisfaction in developmental psychopathology among adolescents with obesity. Participants were 32 adolescents with obesity and 32 with normal weight, aged 11–16 years and school-going. Both groups were matched for age, gender and academic levels on one-to-one basis. Those with a body mass index (BMI) ≥ 30 kg/m² were considered obese, and those with a BMI < 25 kg/m² were considered as normal weight. All the participants were assessed using standard scales of body-image and developmental psychopathology. Results indicated that both obesity and poor body-image correlated with psychopathology in specific domains, but neither of them predicted psychopathology. This study suggests that body-image and obesity are risk factors but not predictors of psychopathology. However, psychosocial interventions are indicated to address the issues of body satisfaction and self-image in adolescents with obesity.     

Ghrelin level negatively predicts quality of life in obese women

A cross-sectional cohort study was conducted to investigate whether ghrelin level in obese women predicts the quality of life (QOL). A total of 307 subjects fulfilled the criteria: (1) age between 20 and 65 years old, (2) body mass index ≥27 kg/m² (3) waist circumference ≥80 cm were enrolled in the study. All subjects were assigned to one of the plasma ghrelin level categories according to the quartiles. The median of age and BMI of the 307 obese women were 45 ± 18 years and 29.9 ± 4.1 kg/m², respectively. The main outcome evaluated is the associations of plasma ghrelin level and QOL, which were evaluated using multiple linear regression analysis. Results of linear trend test show significant statistical difference in plasma lipoproteins (triglyceride, cholesterol, HDL-cholestero and LDL-cholesterol = and levels of obesity-related hormone peptides, including leptin, adiponectin, insulin among quartiles of ghrelin. Multiple liner regression analysis of serum obesity-related hormone peptide level and QOL using stepwise method shows ghrelin concentration was the only predictor of QOL, including PCS-12 level (β = ?0.18, p = 0.001), MCS-12 level (β = ?0.14, p = 0.009), WHOQOL-BREF scores: physical (β = ?0.13, p = 0.03), psychological (β = ?0.16, p = 0.007), social (β = ?0.21, p?= < 0.001), and environmental (β = ?0.22, p?= <0.001), after adjusting other factors for obese female subjects. This study demonstrated that ghrelin concentration is strongly associated with QOL level among obese women. Hence, ghrelin concentration might be a valuable marker to be monitored in obese women.     

The adoption of physical activity and eating behaviors among persons with obesity and in the general population: the role of implicit attitudes within the Theory of Planned Behavior

Obesity can be prevented by the combined adoption of a regular physical activity (PA) and healthy eating behaviors (EB). Researchers mainly focused on socio-cognitive models, such as the Theory of Planned Behavior (TPB), to identify the psychological antecedents of these behaviors. However, few studies were interested in testing the potential contribution of automatic processes in the prediction of PA and EB. Thus, the main objective of this study was to explore the specific role of implicit attitudes in the pattern of prediction of self-reported PA and EB in the TPB framework, among persons with obesity and in adults from the general population. One hundred and fifty-three adults participated to this cross-sectional study among which 59 obese persons (74% women, age: 50.6 ± 12.3 years, BMI: 36.8 ± 4.03 kg m^–²) and 94 people from the general population (51% women; age: 34.7 ± 8.9 years). Implicit attitudes toward PA and EB were estimated through two Implicit Association Tests. TPB variables, PA and EB were assessed by questionnaire. Regarding to the prediction of PA, a significant contribution of implicit attitudes emerged in obese people, β = .25; 95%[CI: .01, .50]; P = .044, beyond the TPB variables, contrary to participants from the general population. The present study suggests that implicit attitudes play a specific role among persons with obesity regarding PA. Other studies are needed to examine which kind of psychological processes are specifically associated with PA and EB among obese people.     

Symbols and Similarity: You Can Get Too Much of a Good Thing

A method for eliciting extended explanations was used to evaluate predictions from the “theory-theory” account of developing psychological reasoning. Children were repeatedly asked to explain the actions or emotions of story characters with false beliefs. Questioning elicited false belief attributions in half of 3-year-olds (Study 1, N = 16, age M = 3;6) and most 4-year-olds who failed belief prediction tasks (Study 2, N = 30, M = 4;5). In Study 3, 30 prediction failers (M = 5;1) gave significantly more false belief explanations for emotions than for actions. Across the studies, desire and emotion explanations emerged early and often, reflecting the primacy of these constructs in the children's understanding of psychological causality. Results are discussed in terms of their implications for developmental mechanism.     

The Influence of Body Mass Index on the Perceived Quality of Life during Pregnancy

Obesity contributes to various pregnancy complications and therefore, may compromise maternal quality of life. The study aim was to investigate the relationship between body mass index (BMI) and health-related quality of life (HRQoL) during pregnancy. Study involved every 6th woman who gave birth in the Clinic for Obstetrics and Gynecology Clinical Center of Serbia during the year 2010. Initial and end pregnancy BMIs were calculated for every woman. The parturients (604) completed the SF36 questionnaire (physical-PHC; mental-MHC; total quality of life-TQL), Beck’s Depression Inventory, Fatigue Severity Scale, Pregnancy Symptom Scale, Multidimensional Personal Support Scale, and Acceptance of Illness Scale. Before pregnancy most women had normal or decreased weight, while at the end of pregnancy the majority were overweight or obese (p?=?0.000). Initial and end pregnancy weights (p?<?0.05) and BMIs (p?<?0.05) were positively correlated with depression. Depression was significantly lower in overweight compared to mildly or morbidly obese women during pregnancy (p?<?0.05). Pregnancy weight change correlated negatively with PHC (p?=?0.029), and positively with fatigue (p?=?0.030), and symptoms (p?=?0.011). Of all BMI categories, morbidly obese women had the worst feeling of social support (p?<?0.05). Pregnancy symptoms were significantly less problematic in women with normal weight compared to overweight and obese women during pregnancy (p?<?0.05). Assessing the impact of all investigated parameters together, we established significant models for PHC (p?=?0.036), depression (p?=?0.030), and fatigue (p?=?0.038). Pregnant women should be advised to keep their gestational weight gain within the normal recommended range to have a good pregnancy outcome and HRQoL.     

Path analysis of exercise treatment-induced changes in psychological factors leading to weight loss

Physical activity may affect weight loss largely through psychological pathways associated with eating changes, especially in obese individuals whose caloric expenditure through exercise is typically small. Direct testing of this is, however, lacking. Previously sedentary adults (N?=?114; 77% female; M _age?=?43.3 years), with a minimum body mass index (BMI) of 35?kg/m² (M _BMI?=?42.0?kg/m²), participated in a 24-week treatment of cognitive-behavioural exercise support and nutrition information. A path model based on tenets of social cognitive and self-efficacy theory was constructed. It was expected that improvements in self-efficacy, physical self-concept, body satisfaction and mood associated with the exercise treatment would predict changes in self-regulation and increased physical activity. It was also hypothesised that improvements in self-efficacy and self-regulation for appropriate eating would transfer from these relationships and predict weight loss. After three theoretically viable paths were added based on modification indices, structural equation modelling indicated a good fit with the data, χ ²(16)?=?20.53, p?=?0.20; RMSEA?=?0.05; SRMR?=?0.06; CFI?=?0.97; TLI?=?0.95. Associations of psychological effects linked to exercise programme participation with predictors of appropriate eating and weight loss were found, and may inform theory, research and treatments.     

Prevalence of personality disorders among bulimics,nonbulimic binge eaters,and normal controls

We examined the comorbidity of bulimia and personality pathology among college women. Subjects included women (n=23) meeting DSM-III-R criteria for bulimia nervosa (bulimics), women (n=23) who reported binge eating but did not fulfill the criteria for bulimia nervosa (binge eaters), and women (n=23) who did not binge eat (normals). The subjects completed an assessment battery consisting of the Personality Disorders Examination and the SCID as well as the Beck Depression Inventory, the Rosenberg Self-Esteem Index, and measures of impulsivity and self-defeating tendencies. Fourteen of 23 bulimics (61%) met criterion for a personality disorder using DSM-III-R Axis II criteria. In comparison, 3 of 23 (13%) binge eaters and 1 of 23 (4%) normal subjects received an Axis II diagnosis. Borderline and self-defeating diagnoses were the predominant personality disorders in 96% of the bulimics exhibiting clinically significant personality pathology. Bulimics also exhibited significantly more depression, impulsivity, and self-defeating behavior and lower self-esteem than binge eaters and normals. The findings are discussed within a conceptual framework that posits an interaction between personality pathology and restrained eating.     

The influence of gender role typing on the expression of depressive symptoms

This study investigated the influence of gender role typing on the expression of depressive symptoms. Previous research (Padesky & Hammen, 1981) has found that men and women differ in their expression of depressive symptoms and has proposed gender role expectations as a possible explanation. This study considered gender role typing as a possible moderating factor of depressive symptoms. Undergraduates (99 men, 360 women) were divided into masculine and feminine groups according to the Bem Sex Role Inventory. Depressive symptoms were measured by the Beck Depression Inventory (BDI). Gender role typing differences emerged on the BDI with feminine subjects reporting more emotional symptoms than masculine subjects (p<.05) and masculine subjects reporting more withdrawal and somatic symptoms than feminine subjects (p<.05). The results are consistent with the hypothesis that depressive symptoms are influenced by societal expectations. Future research should consider the influence of gender role typing on the expression of depressive symptoms.     

Feeling Closer to the Future Self and Doing Better: Temporal Psychological Mechanisms Underlying Academic Performance

This research examined the function of future self‐continuity and its potential downstream consequences for academic performance through relations with other temporal psychological factors and self‐control. We also addressed the influence of cultural factors by testing whether these relations differed by college generation status. Undergraduate students enrolled at a large public university participated in two studies (Study 1: N = 119, M_age = 20.55, 56.4% women; Study 2: N = 403, M_age = 19.83, 58.3% women) in which they completed measures of temporal psychological factors and psychological resources. In Study 2, we also obtained academic records to link responses to academic performance. Future self‐continuity predicted subsequent academic performance and was related positively to future focus, negatively to present focus, and positively to self‐control. Additionally, the relation between future focus and self‐control was stronger for continuing‐generation college students than first‐generation college students. Future self‐continuity plays a pivotal role in academic contexts. Findings suggest that it may have positive downstream consequences on academic achievement by directing attention away from the present and toward the future, which promotes self‐control. Further, the strategy of focusing on the future may be effective in promoting self‐control only for certain cultural groups.     

Cultural influences on body dissatisfaction,body change behaviours,and disordered eating of Japanese adolescents

We administered a paper‐and‐pencil questionnaire to 133 female and 99 male Japanese high school students 13–18 years old (M = 15.9, SD = 1.57) from the Kansai area to examine cultural influences on their body image and body change behaviours. Our aim was to ascertain the independent and combined influences from traditional Japanese, modern Japanese, and Western values. Cluster analyses identified four ‘acculturative’ groups: ‘anti‐modern’, ‘traditional’, ‘pro‐modern/anti‐traditional’, and ‘pro‐Western/anti‐Japanese’. Pro‐modern and pro‐Western adolescents were most dissatisfied with their bodies, and pro‐Western adolescents were also most likely to attempt weight loss. The results demonstrate the value of assessing cultural interactions in Japan along three dimensions.     

The Effect of Effort and Weight Controllability on Perceptions of Obese Individuals

We examined the impact of offset controllability (capability of losing weight) and offset effort (efforts to lose weight) on judgments of an obese target. Participants (n = 216) read about an obese person whose body weight was controllable/uncontrollable, and who did/did not put in effort to eat healthily and exercise. Effort played a more important role than controllability in evaluations of the target. Targets who put in effort to be healthy were ascribed fewer obesity stereotypes, evoked less disgust, and were considered to have a more acceptable lifestyle. These findings extend attribution theory and have implications for strategies to reduce weight bias.