Mental Health Variables Impact Weight Loss, Especially in Patients with Obesity and Binge Eating: A Mediation Model on the Role of Eating Disorder Pathology.

behavior weight loss intervention binge eating eating behavior impulsivity mental health obesity

Journal

Nutrients
ISSN: 2072-6643
Titre abrégé: Nutrients
Pays: Switzerland
ID NLM: 101521595

Informations de publication

Date de publication:
09 Sep 2023
Historique:
received: 27 07 2023
revised: 05 09 2023
accepted: 06 09 2023
medline: 29 9 2023
pubmed: 28 9 2023
entrez: 28 9 2023
Statut: epublish

Résumé

Various mental health and eating behavior variables have been independently associated with predicting weight loss in individuals with obesity. This study aims to investigate a mediation model that assesses the distinct contributions of these variables in predicting weight changes in patients with obesity following an outpatient behavioral weight loss intervention (BWLI). General mental health (depression, anxiety, stress, impulsivity), eating behavior (cognitive restraint, disinhibition, hunger), eating disorder pathology, and body mass index (BMI) were assessed in a group of 297 patients with obesity at the admission of a BWLI program. BMI was re-evaluated during the final treatment session. A mediation model was employed to examine whether mental health and eating behavior variables predicted BMI changes, with eating disorder pathology serving as a mediator. The model was tested both overall and within two patient subgroups: those with regular binge eating (≥four episodes/month) and those without. In the overall sample (n = 238), the relationships between depression, impulsivity, and cognitive restraint with BMI change were mediated by eating disorder pathology. In the subgroup with regular binge eating (n = 99, 41.6%), the associations between stress and disinhibition with BMI change were additionally mediated by eating disorder pathology. In the subgroup without regular binge eating, eating disorder pathology showed no mediating effect. Multiple mental health and eating behavior variables assessed at admission predicted BMI changes, particularly when mediated by eating disorder pathology in patients with regular binge eating. A comprehensive psychopathological assessment prior to starting BWLI may help identify multiple factors affecting prognosis and treatment outcomes. Long-term follow-up studies in this field are required.

Sections du résumé

BACKGROUND BACKGROUND
Various mental health and eating behavior variables have been independently associated with predicting weight loss in individuals with obesity. This study aims to investigate a mediation model that assesses the distinct contributions of these variables in predicting weight changes in patients with obesity following an outpatient behavioral weight loss intervention (BWLI).
METHODS METHODS
General mental health (depression, anxiety, stress, impulsivity), eating behavior (cognitive restraint, disinhibition, hunger), eating disorder pathology, and body mass index (BMI) were assessed in a group of 297 patients with obesity at the admission of a BWLI program. BMI was re-evaluated during the final treatment session. A mediation model was employed to examine whether mental health and eating behavior variables predicted BMI changes, with eating disorder pathology serving as a mediator. The model was tested both overall and within two patient subgroups: those with regular binge eating (≥four episodes/month) and those without.
RESULTS RESULTS
In the overall sample (n = 238), the relationships between depression, impulsivity, and cognitive restraint with BMI change were mediated by eating disorder pathology. In the subgroup with regular binge eating (n = 99, 41.6%), the associations between stress and disinhibition with BMI change were additionally mediated by eating disorder pathology. In the subgroup without regular binge eating, eating disorder pathology showed no mediating effect.
DISCUSSION CONCLUSIONS
Multiple mental health and eating behavior variables assessed at admission predicted BMI changes, particularly when mediated by eating disorder pathology in patients with regular binge eating. A comprehensive psychopathological assessment prior to starting BWLI may help identify multiple factors affecting prognosis and treatment outcomes. Long-term follow-up studies in this field are required.

Identifiants

pubmed: 37764699
pii: nu15183915
doi: 10.3390/nu15183915
pmc: PMC10537364
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Ministry of Science, Research and the Arts Baden-Württemberg, Germany
ID : na

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Auteurs

Jacopo Pruccoli (J)

Pediatric Neurology and Psychiatry Unit, IRCCS Istituto delle Scienze Neurologiche di Bologna, Regional Center for Feeding and Eating Disorders in the Developmental Age, 40138 Bologna, Italy.
Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy.

Isabelle Mack (I)

Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, 72076 Tübingen, Germany.
Centre of Excellence for Eating Disorders Tübingen (KOMET), 72076 Tübingen, Germany.

Bea Klos (B)

Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, 72076 Tübingen, Germany.
Centre of Excellence for Eating Disorders Tübingen (KOMET), 72076 Tübingen, Germany.

Sandra Schild (S)

Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, 72076 Tübingen, Germany.
Centre of Excellence for Eating Disorders Tübingen (KOMET), 72076 Tübingen, Germany.

Andreas Stengel (A)

Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, 72076 Tübingen, Germany.
Centre of Excellence for Eating Disorders Tübingen (KOMET), 72076 Tübingen, Germany.
DZPG (German Center for Mental Health), 72076 Tübingen, Germany.
Department for Psychosomatic Medicine, Charité Center for Internal Medicine and Dermatology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität at Berlin, and Berlin Institute of Health, 12203 Berlin, Germany.

Stephan Zipfel (S)

Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, 72076 Tübingen, Germany.
Centre of Excellence for Eating Disorders Tübingen (KOMET), 72076 Tübingen, Germany.
DZPG (German Center for Mental Health), 72076 Tübingen, Germany.

Katrin Elisabeth Giel (KE)

Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, 72076 Tübingen, Germany.
Centre of Excellence for Eating Disorders Tübingen (KOMET), 72076 Tübingen, Germany.
DZPG (German Center for Mental Health), 72076 Tübingen, Germany.

Kathrin Schag (K)

Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, 72076 Tübingen, Germany.
Centre of Excellence for Eating Disorders Tübingen (KOMET), 72076 Tübingen, Germany.

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