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Behavior and Psychology

Obesity and psychosocial impairment: mediating roles of health status, weight/shape concerns and binge eating in a community sample of women and men

Abstract

Objectives:

We examined the relative importance of physical health status, weight/shape concerns and binge eating as mediators of the association between obesity and psychosocial impairment in a community sample of women and men.

Methods:

Self-report measures of eating disorder features, perceived physical health and psychosocial functioning were completed by a general population sample of women and men classified as obese or non-obese (women: obese=276, non-obese=1220; men: obese=169, non-obese=769). Moderated mediation analysis was used to assess the relative importance of each of the putative mediators in accounting for observed associations between obesity and each outcome measure and possible moderation of these effects by sex.

Results:

Weight/shape concerns and physical health were equally strong mediators of the association between obesity and psychosocial impairment. This was the case for both men and women and for each of three measures of psychosocial functioning—general psychological distress, life satisfaction and social support—employed. The effects of binge eating were modest and reached statistical significance only for the life satisfaction measure in men.

Conclusions:

A greater focus on body acceptance may be indicated in obesity prevention and weight-management programs.

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References

  1. Mond JM, Baune BT Overweight, medical comorbidity and health realted quality of life in a community sample of women and men. Obesity 2009; 17: 1627–1634.

    Article  Google Scholar 

  2. Goldney RD, Dunn KI, Air TM, Dal Grande E, Taylor AW Relationships between body mass index, mental health, and suicidal ideation: population perspective using two methods. Aust N Z J Psychiatry 2009; 43: 52–658.

    Google Scholar 

  3. Friedman MA Brownell KD Psychological consequences of obesity. Eating Disorders and Obesity: a Comprehensive Handbook. 2nd edn. The Guilford Press: New York, 2002, pp 50–61.

    Google Scholar 

  4. Carr D, Friedman MA, Jaffe K Understanding the relationship between obesity and positive and negative affect: the role of psychosocial mechanisms. Body Image 2007; 4: 165–177.

    Article  Google Scholar 

  5. Mond JM, Rodgers B, Hay PJ, Darby A, Owen C, Baune BT et al. Obesity and Impairment in Psychosocial Functioning in Women: the mediating role of eating disorder features. Obesity 2007; 15; 2769–2779.

    Article  Google Scholar 

  6. Heo M, Allison DB, Faith MS, Zhu S, Fontaine KR Obesity and quality of life: mediating effects of pain and comorbidities. Obes Res 2003; 11: 209–216.

    Article  Google Scholar 

  7. Jorm AF, Korten AE, Christensen H, Jacomb PA, Rodgers B, Parslow RA Association of obesity with anxiety, depression, and emotional well-being: a community survey. Aust N Z J Public Health 2003; 27: 434–440.

    Article  Google Scholar 

  8. Thompson JK The (mis)measurement of body image: ten strategies to improve assessment for applied and research purposes. Body Image 2004; 1: 7–14.

    Article  Google Scholar 

  9. Jansen A, Havermans R, Nederkorrn C, Roefs A Jolly fat or sad fat? subtyping non-eating disordered overweight and obesity along and affect dimension. Appetite 2008; 51: 635–640.

    Article  Google Scholar 

  10. Mond JM, van den Berg P, Boutelle K, Hannan P, Neumark-Sztainer D Obesity, body dissatisfaction, and emotional well-being in early and late adolescence: findings from the project EAT study. J Adolesc Health 2011; 48: 373–378.

    Article  Google Scholar 

  11. Darby A, Hay P, Mond J, Rodgers B, Owen C Disordered eating behaviours and cognitions in young women with obesity: relationship with psychological status. Int J Obes 2007; 31: 876–882.

    Article  CAS  Google Scholar 

  12. Rieger E, Wilfley DE, Stein RI, Marino V, Crow SJ A comparison of quality of life in obese individuals with and without binge eating disorder. Int J Eat Disord 2005; 37: 234–240.

    Article  Google Scholar 

  13. Mond JM, Mitchison D, Hay PJ Eating disordered behavior in men: prevalance, impairment in quality of life, and implications for prevention and health promotion. in Current Findings on Males with Eating Disorders Cohn L, Lemberg R (eds). 2014. Routledge: UK, pp 195–208.

    Google Scholar 

  14. Neumark-Sztainer D Integrating messages from eating disorders field into obesity prevention. Adolesc Med: State Art Rev 2012; 23: 529–543.

    Google Scholar 

  15. Fontaine KR, Bartlett SJ, Barofski I Health-related quality of life among obese persons seeking and not currently seeking treatment. Int J Eat Disord 2000; 27: 101–105.

    Article  CAS  Google Scholar 

  16. Lucas N, Windsor TD, Caldwell TM, Rodgers B Psychological distress in non-drinkers: associations with previous heavy drinking and current social relationships. Alcohol Alcohol 2010; 45: 95–102.

    Article  Google Scholar 

  17. Fairburn CG, Beglin SJ Assessment of eating disorders: interview of self-reported questionnaire? Int J Eat Disord 1994; 16: 363–370.

    CAS  PubMed  Google Scholar 

  18. Berg KC, Peterson CB, Frazier P, Crow SJ Psychometric evaluation of the eating disorder examination and eating disorder examination-questionnaire: a systematic review of the literature. Int J Eat Disord 2012; 45: 428–438.

    Article  Google Scholar 

  19. Manor O, Matthews S, Power C Dichotomous or categorical response? analysing self-rated health and lifetime social class. Int J Epidemiol 2000; 29: 149–157.

    Article  CAS  Google Scholar 

  20. DeSalvo KB, Fan VS, McDonell MB, Fihn SD Predicting mortality and healthcare utilisation with a single question. Health Ser Res 2005; 40: 1234–1246.

    Article  Google Scholar 

  21. Jylha M What is self-rated health and why does it predict mortality? towards a unified conceptual model. Soc Sci Med 2009; 69: 307–316.

    Article  Google Scholar 

  22. Kessler RC, Barker PR, Colpe LJ, Epstein JF, Gfroerer JC, Hiripi E Screening for serious mental illness in the general population. Arch Gen Psychiatry 2003; 60: 184–189.

    Article  Google Scholar 

  23. Sanderson K, Andrews G Prevalence and severity of mental health related disability and relationship to diagnosis. Psychiatr Serv 2002; 53: 80–86.

    Article  Google Scholar 

  24. Diener E, Emmons RA, Larsen RJ, Griffin S The Satisfaction With Life Scale. J Pers Assess 1985; 49: 71–75.

    Article  CAS  Google Scholar 

  25. Pavot W, Diener E The Satisfaction With Life Scale and the emerging construct of life satisfaction. J Positive Psychol 2008; 3: 137–152.

    Article  Google Scholar 

  26. Sherbourne CD, Steward AL The MOS Social Support Survey. Soc Sci Med 1991; 32: 705–714.

    Article  CAS  Google Scholar 

  27. Fabricatore AN, Wadden TA Obesity. Ann Rev Clin Psychol 2006; 2: 357–377.

    Article  Google Scholar 

  28. Hayes AF Introduction to Mediation, Moderation, and Conditional Path Analysis: A Regression-based Approach. The Guilford Press: NY, 2013.

    Google Scholar 

  29. Hayes AF PROCESS: A versatile computational tool for observed variable mediation, moderation and conditional process modelling. 2013 (21 May 2013); available from http://www.afhayes.com/.

  30. Lavender JM, De Young KP, Anderson DA Eating Disorder Examination Questionnaire (EDE-Q): norms for undergraduate men. Eat Behav 2010; 11: 119–121.

    Article  Google Scholar 

  31. Mond JM, Hay PJ, Rodgers B, Owen C Eating Disorder Examination Questionnaire (EDE-Q): norms for young adult women. Behav Res Ther 2006; 44: 53–62.

    Article  CAS  Google Scholar 

  32. ABS, National Health Survey. Summary of Results, 2004-05. Australian Bureau of Statistics: Canberra, 2006.

  33. Mond JM, Rodgers B, Hay P, Owen C Mental health impairment in underweight women: do body dissatisfaction and eating disordered behaviour play a role? BMC Public Health 2011; 11: 547.

    Article  Google Scholar 

  34. Grilo CM Why no cognitive body image feature such as overevaluation of shape/weight in the binge eatng disorder diagnosis? Int J Eat Disord 2012; 46: 208–211.

    Article  Google Scholar 

  35. Mond JM, Latner JD, Hay PJ, Owen C, Rodgers B Quality of life impairment associated with body dissatisfaction in a general population sample of women. BMC Public Health 2013; 2013: 920.

    Article  Google Scholar 

  36. Mond JM, Hay PJ, Rodgers B, Owen C Mental health impairment associated with eating-disorder features on a community sample of women. J Ment Health 2011; 20: 456–466.

    Article  CAS  Google Scholar 

  37. Latner JD, Mond JM, Vallance JK, Gleaves DH, Buckett G Quality of life impairment and the attitudinal and behavioral features of eating disorders. J Nerv Ment Dis 2013; 201: 592–597.

    Article  Google Scholar 

  38. Mond JM, Hay PJ, Rodgers B, Owen C Comparing the health burden of eating-disordered behavior and overweight in women. J Womens Health 2009; 18: 1–10.

    Article  Google Scholar 

  39. Palinkas LA, Wingard DL, Barrett-Connor E Depressive symptoms in overweight and obese older adults: a test of the ‘jolly fat’ hypothesis. J Psychosom Res 1996; 40: 59–66.

    Article  CAS  Google Scholar 

  40. Crisp AH, Queenan M, Sittampaln Y, Harris G 'Jolly fat' revisited. J Psychosom Res 1980; 24: 233–241.

    Article  CAS  Google Scholar 

  41. McCrea RL, Berger YG, King MB Body mass index and common mental disorders: exploring the shape of association and its moderation by age, gender and education. Int J Obes 2012; 36: 414–421.

    Article  CAS  Google Scholar 

  42. Mitchison D, Mond JM, Slewa-Younan S, Hay P Impairment associated with eating disorder features: a general population study. Int J Eat Disord 2013; 46: 375–380.

    Article  Google Scholar 

  43. Waters E, de Silva-Sanigorski A, Hall BJ, Brown T, Campbell KJ, Gao Y et al. Interventions for preventing obesity in children. Cochrane Database Syst Rev 2011; ((12)): CD001871.

  44. Bacon L, Aphramor L Weight science: evaluating the evidence for a paradigm shift. Nutr J 2011; 10: 1–13.

    Article  Google Scholar 

  45. Rosen JC Obesity and body image. in Eating Disorders and Obesity: a Comprehensive Handbook Fairburn CG, Brownell KD (eds). The Guilford Press: New York, 2002, pp 399–402.

    Google Scholar 

  46. Foster GD, Wadden TA Social and psychological effects of weight loss. in Eating Disorders and Obesity: a Comprehensive Handbook Fairburn CG, Brownell KD eds. 2002. The Guilford Press: New York.

    Google Scholar 

  47. Mustillo S, Hendrix K, Schafer M Trajectories of body mass and self concept in black and white girls: the lingering effects of stigma. J Health Soc Behav 2012; 53: 2–16.

    Article  Google Scholar 

  48. Palmeira AL, Branco TL, Martins SC, Minderico CS, Silva MN, Vieira PN et al. Change in body image and psychological well-being during behavioural obesity treatment: associations with weight loss and maintenance. Body Image 2010; 7: 187–193.

    Article  Google Scholar 

  49. Cash TF The Body Image Workbook: An Eight-step Program for Learning to Like Your Looks 2nd edn, 2008 New Harbinger: Oakland, CA.

  50. Devlin MJ, Fischer SE Treatment of binge eating disorder. in Eating Disorders and Obesity: a Comprehensive Handbook Wonderlich S, Mitchell JE, de Zwann M, Steiger H eds. Guilford Press: New York, NY, 2005.

    Google Scholar 

  51. Gorber CS, Tremblay M, Moher D, Gorber B A comparison of direct vs self-report measures for assessing heght, weight and body mass index: a systematic review. Obes Rev 2007; 8: 307–326.

    Article  Google Scholar 

  52. Grilo CM, Masheb RM, Robin M, Terence G A comparison of different methods for assessing the features of eating disorders. J Consult Clin Psychol 2001; 69: 317–322.

    Article  CAS  Google Scholar 

  53. Luppido FS, de Wit LM, Bouvy PF, Stijnen T, Cuijpers P, Penninx BW et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry 2010; 67: 220–229.

    Article  Google Scholar 

  54. Sobel ME Asymptotic confidence intervals for indirect effects in structural equation models. in Sociological Methodology Leinhart S. (eds) Jossey-Bass: San Francisco, 1982; 290–312.

    Google Scholar 

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van Zutven, K., Mond, J., Latner, J. et al. Obesity and psychosocial impairment: mediating roles of health status, weight/shape concerns and binge eating in a community sample of women and men. Int J Obes 39, 346–352 (2015). https://doi.org/10.1038/ijo.2014.100

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