Alexithymia and metabolic syndrome: the mediating role of binge eating

Abstract

Purpose Alexithymia, a personality trait characterized by difficulties in emotional processing, has been associated with unhealthy behaviors and chronic medical conditions. This study aimed to further develop our understanding of this complex relationship by investigating whether alexithymia increases the risk of metabolic syndrome (MetS) in participants with obesity or overweight through the mediating role of binge eating (BE). Methods A consecutive sample of 238 treatment-seeking patients with obesity or overweight were recruited. Alexithymia (TAS-20), binge eating symptoms (BES), body mass index (BMI), and depression and anxiety symptoms (HADS) were concurrently assessed. Results Almost half of the participants met the criteria for MetS (44.12%). Compared to patients without MetS, those with MetS were older, had a longer duration of overweight, and had a higher BMI (p < 0.01). Individual with MetS also had higher HADS, BES, and TAS-20 scores, particularly difficulty identifying and describing feelings. The structural equation modeling (SEM) analysis revealed that BES levels exerted a significant direct effect on MetS (p < 0.01), and that TAS-20 levels exerted a significant direct effect on BES (p < 0.01), anxiety (p < 0.001) and depression (p < 0.001). Moreover, psychological distress (anxiety, p = 0.01, and depression, p = .05) indirectly affected MetS through the mediating effect of BES, and TAS-20 (p = 0.01) indirectly affected MetS through the mediating effect of HADS and BES. Finally, age had a significant direct effect on MetS (p < 0.001). Conclusion Our findings indicate that alexithymia is a concurrent causative factor to the development of MetS through the mediating role of BE and psychological distress. Level of evidence Level III, case–control analytic study.

Impact of Alexithymia on the Lipid Profile in Major Depressed Individuals

“…Physiopathologically, several elements could help to better understand this particular relationship between alexithymia and dyslipidaemia in major depression. First, in major depressed individuals, alexithymia may be associated with the occurrence of major psychological distress leading to the development of avoidance strategies [ 33 , 34 ]. However, some of these strategies for avoiding the psychic pain associated with alexithymia are characterised by the development of inadequate eating behaviours (such as “binge eating”) favouring the occurrence of obesity that plays a central role in the pathophysiology of the different components of the metabolic syndrome (such as dyslipidaemia) [ 33 , 34 ].…”

“…First, in major depressed individuals, alexithymia may be associated with the occurrence of major psychological distress leading to the development of avoidance strategies [ 33 , 34 ]. However, some of these strategies for avoiding the psychic pain associated with alexithymia are characterised by the development of inadequate eating behaviours (such as “binge eating”) favouring the occurrence of obesity that plays a central role in the pathophysiology of the different components of the metabolic syndrome (such as dyslipidaemia) [ 33 , 34 ]. Second, in major depressed individuals, preexisting alterations in some adipocytokines (such as adiponectin) involved in the regulation of lipid metabolism [ 35 ] could be potentiated by alexithymia given its negative impact on the secretion of these hormones [ 36 ].…”

Hematoloji̇k Kanser Tanisi Alan Bi̇reylerde Di̇stres Ve Aleksi̇ti̇mi̇ni̇n İncelenmesi̇

“…Literatür incelemesi sonucunda kanser tanısı alan bireylerde bu ilişkiyi değerlendiren çalışmanın olmadığı görülmüştür. Bu nedenle bu ilişkiyi değerlendiren ve örneklemini diğer hastalıkların oluşturduğu çalışmalar incelenmiş, benzer sonuçların olduğu görülmüştür (18,26,27). Fibromiyalji ile ilgili yapılan çalışmalarda distres düzeyinin artmasında aleksitiminin etkisi olduğu saptanmıştır (28,29).…”

“…Ruhsal hastalığa sahip bireyler ile yapılan bir çalışmada aleksitimi ve distres puanları arasında pozitif ve anlamlı bir ilişkinin olduğu gösterilmiştir (30). Başka çalışmada ise Hidradenitis suppurativa tanısı olan bireylerin %46,1'inin distres düzeyinin yüksek olduğu ve bunların arasında %78'inin ise aleksitimik olduğu rapor edilmiştir (27). Bu benzerliğin nedeninin bir hastalık sürecinin aynı olmasa da benzer olması ile ilişkili olduğu düşünülmektedir.…”

Improvement in binge eating and alexithymia predicts weight loss at 9-month follow-up of the lifestyle modification program

“…It is composed of two higherorder factors: a deficit of affect awareness (as difficulty identifying feelings [DIF] and difficulty describing feelings [DDF]) and operatory thinking (externally-oriented thinking [EOT] and poor imaginal processes) [19]. These features are assumed to reflect the cognitive deficits in processing and regulation of emotions related to anxiety and depression, and to influence health-related behaviors and symptom onset [20]. High alexithymia has been identified among the risk factors for the onset of several psychological and physical health issues (for a review, see [19]), including reduced weight management, sedentary lifestyle [21], and disordered eating behavior [22].…”