Weight-related correlates of psychological dysregulation in adolescent and young adult (AYA) females with severe obesity

Abstract

Objective Severe obesity is the fastest growing pediatric subgroup of excess weight levels. Psychological dysregulation (i.e., impairments in regulating cognitive, emotional, and/or behavioral processes) has been associated with obesity and poorer weight loss outcomes. The present study explored associations of dysregulation with weight-related variables among adolescent and young adult (AYA) females with severe obesity. Methods Fifty-four AYA females with severe obesity (MBMI=48.71 kg/m2; Mage=18.29, R=15–21 years; 59.3% White) completed self-report measures of psychological dysregulation and weight-related constructs including meal patterns, problematic eating behaviors, and body and weight dissatisfaction, as non-surgical comparison participants in a multi-site study of adolescent bariatric surgery outcomes. Pearson and bivariate correlations were conducted and stratified by age group to analyze associations between dysregulation subscales (affective, behavioral, cognitive) and weight-related variables. Results Breakfast was the most frequently skipped meal (consumed 3–4 times/week). Eating out was common (4–5 times/week) and mostly occurred at fast-food restaurants. Evening hyperphagia (61.11%) and eating in the absence of hunger (37.04%) were commonly endorsed, while unplanned eating (29.63%), a sense of loss of control over eating (22.22%), eating beyond satiety (22.22%), night eating (12.96%), and binge eating (11.11%) were less common. Almost half of the sample endorsed extreme weight dissatisfaction. Dysregulation was associated with most weight-related attitudes and behaviors of interest in young adults but select patterns emerged for adolescents. Conclusions Higher levels of psychological dysregulation are associated with greater BMI, problematic eating patterns and behaviors, and body dissatisfaction in AYA females with severe obesity. These findings have implications for developing novel intervention strategies for severe obesity in AYAs that may have a multidimensional impact on functioning (e.g., psychosocial health, weight loss behaviors).

Psychosocial, behavioral and clinical correlates of children with overweight and obesity

“…In this study, there was no association of either depression or anxiety with emotional eating, but other studies have found emotional eating as a mediator for obesity in individuals with depression [32,33]. A high level of psychosocial dysregulation along with problematic eating patterns and behaviors was noted by Gowen et al in their study of 54 young adults and adolescents [34]. Similarly, in a comparable group of adolescents prior to bariatric surgery, higher BMI, depressive symptoms and the number of medical comorbidities were significant predictors of the impaired weight related quality of life and closely related to dysregulated eating behaviors [35].…”

Disordered Eating Attitudes and Behaviors in Youth with Overweight and Obesity: Implications for Treatment

“…Moreover, evidence by Goldschmidt and colleagues (2015) suggests a meditational model in which lower EF abilities are a precursor to binge eating, which in turn promotes excess calorie consumption and weight gain over time [34]. Another recent study found that adolescents with obesity who endorsed more cognitive dysregulation were more likely to endorse LOC eating [35]. …”

Socioenvironmental, Personal, and Behavioral Correlates of Severe Obesity among an Ethnically/Racially Diverse Sample of US Adolescents

“…Although it is important to note that assessments of binge eating that rely on self-report may overestimate binge eating compared to gold standard clinical interviews, 32,33 previous studies of clinical samples of adolescents with severe obesity have similarly observed a high prevalence of binge eating or loss of control eating. [34][35][36] Furthermore, a relationship between self-report of disordered eating behaviors and higher levels of distress and dysfunction has been extensively documented in the peerreviewed literature. 37 Binge eating may therefore be a distinguishing factor in regard to risk for progressing from class 1 to severe obesity and an important contributor to treatment challenges.…”