Weight status and psychosomatic complaints in Swedish adolescent boys and girls: does family support play a buffering role?

BACKGROUND: Psychosomatic complaints have increased among adolescents in recent decades, as have overweight and obesity rates. Both of these trends are regarded as public health concerns. However, the associations between weight status and psychosomatic complaints are not yet clear, necessitating further research. The aim of the present study was to investigate the associations between weight status and psychosomatic complaints in Swedish adolescent boys and girls, as well as to explore the potential buffering effect of family support. METHODS: The data was obtained from the cross-sectional Swedish Health Behaviour in School-aged Children (HBSC) study conducted in 2017/18, which involved 3,135 students aged 11, 13, and 15 years. Weight status was based on self-reported information on weight and height, which allowed for the calculation of body mass index (BMI) and the categorisation of participants into three groups: non-overweight, overweight, and obese. Psychosomatic complaints were assessed based on information regarding the frequency of eight different complaints, which were summed into an index. Family support was measured using three items describing the level of perceived emotional support, and an index was created, which was dichotomised into low and high family support. Gender stratified linear regression models were run to examine the associations between weight status and psychosomatic complaints. Age and family affluence were included as covariates. Interaction terms were included to evaluate whether family support moderated the main association. RESULTS: Obesity was associated with higher levels of psychosomatic complaints in both boys and girls when compared to being non-overweight (boys: b = 2.56, 95% CI 0.32, 4.79; girls: b = 3.35, 95% CI 0.77, 5.94), while being overweight did not show any statistically significant associations with the outcome (boys: b = 0.21, 95% CI -0.72, 1.15; girls: b = 0.78, 95% CI -0.42, 1.98). In girls, a statistically significant interaction effect between family support and weight status was observed (p = 0.031), indicating that family support buffered against psychosomatic complaints in girls with obesity. No statistically significant interaction was found for boys (p = 0.642). CONCLUSIONS: The findings of this study highlight the importance of public health initiatives aimed at preventing childhood obesity. They also underscore the significant role of family support in reducing psychosomatic complaints among adolescents with obesity. Further research is necessary to gain a deeper understanding of these relationships.

Relationship between emotional eating and nutritional intake in adult women with overweight and obesity: a cross-sectional study.

BACKGROUND: Emotional eating (EE) is particularly prevalent in overweight or obese women, who may turn to food as a way to cope with stress, sadness, or anxiety. Limited research has been conducted on the association between EE and nutritional intake. Therefore, present study was designed to explore this association in adult women with overweight and obesity. METHODS: In this cross-sectional study, the relationship between EE and nutritional intake in 303 overweight and obese women (aged 18-50 years) was examined. The researchers used the validated semi-quantitative Food Frequency Questionnaire (FFQ) to assess participants' nutritional intake and the Dutch Eating Behavior Questionnaire (DEBQ) to evaluate their eating behavior. To determine the association between EE and nutritional intake, we employed the multiple linear regression analysis. RESULTS: The frequency of high intensity EE was 64.4% among the study participants and the mean total score of EE subscale of DBEQ was 2.32 ± 0.81. The total score of EE was positively associated with the energy intake (ß = 0.396, P = 0.007), even after adjusting for age and BMI. In addition, a significant inverse association was found between the score of EE and the daily intake of calcium (ß= -0.219, P = 0.026), riboflavin (ß= -0.166, P = 0.043), and vitamin B12 (ß= -0.271, P = 0.035), independent from energy and age. Also the results showed a significant positive association between the score of EE and the frequency of daily intake of cracker, muffin, cake, cream cake, pastry, candy, ice cream, pickles, melon, hydrogenated vegetable oil, peanut, salted and roasted seeds, and corn-cheese puff snack. CONCLUSION: This study found that overweight or obese women with higher intensity of EE might have a higher intake of energy and a lower intake of dietary calcium, riboflavin and vitamin B12. Integrating a balanced diet with psychotherapy is suggested to help individuals with EE reducing the urge to eat in response to emotions.

Assessing the effectiveness of health belief model-based educational interventions on weight control intentions among Malaysians.

Obesity and overweight are major health concerns, with a 19.7% prevalence among Malaysian adults, as reported in the 2019 National Health and Morbidity Survey. This study assessed the effectiveness of an educational intervention on weight control intention using the Health Belief Model (HBM). A quasi-experimental design was employed, involving 140 participants equally divided into an intervention group (IG) and a control group (CG). Post-intervention, the IG showed significant improvement in perceived self-efficacy in dieting (mean score 3.96 ± 0.85) compared to the CG (3.76 ± 0.86, p = 0.003). Perceived self-efficacy in exercise also increased in the IG (4.12 ± 0.52) compared to the CG (3.51 ± 0.94, p < 0.001). While behavioral intention scores improved in the IG (4.00 ± 0.59), the difference was not significant (p = 0.300). This study highlights that educational interventions using HBM can effectively improve self-efficacy and influence weight control behaviors.

Barriers and facilitators to weight-loss in patients with overweight/obesity and cardiac disease: a realist qualitative synthesis.

PURPOSE: Lifestyle advice for cardiac patients with overweight/obesity includes weight management, yet few achieve significant weight loss. People with heart disease may require different support to the general population. We synthesized evidence that reported cardiac patients' weight management experiences to identify barriers and facilitators to weight loss. METHODS: Our realist review identified five manuscripts reporting four studies of weight management experiences of people with heart disease. The capability, opportunity, motivation behaviour change model (COM-B) provided the framework for thematic synthesis. RESULTS: The studies included qualitative data from 117 participants and revealed factors favouring or impeding effective weight management during cardiac rehabilitation (CR) and in participants' daily lives. We identified four major themes illustrating participants' wish to change harmful health behaviours, adopting exercise and psychological strategies to facilitate change, social and professional support, and regaining control after a cardiac event. These themes broadly aligned with the COM-B categories of capability, opportunity, and motivation. CONCLUSIONS: Most cardiac patients with overweight/obesity express a desire to lose weight. Participants preferred personalized services that could adapt to meet their individual needs, but struggled to make sustainable changes for interconnecting psychological, social, cultural, and financial reasons. Consideration of these complexities when designing programmes may help to support successful weight management.

National Trends in the Prevalence of Self-Perceived Overweight Among Adolescents Between 2005 and 2022: Nationwide Representative Study.

BACKGROUND: Despite several studies on self-evaluation of health and body shape, existing research on the risk factors of self-perceived overweight is insufficient, especially during the COVID-19 pandemic. OBJECTIVE: This study aims to identify the risk factors affecting self-perceived overweight and examine how the prevalence of self-perceived overweight has changed before and during the COVID-19 pandemic. Specifically, we analyzed the impact of altered lifestyles due to COVID-19 on this phenomenon. METHODS: The data used in the study were obtained from middle and high school students who participated in the Korean Youth Risk Behavior Web-based Survey (N=1,189,586). This survey was a 2-stage stratified cluster sampling survey representative of South Korean adolescents. We grouped the survey results by year and estimated the slope in the prevalence of self-perceived overweight before and during the pandemic using weighted linear regression, as well as the prevalence tendencies of self-perceived overweight according to various risk factors. We used prevalence ratios to identify the risk factors for self-perceived overweight. In addition, we conducted comparisons of risk factors in different periods to identify their associations with the COVID-19 pandemic. RESULTS: The prevalence of self-perceived overweight was much higher than BMI-based overweight among 1,189,586 middle and high school participants (grade 7-12) from 2005 to 2022 (female participants: n=577,102, 48.51%). From 2005 to 2019 (prepandemic), the prevalence of self-perceived overweight increased (ß=2.80, 95% CI 2.70-2.90), but from 2020 to 2022 (pandemic) it decreased (ß=-0.53, 95% CI -0.74 to -0.33). During the pandemic, individuals with higher levels of stress or lower household economic status exhibited a more substantial decrease in the rate of self-perceived overweight. The prevalence of self-perceived overweight tended to be higher among individuals with poor academic performance, lower economic status, poorer subjective health, and a higher stress level. CONCLUSIONS: Our nationwide study, conducted over 18 years, indicated that self-perceived overweight decreased during the COVID-19 period while identifying low academic performance and economic status as risk factors. These findings suggest the need for policies and facilities to address serious dieting and body dissatisfaction resulting from self-perceived overweight by developing counseling programs for adolescents with risk factors such as lower school performance and economic status.

Beyond Distracted Eating: Cognitive Distraction Downregulates Odor Pleasantness and Interacts with Weight Status.

Considering the widespread issue of distracted eating, our study investigates how cognitive distraction influences the sensory perception of food-related odors among individuals with varying weight statuses. We conducted an exploratory, randomized, and cross-sectional experimental study, using the Tetris game to simulate real-life cognitive distraction, incorporating two distraction levels (low and high) and presenting five distinct odors. A total of 59 participants, categorized into a lean (n = 30) and overweight/obese group (n = 29) based on their body mass index (BMI), received odor stimuli while playing Tetris at low and high difficulty, corresponding to low and high distraction levels, respectively. Participants subsequently rated odor intensity and pleasantness under the two cognitive distraction conditions. Respiratory movements were monitored to ensure accurate olfactory stimulation. Our findings revealed no significant difference in odor intensity ratings across distraction levels (p = 0.903). However, there was a significant reduction in odor pleasantness under high cognitive distraction (p = 0.007), more pronounced in lean participants compared to those with an overweight status (p = 0.035). Additionally, an interaction between gender and cognitive distraction effects was observed in odor pleasantness perception. The differential effects of distraction across weight-status groups and genders are discussed in the context of hedonic motivation and compensatory mechanisms. This study sheds light onto the sensory mechanisms underlying distracted eating and could inform more personalized strategies for promoting healthier eating habits in a world dominated by distractions.

Irruption of Network Analysis to Explain Dietary, Psychological and Nutritional Patterns and Metabolic Health Status in Metabolically Healthy and Unhealthy Overweight and Obese University Students: Ecuadorian Case.

BACKGROUND: The association between dietary nutritional patterns, psychological factors, and metabolic health status has not been investigated in university students. There are studies that include numerous variables to test hypotheses from various theoretical bases, but due to their complexity, they have not been studied in combination. The scientific community recognizes the use of Gaussian graphical models (GGM) as a set of novel methods capable of addressing this. OBJECTIVE: To apply GGMs to derive specific networks for groups of healthy and unhealthy obese individuals that represent nutritional, psychological, and metabolic patterns in an Ecuadorian population. METHODOLOGY: This was a quantitative, non-experimental, cross-sectional, correlational study conducted on a sample of 230 obese/overweight university students, selected through a multi-stage random sampling method. To assess usual dietary intake, a Food Frequency Questionnaire (FFQ) was used; to evaluate psychological profiles (anxiety, depression, and stress), the DASS-21 scale was employed; blood pressure and anthropometric data were collected; and insulin levels, lipid profiles, and glucose levels were determined using fasting blood samples. The International Diabetes Federation (IDF) criteria were applied to identify metabolically healthy and unhealthy individuals. Statistical analysis relied on univariate methods (frequencies, measures of central tendency, and dispersion), and the relationships were analyzed through networks. The Mann-Whitney U test was used to analyze differences between groups. RESULTS: In metabolically unhealthy obese individuals, GGMs identified a primary network consisting of the influence of waist circumference on blood pressure and insulin levels. In the healthy obese group, a different network was identified, incorporating stress and anxiety variables that influenced blood pressure, anthropometry, and insulin levels. Other identified networks show the dynamics of obesity and the effect of waist circumference on triglycerides, anxiety, and riboflavin intake. CONCLUSIONS: GGMs are an exploratory method that can be used to construct networks that illustrate the behavior of obesity in the studied population. In the future, the identified networks could form the basis for updating obesity management protocols in Primary Care Units and supporting clinical interventions in Ecuador.

Validity of the Addiction-like Eating Behavior Scale among Patients with Compulsive Eating.

Food addiction (FA) and binge eating disorder (BED) co-occur and share compulsive eating symptoms. When using an FA measure, it is important to evaluate its performance in a population presenting compulsive eating. The study aims to validate the Addiction-like Eating Behavior Scale (AEBS) among a clinical sample characterized by compulsive eating and overweight/obesity and to evaluate its incremental validity over the Yale Food Addiction Scale 2.0 (YFAS). Patients seeking help for compulsive eating (n = 220), between January 2020 and July 2023, completed online questionnaires, including FA, compulsive eating, and BMI evaluations. The factor structure, internal consistency, and convergent, divergent, and incremental validity were tested. The sample had a mean age of 44.4 years old (SD = 12.7) and a mean BMI of 38.2 (SD = 8.0). The two-factor structure provided a good fit for the data, with factor loadings from 0.55 to 0.82 (except for item 15) and the internal consistency was high (ω = 0.84-0.89). The AEBS was positively correlated with the YFAS (r = 0.66), binge eating (r = 0.67), grazing (r = 0.47), craving (r = 0.74), and BMI (r = 0.26), and negatively correlated with dietary restraint (r = -0.37), supporting good convergent and divergent validity. For each measure of compulsive eating, linear regression showed that the AEBS "appetite drive" subscale had a unique contribution over the YFAS. This study provided evidence that the AEBS is a valid measure among a clinical sample of patients with compulsive eating and overweight/obesity. However, questions remain as to whether the AEBS is a measure of FA or compulsive eating.

Ideal body image and socioeconomic factors: exploring the perceptions of Kenyan women.

BACKGROUND: Non-communicable diseases are an increasing threat in sub-Saharan Africa (SSA), and overweight and obesity are affecting people across all socioeconomic groups. Some studies suggest that big body sizes may be perceived as desirable among women in SSA and that high prevalence of obesity and overweight are especially present in low socioeconomic societies. This study explores the role of socioeconomic factors in the perception of the ideal body among Kenyan women and whether perceptions and beliefs about the ideal body should be considered relevant when targeting the prevention of obesity and overweight. METHOD: In-depth interviews were conducted with 8 Kenyan women with varying educational backgrounds, aged between 21 and 48, using a qualitative study design. The interviews were conducted in December 2022 and January 2023 in Nairobi, audio-recorded, transcribed and analysed through qualitative content analysis and a coding system using deductive and inductive codes. RESULTS: The participants reported that conclusions about a person's health and wealth status are drawn based on different body sizes. Furthermore, traditional views about the ideal body size, societal pressure, as well as the women's own experience with their body size play a role in the perception of an ideal body. CONCLUSION: Small-sized women desire to gain weight as society may view them as weak and sick. Big-sized women aim to reduce weight primarily due to health complications. Nevertheless, traditionally, a big-sized woman is considered strong and wealthy, creating external pressure on women to fulfil this body image-these findings emphasise traditional aspects in designing culturally sensitive prevention and intervention methods to address overweight and obesity.

Patient Perceptions of Weight Stigma Experiences in Healthcare: A Qualitative Analysis.

BACKGROUND: Weight stigma is the social devaluation and denigration of individuals because of their excess body weight, resulting in poorer physical and mental health and healthcare avoidance. Attribution Theory and Goffman's theory of spoiled identity provided a general overarching framework for understanding weight stigma experiences. OBJECTIVE: Our purpose was to explore weight stigma experiences from a broad range of perspectives emphasizing identities typically excluded in the weight stigma literature. DESIGN: We conducted a qualitative descriptive study with data drawn from 73 substantive narrative comments from participants who responded to a larger survey. RESULTS: Analysis developed five themes: Working on weight, Not being overweight, Lack of help and empathy, Exposure and embarrassment and Positive experiences. Individuals who would be clinically assessed as overweight, especially men, often did not identify with having a weight problem and found the framing of personal responsibility for weight empowering. Participants with larger body sizes more often attributed embarrassment and shame about weight to treatment in the clinical setting. Older participants were more likely to have positive experiences. CONCLUSIONS: The findings suggest ongoing tension between the framing of weight as a personal responsibility as opposed to a multifactorial condition with many uncontrollable aspects. Gender, age and body size shaped respondent perspectives, with some young male respondents finding empowerment through perceived personal control of weight. The healthcare system perpetuates weight stigma through lack of adequate equipment and excessively weight-centric medical counselling. Recommending a healthy lifestyle to patients without support or personalized medical assessment may perpetuate weight stigma and associated detrimental health outcomes. PATIENT OR PUBLIC CONTRIBUTION: Patients with obesity and overweight were integral to this study, providing comments for our qualitative analyses.

Verbal Weight-Related Abuse and Binge Eating Behavior: The Mediating Role of Attentional Bias to Threat Cues and Difficulties in Emotion Regulation.

INTRODUCTION: Previous studies investigated the impact of weight-related abuse (WRA) on eating pathology. However, the circumstances of such an effect are still unclear. Our study aimed to examine the relationship between verbal WRA and binge eating (BE) behavior via attentional bias (AB) to threat cues and difficulties in emotion regulation. METHOD: We conducted a parallel mediation model. On the basis of the purposive sampling method, 183 individuals with obesity and overweight (70.5% female and 28.4% male; Meanage = 32.78), from February to June 2019, were recruited from a nutrition clinic in Tehran. The participants completed the BE scale (BES), the weight-related abuse questionnaire (WRAQ), the difficulties in emotion regulation scale (DERS), and the dot probe task (DPT). RESULTS: AB to threat cues had a significantly negative association with verbal WRA and BE. Difficulties in emotion regulation showed a significant positive association with verbal WRA and BE. The parallel mediation model showed a direct effect of verbal WRA on BE. Moreover, the bootstrap analysis revealed that difficulties in emotion regulation could mediate the association between verbal WRA and BE. CONCLUSIONS: Our findings suggest that experiences of verbal WRA can contribute to cognitive bias to negative emotion, maladaptive emotion regulation strategies, and behavioral problems like BE.

Efficacy of Dichrostachys Glomerata Supplementation on Overweight and Mildly Obese Adult's Weight, Mood, and Health-Related Quality of Life: A Randomized Double-Blind Placebo-Controlled Trial.

Despite their widespread use, research is needed to evaluate the weight loss and related health/wellness outcomes of herbal plants. Preliminary research found that the fruit of Dichrostachys glomerata is safe and has potential weight loss effects. This study aimed to examine the effect of a standardized powder of D. glomerata fruit pods (DYG-400®) on weight, food cravings, mood, and health-related quality of life of overweight and mildly obese adults. In this CONSORT-compliant double-blind placebo-controlled trial, 56 adults (Mean [M] age = 44.50, M [body mass index] BMI = 31.66) were randomized to either the D. glomerata Group (DG; 300 mg/d) or Placebo Group (PG; rice protein, 300 mg/d) for 60 days. Participants weight was assessed along with self-report assessments of the Food Cravings Questionnaire, CDC Health-related Quality of Life, Perceived Stress Scale, Trait Anxiety Inventory, and Profile of Mood States at Baseline, Day 30, and Day 60. The data were collected from March 2023 to June 2023 and stored electronically, and analyzed using general linear models with repeated measures. DG lost more weight at Day 60 compared to PG, p = .05 (4.11 vs. 2.19 lbs). DG had reduced food cravings from Baseline to Day 30 and Day 60 compared to PG, p < .001. Perceived stress, p < .001, and mood, p = .017, improved from Baseline to Day 60 for DG compared to PG. Anxiety decreased from Baseline to Day 60 for DG and from Baseline to Day 30 for PG, p < .001. Health-related Quality of Life improved for DG compared to PG, p < .001. D. glomerata (DYG-400®) may be an effective herbal intervention to promote weight loss and health. Extended clinical trials across diverse populations and settings are needed.Clinical trial registry number and website: ISRCTN10099861, https://doi.org/10.1186/ISRCTN10099861.

Weight loss trends in Korean adolescents (2005-2021): Exploring the impact of measured and self-perceived weight status.

OBJECTIVE: This study aims to assess the trends in the proportions of weight loss efforts among Korean adolescents aged 10-18 years from 2005 to 2021, examining variations based on weight status, to examine factors related to weight loss efforts by weight status, and to evaluate weight loss efforts based on the combination of measured and self-perceived weight status. METHODS: Complex sample design analyses were conducted on a dataset comprising 10,760 adolescents, utilizing information from the Korea National Health and Nutrition Examination Survey, a nationally representative dataset. Participants were categorized into non-overweight and overweight groups using a BMI percentile threshold of 85. RESULTS: 22-29 % of non-overweight adolescents and 54-77 % of adolescents with overweight engaged in weight loss efforts. Among adolescents who attempted to lose weight from 2005 to 2017, 39.5-57.1 % tried both of diet and exercise, 22.7-47.4 % tried exercise alone, and 10.2-26.7 % tried diet alone. Female gender, older age, and higher self-perceived weight status were associated with increased odds of weight loss efforts, irrespective of actual weight status. For adolescents perceiving themselves as obese, the odds of attempting weight loss were 8.32 for non-overweight boys, 2.02 for non-overweight girls, 15.28 for overweight boys, and 5.77 for overweight girls compared to controls who were non-overweight and perceived themselves as not obese. CONCLUSION: Weight loss efforts among Korean adolescents aged 10 to 18 remained consistent irrespective of their actual weight over 16 years. Throughout this period, adolescents who perceived themselves as obese were more likely to attempt weight loss, independent of their true weight status. Hence, subjective weight perception plays a significant role in influencing weight loss behaviors among adolescents.

The association between depressive symptoms and overweight or obesity in prepubertal children: Findings from the QUALITY cohort.

BACKGROUND: Youth obesity and depression are public health concerns. Although meta-analyses suggest a positive association between those conditions in adults and adolescents, evidence remains unclear in prepubertal children. We examined the bidirectional associations between levels of depressive symptoms and weight status in 8-10-year-old children with a parental history of obesity, over two years, and whether they differ by sex. METHODS: Data were drawn from the QUebec Adipose and Lifestyle InvesTigation in Youth Cohort Study's baseline and first follow-up evaluations (n = 558). Depressive symptoms were assessed using the 12-item Center for Epidemiological Studies Depression scale and weight status using body mass index z-scores based on World Health Organization standards. Linear and logistic regression models were used to test the directionality and magnitude of the associations, adjusting for age, sex, physical activity, screen time, parental education, alcohol and cigarette use, and baseline outcome measure. RESULTS: Children with higher levels of depressive symptoms at baseline were not more likely to have overweight/obesity at follow-up (odds ratio [95 % Coefficient Interval] = 0.95[0.88;1.02]). Baseline overweight/obesity was not associated with subsequent higher levels of depressive symptoms (beta coefficient [95 % Coefficient Interval] = 0.20 [-0.47;0.87]). No sex differences emerged. LIMITATIONS: Selection bias may have occurred due to loss at follow-up (10 % attrition) and exclusion of 6 participants taking mood disorder medication. CONCLUSIONS: Unlike in adults and adolescents, no association between weight status and depressive symptoms was observed in childhood over two years. Underlying mechanisms linking both conditions later in life may not apply as early as prepubertal childhood.

The relationship between perceived stress and emotional eating in bus drivers: the effect of shift work.

This study discusses the relationship between perceived stress and emotional eating based on shiftwork in city bus drivers. It was conducted with 1403 male city bus drivers working in Istanbul. Questions about the drivers' physical activity and dietary habits, the Healthy Diet Index (HDI), Emotional Appetite Questionnaire and Perceived Stress Scale-10 data were collected and evaluated in two groups: shift and non-shift employees. It was found that the shift workers (SWs) have lower perceived stress, physical activity, HDI and positive emotional appetite averages. In addition, for SWs, a positive correlation was found between negative emotional appetite scores and physical activity and HDI scores. In conclusion, the drivers working in shifts were found to be slightly overweight and had lower physical activity levels, had lower HDI scores, and their nutritional status was more negatively impacted than their counterparts.

Episodic future thinking improves intertemporal choice and food choice in individuals with higher weight: A systematic review and meta-analysis.

Episodic future thinking (EFT) strengthens self-regulation abilities by increasing the perceived value of long-term reinforcements and reducing impulsive choice in delay discounting tasks. As such, EFT interventions have the potential to improve dietary and eating-related decision-making in individuals with obesity or binge eating symptoms, conditions associated with elevated delay discounting. Here, we meta-analyzed evidence from 12 studies that assessed whether EFT interventions improve delay discounting and real-world food choice compared to control interventions. Included studies involved 951 adults with overweight or obesity (body mass index [BMI] ≥25). There were no studies involving participants with binge eating disorder. EFT intervention pooled effects were significant, improving delay discounting with a medium effect, g = 0.55, p < 0.0001, and subsequent food choice outcomes with a small effect, g = 0.31, p < 0.01. Notably, our review is the first to analyze mechanisms of effect in this population, demonstrating that improvements were greater when temporal horizons of EFT episodes were aligned with delay discounting tasks and more distant horizons predicted far-transfer to subsequent dietary and eating-related choices. Our findings thus show that EFT is an effective intervention for individuals with higher weight at risk of adverse health consequences.

Identification of Psychological Treatment Dropout Predictors Using Machine Learning Models on Italian Patients Living with Overweight and Obesity Ineligible for Bariatric Surgery.

According to the main international guidelines, patients with obesity and psychiatric/psychological disorders who cannot be addressed to surgery are recommended to follow a nutritional approach and a psychological treatment. A total of 94 patients (T0) completed a battery of self-report measures: Symptom Checklist-90-Revised (SCL-90-R), Barratt Impulsiveness Scale-11 (BIS-11), Binge-Eating Scale (BES), Obesity-Related Well-Being Questionnaire-97 (ORWELL-97), and Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Then, twelve sessions of a brief psychodynamic psychotherapy were delivered, which was followed by the participants completing the follow-up evaluation (T1). Two groups of patients were identified: Group 1 (n = 65), who fully completed the assessment in both T0 and T1; and Group 2-dropout (n = 29), who fulfilled the assessment only at T0 and not at T1. Machine learning models were implemented to investigate which variables were most associated with treatment failure. The classification tree model identified patients who were dropping out of treatment with an accuracy of about 80% by considering two variables: the MMPI-2 Correction (K) scale and the SCL-90-R Phobic Anxiety (PHOB) scale. Given the limited number of studies on this topic, the present results highlight the importance of considering the patient's level of adaptation and the social context in which they are integrated in treatment planning. Cautionary notes, implications, and future directions are discussed.

Nutritional and Psychosocial Intervention to Improve the Self-Concept of Body Image and Increase the Self-Esteem of Overweight and Obese Individuals: A Quasi-Experimental Study.

Negative habits persist in contemporary society that can sometimes result in overweight or the deterioration of body image. This study aimed to assess the suitability of a nutritional and psychosocial intervention as part of an interdisciplinary approach to improve the perception of body image and increase the self-esteem of individuals who are overweight or obese. A total of 55 participants (25 men and 30 women) were included in this quasi-experimental intervention study. Measurements were taken as part of an ambulatory treatment to obtain values for weight, self-esteem, and body image perception using the Rosenberg scale and the Body Self-Esteem scale. At the end of the intervention and after one year, the weight reductions reached an average of 13.4 kg, positive self-image perception improved from a mean of 88.73 at pretest to 148.02 at follow-up, and self-esteem improved from a mean of 22.6 to 32.6. These were all statistically significant changes (p < 0.001). The model is effective in terms of weight reduction, together with improved levels of self-esteem and favorable perceptions of body image.

C-reactive protein across pregnancy in individuals exposed to childhood maltreatment: The role of psychological and physical sequelae of maltreatment.

BACKGROUND: Childhood maltreatment (CM) has long-term consequences for the regulation of stress biology which are particularly pronounced when mental and physical health sequelae have manifested. C-reactive protein (CRP) has been shown to be elevated in the non-pregnant state in association with CM as well as in the setting of CM-associated mental and physical health sequelae. In pregnancy, however, the association between CM and CRP is less clear. We sought to examine this association and consider the moderating role of four common health sequelae of CM (maternal depressive symptoms, overweight/obesity, smoking, and hypertensive disorders during pregnancy). METHODS: A prospective, longitudinal study of 744 healthy pregnant participants was conducted, with analyses focusing on a sample of 643 participants. CM was assessed with the Childhood Trauma Questionnaire (CTQ) and categorized by whether no vs. one or more moderate to severe CM experiences were reported. Blood serum concentrations of CRP, maternal depression severity (continuous scores of the Center for Epidemiologic Studies Depression Scale, CES-D) and smoking during pregnancy were assessed in early (16.52 ± 2.50 weeks gestation) and late (33.65 ± 1.18 weeks gestation) pregnancy. Pre-pregnancy body mass index (BMI) was obtained at the first study visit and hypertensive disorders diagnosed during pregnancy were obtained from the medical record. Linear mixed effects models were employed to assess main effects of CM as well as interactive effects of CM and four common CM-associated sequelae as well as a sum score of these sequelae on repeatedly measured CRP concentration. In secondary analyses, we conducted latent class analyses to classify participants based on their specific experiences of childhood abuse and/or neglect and to assess the association of these CM subgroups with CM sequelae and CRP. All analyses were adjusted for potential confounders (maternal race and ethnicity and education/income). RESULTS: CRP concentration decreased from early to late pregnancy (B = -0.06, SE = 0.01, p < 0.001). While there was no main effect of CM on CRP (p = 0.49), the interaction of CM and depressive symptoms was associated with CRP concentration (B = 0.08, SE = 0.04, p < 0.05), indicating higher CRP across pregnancy with increasing levels of depressive symptoms during pregnancy in participants with CM experience. This interaction was mainly driven by participants with co-occurring physical and emotional maltreatment. For none of the other CM-associated sequelae a statistically significant interaction with CM on CRP concentration was observed. CONCLUSIONS: These results add to the growing empirical evidence suggesting higher inflammation during pregnancy in participants exposed to CM who experience depressive symptoms and highlight the detrimental effects of multiple co-occurring experiences of maltreatment. Given the negative consequences of chronic inflammatory state for the mother and the developing fetus, monitoring and treating psychiatric sequelae during pregnancy among participants exposed to CM is potentially an important opportunity to dampen long-term detrimental effects of CM, serving at least two generations.

Pre-pregnancy overweight or obesity moderates the association between prenatal maternal depressive symptoms and infant cord blood omega-3 levels.

BACKGROUND: Empirical evidence has demonstrated associations between pre-pregnancy obesity and perinatal maternal depressive symptoms. Omega-3 is an essential fatty acid derived from dietary sources that is critical for fetal brain development. Pre-pregnancy obesity is associated with higher omega-3 intake, but a weaker association between dietary intake and respective maternal and cord blood omega-3 levels. Further, lower intake of omega-3 during pregnancy has been linked to higher depressive symptoms. Yet, prior studies have not examined the interactive effects of pre-pregnancy overweight or obesity (OWOB) and prenatal maternal mental health symptoms on infant cord blood omega-3 levels. METHODS: Participants included 394 maternal-infant dyads from the NIH Environmental influences on Child Health Outcomes (ECHO) - Safe Passage Study in South Dakota. A pre-pregnancy body mass index (BMI) > 25 was used to dichotomize participants as OWOB (54%) vs. non-OWOB (46%). Prenatal maternal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS) and prenatal maternal anxiety symptoms were measured using the State-Trait Anxiety Inventory (STAI). We implemented linear regression models to examine the interaction term between pre-pregnancy BMI category and prenatal maternal mental health symptoms on cord blood omega-3 levels. Secondary analyses were stratified by pre-pregnancy BMI category. RESULTS: We observed a significant interaction between pre-pregnancy BMI category and prenatal maternal depressive symptoms with cord blood omega-3 (F(4,379) = 6.21, p < .0001, adj. R2 = 0.05). Stratified models revealed an association between prenatal maternal depressive symptoms with lower cord blood omega-3 levels only among individuals with pre-pregnancy OWOB (ß = -0.06, 95% CI = -0.11, -0.02; F (2,208) = 4.00, p < .05, adj R2 = 0.03). No associations were observed among non-OWOB participants. CONCLUSIONS: Findings suggest maternal-placental transfer of omega-3 may represent one pathway by which maternal metabolic and mental health impacts infant development.