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Psychological distress and quality of life in Iranian adolescents with overweight/obesity: mediating roles of weight bias internalization and insomnia

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Abstract

Purpose

To examine whether weight-related self-stigma (aka weight bias internalization) and insomnia are potential predictors of psychological distress and quality of life (QoL) among Iranian adolescents with overweight (OW)/obesity (OB). To examine whether weight-related self-stigma and insomnia are potential mediators in the relationship between excess weight and health outcomes of distress and QoL.

Methods

All participants (n = 934; 444 males; mean age = 15.7 ± 1.2 years; zBMI = 2.8 ± 1.0) completed questionnaires on weight-related self-stigma and insomnia at baseline. Six months later, they completed questionnaires on psychological distress and QoL to assess health outcomes. Relationships among variables were tested using mediation analyses with bootstrapping method.

Results

Weight-related self-stigma significantly mediated the effects of zBMI on psychological distress (effect = 0.22; bootstrapping SE = 0.09; 95% CI = 0.08, 0.45), psychosocial QoL (effect = − 0.64; bootstrapping SE = 0.19; 95% CI = − 1.10, − 0.32), and physical QoL (effect = − 1.35; bootstrapping SE = 0.54; 95% CI = − 2.43, − 0.26). Insomnia also significantly mediated the effects of zBMI on psychological distress (effect = 2.18; bootstrapping SE = 0.31; 95% CI = 1.61, 2.81), psychosocial QoL (effect = − 0.89; bootstrapping SE = 0.33; 95% CI = − 1.60, − 0.28), and physical QoL (effect = − 0.83; bootstrapping SE = 0.42; 95% CI = − 1.69, − 0.02). Full mediations were found in psychosocial QoL; partial mediations were found in psychological distress and physical QoL.

Conclusions

Weight-related self-stigma and insomnia were significant mediators in the effects of excess weight on health outcomes. Therefore, it is important to identify and treat weight-related self-stigma and insomnia for adolescents with OW/OB.

Level of evidence

Level V, cross-sectional descriptive study.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong

    Chung-Ying Lin

  2. Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

    Vida Imani

  3. Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden

    Anders Broström, Karina Huus, Maria Björk & Amir H. Pakpour

  4. School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Eric A. Hodges

  5. Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Shahid Bahonar Blvd, Qazvin, 3419759811, Iran

    Amir H. Pakpour

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  1. Chung-Ying Lin
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Correspondence to Amir H. Pakpour.

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Lin, CY., Imani, V., Broström, A. et al. Psychological distress and quality of life in Iranian adolescents with overweight/obesity: mediating roles of weight bias internalization and insomnia. Eat Weight Disord 25, 1583–1592 (2020). https://doi.org/10.1007/s40519-019-00795-5

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