Advertisement

The behavioral pathway model to overweight and obesity: coping strategies, eating behaviors and body mass index

  • Carmen VarelaEmail author
  • Ana Andrés
  • Carmina Saldaña
Original Article
  • 59 Downloads

Abstract

Purpose

Obese and overweight people deal with more daily problems and stressful situations than normal-weight individuals, for example, discrimination and bias. The aims of the present study were twofold: to identify differences between overweight and normal-weight people in coping strategies and eating behaviors, and to examine the relationship between coping strategies, eating behaviors and BMI.

Methods

Sample of the present study consisted of 473 participants, 76.7% women (mean age = 32.7; SD = 11.4). Participants completed an ad hoc sociodemographic data questionnaire, the Coping Strategies Inventory, and the Dutch Eating Behavior Questionnaire. Welch’s t test and X2 comparison analysis were used to identify differences in coping strategies and eating behaviors, according two BMI groups, normal weight and overweight. To analyze the relationship between coping strategies, eating behaviors and BMI, a structural equation modeling was conducted.

Results

Overweight participants score significantly higher in passive coping strategies such as self-criticism, wishful thinking and social withdrawal, and unhealthy eating behaviors such as emotional eating and restrained eating. Structural equation modeling included these variables, coping strategies are more likely to conduct to unhealthy eating behaviors and these are more likely to promote and maintain a high BMI. The model showed an adequate data fit.

Conclusions

This research proposes a relationship between the variables analyzed. It has been proved that passive coping strategies predict a high BMI via unhealthy eating behaviors, especially emotional eating. These results are promising to improve the current prevention obesity programs and weight control treatments.

Level of evidence

Level III, case–control analytic study.

Keywords

Obesity Overweight Coping strategies Eating behaviors Structural equation modeling 

Notes

Funding

This study is part of the project PSI2013-45292-R funded by the Spanish Ministry of Economy and Competitiveness.

Compliance with ethical standard

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    World Health Organization (2017) Obesity and overweight (Prevalence). Retrieved from http://www.who.int/mediacentre/factsheets/fs311/es/. Accessed 17 Oct 2017
  2. 2.
    Lunn TE, Nowson CA, Worsley A, Torres SJ (2014) Does personality affect dietary intake? Nutrition 30(4):403–409.  https://doi.org/10.1016/j.nut.2013.08.012 Google Scholar
  3. 3.
    Rajan TM, Menon V (2017) Psychiatric disorders and obesity: a review of association studies. J Postgrad Med 63(3):182–190.  https://doi.org/10.4103/jpgm.JPGM_712_16 Google Scholar
  4. 4.
    Vittengl JR (2018) Mediation of the bidirectional relations between obesity and depression among women. Psychiatry Res 264:254–259.  https://doi.org/10.1016/j.psychres.2018.03.023 Google Scholar
  5. 5.
    Puhl RM, Brownell KD (2006) Confronting and coping weight stigma: an investigation of overweight and obese adults. Obesity 14(10):1802–1815.  https://doi.org/10.1038/oby.2006.208 Google Scholar
  6. 6.
    O’Brien KS, Latner JD, Puhl RM, Vartanian LR, Giles C, Griva K, Carter A (2016) The relationship between weight stigma and eating behavior is explained by weight bias internalization and psychological distress. Appetite 102:70–76.  https://doi.org/10.1016/j.appet.2016.02.032 Google Scholar
  7. 7.
    Vartanian LR, Porter AM (2016) Weight stigma and eating behavior: a review of the literature. Appetite 102:2–14.  https://doi.org/10.1016/j.appet.2016.01.034 Google Scholar
  8. 8.
    Hayward LE, Vartanian LR, Pinkus RT (2018) Weight stigma predicts psychological well-being through internalized weight bias and maladaptive coping responses. Obesity 26:755–761.  https://doi.org/10.1002/oby.22126 Google Scholar
  9. 9.
    Farhangi MA, Eman-Alizadeh M, Hamedi F, Jahangiry L (2017) Weight self-stigma and its association with quality of life and psychological distress among overweight and obese women. Eat Weight Disord 22:451–456.  https://doi.org/10.1007/s40519-016-0288-2 Google Scholar
  10. 10.
    Himmelstein MS, Puhl R, Quinn D (2018) Weight Stigma and Health: the mediating role of coping responses. Health Psychol 37(2):139–147.  https://doi.org/10.1037/hea0000575 Google Scholar
  11. 11.
    Rand K, Vallis M, Aston M, Price S, Piccinini-Vallis H, Rehman L, Kirk SF (2017) It is not the diet; it is the mental part we need help with. A multilevel analysis of psychological, emotional, and social well-being in obesity. Int J Qual Stud Health Well-being 12(1):1–15.  https://doi.org/10.1080/17482631.2017.1306421 Google Scholar
  12. 12.
    Manzoni GM, Cesa GL, Bacchetta M, Castelnuovo G, Conti S, Gaggioli A, Mantovani F, Molinari E, Cárdenas-López G, Riva G (2016) Virtual reality enhanced cognitive-behavioral therapy for morbid obesity: a randomized controlled study with 1 year follow-up. Cyberpsychol Behav Soc Netw 19(2):134–140.  https://doi.org/10.1089/cyber.2015.0208 Google Scholar
  13. 13.
    Kirk SF, Price SL, Penney TL, Rehman L, Lyons RF, Piccinini-Vallis H, Vallis TM, Curran J, Aston M (2014) Blame, shame and lack of support: a multilevel study on obesity management. Qual Health Res 24(6):790–800.  https://doi.org/10.1177/1049732314529667 Google Scholar
  14. 14.
    Mussap AJ, Manger E, Gold RS (2016) Weight-control effort can increase obesity stereotyping. Pers Individ Differ 88:178–181.  https://doi.org/10.1016/j.paid.2015.09.014 Google Scholar
  15. 15.
    Spahlholz J, Pabst A, Riedel-Heller SG, Luck-Sikorski C (2016) Coping with perceived weight discrimination: testing a theoretical model for examining the relationship between perceived weight discrimination and depressive symptoms in a representative sample of individuals with obesity. Int J Obes 40:1915–1921.  https://doi.org/10.1038/ijo.2016.164 Google Scholar
  16. 16.
    Sutin AR, Ferrucci L, Zonderman AB, Terracciano A (2011) Personality and obesity across the adult lifespan. J Pers Soc Psychol 101(3):579–592.  https://doi.org/10.1037/a0024286 Google Scholar
  17. 17.
    Puhl RM, Himmelstein MS (2018) Weight bias internalization among adolescents seeking weight loss: implications for eating behaviors and parental communication. Front Psychol 9:2271.  https://doi.org/10.3389/fpsyg.2018.02271 Google Scholar
  18. 18.
    Carels RA, Hlavka R, Selensky JC, Solar C, Rossi J, Miller C (2018) A daily diary study of internalized weight bias and its psychological, eating and exercise correlates. Psychol Health 34(3):306–320.  https://doi.org/10.1080/08870446.2018.1525491 Google Scholar
  19. 19.
    Papadopoulos S, Brennan L (2015) Correlates of weight stigma in adults with overweight and obesity: a systematic literature review. Obesity 23(9):1743–1760.  https://doi.org/10.1002/oby.21187 Google Scholar
  20. 20.
    Palmeira L, Pinto J, Cunha M, Carvalho S (2017) Finding the link between internalized weight-stigma and binge eating behaviors in Portuguese adult women with overweight and obesity: the mediator role of self-criticism and self-reassurance. Eat Behav 26:50–54.  https://doi.org/10.1016/j.eatbeh.2017.01.006 Google Scholar
  21. 21.
    Boggiano MM, Wenger LE, Burgess E, Tatum MM, Sylvester MD, Morgan PR, Morse KE (2015) Eating tasty food to cope, enhance reward, socialize or conform: what other psychological characteristics describe each of these motives? J Health Psychol 22(6):280–289.  https://doi.org/10.1177/1359105315600240 Google Scholar
  22. 22.
    Van Strien T, Frijters J, Bergers G, Defares P (1986) The Dutch Eating Behavior Questionnaire (DEBQ) for assessment of restrained, emotional and external eating behaviors. Eat Behav 5(2):295–315.  https://doi.org/10.1002/1098-108X(198602)5:2%3c295:AID-EAT2260050209%3e3.0.CO;2-T Google Scholar
  23. 23.
    Elfhag K, Rössner S (2005) Who succeeds in maintaining weight loss? A conceptual review of factors associated with weight loss maintenance of weight regain. Obes Rev 6:67–85.  https://doi.org/10.1111/j.1467-789X.2005.00170.x Google Scholar
  24. 24.
    Li W, Rukavina P (2009) A review on coping mechanism against obesity bias in physical activities/education settings. Obes Rev 10:87–95.  https://doi.org/10.1111/j.1467-789x.2008.00582.x Google Scholar
  25. 25.
    Young D, Limbers CA (2017) Avoidant coping moderates the relationship between stress and depressive emotional eating in adolescents. Eat Weight Disord 22:683–691.  https://doi.org/10.1007/s40519-017-0396-7 Google Scholar
  26. 26.
    Tobin D, Holroyd K, Reynols R, Kigal J (1989) The hierarchical factor structure of Coping Strategies Inventory. Cognitive Ther Res 13:343–361.  https://doi.org/10.1007/BF01173478 Google Scholar
  27. 27.
    Cano F, Rodríguez L, García J (2007) Adaptación Española del Inventario de Estrategias de Afrontamiento. Actas Esp Psiquiatri 35(1):29–39Google Scholar
  28. 28.
    Cebolla A, Barrada JR, Van Strien T, Oliver E, Baños R (2014) Validation of the Dutch Eating Behavior Questionnaire (DEBQ) in a sample of Spanish women. Appetite 73:58–64.  https://doi.org/10.1016/j.appet.2013.10.014 Google Scholar
  29. 29.
    Delacre M, Lakens D, Leys C (2017) Why psychologists should by default use Welch’s t-test instead of Student’s t-test. Int Rev Soc Psychol 30(1):92–101.  https://doi.org/10.5334/irsp.82 Google Scholar
  30. 30.
    Ledesma R, Macbeth G, Cortada de Kohan N (2008) Tamaño del efecto: Revisión teórica y aplicaciones con el sistema estadístico vista. Rev Latinoam Psicol 40(3):425–439. Retrieved from: http://www.scielo.org.co/pdf/rlps/v40n3/v40n3a03.pdf. Accessed 21 Feb 2019
  31. 31.
    Cohen J (1988) Statistical power analysis for behavioral sciences. Lawrence Erlbaum Associates Publishers, HillsdaleGoogle Scholar
  32. 32.
    Hu LT, Bentler PM (1999) Cutoff criteria for fit indexes in covariance structural analysis: conventional criteria versus new alternatives. Struct Equ Modeling 6:1–55.  https://doi.org/10.1080/10705519909540118 Google Scholar
  33. 33.
    Reas DL, Nygard JF, Svensson E, Sørensen T, Sandanger I (2007) Changes in body mass index by age, gender, and socio-economic status among a cohort of Norwegian men and women (1990–2001). BMC Public Health 7:269.  https://doi.org/10.1186/1471-2458-7-269 Google Scholar
  34. 34.
    Pickett KE, Kelly S, Brunner Lobstein, Wilkinson R (2005) Wider income gaps, wider waistbands? An ecological study of obesity and income inequality. J Epidemiol Community Health 59:670–674.  https://doi.org/10.1136/jech.2004.028795 Google Scholar
  35. 35.
    Baños R, Cebolla A, Moragrega I, Van Strien T, Fernández-Aranda F, Agüera Z, de la Torre R, Casanueva F, Fernández-Real J, Fernández-García j, Frübhbeck G, Gómez-Ambrosi J, Jiménez-Murcia S, Rodríguez R, Tinahones F, Botella C (2014) Relationship between eating styles and temperament in anorexia nervosa, healthy control and morbid obesity female sample. Appetite 76:76–83.  https://doi.org/10.1016/j.appet.2014.01.012 Google Scholar
  36. 36.
    Schulte EM, Grilo CM, Gearhardt AN (2016) Shared and unique mechanisms underlying binge eating disorder and addictive disorders. Clin Psychol Rev 44:125–139.  https://doi.org/10.1016/j.cpr.2016.02.001 Google Scholar
  37. 37.
    Lowe MR, Arigo D, Butryn ML, Gilbert JR, Sarwer D, Stice E (2016) Hedonic hunger prospectively predicts onset and maintenance of loss control eating among college women. Health Psychol 35(3):238–244.  https://doi.org/10.1037/hea0000291 Google Scholar
  38. 38.
    Brownell KD (2004) The LEARN program for weight management. American Health Publishing Company, DallasGoogle Scholar
  39. 39.
    Lora-Cortaz T, Saucedo-Molina J (2006) Conductas alimentarias de riesgo e imagen corporal en una muestra de mujeres adultas de la Ciudad de México. Salud Ment 29(3):60–67. Retrieved from: http://www.redalyc.org/articulo.oa?id=58232908. Accessed 21 Feb 2019
  40. 40.
    Cooper Z, Fairburn CG, Hawker DM (2004) Cognitive-behavioral therapy treatment of obesity: a clinician’s guide. The Guilford Press, New YorkGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Clinical Psychology and Psychobiology, Faculty of PsychologyUniversity of BarcelonaBarcelonaSpain
  2. 2.Faculty of Psychology, Education Sciences and SportUniversity Ramon LlullBarcelonaSpain

Personalised recommendations