Skip to main content

Advertisement

SpringerLink
Log in

Emotion dysregulation and pediatric obesity: investigating the role of Internet addiction and eating behaviors on this relationship in an adolescent sample

  • Original Article
  • Published:
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

Abstract

Objective

The first aim was to investigate whether there was a mediator role of Internet addiction or uncontrolled/emotional eating on the association between emotion dysregulation and body mass index-standard deviation score (BMI-SDS). The second aim was to detect which of these variables (emotion dysregulation, Internet addiction, and uncontrolled/emotional eating) significantly affect the presence of obesity (OB).

Methods

A total of 123 adolescents (OB (n = 65, 57% of girls, mean age = 15 ± 1.9, BMI percentile between 95 and 99) and healthy control (HC) (n = 58; 53% of girls, mean age = 15.5 ± 1.8, BMI percentile between 1 and 84) aged between 11 and 18 were recruited. Difficulties in Emotion Regulation Scale (DERS) and Internet Addiction Test (IAT) were completed by adolescents. Uncontrolled and emotional eating behaviors were measured by Three Factors Eating Questionnaire (TFE-Q)’s sub-domains.

Results

There was no significant direct effect of DERS on BMI-SDS, whereas the indirect effect of DERS on BMI-SDS which was mediated by both IAT and TFE-Q was statistically significant. In logistic regression analysis, an increase by 1 point in DERS total score escalated the odds of being OB by 2%. Moreover, a 22-fold increased risk of OB has been detected in moderate/severe Internet addiction compared to no addiction.

Conclusion

This cross-sectional study showed that the association between emotion dysregulation and BMI-SDS was totally mediated by internet addiction and uncontrolled/emotional eating. In addition, emotion dysregulation and Internet addiction were significant determinants of OB. A prospective study is needed to detect the causal relationship between these variables.

Level of evidence

Level III, case–control analytic study.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. World Health Organization (2016) Consideration of the evidence on childhood obesity for the commission on ending childhood obesity: report of the ad hoc working group on science and evidence for ending childhood obesity. Switzerland, Geneva

    Google Scholar 

  2. Bhadoria A, Sahoo K, Sahoo B et al (2015) Childhood obesity: Causes and consequences. J Family Med Prim Care. https://doi.org/10.4103/2249-4863.154628

    Article  PubMed  PubMed Central  Google Scholar 

  3. Wang Y, Cai L, Wu Y et al (2015) What childhood obesity prevention programmes work? A systematic review and meta-analysis: childhood obesity prevention. Obes Rev. https://doi.org/10.1111/obr.12277

    Article  PubMed  PubMed Central  Google Scholar 

  4. Gratz KL, Roemer L (2004) Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the difficulties in emotion regulation scale. J Psychopathol Behav Assess 26:41–54

    Article  Google Scholar 

  5. Gross JJ (2008) Handbook of emotion regulation. Guilford, London

    Google Scholar 

  6. Monell E, Clinton D, Birgegård A (2018) Emotion dysregulation and eating disorders-associations with diagnostic presentation and key symptoms. Int J Eat Disord. https://doi.org/10.1002/eat.22925

    Article  PubMed  Google Scholar 

  7. Fernandes J, Ferreira-Santos F, Miller K, Torres S (2018) Emotional processing in obesity: a systematic review and exploratory meta-analysis: emotional processing in obesity. Obes Rev. https://doi.org/10.1111/obr.12607

    Article  PubMed  Google Scholar 

  8. Gade H, Hjelmesæth J, Rosenvinge JH, Friborg O (2014) Effectiveness of a cognitive behavioral therapy for dysfunctional eating among patients admitted for bariatric surgery: a randomized controlled trial. J Obes. https://doi.org/10.1155/2014/127936

    Article  PubMed  PubMed Central  Google Scholar 

  9. van Strien T, Beijers R, Smeekens S et al (2019) Parenting quality in infancy and emotional eating in adolescence: Mediation through emotion suppression and alexithymia. Appetite. https://doi.org/10.1016/j.appet.2019.104339

    Article  PubMed  Google Scholar 

  10. van Strien T (2018) Causes of emotional eating and matched treatment of obesity. Curr Diab Rep. https://doi.org/10.1007/s11892-018-1000-x

    Article  PubMed  PubMed Central  Google Scholar 

  11. Leehr EJ, Krohmer K, Schag K et al (2015) Emotion regulation model in binge eating disorder and obesity—a systematic review. Neurosci Biobeha Rev. https://doi.org/10.1016/j.neubiorev.2014.12.008

    Article  Google Scholar 

  12. Koenders PG, van Strien T (2011) Emotional eating, rather than lifestyle behavior, drives weight gain in a prospective study in 1562 employees. J Occup Environ Med 53:1287–1293

    Article  PubMed  Google Scholar 

  13. Sung J, Lee K, Song Y-M (2009) Relationship of eating behavior to long-term weight change and body mass index: the Healthy Twin study. Eat Weight Disord. https://doi.org/10.1007/BF03327806

    Article  PubMed  Google Scholar 

  14. van Strien T, Peter Herman C, Verheijden MW (2012) Eating style, overeating and weight gain. A prospective 2-year follow-up study in a representative Dutch sample. Appetite. https://doi.org/10.1016/j.appet.2012.08.009

    Article  PubMed  Google Scholar 

  15. Jones J, Kauffman BY, Rosenfield D et al (2019) Emotion dysregulation and body mass index: the explanatory role of emotional eating among adult smokers. Eat Behav. https://doi.org/10.1016/j.eatbeh.2019.05.003

    Article  PubMed  PubMed Central  Google Scholar 

  16. Pink AE, Lee M, Price M, Williams C (2019) A serial mediation model of the relationship between alexithymia and BMI: the role of negative affect, negative urgency and emotional eating. Appetite. https://doi.org/10.1016/j.appet.2018.11.014

    Article  PubMed  Google Scholar 

  17. Association AP et al (2013) Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub, USA

    Book  Google Scholar 

  18. Kelly NR, Tanofsky-Kraff M, Vannucci A et al (2016) Emotion dysregulation and loss-of-control eating in children and adolescents. Health Psychol. https://doi.org/10.1037/hea0000389

    Article  PubMed  PubMed Central  Google Scholar 

  19. Tanofsky-Kraff M, Yanovski SZ, Schvey NA et al (2009) A prospective study of loss of control eating for body weight gain in children at high risk for adult obesity. Int J Eat Disord. https://doi.org/10.1002/eat.20580

    Article  PubMed  PubMed Central  Google Scholar 

  20. Goldschmidt AB, Lavender JM, Hipwell AE et al (2017) Emotion regulation and loss of control eating in community-based adolescents. J Abnorm Child Psychol. https://doi.org/10.1007/s10802-016-0152-x

    Article  PubMed  PubMed Central  Google Scholar 

  21. Young KS (1998) Internet Addiction: The emergence of a new clinical disorder. Cyberpsychol Behav. https://doi.org/10.1089/cpb.1998.1.237

    Article  Google Scholar 

  22. Aghasi M, Matinfar A, Golzarand M et al (2019) Internet use in relation to overweight and obesity: a systematic review and meta-analysis of cross-sectional studies. Adv Nutr. https://doi.org/10.1093/advances/nmz073

    Article  PubMed Central  Google Scholar 

  23. Bozkurt H, Özer S, Şahin S, Sönmezgöz E (2018) Internet use patterns and internet addiction in children and adolescents with obesity. Pediatr Obes 13:301–306

    Article  CAS  PubMed  Google Scholar 

  24. Canan F, Yildirim O, Ustunel TY et al (2014) The relationship between internet addiction and body mass index in Turkish adolescents. Cyberpsychol Behav Soc Netw. https://doi.org/10.1089/cyber.2012.0733

    Article  PubMed  Google Scholar 

  25. Li M, Deng Y, Ren Y et al (2014) Obesity status of middle school students in Xiangtan and its relationship with internet addiction: obesity and Internet Addiction. Obesity. https://doi.org/10.1002/oby.20595

    Article  PubMed  Google Scholar 

  26. Spada MM, Marino C (2017) Metacognitions and emotion regulation as predictors of problematic internet use in adolescents. Clin Neuropsychiatry 14:59–63

    Google Scholar 

  27. Percinel I, Ozbaran B, Kose S et al (2018) Increased deficits in emotion recognition and regulation in children and adolescents with exogenous obesity. World J Biol Psychia. https://doi.org/10.1080/15622975.2016.1265147

    Article  Google Scholar 

  28. Mo PKH, Chan VWY, Chan SW, Lau JTF (2018) The role of social support on emotion dysregulation and internet addiction among Chinese adolescents: a structural equation model. Addict Behav. https://doi.org/10.1016/j.addbeh.2018.01.027

    Article  PubMed  Google Scholar 

  29. Tabatabaee HR, Rezaianzadeh A, Jamshidi M (2018) Mediators in the relationship between internet addiction and body mass index: a path model approach using partial least square. J Res Health Sci 18:e00423

    PubMed  PubMed Central  Google Scholar 

  30. Megalakaki O, Mouveaux M, Hubin-Gayte M, Wypych L (2013) Body image and cognitive restraint are risk factors for obesity in French adolescents. Eat Weight Disord. https://doi.org/10.1007/s40519-013-0027-x

    Article  PubMed  Google Scholar 

  31. Dinsdale H, Ridler C, Ells L (2011) A simple guide to classifying body mass index in children. National Obesity Observatory, Oxford

    Google Scholar 

  32. Neyzi O, Bundak R, Gökçay G et al (2015) Reference values for weight, height, head circumference, and body mass index in Turkish children. J Clin Res Pediatr Endocrinol 7:280

    Article  PubMed  PubMed Central  Google Scholar 

  33. Ünal GBTY, F, Pehlivantürk B, Kültür EÇ, Akdemir D, (2004) Reliability and validity of schedule for affective disorders and schizophrenia for school age children-present and lifetime version-turkish version (K-SADS-PL-T). Turk J Child Adolesc Ment Health 11:109–116

    Google Scholar 

  34. Kirac D, Kaspar E, Avcilar T et al (2015) A new method for investigating eating behaviours related with obesity: three-factor eating questionnaire. Clin Exp Health Sci. https://doi.org/10.5455/musbed.20150602015512

    Article  Google Scholar 

  35. Sarıtaş-Atalar D, Gençöz T, Özen A (2015) Confirmatory factor analyses of the difficulties in emotion regulation scale (DERS) in a Turkish adolescent sample. Eur J Psychol Assess. https://doi.org/10.1027/1015-5759/a000199

    Article  Google Scholar 

  36. Boysan M, Kuss DJ, Barut Y et al (2017) Psychometric properties of the Turkish version of the Internet Addiction Test (IAT). Addict Behav. https://doi.org/10.1016/j.addbeh.2015.09.002

    Article  PubMed  Google Scholar 

  37. Garson GD (2016) Partial least squares: regression and structural equation models. Statistical Associates Publishers, North Carolina

    Google Scholar 

  38. Chin WW et al (1998) The partial least squares approach to structural equation modeling. In: Marcoulides GA (ed) Modern methods for business research, 1st edn. Psychology Press, Newyork

    Google Scholar 

  39. Gaetano J (2013) Holm-Bonferroni sequential correction: an excel calculator—Ver. 1.2. https://bit.ly/2vaUu3y. Accessed 22 Aug 2020

  40. Dijkstra TK, Henseler J (2015) Consistent and asymptotically normal PLS estimators for linear structural equations. Comput Stat Data An 81:10–23. https://doi.org/10.1016/j.csda.2014.07.008

    Article  Google Scholar 

  41. Bariola E, Gullone E, Hughes EK (2011) Child and adolescent emotion regulation: the role of parental emotion regulation and expression. Clin Child Fam Psychol Rev. https://doi.org/10.1007/s10567-011-0092-5

    Article  PubMed  Google Scholar 

  42. Braden A, Rhee K, Peterson CB et al (2014) Associations between child emotional eating and general parenting style, feeding practices, and parent psychopathology. Appetite. https://doi.org/10.1016/j.appet.2014.04.017

    Article  PubMed  Google Scholar 

  43. Tanofsky-Kraff M, Cohen ML, Yanovski SZ et al (2006) A prospective study of psychological predictors of body fat gain among children at high risk for adult obesity. Pediatrics 117:1203–1209

    Article  PubMed  Google Scholar 

  44. Pettorruso M, Valle S, Cavic E et al (2020) Problematic Internet use (PIU), personality profiles and emotion dysregulation in a cohort of young adults: trajectories from risky behaviors to addiction. Psychiatry Res. https://doi.org/10.1016/j.psychres.2020.113036

    Article  PubMed  Google Scholar 

  45. Dogan H, Bozgeyikli H, Bozdas C (2015) Perceived parenting styles as predictor of internet addiction in adolescence. Int J Sci Res. https://doi.org/10.21890/ijres.87952

    Article  Google Scholar 

  46. Xiuqin H, Huimin Z, Mengchen L et al (2010) Mental health, personality, and parental rearing styles of adolescents with internet addiction disorder. Cyberpsychol Behav Soc Netw. https://doi.org/10.1089/cyber.2009.0222

    Article  PubMed  Google Scholar 

  47. Blasi MD, Giardina A, Giordano C et al (2019) Problematic video game use as an emotional coping strategy: evidence from a sample of MMORPG gamers. J Behav Addict. https://doi.org/10.1556/2006.8.2019.02

    Article  PubMed  PubMed Central  Google Scholar 

  48. Wu CST, Wong HT, Yu KF et al (2016) Parenting approaches, family functionality, and internet addiction among Hong Kong adolescents. BMC Pediatr. https://doi.org/10.1186/s12887-016-0666-y

    Article  PubMed  PubMed Central  Google Scholar 

  49. Kim Y, Park JY, Kim SB et al (2010) The effects of Internet addiction on the lifestyle and dietary behavior of Korean adolescents. Nutr Res Pract. https://doi.org/10.4162/nrp.2010.4.1.51

    Article  PubMed  PubMed Central  Google Scholar 

  50. Lissau I, Sørensen TIA, Lissau I (1994) Parental neglect during childhood and increased risk of obesity in young adulthood. The Lancet. https://doi.org/10.1016/S0140-6736(94)91163-0

    Article  Google Scholar 

  51. Rhee KE (2006) Parenting styles and overweight status in first grade. Pediatrics. https://doi.org/10.1542/peds.2005-2259

    Article  PubMed  Google Scholar 

  52. Vollmer RL, Mobley AR (2013) Parenting styles, feeding styles, and their influence on child obesogenic behaviors and body weight. A review Appetite 71:232–241

    Article  PubMed  Google Scholar 

  53. Baker KD, Loughman A, Spencer SJ, Reichelt AC (2017) The impact of obesity and hypercaloric diet consumption on anxiety and emotional behavior across the lifespan. Neurosci Biobehav Rev. https://doi.org/10.1016/j.neubiorev.2017.10.014

    Article  PubMed  Google Scholar 

  54. Li G, Hou G, Yang D et al (2019) Relationship between anxiety, depression, sex, obesity, and internet addiction in Chinese adolescents: a short-term longitudinal study. Addict Behav. https://doi.org/10.1016/j.addbeh.2018.12.009

    Article  PubMed  PubMed Central  Google Scholar 

  55. Goossens L, Braet C, Van Vlierberghe L, Mels S (2009) Loss of control over eating in overweight youngsters: the role of anxiety, depression and emotional eating. Eur Eat Disord Rev. https://doi.org/10.1002/erv.892

    Article  PubMed  Google Scholar 

  56. Volkow ND, Wang G-J, Tomasi D, Baler RD (2013) Obesity and addiction: neurobiological overlaps: overlaps between drug and food addiction. Obes Rev. https://doi.org/10.1111/j.1467-789X.2012.01031.x

    Article  PubMed  Google Scholar 

  57. Kuss DJ, Griffiths MD (2012) Internet and gaming addiction: a systematic literature review of neuroimaging studies. Brain Sci. https://doi.org/10.3390/brainsci2030347

    Article  PubMed  PubMed Central  Google Scholar 

  58. Lee NM, Carter A, Owen N, Hall WD (2012) The neurobiology of overeating: treating overweight individuals should make use of neuroscience research, but not at the expense of population approaches to diet and lifestyle. EMBO Rep. https://doi.org/10.1038/embor.2012.115

    Article  PubMed  PubMed Central  Google Scholar 

  59. Martin RE, Ochsner KN (2016) The neuroscience of emotion regulation development: implications for education. Curr Opin Behav Sci. https://doi.org/10.1016/j.cobeha.2016.06.006

    Article  PubMed  PubMed Central  Google Scholar 

  60. Ricca V, Castellini G, Mannucci E et al (2010) Comparison of individual and group cognitive behavioral therapy for binge eating disorder. A randomized, three-year follow-up study. Appetite. https://doi.org/10.1016/j.appet.2010.09.019

    Article  PubMed  Google Scholar 

Download references

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry, Ministry of Health Ankara City Hospital, Bilkent, Üniversiteler, Bilkent Blv. No:1, 06800, Ankara, Turkey

    Helin Yilmaz Kafali, Serap Akpinar, Merve Erguven Demirtas & Ozden Sukran Uneri

  2. Department of Child Endocrinology, Ministry of Health Ankara City Hospital, Ankara, Turkey

    Seyit Ahmet Uçaktürk & Eda Mengen

  3. Department of Child and Adolescent Psychiatry, Ankara Yildirim Beyazit University, Ankara, Turkey

    Ozden Sukran Uneri

Authors
  1. Helin Yilmaz Kafali
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Seyit Ahmet Uçaktürk
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Eda Mengen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Serap Akpinar
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Merve Erguven Demirtas
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ozden Sukran Uneri
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Helin Yilmaz Kafali.

Ethics declarations

Conflict of interest

The authors declared no conflict of interest.

Ethical approval

The Ethics Committee of the Ministry of Health Ankara City Hospital approved the current study (E1/199/2019). Patients and parents were verbally informed on the design of the study, and written informed consent forms in accordance with the Declaration of Helsinki were obtained from both of them.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yilmaz Kafali, H., Uçaktürk, S.A., Mengen, E. et al. Emotion dysregulation and pediatric obesity: investigating the role of Internet addiction and eating behaviors on this relationship in an adolescent sample. Eat Weight Disord 26, 1767–1779 (2021). https://doi.org/10.1007/s40519-020-00999-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40519-020-00999-0

Keywords

Search

Navigation