A new model of the role of psychological and emotional distress in promoting obesity: conceptual review with implications for treatment and prevention

Abstract

The lack of significant treatment and prevention progress highlights the need for a more expanded strategy. Given the robust association between socioeconomic factors and obesity, combined with new insights into how socioeconomic disadvantage affects both behaviour and biology, a new causal model is proposed. The model posits that psychological and emotional distress is a fundamental link between socioeconomic disadvantage and weight gain. At particular risk are children growing up in a disharmonious family environment, mainly caused by parental socioeconomic disadvantage, where they are exposed to parental frustrations, relationship discord, a lack of support and cohesion, negative belief systems, unmet emotional needs and general insecurity. Without adequate resilience, such experiences increase the risk of psychological and emotional distress, including low self-esteem and self-worth, negative emotions, negative self-belief, powerlessness, depression, anxiety, insecurity and a heightened sensitivity to stress. These inner disturbances eventually cause a psycho-emotional overload, triggering a cascade of weight gain-inducing effects including maladaptive coping strategies such as eating to suppress negative emotions, chronic stress, appetite up-regulation, low-grade inflammation and possibly reduced basal metabolism. Over time, this causes obesity, circular causality and further weight gain. Tackling these proposed root causes of weight gain could potentially improve both treatment and prevention outcomes.

The Three-Factor Eating Questionnaire-R18 Polish version: factor structure analysis among normal weight and obese adult women

“…In addition, obesity signifies non-adaptive coping strategies and the regulation of emotional state through food [54]. There is a high probability that due to strong stigmatization and alienation, individuals with obesity are faced with negative emotions and cope by engaging in (emotional) eating [55][56][57][58].…”

Adult Neurogenesis and Mental Illness

“…One possibility is that impoverished standard rodent cage environments model low socioeconomic status (Milgram et al, 2006). It has long been thought that socioeconomic status contributes to mental health, with higher prevalence of depression, anxiety, and schizophrenia in lower-income populations (Hemmingsson, 2014;Holzer et al, 1986;Kessler et al, 1994;Zimmerman and Katon, 2005). The specific environmental features responsible for the risk are difficult to delineate, however.…”

The role of emotion regulation in childhood obesity: implications for prevention and treatment

“…The potential role of psychological and emotional distress in obesity development has been less extensively researched (3) , but a generally positive relationship was found between negative affect or stress in children and weight gain (see Table 1) . This is particularly relevant because mental disorders affect 10-20 % of children and adolescents worldwide (28) and 47·7 % of the children in a European study presented psychosomatic or emotional symptoms (29) .…”

“…First, it has been assumed that the associations between stress and obesity share genetic factors like polymorphism on the serotonin 5-HT 2C receptor gene, monoamine oxidase A, serotonin transporter gene or the fat mass and obesity associated gene (FTO gene) (160)(161)(162) . In addition, a recent review suggested that socio-economic disadvantages and family disharmony are a common starting point for weight gain and psychological distress in children (3) . At the same time, several prenatal, perinatal and postnatal factors (for example, toxics exposure, maternal nutrition, maternal stress, maternal psychopathology and negative events during early life) have been identified as obesity and/or neurodevelopmental risk factors (161,163,164) .…”