Perceived Stress Mediates the Relationship of Body Image and Depressive Symptoms in Individuals With Obesity

Abstract

Obesity is a world-wide increasing condition classified by a BMI ≥ 30 kg/m2 that is frequently accompanied by various somatic comorbidities as well as an increased risk for mental comorbidities. Studies show associations of obesity with symptoms of depression, lower quality of life, and higher (perceived) stress compared to the general population. Body image has also been shown to play an important role in eating and weight disorders. The present study therefore aims to contribute to the understanding of the relationship of body image, perceived stress, and symptoms of depression in a morbidly obese population. N = 579 individuals with obesity were included upon presentation at a university clinic. The hypothesized mediating role of perceived stress in the relationship of body image dimensions and symptoms of depression could be confirmed. The results underline the importance of identifying promising stress management techniques and addressing perceived stress e.g. through mindfulness based approaches in the (lifestyle and/or weight) interventions for obesity taking into account the specific stressors of obesity affected individuals such as body image.

Unhealthy Food and Psychological Stress: The Association between Ultra-Processed Food Consumption and Perceived Stress in Working-Class Young Adults

“…Ultra-processed food consumption increases the risk of excessive weight gain and obesity. People with obesity are more frequently dissatisfied with their bodies compared to those with a normal weight, affecting perceived stress [35]. Additionally, a study has shown a positive association between perceived stress and the combination of high unhealthy food consumption, such as junk food, and a negative association with healthy foods, such as fruits and vegetables [36].…”

Effects of Bariatric Surgery on Depression: Role of Body Image

“…So far, a common interpretation of associations between disordered eating, body image, and depression was that obese people have “healthy” body dissatisfaction due to their excess weight that normalizes when they adopt healthy eating habits and normalize their weight. Instead, our study along with other literature [ 8 , 9 , 20 , 21 ] suggests that a subgroup of patients with obesity presents with pathological body image in the sense of body dissatisfaction, overvaluation of weight and shape, and low self-esteem. It is known that these symptoms can even deteriorate after bariatric surgery, since most patients suffer from excess skin [ 22 ].…”

“…It has been suggested that overall psychosocial functioning improves after bariatric surgery [4,7], yet the likelihood of improvement and its mechanism remain unclear. A relevant mechanism of psychosocial functioning in obesity might be the interactions between disordered eating, depression and body image [4,8,9]. The latter is a fundamental aspect of the self-concept, because it is a constant characteristic and includes meaning of the body for self-esteem.…”

A Brief Assessment of Body Image Perception: Norm Values and Factorial Structure of the Short Version of the FKB-20

“…This measure has been applied in numerous studies and clinical settings, showing satisfactory psychometric properties and especially a high sensitivity to change and detect eating disorders, e.g., anorexia nervosa (Löwe and Clement, 1996;Albani et al, 2006a;Mölbert et al, 2018). It was also applied to specify body dysmorphia disorder (Sack et al, 2002;Schieber and Martin, 2016) and measure the effects of different group therapy interventions in patients with multiple sclerosis (Tesar et al, 2003;Veleva et al, 2018), cancer (Grübel, 2003;Esser et al, 2018), a heart attack (Löwe et al, 2002) and obesity (Hotter et al, 2003;Ziser et al, 2019). Besides that, it was revealed that patients with a mental illness or pronounced psychological distress reported higher values on the RBI subscale and lower values on the VBD subscale (Löwe et al, 2003).…”