The Mediating Effects of Eating Disorder, Food Addiction, and Insomnia in the Association between Psychological Distress and Being Overweight among Iranian Adolescents

Abstract

With obesity and excess weight remaining a serious concern worldwide, investigating the mechanisms underlying this is of great importance. Psychological distress is a possible trigger contributing to excess weight for adolescents. Moreover, the association between psychological distress and excess weight may be mediated by eating disorder, food addiction, and insomnia. The present study utilized parallel mediation analysis to assess the aforementioned associations and possible mediation effects among Iranian adolescents. Through stratified and clustered sampling, adolescents (N = 861; mean ± SD age = 15.9 ± 3.2; 372 males) participated and were followed for a one-year period. Excess weight (standardized body mass index, z-BMI); psychological distress (Depression, Anxiety, and Stress Scale-21); eating disorder attitudes (Eating Attitude Test-26); food addiction (Yale Food Addiction Scale for Children); and insomnia (Insomnia Severity Index) were assessed. Eating disorder attitudes, food addiction, and insomnia were significant mediators in the association of psychological distress and z-BMI. Additionally, psychological distress had direct effects on z-BMI. Given that eating disorder attitudes, food addiction, and insomnia showed mediated effects in the temporal association of psychological distress and excess weight, healthcare providers are encouraged to design programs on improving these three mediators to help adolescents overcome excess weight problems.

Prevalence of food addiction in children and adolescents: A systematic review and meta‐analysis

“…Kappa for the abstract review was 0.88 (95% CI; 0.77–0.98), and Kappa for the full text review was 0.92 (95% CI; 0.84–0.99). All 22 studies were cross‐sectional 24,28–48 . No longitudinal studies were identified in the search.…”

“…Prevalence of FA as determined using the YFAS‐C has been reported in 18 publications 24,28–32,34–39,41,42,45–48 (Table 2). The meta‐analysis estimated an overall FA prevalence at 15% (95% CI: 11–19%) among children and adolescents, with an I 2 of 95.64%.…”

“…The mean YFAS‐C score was calculated to be 2.06 (95% CI: 1.66–2.46) among the 12 studies 24,32,34–36,38,39,41,44,45,47,48 that reported the mean scores (Table 3). Heterogeneity ( I 2 ) index was 98.8%.…”

“…Given limited information on the prevalence of FA among children and adolescents, the present systematic review and meta‐analysis assessed FA in this population. After identifying 22 studies 24,28–48 with a total of 6,996 participants, the prevalence of FA found in children and adolescents was relatively high (15%; 95% CI 11–19%). Moreover, the analyzed studies were published recently, with the earliest study published in 2013 25 and the remaining 21 studies published in the past 5 years 28–48 .…”

Psychological correlates of eating behavior in overweight/obese adolescents in Taiwan: Psychometric and correlation analysis of the Three-Factor Eating Questionnaire (TFEQ)-R21

“…That is, if body image issues and anxiety have an adverse impact on weight gain among adolescents, the association could be via the mediation effect of eating behaviors. 33 Understanding these risk factors for disordered eating behavior in an obesogenic context is imperative in the weight management context.…”