Examining the Relationships of Increase in Body Mass Index with Mindful Eating, Problem Solving Skills, and Mood Symptoms
Gamze Kılıç, Belemir Şule Samar, Koray Akkuş, Günay Serap Tekinsav SütcüBody mass index (BMI) is commonly used as a determinant of healthy weight, with high values being suggestive of obesity – a highly prevalent public health problem. Identifying the underlying psychological factors of high BMI is critical for preventing and treating obesity. The present study addresses this issue by exploring the relationships BMI has with problem-solving skills, mood symptoms (depression and anxiety), and mindful eating. A demographic information form, the Mindful Eating Questionnaire-30, the Hospital Anxiety and Depression Scale, and the Problem Solving Inventory were used to collect data from 619 study participants aged 18–65 years. First, the participants were divided into two groups based on their BMIs as those who are considered obese and those who are not. The data from the two groups were compared to identify any differences in their anxiety, depression, problem-solving skills, and mindful eating scores. In the next stage, their problem-solving skills, depression, anxiety, and sub-dimensions of mindful eating were tested with regard to being able to predict their BMI. The results revealed that the non-obese individuals scored higher in the sub-dimensions of mindful eating, emotional eating, eating control, conscious eating, and interference and lower in the sub-dimension of awareness compared to the obese individuals. In addition, the non-obese individuals showed fewer symptoms of depression and anxiety and had better problem-solving skills compared to the obese group. The hierarchical regression analysis showed that age, education level, problem-solving skills, depressive symptoms, and the sub-dimensions of mindful eating predict BMI. Moreover, the sub-dimensions of mindful eating were found to positively predict BMI, even when controlling for age, education, and depressive symptoms. The present study has thus identified the detrimental role that depressive symptoms, insufficient problem-solving skills, and problematic eating behaviors have regarding increased BMI. As a result, taking these factors into consideration is thought to be able to benefit prevention and treatment studies.
Beden Kitle İndeksindeki Artış ile Yeme Farkındalığı, Problem Çözme Becerileri ve Duygudurum Belirtileri Arasındaki İlişkilerin İncelenmesi
Gamze Kılıç, Belemir Şule Samar, Koray Akkuş, Günay Serap Tekinsav SütcüBireylerin vücut ağırlıklarının sağlıklı olup olmadığının belirlenmesinde yaygın olarak kullanılan yöntemlerden biri olan beden kitle indeksindeki (BKİ) artış obeziteye işaret etmektedir. Obezite yaygınlığı giderek artan bir halk sağlığı sorunudur. Bu nedenle gelişiminde etkili olan psikolojik faktörlerin belirlenmesi hem önleme hem de tedavi sürecine katkıda bulunabilir. Bu çalışmada BKİ ile problem çözme becerileri, duygudurum belirtileri (depresyon ve kaygı) ve yeme farkındalığı arasındaki ilişkilerin incelenmesi amaçlanmıştır. 18-65 yaş arası toplam 619 katılımcıdan veri toplamak amacıyla Demografik Bilgi Formu, Yeme Farkındalığı Ölçeği-30, Hastane Anksiyete ve Depresyon Ölçeği ve Problem Çözme Envanteri kullanılmıştır. Öncelikli olarak, katılımcılar BKİ’ye göre obezitesi olan ve olmayan bireyler olarak iki gruba ayrılmıştır. Bu iki grubun verileri anksiyete, depresyon, problem çözme becerileri ve yeme farkındalığı puanlarının farklılaşıp farklılaşmadığını tespit etmek amacıyla karşılaştırılmıştır. Ardından problem çözme becerisi, depresyon, anksiyete ve yeme farkındalığının alt boyutlarının BKİ’yi yordayıcılığı test edilmiştir. Analiz sonuçlarına göre obezitesi olmayan bireyler obezitesi olanlara göre düşünmeden yeme, duygusal yeme, yeme kontrolü, bilinçli beslenme ve enterferans alt boyutlarından daha yüksek; farkındalık alt boyutundan ise daha düşük puan almışlardır. Ayrıca obezitesi olmayan grupta depresyon ve kaygı belirtileri anlamlı olarak daha düşüktür ve problem çözme becerileri daha yüksektir. Yapılan hiyerarşik regresyon analizine göre yaş, eğitim düzeyi, problem çözme becerileri, depresyon belirtileri ve yeme farkındalığının alt boyutları BKİ’yi yordamaktadır. Dahası, yaş, eğitim düzeyi ve depresif semptomlar kontrol edildikten sonra dahi yeme farkındalığının alt boyutlarının BKİ’yi pozitif yönde yordadığı belirlenmiştir. Çalışmanın sonuçları depresyon belirtilerinin, yetersiz problem çözme becerilerinin ve sorunlu yeme davranışlarının vücut ağırlığındaki artışa katkıda bulunabileceğini ortaya koymaktadır. Sonuç olarak, yapılan tedavi çalışmalarında bu faktörlerin göz önünde bulundurulması yararlı olabilir.
Obesity is defined as the excessive accumulation of fat in the body and has become increasingly more common all over the world (Arroyo-Johnson & Mincey, 2016; Williams et al., 2015). Body mass index (BMI) is one of the most common indicators of whether someone is overweight or underweight. People with a BMI higher than 30 are considered obese (World Health Organization [WHO], 2021). Studies have reported obesity to be associated with both physical and mental disorders (Cederberg & Laakso, 2014; Husky et al., 2018; McCrea et al., 2012; Rajan & Menon, 2017). Although studies exist that have revealed obesity to have a relationship with depression (Jung et al., 2017), anxiety (Gariepy et al., 2010), problemsolving skills (Fitzpatrick et al., 2013), and mindful eating (Pintado-Cucarella & RodriguezSaldado, 2016), no study to the best of our knowledge has yet occurred in which all these factors are analyzed together. A review of the literature reveals contradictory findings regarding the relationship between problem-solving skills and obesity (see Favieri et al., 2019). Additionally, when considering the relationship between mindful eating and other variables, determining the unique effect of mindful eating on BMI is seen to be important after controlling for all other variables were controlled. The present study investigates the relationships between these variables through a comparison of two different groups (obese and non-obese) and seeks to contribute to the literature by exploring the effects from mindful eating while controlling for all other variables.
Method
After obtaining the required ethical permission for conducting the study, data were collected from 619 participants (483 females, 136 males) aged 18–65 yrs. from different cities in Turkey. The participants were first divided into two groups based on having BMI scores greater than (obese) or less (non-obese) than 30 and then asked to fill out a demographic information form (DIF), the Hospital Anxiety and Depression Scale (HADS; Zigmund & Snaith, 1983), the Problem Solving Inventory (PSI; Heppner & Peterson, 1982), and the Mindful Eating Questionnaire-30 (MEQ-30; Framson et al., 2009). The two groups were compared using ANOVA and MANOVA analyses, and correlation analyses were conducted to examine the relationship the variables have with BMI. Lastly, a hierarchical regression analysis was performed to explore the predictive role the factors of depression, problem-solving skills, and the sub-dimensions of mindful eating have regarding BMI.
Results
Symptoms of depression (F(1, 617) = 13.96, p < .001) and anxiety (F(1, 617) = 4.16, p < .05) were found to be significantly lower and problem-solving skill levels were found to be higher (F(1, 167) = 15.27, p < .001) in the non-obese group. The sub-dimensions of mindful eating were examined using MANOVA, which revealed non-obese individuals to have higher functional scores in the sub-dimensions of mindless eating (F(1, 617) = 52.41, p < .001), emotional eating (F(1, 617) = 25.07, p < .001), eating control (F(1, 617) = 31.4, p < .001), conscious eating (F(1, 617) = 41.88, p < .001), and interference (F(1, 617) = 19.97, p < .001) and lower scores in the sub-dimension of awareness (F(1, 617) = 9.68, p < .007) compared to the obese individuals. Correlation analyses have revealed BMI to not be correlated with anxiety or mindful eating (p > .05) and to be negatively correlated with problem-solving skills at a marginal level (p = .05). Positive correlations were found between BMI and all the other variables. The hierarchical regression analysis included age and education level in the first stage, followed by problem-solving skills in the second stage, depression in the third stage, and mindful eating in the fourth stage. The results indicate age, education level, problem-solving skills, depressive symptoms, and mindful eating to all predict BMI (R2 = .40, F(6, 602) = 41.6, p < .001). Furthermore, the subdimensions of mindful eating positively predict BMI even after controlling for all the other variables.
Discussion
The present study has investigated the relationships BMI has with symptoms of depression and anxiety, problem-solving skills, and mindful eating. Group comparisons (obese and non-obese groups) revealed obese individuals to exhibit more symptoms of depression and anxiety and to have significantly lower scores for problem-solving skills and mindful eating. Obese individuals are more likely to experience health problems and be less physically active, and to have weight gain/loss cycles that are likely associated with their increased depression and anxiety levels (Fabricatore et al., 2005; Faith et al., 2002; Hettema et al., 2001; Sareen et al., 2005). The findings from the present study reveal that those suffering from obesity scored lower in problem-solving, which may indicate that people with poor problem-solving skills resort to eating as a coping method. For this reason, taking problem-solving skills into consideration in future intervention studies would be beneficial. In concurrence with previous studies in the literature, the present study found mindful eating scores (which are based on skills such as starting and ending eating habits, being unaffected by environmental stimuli, conscious and healthy eating, and not eating to regulate emotions) to be lower in obese individuals. Raising awareness of these issues may improve the effectiveness of efforts to prevent and treat obesity.
The results of the present study may also serve as a guide when structuring future intervention programs. Longitudinal studies are needed in the future to better reveal the cause-and-effect relationships among the variables studied as the subjects of this research.
