Schreiber Dana R, Dautovich Natalie D
Department of Psychology, Virginia Commonwealth University, Richmond, VA.
Menopause. 2017 Oct;24(10):1190-1199. doi: 10.1097/GME.0000000000000897.
Obesity is prevalent in midlife women and contributes to poor health outcomes. Understanding mechanisms leading to weight gain in this population is of importance for prevention and intervention. The current study investigated the association between depressive symptoms and weight in midlife women by examining stress eating as a mediator between depressive symptoms and weight; and menopause status as a moderator of the associations of depressive symptoms, stress eating, and weight.
An archival analysis was performed using data from the Midlife in the United States II study. The sample consisted of 815 premenopausal and postmenopausal women. Measures included the Composite International Diagnostic Interview-Short Form, a coping questionnaire, and body mass index.
Moderated mediation analyses were conducted with ordinary least squares path analyses using Hayes' PROCESS macro. Controlling for covariates, depressive symptoms were not directly associated with weight (b = -0.4, 95% confidence interval [CI] -0.4, 0.1). However, stress eating was a significant mediator between depressive symptoms and weight (b = 0.3, 95% CI 0.06, 0.3).The mediation was conditional on menopausal stage (b = 0.2, 95% CI 0.05, 0.4), with depressive symptoms and stress eating significantly associated in postmenopausal, not premenopausal women (b = 0.3, 95% CI 0.2, 0.5).
Both stress eating and menopause status significantly contributed to the depressive symptom-weight association. Psychosocial factors play an important role in the association between depressive symptoms and weight, and the results highlight the need to focus on both behavioral factors, and also menopause status, when identifying who is at risk for the development of poor weight outcomes.
肥胖在中年女性中普遍存在，并导致不良健康后果。了解该人群体重增加的机制对于预防和干预至关重要。本研究通过将情绪化进食作为抑郁症状与体重之间的中介因素，以及将绝经状态作为抑郁症状、情绪化进食和体重之间关联的调节因素，来调查中年女性抑郁症状与体重之间的关联。
使用来自美国中年II期研究的数据进行档案分析。样本包括815名绝经前和绝经后女性。测量指标包括复合国际诊断访谈简表、应对问卷和体重指数。
使用Hayes的PROCESS宏通过普通最小二乘法路径分析进行调节中介分析。在控制协变量后，抑郁症状与体重无直接关联（b = -0.4，95%置信区间[CI] -0.4，0.1）。然而，情绪化进食是抑郁症状与体重之间的显著中介因素（b = 0.3，95% CI 0.06，0.3）。这种中介作用取决于绝经阶段（b = 0.2，95% CI 0.05，0.4），抑郁症状与情绪化进食在绝经后女性中显著相关，而在绝经前女性中不相关（b = 0.3，95% CI 0.2，0.5）。
情绪化进食和绝经状态均对抑郁症状与体重的关联有显著影响。社会心理因素在抑郁症状与体重的关联中起重要作用，研究结果凸显了在确定体重不良后果风险人群时，既要关注行为因素，也要关注绝经状态。
