Alpert Medical School of Brown University & Weight Control and Diabetes Research Center, The Miriam Hospital, United States of America.
Department of Psychiatry, Columbia University Irving Medical Center & New York State Psychiatric Institute, United States of America.
Eat Behav. 2020 Aug;38:101402. doi: 10.1016/j.eatbeh.2020.101402. Epub 2020 May 22.
Stress negatively impacts adolescent weight status and eating behaviors. Previous research investigating this association has focused on traumatic events in childhood, but little is known about the impact of commonly experienced stressful life events and weight-related outcome. The aim of this cross-sectional study was to examine the association between negative life events and weight-related outcomes (i.e., weight status, disordered eating behaviors, insulin sensitivity) in a sample of treatment-seeking adolescents with overweight and obesity. A further aim of the study was to examine the potential mediating role of depression.
Adolescents (N = 170; M age = 14.8; 62% female) presenting to an interdisciplinary weight management program completed measures related to negative life events, disordered eating patterns, and depressive symptoms prior to initiating treatment. Weight status and insulin sensitivity (using fasting glucose and fasting insulin) were objectively measured.
Stressful experiences during childhood were significantly related to weight status, F = 2.78, p < .05, and disordered eating, F = 5.51, p < .001, in regression analyses. Stressful life events were not related to insulin sensitivity. Depressive symptoms mediated the association between stressful experiences and disordered eating (b = 0.001, [CI = 0.0002, 0.0011]). Depressive symptoms did not mediate this association for weight status or insulin sensitivity.
Findings from the present study suggest that relatively common stressful events may be associated with development of disordered eating patterns in adolescents with overweight or obesity presenting to treatment. Providers working in weight management settings should consider assessing a range of potentially stressful life events and their potential weight-related implications.
压力对青少年的体重状况和饮食习惯有负面影响。以前研究这一关联的研究集中在儿童时期的创伤事件上,但对于常见的压力生活事件和与体重相关的结果之间的影响知之甚少。本横断面研究的目的是在寻求超重和肥胖治疗的青少年样本中,研究负面生活事件与与体重相关的结果(即体重状况、饮食失调行为、胰岛素敏感性)之间的关联。研究的另一个目的是检验抑郁的潜在中介作用。
在开始治疗之前,向参加跨学科体重管理计划的青少年(N=170;M 年龄=14.8;62%为女性)完成了与负面生活事件、饮食失调模式和抑郁症状相关的测量。客观测量体重状况和胰岛素敏感性(使用空腹血糖和空腹胰岛素)。
在回归分析中,童年时期的压力经历与体重状况显著相关,F=2.78,p<0.05,与饮食失调显著相关,F=5.51,p<0.001。压力生活事件与胰岛素敏感性无关。抑郁症状中介了压力经历与饮食失调之间的关联(b=0.001,[CI=0.0002,0.0011])。抑郁症状并未对体重状况或胰岛素敏感性的这种关联进行中介。
本研究的结果表明,超重或肥胖青少年在接受治疗时,相对常见的压力事件可能与饮食失调模式的发展有关。在体重管理环境中工作的提供者应考虑评估一系列潜在的压力生活事件及其潜在的与体重相关的影响。