Stice Eric, Yamamiya Yuko
Stanford University.
Temple University, Japan Campus.
Res Sq. 2025 Aug 6:rs.3.rs-7230160. doi: 10.21203/rs.3.rs-7230160/v1.
BACKGROUND/OBJECTIVES: The evidence that overweight and obesity often cooccur with eating disorders, overeating and binge eating increase risk for future eating disorder onset, and a prevention program that reduces overeating prevents future eating disorder onset suggests factors that increase risk for eating disorders may also increase risk for unhealthy weight gain. We test whether predictors of future eating disorder onset, which include both risk factors and prodromal symptoms, also predict future onset of overweight or obesity.
SUBJECTS/METHODS: Data were collected from 1 952 adolescent girls and young women who completed annual assessments over a 3-year period. Among them, our final sample consisted of 1 669 participants ( age = 19.4, = 4.9) who met the inclusion criteria. Logistic regression models tested whether each established eating disorder risk factor predicted future onset of overweight or obesity. Classification tree analysis tested for interactions among the predictors.
Body dissatisfaction (OR = 1.43, 95% CI [1.23, 1.66], < .001), negative affect (OR = 1.20, 95% CI [1.05, 1.37], = .006), and feeling fat (OR = 1.37, 95% CI [1.19, 1.58], < .001) increased risk for future onset of overweight/obesity and lower-than-expected body weight reduced risk (OR = 0.62, 95% CI [0.37, 0.83], = .014), though only body dissatisfaction (OR = 1.25, 95% CI [1.04, 1.51], = .017) and lower-than-expected body weight (OR = 0.65, 95% CI [0.38, 0.87], = .026) showed unique predictive effects in a multivariate model. The classification tree model indicated that high body dissatisfaction showed the strongest predictive effect, and that elevated negative affect further amplified risk; results also revealed a distinct risk pathway characterized by low psychosocial impairment.
Results identified several risk and protective factors for overweight/obesity onset, which may work together in a synergistic faction to increase risk for overweight/obesity.
背景/目的：超重和肥胖常与饮食失调同时出现，暴饮暴食会增加未来饮食失调发作的风险，一项减少暴饮暴食的预防计划可预防未来饮食失调的发作，这表明增加饮食失调风险的因素也可能增加不健康体重增加的风险。我们测试未来饮食失调发作的预测因素（包括风险因素和前驱症状）是否也能预测超重或肥胖的未来发作。
受试者/方法：数据收集自1952名青春期女孩和年轻女性，她们在3年期间完成了年度评估。其中，我们的最终样本包括1669名符合纳入标准的参与者（年龄=19.4，标准差=4.9）。逻辑回归模型测试了每个已确定的饮食失调风险因素是否能预测超重或肥胖的未来发作。分类树分析测试了预测因素之间的相互作用。
身体不满（比值比=1.43，95%置信区间[1.23，1.66]，P<.001）、消极情绪（比值比=1.20，95%置信区间[1.05，1.37]，P=.006）和感觉肥胖（比值比=1.37，95%置信区间[1.19，1.58]，P<.001）会增加未来超重/肥胖发作的风险，而低于预期的体重则会降低风险（比值比=0.62，95%置信区间[0.37，0.83]，P=.014），不过在多变量模型中只有身体不满（比值比=1.25，95%置信区间[1.04，1.51]，P=.017）和低于预期的体重（比值比=0.65，95%置信区间[0.38，0.87]，P=.026）显示出独特的预测作用。分类树模型表明，高身体不满显示出最强的预测作用，消极情绪升高会进一步放大风险；结果还揭示了一条以低心理社会损害为特征的独特风险途径。
研究结果确定了超重/肥胖发作的几个风险和保护因素，这些因素可能协同作用，增加超重/肥胖的风险。
