Alexithymia and metabolic syndrome: the mediating role of binge eating

Chiara Conti,Katie Richards,Melania Severo,Piero Porcelli,Maria Teresa Guagnano,Giulia Di Francesco,Roberta Lanzara

doi:10.1007/s40519-020-00964-x

Abstract

PurposeAlexithymia, a personality trait characterized by difficulties in emotional processing, has been associated with unhealthy behaviors and chronic medical conditions. This study aimed to further develop our understanding of this complex relationship by investigating whether alexithymia increases the risk of metabolic syndrome (MetS) in participants with obesity or overweight through the mediating role of binge eating (BE).MethodsA consecutive sample of 238 treatment-seeking patients with obesity or overweight were recruited. Alexithymia (TAS-20), binge eating symptoms (BES), body mass index (BMI), and depression and anxiety symptoms (HADS) were concurrently assessed.ResultsAlmost half of the participants met the criteria for MetS (44.12%). Compared to patients without MetS, those with MetS were older, had a longer duration of overweight, and had a higher BMI (p < 0.01). Individual with MetS also had higher HADS, BES, and TAS-20 scores, particularly difficulty identifying and describing feelings. The structural equation modeling (SEM) analysis revealed that BES levels exerted a significant direct effect on MetS (p < 0.01), and that TAS-20 levels exerted a significant direct effect on BES (p < 0.01), anxiety (p < 0.001) and depression (p < 0.001). Moreover, psychological distress (anxiety, p = 0.01, and depression, p = .05) indirectly affected MetS through the mediating effect of BES, and TAS-20 (p = 0.01) indirectly affected MetS through the mediating effect of HADS and BES. Finally, age had a significant direct effect on MetS (p < 0.001).ConclusionOur findings indicate that alexithymia is a concurrent causative factor to the development of MetS through the mediating role of BE and psychological distress.Level of evidenceLevel III, case–control analytic study.

Highlights

Both obesity and metabolic syndrome (MetS) are growing public health problems [1]
We aimed to explore the association between alexithymia and MetS by including maladaptive eating behavior and psychological distress as mediating factors
The present study investigated whether alexithymia may constitute a potential risk factor for the development of MetS in outpatients with obesity or overweight, and whether a Binge eating (BE) behavioral pattern and psychological distress may play a mediating role

Summary

Introduction

Both obesity and metabolic syndrome (MetS) are growing public health problems [1]. The prevalence of both conditions has increased dramatically in industrialized countries over the past 30 years [2]. MetS is highly prevalent among adults, ranging 7–34% in men and 5–22% in women [6], but can affect children and adolescents. Several of the identified causes and risk factors for obesity and MetS are related to unhealthy lifestyles, such as poor dietary patterns, sedentary lifestyle, and decreases or increases in sleep duration [10]

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