Abstract
Obesity is a world-wide increasing condition classified by a BMI ≥ 30 kg/m2 that is frequently accompanied by various somatic comorbidities as well as an increased risk for mental comorbidities. Studies show associations of obesity with symptoms of depression, lower quality of life, and higher (perceived) stress compared to the general population. Body image has also been shown to play an important role in eating and weight disorders. The present study therefore aims to contribute to the understanding of the relationship of body image, perceived stress, and symptoms of depression in a morbidly obese population. N = 579 individuals with obesity were included upon presentation at a university clinic. The hypothesized mediating role of perceived stress in the relationship of body image dimensions and symptoms of depression could be confirmed. The results underline the importance of identifying promising stress management techniques and addressing perceived stress e.g. through mindfulness based approaches in the (lifestyle and/or weight) interventions for obesity taking into account the specific stressors of obesity affected individuals such as body image.
Highlights
The prevalence of obesity has constantly increased in past years [1]
We found perceived stress to be a significant mediator for negative dimensions of body image as well as positive body image dimensions
The mediation model explained a good portion of variance of the relationships of body image dimensions, perceived stress and symptoms of depression in our obese study population
Summary
The prevalence of obesity has constantly increased in past years [1]. The World Health Organization categorizes the severity of obesity in three classes: Having a body mass index (BMI) between 30 and 34.9 kg/m2 corresponds to class I obesity, a BMI between 35 and 39.9 as class II obesity, and a BMI ≥40 as class III obesity [2]. Obesity is often accompanied by various somatic comorbidities such as diabetes mellitus, hypertension or fat metabolism disorders [3]. There is an increased risk for mental comorbidities such as depression or eating disorders [1]. In case of the potential comorbidity of depression, the association between obesity and depressive symptoms seems to be of reciprocal nature [4]. There is evidence that obesity increases the risk for depression [4, 6]. Some studies suggested a linear association between severity of obesity and increased risk of depression and decreased quality of life [7]. Body Image in Obesity did not replicate this observation and suggested a more complex association [8]. A possible explanation for these incoherent observations is that psychological variables rather than weight alone drive the associations between BMI and depression
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