The interplay between emotion dysregulation, psychological distress, emotional eating, and weight status: A path model

Background/objective: The aim of the current cross-sectional study is to assess the relations between emotion dysregulation, psychological distress, emotional eating, and BMI in a sample of Italian young adults (20-35).Methods: A total sample of 600 participants frm the general population, were asked to fill in demographical and physical data, the Difficulties in Emotion Regulation Scale, the Depression Anxiety and Stress Scale, and the Emotional Eating subscale of the Dutch Eating Behavior Questionnaire via an online anonymous survey. Relations between variables have been inspected using a path model. Results: Results showed that emotion dysregulation was a contributor to higher levels of psychological distress [b= 0.348; SE: 0.020; p=<0.001; 95% BC-CI (0.306–0.387)] and emotional eating [b= 0.010; SE: 0.002; p=<0.001; 95% BC-CI (0.006–0.014)] which in turn, was related to higher Body Mass Index [b= 0.0574; SE: 0.145; p=<0.001; 95% BC-CI (0.286–0.863)]. Conclusions: By providing additional evidence concerning the role of emotion dysregulation for physical and psychological outcomes, the current study could inform for improving psychological interventions aimed to promote emotion regulation strategies aimed at fostering physical and psychological well-being. (AU)

The interplay between emotion dysregulation, psychological distress, emotional eating, and weight status: A path model.

Background/objective: The aim of the current cross-sectional study is to assess the relations between emotion dysregulation, psychological distress, emotional eating, and BMI in a sample of Italian young adults (20-35). Methods: A total sample of 600 participants frm the general population, were asked to fill in demographical and physical data, the Difficulties in Emotion Regulation Scale, the Depression Anxiety and Stress Scale, and the Emotional Eating subscale of the Dutch Eating Behavior Questionnaire via an online anonymous survey. Relations between variables have been inspected using a path model. Results: Results showed that emotion dysregulation was a contributor to higher levels of psychological distress [b= 0.348; SE: 0.020; p=<0.001; 95% BC-CI (0.306-0.387)] and emotional eating [b= 0.010; SE: 0.002; p=<0.001; 95% BC-CI (0.006-0.014)] which in turn, was related to higher Body Mass Index [b= 0.0574; SE: 0.145; p=<0.001; 95% BC-CI (0.286-0.863)]. Conclusions: By providing additional evidence concerning the role of emotion dysregulation for physical and psychological outcomes, the current study could inform for improving psychological interventions aimed to promote emotion regulation strategies aimed at fostering physical and psychological well-being.

Corrigendum: The mediating role of psychological inflexibility in the relationship between anxiety, depression, and emotional eating in adult individuals with obesity.

[This corrects the article DOI: 10.3389/fpsyg.2022.861341.].

Preliminary Results from the ACTyourCHANGE in Teens Protocol: A Randomized Controlled Trial Evaluating Acceptance and Commitment Therapy for Adolescents with Obesity.

The study shows preliminary results of "The ACTyourCHANGE in Teens" project, a Randomized Controlled Trial aimed at evaluating the efficacy of an Acceptance and Commitment Therapy-based intervention combined with treatment as usual (ACT+TAU) compared to TAU only, for improving psychological well-being, psychological distress, experiential avoidance and fusion, emotion dysregulation, and emotional eating in a sample of 34 in-patient adolescents with obesity (Body Mass Index > 97th centile). Mixed between-within 2 × 2 repeated-measures analyses of variances (ANOVAs) were carried out to examine the changes in psychological conditions of participants over time. Moderation analyses were also conducted to test whether pre-test anxiety, depression, stress, and experiential avoidance and fusion predicted emotional eating at post-test with groups (ACT+TAU vs. TAU only) as moderators. Only a significant interaction effect (time × group) from pre- to post-test (p = 0.031) and a significant main effect of time on anxiety (p < 0.001) and emotional eating (p = 0.010) were found. Only in the TAU only group were higher levels of depression (p = 0.0011), stress (p = 0.0012), and experiential avoidance and fusion (p = 0.0282) at pre-test significantly associated with higher emotional eating at post-test. Although future replication and improvements of the study may allow us to obtain more consistent results, this preliminary evidence is actually promising.

The Mediating Role of Psychological Inflexibility in the Relationship Between Anxiety, Depression, and Emotional Eating in Adult Individuals With Obesity.

The aim of this cross-sectional study is to investigate the role of psychological inflexibility in the relationship between anxiety and depression and emotional eating in a sample of 123 inpatient Italian adult individuals with obesity. Participants completed the Anxiety and Depression subscales of the Psychological General Well-Being Inventory, the Acceptance and Action Questionnaire, and the Emotional Eating subscale of the Dutch Eating Behavior Questionnaire to assess anxiety and depression, psychological inflexibility, and emotional eating, respectively. Results showed that the indirect effect of PGWBI-A on DEBQ-EE through AAQ-II was significant [b = -0.0155; SE = 0.076; 95% BC-CI (-0.0320 to -0.023)]. Similarly, the indirect effect of PGWBI-D on DEBQ-EE through AAQ-II was significant [b = -0.0383; SE = 0.0207; 95% BC-CI (-0.0810 to -0.0002)]. These findings may help to plan and develop specific psychological interventions aimed at addressing emotional eating through targeting psychological inflexibility to be included in obesity treatment programs.

ACTonFood. Acceptance and Commitment Therapy-Based Group Treatment Compared to Cognitive Behavioral Therapy-Based Group Treatment for Weight Loss Maintenance: An Individually Randomized Group Treatment Trial.

The purpose of this Individually Randomized Group Treatment Trial was to compare an Acceptance and Commitment Therapy-based (ACT) group intervention and a Cognitive Behavioral Therapy-based (CBT) group intervention for weight loss maintenance in a sample of adult patients with obesity seeking treatment for weight loss. One hundred and fifty-five adults (BMI: Kg/m2 = 43.8 [6.8]) attending a multidisciplinary rehabilitation program for weight loss were randomized into two conditions: ACT and CBT. Demographical, physical, and clinical data were assessed at the beginning of the program (t0), at discharge (t1), and at 6-month follow-up (t2). The following measures were administered: The Acceptance and Action Questionnaire-II (AAQ-II) and the Clinical Outcome in Routine Evaluation-Outcome Measure (CORE-OM). Generalized linear mixed models were performed to assess differences between groups. Moderation effects for gender and Eating Disorders (ED) have been considered. From baseline to discharge, no significant differences between interventions were found, with the only exception of an improvement in the CORE-OM total score and in the CORE-OM subjective wellbeing subscale for those in the CBT condition. From discharge to follow-up, ACT group participants showed significant results in terms of weight loss maintenance, CORE-OM total score, and CORE-OM and AAQ-II wellbeing, symptoms, and psychological problems subscales. Gender moderated the effects of time and intervention on the CORE-OM subscale reporting the risk for self-harm or harm of others. The presence of an eating disorder moderated the effect of time and intervention on the CORE-OM total score, on the CORE-OM symptoms and psychological problems subscales, and on the AAQ-II. Patients who received the ACT intervention were more likely to achieve a ≥5% weight loss from baseline to follow-up and to maintain the weight loss after discharge. The ACT intervention was thus effective in maintaining weight loss over time.

The ACTyourCHANGE in Teens Study Protocol: An Acceptance and Commitment Therapy-Based Intervention for Adolescents with Obesity: A Randomized Controlled Trial.

This Randomized Controlled Trial [(RCT) aims to evaluate the effectiveness of a brief Acceptance and Commitment Therapy (ACT)-based intervention combined with treatment as usual (TAU) compared to TAU only in improving psychological conditions in a sample of adolescents with obesity (body mass index, BMI > 97th percentile for age and sex) within the context of a wider multidisciplinary rehabilitation program for weight loss. Fifty consecutive adolescents (12-17 years) of both genders with obesity will be recruited among the patients hospitalized in a clinical center for obesity rehabilitation and randomly allocated into two experimental conditions: ACT + TAU vs. TAU only. Both groups will attend a three-week in-hospital multidisciplinary rehabilitation program for weight loss. The ACT + TAU condition comprises a psychological intervention based on ACT combined with a standard psychological assessment and support to the hospitalization. The TAU comprises the standard psychological assessment and support to the hospitalization. At pre- to post-psychological intervention, participants will complete the Avoidance and Fusion Questionnaire for Youth, the Psychological Well-Being Scale, the Depression Anxiety Stress Scale, the Difficulties in Emotion Regulation Scale, and the Emotional Eating subscale of the Dutch Eating Behavior Questionnaire to assess psychological well-being as the primary outcome and experiential avoidance, psychological distress, emotional dysregulation, and emotional eating as secondary outcomes. Repeated-measures ANOVAs (2 × 2) will be conducted. The study will assess the effectiveness of a brief ACT-based intervention for adolescents with obesity in improving their psychological conditions by targeting specific core processes of the ACT framework (openness, awareness, and engagement). Future directions of the study will assess whether these psychological processes will contribute to addressing long-term weight loss.

The ACTyourCHANGE study protocol: promoting a healthy lifestyle in patients with obesity with Acceptance and Commitment Therapy-a randomized controlled trial.

BACKGROUND: As treatment of choice in promoting psychological flexibility, Acceptance and Commitment Therapy (ACT) was found to be effective in several conditions, and among different populations, including weight management in individuals with obesity. However, the mechanism of action of psychological flexibility is less known. The aim of the present study is, within the context of a brief ACT intervention for behavioral change and behavioral maintenance of a healthy lifestyle in a sample of inpatients with obesity, to explore the effect of each subcomponent of the psychological flexibility model on treatment processes and outcomes. METHODS: A randomized controlled trial will be conducted. Ninety Italian adult inpatients with obesity attending a rehabilitation program for weight loss will be randomly allocated into three experimental conditions targeting respectively each subcomponent of the psychological flexibility model: group Engage focused on values-oriented behaviors, group Openness focused on acceptance and cognitive defusion, and group Awareness focused on being present and aware of thoughts, feelings, and behaviors at every moment. Weight, BMI (kg/m2), the Psychological General Well-Being Inventory (PGWBI), the Outcome Questionnaire-45.2 (OQ-45.2), the Depression Anxiety and Stress Scale (DASS-21), the Difficulties in Emotion Regulation Scale (DERS), the Dutch Eating Behaviors Questionnaire (DEBQ), the Brief Values Inventory (BVI), the Committed Action Questionnaire (CAQ), the Italian-Cognitive Fusion Questionnaire (I-CFQ), the Five Facet Mindfulness Questionnaire (FFMQ), and the Acceptance and Action Questionnaire (AAQ-II) will be assessed at the beginning (time 0), at the end of psychological intervention (time 1), and after 3 (time 2) and 6 months (time 3) and 9 months (time 4) from discharge. During the following month after discharge, outpatients will be monitored in their adherence to a healthy lifestyle, using a wearable device. To assess the effectiveness of the intervention, mixed between-within 3 (conditions) × 4 (times) repeated measure ANOVAs will be conducted to examine changes from time 0 to time 1, 2, 3, and 4 in means of weight, BMI, and means of scores PGWBI, OQ-45.2, DASS, DERS, DEBQ, AAQ-II, BVI, CAQ, I-CFQ, and FFMQ, between three groups. DISCUSSION: This study will contribute to clarify the mechanism of action of each subcomponent of the psychological flexibility model and understand its impact on the promotion of a healthy lifestyle. TRIAL REGISTRATION: ClinicalTrials.gov NCT04474509 . Registered on July 4, 2020.

Improvement of Pulmonary Function after Comprehensive Obesity Rehabilitation Program in Obese Patients.

Obesity is a major risk factor of cardiovascular, osteoarthritis, metabolic and pulmonary disorders, and exercise is an efficient method for treating obesity. However, obese patients often complain of dyspnea on exertion, which makes it difficult to continue exercise program. Obesity is also known to have an adverse effect on pulmonary function. The purpose of this study was to examine the effects of a comprehensive obesity rehabilitation (COR) program on pulmonary function in Japanese patients with morbid obesity. We enrolled 29 Japanese obese patients (14 males and 15 females) with BMI > 29 and an average age of 42.2 ± 11.7 years, who underwent the COR program for 1-3 months. Our COR program included a calorie-restricted diet, nutritional counseling, exercise training, and health education. We focused on the changes in pulmonary function, anticipating that changes in ventilation volume may contribute to improving exercise tolerance. After the intervention, all the subjects had lost weight, with a mean value of 12.0 kg (P < 0.001). We found that the lung volume compartment was significantly increased after our COR program, and that there is a strong positive correlation between a change in expiratory reserve volume and the weight loss (r = 0.74, P < 0.01). Through the COR program, body fat mass was significantly reduced, while the skeletal muscle mass remained more or less unchanged, which is advantageous for improvement in exercise tolerance. In conclusion, our COR program is helpful to improve the pulmonary function of patients with obesity.

Influence of Obesity on Rehabilitation of Stroke Patients / 中国康复理论与实践

@#Objective To study the influence of obesity on outcome of rehabilitation for the hemiplegic post stroke. Methods 118 hospitalized stroke patients were divided into the normal weight, overweight and obesity groups according to the Body Mass Index. All the patients received rehabilitation for 12 weeks. They were assessed with National Institute of Health Stroke Scale (NIHSS), Fugl-Meyer Assessment (FMA), Berg Balance Scale (BBS) and modified Barthel Index (MBI) before and after rehabilitation. Results The scores of NIHSS, FMA, BBS and MBI improved significantly after rehabilitation in all the groups (P<0.001), and improved the lest in the obesity group in the scores of NIHSS, BBS and MBI (P<0.05). There was no significant difference in FMA score among groups (P>0.05). Conclusion Obesity influences the outcome of rehabilitation, results in poor functioning.