General psychopathology and impulsivity as the pretreatment predictors of medical nutrition therapy outcome in the overweight and obese women

  • Vesna Tepšić Ostojić Military Medical Academy, Clinic for Psychiatry, Belgrade, Serbia
  • Danijela Ristić Medić University of Belgrade, Institute for Medical Research, Centre of Research Exellence in Nutrition and Metabolism, Belgrade, Serbia
  • Tatjana Mraović Military Medical Academy, Institute of Hygiene and Medical Ecology, Belgrade, Serbia
  • Zoran Bukumirić University of Belgrade, Faculty of Medicine, Institute for Medical Statistics and Informatics, Belgrade, Serbia
  • Nadja Vasiljević University of Belgrade, Faculty of Medicine, Institute of Hygiene and Medical Ecology, Belgrade, Serbia
  • Milan Latas Clinical Centre of Serbia, Clinic of Psychiatry, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia
Keywords: body mass index, diet therapy, impulsive behaviour, obesity, overweight, surveys and questionnaires, treatment outcome

Abstract


Abstract

 

Background/Aim. Obesity is the chronic disease and health threatening condition. The number of obese people in the world has taken epidemic conditions. Medical nutritional therapy is the first choice in the treatment of obesity, but it is also accompanied with a great percentage of attrition and a significant weight regain. The aim of our study was to evaluate if psychiatric and specific psychological factors (impulsivity) could be the predictors of successful weight loss. Methods. A study sample consisted of 84 consecutive overweight/obesity women, 20 to 40 years old, who were willing to adhere to the medical nutrition therapy after the initial anthropometric measurements were performed. All participants received a personalized nutritional counseling and a daily diet treatment with 20% caloric restriction from estimated daily energy requirement. At the beginning of the study, the 90-item Symptom Check-list (SCL-90) and the 30-item Barratt Impulsiveness scale (BIS-11) were administrated. At the end of six months of caloric restriction, the conventional diet therapy and control weight measurement, the patients were divided into two groups: the group I – 40 participants (48%) who lost ≥ 10% of their initial body weight (successful group) and the group II – 44 participants (52%) who lost < 10% of their initial weight (unsuccessful). Results. There were no significant differences between groups in the demographic data (age, education level, employment, marital status), baseline anthropometric measurements, and in the general psychopathology total score. Groups I and II were significantly different in the total BIS-11 score (p < 0.001) and in Factor II (motor impulsivity) (p < 0.05). Conclusion. Even though the successful and unsuccessful diet responded participatnts did not differ in the general psychopathology and symptom dimensions, our results pointed out impulsivity as a discriminative factor between them. The total impulsivity and Factor II (motor impulsivity) as an indicator of binge eating were higher in the unsuccessfully responding overweight/obese women on the conventional diet treatment. A focus on impulsivity in a psychotherapeutic work might leed to better outcomes in the medical nutrition therapy.

References

REFERENCES

Centers for Disease Control and Prevention. Defining over-weight and obesity 2012. Available from: https://www.cdc.gov/obesity/adult/defining.html

Tepšić V, Pavlović M, Ristić-Medić D, Ristić V, Lekić N, Tepšić J, et al. Influence of dietary fats on serum phospholipid fatty acid composition and its relation to obesity in animals. Acta Vet 2008; 58(1): 33–41.

World Health Organization. Overweight and obesity 2015. Available from: www.who.int/gho/ncd/risk_factors/overweight/en/

Boričić K, Vasić M, Grozdanov J, Gudelj-Rakić J, Živković Šulović M, Jaćović-Knežević N, et al. Results of the research on the health of the population of Serbia, 2013. Belgrade: Ministarstvo Zdravlja i Institut za Javno zdravlje Srbije “Dr Milan Jovanović-Batut” 2014. (Serbian)

Mraović T, Radaković S, Ristić Medić D, Tepšić Ostojić V, Rađen S, Hajduković Z, et al. The effects of different caloric restriction diets on anthropometric and cardiometabolic risk factors in overweight and obese females. Vojnosanit Pregl 2018; 75(1): 30–8.

Mraović T, Radaković S, Ristić Medić D, Tepšić Ostojić V, Rađen S, Čairović A, et al. The relationship between adiposity parameters and C-reactive protein values in overweight and obese women.Vojnosanit Pregl 2018; 75(2): 185–190.

Markovic D, Ristic-Medic D, Vucic V, Mitrovic G, Nikolic Ivosevic J, Peric T, et al. Association between being overweight and oral health in Serbian schoolchildren. Int J Paediatr Dent 2015; 25(6): 409–17.

Taylor VH, Forhan M, Vigod SN, McIntyre RS, Morrison KM. The impact of obesity on quality of life. Best Pract Res Clin Endocrinol Metab 2013; 27(2): 139–46.

Vasiljevic N, Ralevic S, Kolotkin RL, Marinkovic J, Jorga J. The Relationship Between Weight Loss and Health-related Quality of Life in a Serbian Population. Eur Eat Disord Rev 2012; 20(2): 162–8.

Olshansky SJ, Passaro DJ, Hershow RC, Layden J, Carnes BA, Brody J, et al. A potential decline in life expectancy in the United States in the 21st century. N Engl J Med 2005; 352(11): 1138–45.

Spahlholz J, Baer N, König HH, Riedel-Heller SG, Luck-Sikorski C. Obesity and discrimination - a systematic review and meta-analysis of observational studies. Obes Rev 2016; 17(1): 43–55.

Bouchard C, Pérusse L, Rice T, Rao DC. Genetics of human obesity. In: Bray GA, Bouchard C, editors. Handbook of Obesity: Etiology and Pathophysiology. 2nd ed. New York, NY: Marcel Dekker; 2004. p. 157–200.

Jansen A, Houben K, Roefs A. A Cognitive Profile of Obesity and ItsTranslation into New Interventions. Front Psychol 2015; 6: 1807.

Appelhans BM, French SA, Pagoto SL, Sherwood NE. Managing temptation inobesity treatment: A neurobehavioral model of intervention strategies. Appetite 2016; 96: 268–79.

Meule A, Platte P. Facets of impulsivity interactively predict body fat andbinge eating in young women. Appetite 2015; 87: 352–7.

National Institutes of Health. Clinical Guidelines on the Iden-tification, Evaluation, and Treatment of Overweight and Ob-esity in Adults-The Evidence Report. Obes Res 1998; 6 Suppl 2: 51S–209S.

Varady KA. Intermittent versus daily calorie restriction: which diet regimenis more effective for weight loss? Obes Rev 2011; 12(7): e593–e601.

Lasikiewicz N, Myrissa K, Hoyland A, Lawton CL. Psychological benefits of weight loss following behavioural and/or dietary weight loss interventions. A systematic research review. Appe-tite 2014; 72: 123–37.

Silva I. Importance of emotional regulation in obesity and weight loss treatment. Fractal Rev Psicol 2015; 27(3): 286–90.

Trumbo P, Schlicker S, Yates AA, Poos M. Food and Nutrition Board of the Institute of Medicine, The National Academies. Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein and amino acids. J Am Diet Assoc 2002; 102(11): 1621–30.

Derogatis LR, Lipman RS, Rickels K, Uhlenhuth EH, Covi L. The Hopkins Symptom Checklist (HSCL): a self-report symptom inventory. Behav Sci 1974; 19(1): 1–15.

Patton JH, Stanford MS, Barratt ES. Factor structure of the Bar-ratt impulsiveness scale. J Clin Psychol 1995; 51(6): 768–74.

Dimitriadis D, Mamplekou E, Dimitriadis P, Komessidou V, Dimi-triadis G, Papageorgiou C. The Association between Obesity and Symptoms of Psychopathology and its Relationship with Se-dentary Behavior and Mediterranean Diet. Isr J Psychiatry Re-lat Sci 2016; 53(3): 17–24.

Papelbaum M, Moreira RO, Gaya CW, Preissler C, Coutinho WF. Impact of body mass index on the psychopathological profile of obese women. Rev Bras Psiquiatr 2010; 32(1): 42–6.

Mills JK. A note on interpersonal sensitivity and psychotic symptomatology in obese adult outpatients with a history of childhood obesity. J Psychol 1995; 129(3): 345–8.

Petry NM, Barry D, Pietrzak RH, Wagner JA. Overweight and obesity are associated with psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Psychosom Med 2008; 70(3): 288–97.

Scott KM, McGee MA, Wells JE, Oakley Browne MA. Obesity and mental disorders in the adult general population. J Psychosom Res 2008; 64(1): 97–105.

Carmody TP, Brunner RL, St Jeor ST. Hostility, dieting, and nutrition attitudes in overweight and weight-cycling men and women. Int J Eat Disord 1999; 26(1): 37–42.

Lin HY, Huang CK, Tai CM, Lin HY, Kao YH, Tsai CC, et al. Psychiatric disorders of patients seeking obesity treatment. BMC Psychiatry 2013; 13: 1.

Scott KM, Bruffaerts R, Simon GE, Alonso J, Angermeyer M, de Girolamo G, et al. Obesity and mental disorders in the general population: results from the world mental health surveys. Int J Obes (Lond) 2008; 32(1): 192–200.

Lawlor DA, Hart CL, Hole DJ, Gunnell D, Davey Smith G. Body mass index in middle life and future risk of hospital admission for psychoses or depression: findings from the Renf-rew/Paisley study. Psychol Med 2007; 37(8): 1151–61.

McElroy SL, Kotwal R, Malhotra S, Nelson EB, Keck PE, Nemeroff CB. Are mood disorders and obesity related? A review for the mental health professional. J Clin Psychiatry 2004; 65(5): 634–51, quiz 730.

Moeller FG, Barratt ES, Dougherty DM, Schmitz JM, Swann AC. Psychiatric aspects of impulsivity. Am J Psychiatry 2001; 158(11): 1783–93.

van den Akker K, Stewart K, Antoniou EE, Palmberg A, Jansen A. Food Cue Reactivity, Obesity, and Impulsivity: Are They As-sociated? Curr Adict Rep 2014; 1(4): 301–8.

Davis C, Patte K, Levitan R, Reid C, Tweed S, Curtis C. From motivation to behaviour: a model of reward sensitivity, overeating, and food preferences in the risk profile for obesity. Appetite. 2007; 48(1): 12–9.

Meule A, Westenhöfer J, Kübler A. Food cravings mediate the relationship between rigid, but not flexible control of eating behavior and dieting success. Appetite 2011; 57(3): 582–4.

Guerrieri R, Nederkoorn C, Jansen A. The Effect of an Impulsive Personality on Overeating and Obesity: Current State of Affairs. Psychological Topics 2008; 17: 265–86.

Meule A, Vögele C, Kübler A. Restrained eating is related to ac-celerated reaction to high caloric foods and cardiac autonomic dysregulation. Appetite 2012; 58: 638–44

Redman LM, Heilbronn LK, Martin CK, Alfonso A, Smith SR, Ravussin E. Effect of calorie restriction with or without exercise on body composition and fat distribution. J Clin Endocrinol Metab 2007; 92: 865–72

Published
2021/05/26
Section
Original Paper