gms | German Medical Science

Background: Associations of specific types of stress with increased food intake and subsequent weight gain have been demonstrated in animal models as well as in experimental and epidemiological studies on humans. This study explores the research question to what extent specific obesity related and potentially obesogenic stressors determine perceived stress in individuals with obesity. It was hypothesised that specific obesity related stressors which may stipulate obesogenic behaviour by their a) chronic, b) uncontrollable, c) emotionally or d) socially distressing nature, significantly determine perceived stress in individuals with obesity.

Methods: N = 663 individuals with severe obesity (mean BMI of 45,7 kg/m²) (n = 470 females; n= 193 males) participated in a cross-sectional study using validated standard instruments to assess perceived stress (PSQ-20) as outcome variable and its potential determinants related to obesity (EDI-2). Based on available evidence, a four factorial model of “obesity related obesogenic stressors” was theoretically hypothesised including the dimensions: “Drive for Thinness”, “Impulse Regulation”, “Ineffectiveness” and “Social Insecurity”. The model was tested using multivariate linear regression analyses.

Results: The hypothesised four factorial model of “obesity related obesogenic stressors” resulted in a total variance declaration of 50% (adj. r² = .509) for perceived stress in the investigated population. The relative variance contribution of the four included factors: “Drive for Thinness”, “Impulse Regulation”, “Ineffectiveness” and “Social Insecurity”, differed substantially between the two sexes. “Ineffectiveness” showed the highest single variance determination in both, females and males. Significant single factor contributions ranged from 0.355 (Stand. Beta), (p < 0.001) to 0.106 (Stand. Beta), (p = 0.001).

Conclusions: This study shows that obesity inherent stressors substantially determine perceived stress in individuals with obesity. The findings support the hypothesis of a self-perpetuating interaction of obesity inherent cognitions and emotions with subsequent obesogenic stress, followed by related eating behaviour and (further) weight gain: a vicious circle of “obesity related obesogenic stress”.