The Intermediating Role of Eating, Shape and Weight Concerns Between Depressive Symptoms and Avoiding Behavior in Morbid Obese Patients Seeking Treatment

Abstract

Objective: Patients with obesity have more restrictive eating behavior than those of normal weight, and are thought to cause depressive symptoms by leading to avoidant coping strategies. In this study, it was aimed to investigate the mediating role of eating, shape and weight concern the relationship between restricted eating and depression in individuals applying to bariatric surgery. Method: The study sample was composed of patients with morbid obesity who applied to Ondokuz Mayis University Faculty of Medicine for bariatric surgery between 2016-2018. The sociodemographic data form, Beck Depression Scale and Eating Disorder Rating Scale were filled by the participants. The degree of representation of the observed variables to implicit variables was evaluated by the confirmatory measurement model. Then, the relationship pattern between variables was examined with the structural model test. Multiple fit indices were used in the confirmatory measurement model and the structural equation model. Results: The study group consisted of 224 participants (mean age 37.6 +/- 12.9). The average BMI of the participants is 45.5 +/- 5.9. Three implicit variables were created, namely depression, anxiety, and limited eating. After confirming the measurement model, the mediating role of anxiety between depression and limited eating behavior was examined by path analysis. When the variance relations between the variables were examined, it was seen that restricted eating explained 76% of the variance in anxiety and 25% of the variance in depression. Discussion: Treating obesity from a psychiatric perspective, adopting an approach that takes into account the anxiety about eating, body weight and body image may increase the success of the treatment. A decrease in related anxiety can lead to reduced eating and depression levels.