Directional dependence of dysregulated eating, weight stigma, and psychological distress among children with overweight or obesity: a gaussian graphical model and Bayesian network approach

Author:

Shen Guanghui1,Zou Fan2,Wang Mengting3,Pan Hong3,Jian Wenqian3,Chen Li3,Zou Yang4

Affiliation:

1. Wenzhou Seventh People's Hospital

2. Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University

3. Wenzhou Medical University

4. Sichuan Tourism University

Abstract

Abstract

Background Childhood obesity is a pressing global health concern, with its etiology involving complex interactions among dysregulated eating, weight stigma, and psychological distress. Elucidating the directional dependencies and potential causal pathways among these factors is crucial for intervention development. Method In this study, 572 obese or overweight children aged 10-17completed self-report measures assessing weight stigma, internalized stigma, dysregulated eating (restrained, emotional, and external eating), depression, social anxiety, and school bullying. Gaussian graphical models (GGMs) and Bayesian networks were used to investigate the intricate directional relationships among these variables. Results GGMs revealed weight stigma as the most central node in the network, exhibiting the highest strength and expected influence. Bayesian networks indicated that school bullying was a significant antecedent, directly influencing both weight stigma and depression. Weight stigma emerged as a crucial mediator, transmitting the effects of school bullying to internalized stigma, emotional eating, and psychological distress. Internalized stigma was the sole direct predictor of restrained eating. Depression, influenced by school bullying and internalized stigma, directly affected social anxiety. Conclusion This study emphasizes the importance of addressing weight stigma to alleviate dysregulated eating and psychological distress in obese or over weight children. The findings suggest the need for targeted interventions to combat weight stigma and its negative effects. Comprehending these complex directional dependencies offers a foundation for devising more effective strategies to tackle childhood obesity and related psychological comorbidities.

Publisher

Springer Science and Business Media LLC

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