Gender and Emotional Representation Matter: Own Illness Beliefs and Their Relationship to Obesity

Carmen Henning, Stefanie Schroeder, Sabine Steins-Loeber, Joerg Wolstein, Carmen Henning, Stefanie Schroeder, Sabine Steins-Loeber, Joerg Wolstein

Abstract

Background: Current treatments of obesity often fail to consider gender and psychological aspects, which are essential for weight loss and weight maintenance. The aim of our study was to analyze subjective illness representations (SIRs) of adults with obesity according to the Common-Sense Self-Regulation Model (CSM) by assessing their associations with weight-related variables and gender.

Methods: Data was collected via online self-assessment between April 2017 and March 2018. SIRs were operationalized by the revised Illness Perception Questionnaire (IPQ-R) and illness outcomes according to the CSM were defined as BMI, eating behaviour, physical wellbeing, bodyweight satisfaction, and shape concerns. The sample consisted of 427 adults (M = 42.2 years, SD = 10.9; 82% female) with obesity (BMI: M = 42.3 kg/m2, SD = 9.0). Student's t-tests and multiple hierarchical regression analyses were conducted with the control variables (age and BMI) and subjective illness representations and gender as independent variables.

Results: The explanation of outcome variances was moderate to high (21-43%) except for restraint eating behaviour (10%). Subjective illness representations showed several significant associations with weight-related variables, especially timeline and emotional representations. Female gender was significantly associated with more restraint eating behaviour [F (1, 400) = 4.19, p < 0.001] and females had unfavourable values of the weight-related variables as well as a more cyclic [t (425) = 3.68, p < 0.001], and more emotional representation [t (100) = 5.17, p < 0.001] of their obesity.

Conclusion: The results of this study indicate that gender and subjective illness representations, especially the emotional representation, play an important role for weight-related variables. Therefore, the assessment of SIRs may constitute an economic tool to identify specific individual deficits of self-regulation.

Keywords: BMI; eating behavior; gender; illness beliefs; obesity; self-regulation.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2022 Henning, Schroeder, Steins-Loeber and Wolstein.

Figures

Figure 1
Figure 1
Sample conformation process.
Figure 2
Figure 2
Gender differences. ***p < 0.001.

References

    1. Mensink GBM, Schienkiewitz A, Haftenberger M, Lampert T, Ziese T, Scheidt-Nave C. Übergewicht und Adipositas in Deutschland: Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. (2013) 56:786–94. 10.1007/s00103-012-1656-3
    1. Sammet I, Dammann G, Wiesli P, Müller MK. Adipositas: Interdisziplinäre Behandlung und psychosomatische Perspektive, eds. Stuttgart: W. Kohlhammer Verlag; (2016).
    1. Pagoto SL, Schneider KL, Oleski JL, Luciani JM, Bodenlos JS, Whited MC. Male inclusion in randomized controlled trials of lifestyle weight loss interventions. Obesity (Silver Spring). (2012) 20:1234–9. 10.1038/oby.2011.140
    1. Robertson C, Archibald D, Avenell A, Douglas F, Hoddinott P, van Teijlingen E, et al. . Systematic reviews of and integrated report on the quantitative, qualitative and economic evidence base for the management of obesity in men. Health Technol Assess. (2014) 18:xxiii–xxix, 1–424. 10.3310/hta18350
    1. Crane MM, Jeffery RW, Sherwood NE. Exploring gender differences in a randomized trial of weight loss maintenance. Am J Mens Health. (2017) 11:369–75. 10.1177/1557988316681221
    1. Larsen JK, van Strien T, Eisinga R, Engels R. Gender differences in the association between alexithymia and emotional eating in obes individuals. J Psychosom Res. (2006) 60:237–43. 10.1016/j.jpsychores.2005.07.006
    1. van der Velde C, Schroeder S, Wolstein J, Steins-Löber S. Wirksamkeit von geschlechtsspezifischen Interventionskomponenten in der Behandlung von Personen mit Adipositas – Eine systematische Übersichtsarbeit. in zur 35. Jahrestagung der Deutschen Adipositas-Gesellschaft e.V. (DAG). Georg Thieme Verlag KG; (2019).
    1. Kiefer I, Rathmanner T, Kunze M. Eating and dieting differences in men and women. jmg. (2005) 2:194–201. 10.1016/j.jmhg.2005.04.010
    1. Fraser GE, Welch A, Luben R, Bingham SA, Day NE. The effect of age, sex, and education on food consumption of a middle-aged English cohort-EPIC in East Anglia. Prev Med. (2000) 30:26–34. 10.1006/pmed.1999.0598
    1. Schwartz MB, Brownell KD. Obesity and body image. Body Image. (2004) 1:43–56. 10.1016/S1740-1445(03)00007-X
    1. Tsai SA, Lv N, Xiao L, Ma J. Gender differences in weight-related attitudes and behaviors among overweight and obese adults in the United States. Am J Mens Health. (2016) 10:389–98. 10.1177/1557988314567223
    1. Sabinsky MS, Toft U, Raben A, Holm L. Overweight men's motivations and perceived barriers towards weight loss. Eur J Clin Nutr. (2007) 61:526–31. 10.1038/sj.ejcn.1602537
    1. Zwaan M, de Hilbert A, Herpertz S, Zipfel S, Beutel M, Gefeller O, et al. . Weight loss maintenance in a population-based sample of German adults. Obesity (Silver Spring). (2008) 16:2535–40. 10.1038/oby.2008.392
    1. Svetkey LP, Ard JD, Stevens VJ, Loria CM, Young DY, Hollis JF, et al. . Predictors of long-term weight loss in adults with modest initial weight loss, by sex and race. Obesity (Silver Spring). (2012) 20:1820–8. 10.1038/oby.2011.88
    1. Weinstein SE, Shide DJ, Rolls BJ. Changes in food intake in response to stress in men and women: psychological factors. Appetite. (1997) 28:7–18. 10.1006/appe.1996.0056
    1. Oliver G, Wardle J, Gibson EL. Stress and food choice: a laboratory study. Psychosom Med. (2000) 62:853–65. 10.1097/00006842-200011000-00016
    1. Zellner DA, Loaiza S, Gonzalez Z, Pita J, Morales J, Pecora D, et al. . Food selection changes under stress. Physiol Behav. (2006) 87:789–93. 10.1016/j.physbeh.2006.01.014
    1. Anderson E, Winett R, Wojcik J. Self-regulation, self-efficacy, outcome expectations, and social support: social cognitive theory and nutrition behavior. Ann Behav Med. (2007) 34:304–12. 10.1007/BF02874555
    1. Westen D, Blagov PS. A clinical-empirical model of emotion regulation. In: Gross JJ. editor. Handbook of Emotion Regulation. New York, NY: Guilford Publications; (2007). p. 373–92.
    1. Dutton GR, Perri MG, Dancer-Brown M, Goble M, van Vessem N. Weight loss goals of patients in a health maintenance organization. Eat Behav. (2010) 11:74–8. 10.1016/j.eatbeh.2009.09.007
    1. Opwis M, Schmidt J, Martin A, Salewski C. Gender differences in eating behavior and eating pathology: the mediating role of rumination. Appetite. (2017) 110:103–7. 10.1016/j.appet.2016.12.020
    1. Santos I, Vieira PN, Silva MN, Sardinha LB, Teixeira PJ. Weight control behaviors of highly successful weight loss maintainers: the Portuguese Weight Control Registry. J Behav Med. (2017) 40:366–71. 10.1007/s10865-016-9786-y
    1. Hauner H, Moss A, Berg A, Bischoff SC, Colombo-Benkmann M, Ellrott T, et al. . Interdisziplinäre Leitlinie der Qualität S3 zur “Prävention und Therapie der Adipositas.” Adipositas Ursachen Folgeerkrankungen Therap. (2014) 8:179–221. 10.1055/s-0037-1618857
    1. Teufel M. Aktualisierung der nationalen S3-Leitlinie zur Prävention und Therapie der Adipositas. Psychotherapeut. (2015) 60:64–6. 10.1007/s00278-014-1077-x
    1. Dombrowski SU, Knittle K, Avenell A, Araújo-Soares V, Sniehotta FF. Long term maintenance of weight loss with non-surgical interventions in obese adults: systematic review and meta-analyses of randomised controlled trials. BMJ. (2014) 348:g2646. 10.1136/bmj.g2646
    1. Nordmo M, Danielsen YS, Nordmo M. The challenge of keeping it off, a descriptive systematic review of high-quality, follow-up studies of obesity treatments. Obes Rev. (2020) 21:e12949. 10.1111/obr.12949
    1. Zwaan M, de Müller A. Adipositas: state of the art. Verhaltenstherapie. (2014) 24:93–9. 10.1159/000362508
    1. Bauer K, Lau T, Schwille-Kiuntke J, Schild S, Hauner H, Stengel A, et al. . Conventional weight loss interventions across the different BMI obesity classes: A systematic review and quantitative comparative analysis. Eur Eat Disord Rev. (2020) 28:492–512. 10.1002/erv.2741
    1. Thomas JG, Bond DS, Phelan S, Hill JO, Wing RR. Weight-loss maintenance for 10 years in the National Weight Control Registry. Am J Prev Med. (2014) 46:17–23. 10.1016/j.amepre.2013.08.019
    1. Wing RR, Phelan S. Long-term weight loss maintenance. Am J Clin Nutr. (2005) 82:222–5. 10.1093/ajcn/82.1.222S
    1. Balani R, Herrington H, Bryant E, Lucas C, Kim SC. Nutrition knowledge, attitudes, and self-regulation as predictors of overweight and obesity. J Am Assoc Nurse Pract. (2019) 31:502–10. 10.1097/JXX.0000000000000169
    1. Leventhal H. Findings and theory in the study of fear communications. Adv Exp Soc Psychol. (1970) 5:119–86. 10.1016/S0065-2601(08)60091-X
    1. Leventhal H, Meyer D, Nerenz D. The common sense representation of illness danger. Medical Psychology. (1980) 11:7–30.
    1. Leventhal H, Diefenbach M, Leventhal E. Illness cognition: using common sense to understand treatment adherence and affect cognition interactions. Cognit Ther Res. (1992) 16:143–63. 10.1007/BF01173486
    1. Leventhal H, Phillips LA, Burns E. The common-sense model of self-regulation (CSM): a dynamic framework for understanding illness self-management. J Behav Med. (2016) 39:935–46. 10.1007/s10865-016-9782-2
    1. Leventhal H, Benyamini Y, Brownlee S, Diefenbach M, Leventhal E, Patrick-Miller L, et al. . Illness representations: theoretical foundations. In: Weinman J, Petrie K. editors. Perceptions of Health and Illness. London: Harwood Publishers. (1997). p. 19–45.
    1. Hagger MS, Orbell S. A meta-analytic review of the common-sense model of illness representations. Psychol Health. (2003) 18:141–84. 10.1080/088704403100081321
    1. Hagger MS, Koch S, Chatzisarantis NLD, Orbell S. The common sense model of self-regulation: meta-analysis and test of a process model. Psychol Bull. (2017) 143:1117–54. 10.1037/bul0000118
    1. Moss-Morris R, Weinman J, Petrie K, Horne R, Cameron L, Buick D. The revised illness perception questionnaire (IPQ-R). Psychol Health. (2002) 17:1–16. 10.1080/08870440290001494
    1. McAndrew LM, Crede M, Maestro K, Slotkin S, Kimber J, Phillips LA. Using the common-sense model to understand health outcomes for medically unexplained symptoms: a meta-analysis. Health Psychol Rev. (2019) 13:427–46. 10.1080/17437199.2018.1521730
    1. Bonsaksen T, Haukeland-Parker S, Lerdal A, Fagermoen MS. A 1-year follow-up study exploring the associations between perception of illness and health-related quality of life in persons with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. (2014) 9:41–50. 10.2147/COPD.S52700
    1. Rivera E, Corte C, DeVon HA, Collins EG, Steffen A. A systematic review of illness representation clusters in chronic conditions. Res Nurs Health. (2020) 43:241–54. 10.1002/nur.22013
    1. Hale ED, Treharne GJ, Kitas GD. The common-sense model of self-regulation of health and illness: how can we use it to understand and respond to our patients' needs? Rheumatology. (2007) 46:904–6. 10.1093/rheumatology/kem060
    1. Bonsaksen T, Lerdal A, Fagermoen MS. Factors associated with self-efficacy in persons with chronic illness. Scand J Psychol. (2012) 53:333–9. 10.1111/j.1467-9450.2012.00959.x
    1. Bonsaksen T, Lerdal A, Fagermoen MS. Trajectories of illness perceptions in persons with chronic illness: an explorative longitudinal study. J Health Psychol. (2015) 20:942–53. 10.1177/1359105313504235
    1. Dempster M, Howell D, McCorry NK. Illness perceptions and coping in physical health conditions: a meta-analysis. J Psychosom Res. (2015) 79:506–13. 10.1016/j.jpsychores.2015.10.006
    1. Aujla N, Walker M, Sprigg N, Abrams K, Massey A, Vedhara K. Can illness beliefs, from the common-sense model, prospectively predict adherence to self-management behaviours? A systematic review and meta-analysis. Psychol Health. (2016) 31:931–58. 10.1080/08870446.2016.1153640
    1. Brandes K, Mullan B. Can the common-sense model predict adherence in chronically ill patients? A meta-analysis. Health Psychol Rev. (2014) 8:129–53. 10.1080/17437199.2013.820986
    1. Broadbent E, Ellis CJ, Thomas J, Gamble G, Petrie KJ. Can an illness perception intervention reduce illness anxiety in spouses of myocardial infarction patients? A randomized controlled trial. J Psychosom Res. (2009) 67:11–5. 10.1016/j.jpsychores.2008.11.006
    1. Karekla M, Karademas EC, Gloster AT. The common sense model of self-regulation and acceptance and commitment therapy: integrating strategies to guide interventions for chronic illness. Health Psychol Rev. (2018) 13:490–503. 10.1080/17437199.2018.1437550
    1. Meyer D, Leventhal H, Gutmann M. Common-sense models of illness: the example of hypertension. Health Psychol Rev. (1985) 4:115–35. 10.1037/0278-6133.4.2.115
    1. Kaptein AA, Hughes BM, Scharloo M, Fischer MJ, Snoei L, Weinman J, et al. . Illness perceptions about asthma are determinants of outcome. J Asthma. (2008) 45:459–64. 10.1080/02770900802040043
    1. Fall E, Chakroun-Baggioni N, Böhme P, Maqdasy S, Izaute M, Tauveron I. Common sense model of self-regulation for understanding adherence and quality of life in type 2 diabetes with structural equation modeling. Patient Educ Couns. (2021) 104:171–8. 10.1016/j.pec.2020.06.023
    1. Weinman J, Petrie KJ, Sharpe N, Walker S. Causal attributions in patients and spouses following first-time myocardial infarction and subsequent lifestyle changes. Br J Health Psychol. (2000) 5:263–73. 10.1348/135910700168900
    1. French DP, Cooper A, Weinman J. Illness perceptions predict attendance at cardiac rehabilitation following acute myocardial infarction: a systematic review with meta-analysis. J Psychosom Res. (2006) 61:757–67. 10.1016/j.jpsychores.2006.07.029
    1. Gucht V, de Garcia FK, den Engelsman M, Maes S. Do changes in illness perceptions, physical activity, and behavioural regulation influence fatigue severity and health-related outcomes in CFS patients? J Psychosom Res. (2017) 95:55–61. 10.1016/j.jpsychores.2017.02.009
    1. Christensen SS, Frostholm L, Ørnbøl E, Schröder A. Changes in illness perceptions mediated the effect of cognitive behavioural therapy in severe functional somatic syndromes. J Psychosom Res. (2015) 78:363–70. 10.1016/j.jpsychores.2014.12.005
    1. Anandacoomarasamy A, Fransen M, March L. Obesity and the musculoskeletal system. Curr Opin Rheumatol. (2009) 21:71–7. 10.1097/BOR.0b013e32831bc0d7
    1. World Health Organization . Obesity and Overweight. (2020). Available online at: (accessed August 5, 2020).
    1. Lewis S, Thomas SL, Blood RW, Hyde J, Castle DJ, Komesaroff PA. Do health beliefs and behaviors differ according to severity of obesity? A qualitative study of Australian adults. Int J Environ Res Public Health. (2010) 7:443–59. 10.3390/ijerph7020443
    1. Benyamini Y, Raz O. “I Can Tell You If I'll Really Lose All That Weight”: “I Can Tell You If I'll Really Lose All That Weight”: dispositional and situated optimism as predictors of weight loss following a group intervention weight loss following a group intervention. J Appl Soc Psychol. (2007) 37:844–61. 10.1111/j.1559-1816.2007.00189.x
    1. den Engelsen C, Vos RC, Rijken M, Rutten GEHM. Comparison of perceptions of obesity among adults with central obesity with and without additional cardiometabolic risk factors and among those who were formally obese, 3 years after screening for central obesity. BMC Public Health. (2015) 15:1214. 10.1186/s12889-015-2544-1
    1. Byrne SM, Cooper Z, Fairburn CG. Psychological predictors of weight regain in obesity. Behav Res Ther. (2004) 42:1341–56. 10.1016/j.brat.2003.09.004
    1. Bauer K, Schild S, Sauer H, Teufel M, Stengel A, Giel KE, et al. . Attitude matters! how attitude towards bariatric surgery influences the effects of behavioural weight loss treatment. Obes Facts. (2021) 14:531–42. 10.1159/000517850
    1. Friese M, Engeler M, Florack A. Self-perceived successful weight regulators are less affected by self-regulatory depletion in the domain of eating behavior. Eat Behav. (2015) 16:5–8. 10.1016/j.eatbeh.2014.10.011
    1. Daigle KM, Gang CH, Kopping MF, Gadde KM. Relationship between perceptions of obesity causes and weight loss expectations among adults. J Nutr Educ Behav. (2019) 51:86–90. 10.1016/j.jneb.2018.08.015
    1. Spitzer RL, Williams JB, Kroenke K, Linzer M, deGruy FV, Hahn SR, et al. . Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study. JAMA. (1994) 272:1749–56. 10.1001/jama.1994.03520220043029
    1. Loewe B, Spitzer RL, Zipfel S, Herzog W. PHQ-D Gesundheitsfragebogen für Patienten: Manual Komplettversion und Kurzform. Autorisierte deutsche Version des Prime MD Patient Health Questionnaire (PHQ). Karlsruhe: Pfitzer; (2002).
    1. Glattacker M, Bengel J, Jäckel WH. Die deutschsprachige Version des Illness perception questionnaire-revised. Zeitschrift für Gesundheitspsychologie. (2009) 17:158–69. 10.1026/0943-8149.17.4.158
    1. Palmeira AL, Markland DA, Silva MN, Branco TL, Martins SC, Minderico CS, et al. . Reciprocal effects among changes in weight, body image, and other psychological factors during behavioral obesity treatment: a mediation analysis. Int J Behav Nutr Phys Act. (2009) 6:9. 10.1186/1479-5868-6-9
    1. Chao H-L. Body image change in obese and overweight persons enrolled in weight loss intervention programs: a systematic review and meta-analysis. PLoS ONE. (2015) 10:e0124036. 10.1371/journal.pone.0124036
    1. Mathieu L, Bitterlich N, Meissner F, Wolff M, von Poethig D, Stute P. Illness perception in overweight and obesity and impact on bio-functional age. Arch Gynecol Obstet. (2018) 298:415–26. 10.1007/s00404-018-4827-0
    1. Doll HA, Petersen SEK, Stewart-Brown SL. Obesity and physical and emotional well-being: associations between body mass index, chronic illness, and the physical and mental components of the SF-36 questionnaire. Obes Res. (2000) 8:160–70. 10.1038/oby.2000.17
    1. Lindekilde N, Gladstone BP, Lübeck M, Nielsen J, Clausen L, Vach W, et al. . The impact of bariatric surgery on quality of life: a systematic review and meta-analysis. Obes Rev. (2015) 16:639–51. 10.1111/obr.12294
    1. Fairburn CG, Beglin SJ. Assessment of eating disorders: interview or self-report questionnaire? Int J Eat Disord. (1994) 16:363–70.
    1. Hilbert A, Tuschen-Caffier B, Karwautz A, Niederhofer H, Munsch S. Eating disorder examination-questionnaire. Diagnostica. (2007) 53:144–54. 10.1026/0012-1924.53.3.144
    1. Grunert SC. Ein Inventar zur Erfassung von Selbstaussagen zum Ernährungsverhalten. Diagnostica. (1989) 35:167–79.
    1. van Strien T, Frijters JER, Bergers GPA, Defares PB. The Dutch eating behavior questionnaire (DEBQ) for assessment of restrained, emotional, and external eating behavior. Int J Eat Disord. (1986) 5:295–315. 10.1002/1098-108X(198602)5:2andlt;295::AID-EAT2260050209andgt;;2-T
    1. Kolip P, Schmidt B. Der Fragebogen zur Erfassung körperlichen Wohlbefindens (FEW 16). Zeitschrift für Gesundheitspsychologie. (1999) 7:77–87. 10.1026//0943-8149.7.2.77
    1. Antonovsky A. Health, Stress, and Coping. San Francisco, CA: Jossey-Bass; (1979).
    1. Teixeira PJ, Going SB, Sardinha LB, Lohman TG. A review of psychosocial pre-treatment predictors of weight control. Obes Rev. (2005) 6:43–65. 10.1111/j.1467-789X.2005.00166.x
    1. Jackson SE, Beeken RJ, Wardle J. Predictors of weight loss in obese older adults: findings from the USA and the UK. Obes Facts. (2014) 7:102–10. 10.1159/000362196
    1. Urban D, Mayerl J. Angewandte Regressionsanalyse: Theorie, Technik und Praxis. Wiesbaden: Springer VS; (2018).
    1. Hallam J, Boswell R, DeVito E, Kober H. Gender-related differences in food craving and obesity. Yale J Biol Med. (2016) 27:161–73.
    1. Prill S, Henning C, Schroeder S, Steins-LS, Wolstein J. Does weight-cycling influence illness beliefs in obesity? A gender-sensitive approach. J Obes. (2021) 2021:8861386. 10.1155/2021/8861386
    1. Olson KL, Lillis J, Panza E, Wing RR, Quinn DM, Puhl RR. Body shape concerns across racial and ethnic groups among adults in the United States: more similarities than differences. Body Image. (2020) 35:108–13. 10.1016/j.bodyim.2020.08.013
    1. Nagl M, Hilbert A, Zwaan M, de Braehler E, Kersting A. The german version of the dutch eating behavior questionnaire: psychometric properties, measurement invariance, and population-based norms. PLoS ONE. (2016) 11:e0162510. 10.1371/journal.pone.0162510
    1. Bischoff SC, Schweinlin A. Obesity therapy. Clin Nutr ESPEN. (2020) 38:9–18. 10.1016/j.clnesp.2020.04.013
    1. Henning C, Schroeder S, van der Velde C, Herpertz S, Wolstein J, Löber S. Man(n) ist übergewichtig, weil… Geschlechtsunterschiede subjektiver. Wiesbaden: Ursachenzuschreibungen bei Adipositas; (2018).
    1. Faith MS, Matz PE, Jorge MA. Obesity–depression associations in the population. J Psychosom Res. (2002) 53:935–42. 10.1016/S0022-3999(02)00308-2
    1. Luppino FS, Wit LM, de Bouvy PF, Stijnen T, Cuijpers P, Penninx BWJH, et al. . Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry. (2010) 67:220–9. 10.1001/archgenpsychiatry.2010.2
    1. Agüera Z, Riesco N, Valenciano-Mendoza E, Granero R, Sánchez I, Andreu A, et al. . Illness perception in patients with eating disorders: clinical, personality, and food addiction correlates. Eat Weight Disord. (2021) 26:2287–300. 10.1007/s40519-020-01083-3
    1. Vanhecke TE, Miller WM, Franklin BA, Weber JE, McCullough PA. Awareness, knowledge, and perception of heart disease among adolescents. Eur J Cardiovasc Prev Rehabil. (2006) 13:718–23. 10.1097/01.hjr.0000214611.91490.5e
    1. Pokrajac-Bulian A, Ambrosi-Randić N. Illness perception in overweight and obese patients with cardiovascular diseases. Eat Weight Disord. (2020) 25:69–78. 10.1007/s40519-018-0506-1
    1. Breland JY, Fox AM, Horowitz CR, Leventhal H. Applying a common-sense approach to fighting obesity. J Obes. (2012) 2012:710427. 10.1155/2012/710427
    1. Stockford K, Turner H, Cooper M. Illness perception and its relationship to readiness to change in the eating disorders: a preliminary investigation. Br J Clin Psychol. (2007) 46:139–54. 10.1348/014466506X115786
    1. Wirth A, Hauner H. Adipositas: Ätiologie, Folgekrankheiten, Diagnostik, Therapie. Berlin: Springer; (2013).
    1. Jarolimova J, Tagoni J, Stern TA. Obesity: its epidemiology, comorbidities, and management. Prim Care Companion CNS Disord. (2013) 15:1475. 10.4088/PCC.12f01475
    1. Upadhyay J, Farr O, Perakakis N, Ghaly W, Mantzoros C. Obesity as a disease. Med Clin North Am. (2018) 102:13–33. 10.1016/j.mcna.2017.08.004
    1. Kolotkin RL, Head S, Hamilton M, Tse CK. Assessing impact of weight on quality of life. Obes Res. (1995) 3:49–56. 10.1002/j.1550-8528.1995.tb00120.x
    1. He XZ, Baker DW. Body mass index, physical activity, and the risk of decline in overall health and physical functioning in late middle age. Am J Public Health. (2004) 94:1567–73. 10.2105/AJPH.94.9.1567
    1. Kakoschke N, Kemps E, Tiggemann M. External eating mediates the relationship between impulsivity and unhealthy food intake. Physiol Behav. (2015) 147:117–21. 10.1016/j.physbeh.2015.04.030
    1. Teixeira PJ, Silva MN, Coutinho SR, Palmeira AL, Mata J, Vieira PN, et al. . Mediators of weight loss and weight loss maintenance in middle-aged women. Obesity (Silver Spring). (2010) 18:725–35. 10.1038/oby.2009.281
    1. Skär L, Juuso P, Söderberg S. Health-related quality of life and sense of coherence among people with obesity: Important factors for health management. SAGE Open Med. (2014) 2:2050312114546923. 10.1177/2050312114546923
    1. Nawaz H, Chan W, Abdulrahman M, Larson D, Katz DL. Self-reported weight and height. Am J Prev Med. (2001) 20:294–8. 10.1016/S0749-3797(01)00293-8
    1. Elgar F, Stewart J. Validity of self-report screening for overweight and obesity. Can J Public Health. (2008) 99:423–7. 10.1007/BF03405254
    1. Shapiro JR, Anderson DA. The effects of restraint, gender, and body mass index on the accuracy of self-reported weight. Int J Eat Disord. (2003) 34:177–80. 10.1002/eat.10166
    1. Visscher TLS, Viet al, Kroesbergen IHT, Seidell JC. Underreporting of BMI in adults and its effect on obesity prevalence estimations in the period 1998 to 2001. Obesity (Silver Spring). (2006) 14:2054–63. 10.1038/oby.2006.240
    1. Davis C, Patte K, Curtis C, Reid C. Immediate pleasures and future consequences. A neuropsychological study of binge eating and obesity. Appetite. (2010) 54:208–13. 10.1016/j.appet.2009.11.002
    1. Cohen AK, Rai M, Rehkopf DH, Abrams B. Educational attainment and obesity: a systematic review. Obes Rev. (2013) 14:989–1005. 10.1111/obr.12062
    1. Brogan A, Hevey D, Pignatti R. Anorexia, bulimia, and obesity: shared decision making deficits on the Iowa Gambling Task (IGT). J Int Neuropsychol Soc. (2010) 16:711–5. 10.1017/S1355617710000354

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