Attribution of weight regain to emotional reasons amongst European adults with overweight and obesity who regained weight following a weight loss attempt

Kirby Sainsbury, Elizabeth H Evans, Susanne Pedersen, Marta M Marques, Pedro J Teixeira, Liisa Lähteenmäki, R James Stubbs, Berit L Heitmann, Falko F Sniehotta, Kirby Sainsbury, Elizabeth H Evans, Susanne Pedersen, Marta M Marques, Pedro J Teixeira, Liisa Lähteenmäki, R James Stubbs, Berit L Heitmann, Falko F Sniehotta

Abstract

Purpose: Despite the wide availability of effective weight loss programmes, maintenance of weight loss remains challenging. Difficulties in emotion regulation are associated with binge eating and may represent one barrier to long-term intervention effectiveness in obesity. The purpose of this study was to determine the relationship between emotion regulation difficulties and the extent of weight regain in a sample of adults who had lost, and then regained, weight, and to examine the characteristics associated with emotional difficulties.

Methods: 2000 adults from three European countries (UK, Portugal, and Denmark) completed an online survey assessing self-reported weight loss and regain following their most recent weight loss attempt. They also completed a binge eating disorder screening questionnaire and, if they had regained weight, were asked if they attributed it to any emotional factors (a proxy for emotion regulation difficulties). Spearman's correlations and logistic regression were used to assess the associations between emotion regulation, weight regain, and strategy use.

Results: Emotion regulation difficulties were associated with greater weight regain (N = 1594 who lost and regained weight). Attribution to emotional reasons was associated with younger age, female gender, loss of control and binge eating, lower perceptions of success at maintenance, using more dietary and self-regulatory strategies in weight loss, and fewer dietary strategies in maintenance.

Conclusions: Weight-related emotion regulation difficulties are common amongst regainers and are associated with regaining more weight. Affected individuals are already making frequent use of behavioural strategies during weight loss, but do not apply these consistently beyond active attempts. Simply encouraging the use of more numerous strategies, without concurrently teaching emotion regulation skills, may not be an effective means to improving weight outcomes in this group.

Level of evidence: Level V, descriptive (cross-sectional) study.

Keywords: Binge eating; Emotion regulation; Loss of control; Obesity; Weight loss maintenance.

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Percentage of the sample who endorsed each emotional reason for regain and relationship with WLM, by gender. ***p < .001 (Spearman’s rank-ordered correlations of relationship between each ERR and weight regain); endorsement of comfort eating, stressed, low/down, emotionally drained, and punishment were each associated with greater weight regain/poorer WLM; no emotional reasons was associated with better WLM/lower regain. The proportion of the sample who endorsed at least one ERR was 56% in the UK, 57% in Portugal, and 35% in Denmark (χ2 = 59.3, p < .001). Significant gender differences were observed for all ERR (p = .000–.021)

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