Psychological Mediators of the Association between Obesity and Symptoms of Depression, Anxiety, and Stress

Introduction: There is still paucity of knowledge about which factors can mediate the link between obesity and mental health problems. This study aimed to investigate psychological mediators of the association between different weight profiles (healthy, overweight, and obesity) and symptoms of depression, anxiety, and stress. Methods: A sample of 407 adults (>= 18 years old) with different weight profiles recruited from general population was assessed for symptoms of depression, anxiety, and stress, and dimensions of emotion regulation and body investment/body image. Robust regression and robust mediation analyses were employed to investigate predictors and mediators of mental health outcomes in relation to different weight profiles. Results: Body investment difficulties in relation to body image and body care, and emotion regulation difficulties related to a tendency towards negative secondary responses to negative emotions, and/or denial of distress, significantly mediated the association between obesity and symptoms of depression. The association between obesity and symptoms of anxiety and stress was significantly mediated by body investment difficulties related to body image concerns. Conclusions: The current study brings evidence on specific dimensions of emotion regulation and body image that play a key role for the co-occurrence of mental health problems in individuals with obesity.