Project descriptions: Eating and weight-related disorders

Executive Function and Eating Behavior (2011–2016)

In this project we investigate how self-regulatory abilities (executive functions) are linked to eating problems and bodyweight in elementary school children. We compare hot (affective) and cool (cognitive) executive sub-functions regarding their impact on eating behavior and bodyweight. Longitudinally we examine the stability of executive functions, eating behavior, bodyweight and the relations between these constructs. Executive functions are measured using child appropriate, standardized instruments; eating behavior is assessed via self-report and parent questionnaires.

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Body and emotion perception – their importance for weight and impaired eating behavior in elementary school age

Body and emotion perception of proprioceptive signals, for instance feelings like satiety or hunger, is an important pathological characteristic, whereby body perception is for instance often captured subjectively via questionnaire (i.e. the “Eating Disorder Inventory” (EDI-2; Garner, 1984), here subscale „Interoceptive Awareness“). Applying objective tests, initial works indicate, for instance via the perception of the own heartbeat, a reduced ability for body perception in Anorexia nervosa, Bulimia nervosa and subjects with pathological impaired eating behavior (i.e. Pollatos et al., 2008). The perception of proprioceptive signals (interoception) plays an important role for various conceptions of emotional experience (i.e. Damasio, 1999) and differences in the variable interoception ability interact empirical both with subjective experience, peripheral-physiological factors and with central markers of emotion processing (z.B. Critchley, Wiens, Rotshtein, Ohman, & Dolan, 2004; Herbert, Pollatos, & Schandry, 2007; Pollatos, Kirsch, & Schandry, 2005; Pollatos, Traut-Mattausch, Schroeder, & Schandry, 2007; Wiens, Mezzacappa, & Katkin, 2000). Hence, it is assumed that interindividual differences in the interoceptive sensitivity and in emotion perception act as important interacting intrapersonal risk factors for the development of overweight and pathological eating behavior. However, in this respect little or no findings exist in childhood, which is therefore focused in this study.

This promotion project is located within the framework of the examination of the younger sample of kids between currently 6 and 10 years. They will be examined regarding their ability to detect their own heartbeat (cardio sensibility). Additionally, the variability of the heart rate is going to be recorded to measure the autonomous activity. Furthermore, questionnaire data on emotional intelligence/competence as well as questions about body image are captured. Pathological eating behavior is measured via parental questionnaires and body mass index (BMI) via the real determination of size and weight of the kids. For a more precisely experimental determination of the emotional perception on a behavioral and physiological level, an additional subsample of kids is investigated in a laboratory regarding their emotion recognition and emotion regulation ability.

At the same time correlative connections between interoception ability, variability of heart rate and emotional intelligene/competence on the one hand and pathological eating behavior or BMI on the other hand will be identified. Longitudinally, statements should be made about the temporal stability of the constructs, additionally potential causal event chains should be revealed between the examined variables.

Developmental risk factors for obesity/overweight: The role of learning and behavioral problems (2011–2014)

Overweight / obesity is quite common in today's society. Its global prevalence increases not only in adulthood, but also in childhood and adolescence (as Kurth & Schaffrath Rosario, 2007; Mascara Caffier, 2005; Wabitsch et al., 2005). Middle childhood, and the beginning of school, seems to be a risk period for the development of overweight / obesity in childhood (Kurth & Schaffrath Rosario, 2007). In a series of studies, childhood obesity and childhood overweight were repeatedly brought into connection with various psychosocial impairments such as reduced quality of life, weight-related stigma, increased body dissatisfaction, school performance issues, and learning and behavioral problems (eg Griffiths et al, 2010;. Gray et al., 2011; Puhl & Latner, 2007; Fonseca et al, 2011;. Krukowski et al, 2009;. Sanderson et al, 2011;. Pitrou et al, 2010;. Braet & Beyers, 2009; Dyer et al. , 2007). Altogether, research findings indicate an increased psychosocial burden for overweight / obese children compared to normal weight children, which may have an adverse effect on the further development of those affected.

The current research project is intended primarily to examine the relationship between overweight / obesity and learning and / or behavioral problems in middle childhood, since the direction of effects of these constructs is highly controversial in the literature to date. Specifically longitudinal studies are very rare (as Blaine, 2008; Rampersaud et al., 2005). In the context of the longitudinal design of the current research project, we are offered the opportunity to look at the precise relationship among these constructs over time. In addition, other potential factors of overweight / obesity (for example, self-concept, self-control, experience weight-related teasing and critical comments) will be investigated with regard to the development and / or maintenance of overweight / obesity. Considering that not all overweight / obese children have psychosocial stress, complex moderator and mediation models are tested as well.

The role of weight status and weight stigma in childhood and adolescence (2014–2017)

Obesity and overweight is widespread in most Western countries. The prevalence of obesity has increased in adulthood as well as in childhood (e.g. Kurth & Schaffrath Rosario, 2007; Tuschen-Caffier, 2005; Wabitsch et al., 2005). In many studies has been shown that childhood overweight/obesity correlated significant with psychosocial problems such as lower quality of life, body dissatisfaction, poorer academic performance, social problems and weight stigma (e.g. Griffiths et al., 2010; Gray et al., 2011; Puhl & Latner, 2007; Fonseca et al., 2011; Krukowski et al., 2009; Sanderson et al., 2011; Pitrou et al., 2010; Braet & Beyers, 2009; Dyer et al., 2007).

Stigma and prejudice against obese people has been widely documented and it has been described as the last socially acceptable form of discrimination (Puhl & Brownell, 2001; Pull & Heurer, 2009). Studies in children and adolescents showed that weight teasing was prospective related to lower self-esteem, lower quality of life, body dissatisfaction, depression symptoms and disordered eating, also after controlling for body weight (Eisenberg, Neumark-Sztainer, Haines, Wall, 2006; Libbey, Story, Neumark-Sztainer, Boutelle, 2008).

Bias against overweight and obese individuals may be internalized by affected persons. This internalization of weight bias reflects belief in social stereotypes relating to obesity and negative self-evaluations due to one’s weight (Durso & Latner, 2008). Previous studies in adults showed that weight bias internalization has greater explanatory power of psychosocial problems over and above stigmatizing attitudes, experiences of discrimination, and body mass index (BMI). We hypothesize, that these children who does not internalize weight stigma, would have higher quality of life than those who internalize weight bias.

The research project focuses on prospective associations between overweight/obesity, weight stigma and psychosocial problems in the middle childhood.

Intrapersonal risk factors for binge eating in adolescence (2011-2014)

The project's aim was to explore intrapersonal factors which, in addition to to environmental factors, may lead to eating disorders in the form of binge eating (binge eating). These factors include, among others dissatisfaction with one's own figure or a restricted ability to perceive signals of their own body. Three issues were the focus: First, it was investigated whether intrapersonal factors can only lead to binge eating or other psychological symptoms. A Longitudinal study then went to the question of whether intrapersonal risk factors and eating binges may influence each other, thus forming a so-called vicious circle becomes chronic by the problematic eating behavior. In the third part of the project we explored how different risk factors interact in the development of binge eating.

Disordered eating behavior and gender (2014–2017)

Disordered eating behavior is especially widespread in adolescent females but shows more and more increased rates in males as well. Puberty, which is associated with considerable physical changes, appears as a special risk period for disordered eating behavior. For example, incidence rates of anorexia nervosa and bulimia nervosa reach their peaks during puberty (Jacobi & de Zwaan, 2011). In a large German representative study, 29.4% of girls and 14.4% of boys aged 11 to 17 showed disordered eating behavior (Herpertz-Dahlmann et al., 2008). Although complete clinical syndromes are quite rare, the transition from disordered eating behavior to eating disorders occurs often insidious by a steady growth in restrictive eating and thinking about figure, weight and food. As these factors increase the risk for eating disorders, it is important to investigate their risk factors and developmental models first to develop effective preventive programs hereinafter. Body dissatisfaction is one of the most influential and frequently confirmed risk factor for disordered eating behavior in females (Jacobi et al., 2004). Whereas females focus on weight and shape concerns, muscularity concerns are highly relevant in males (Mohnke & Warschburger, 2011; Presnell et al., 2004). Besides special diets to gain muscle mass, intake of food supplements and steroids are also discussed as consequences of muscularity concerns (Cafri et al., 2005). As prospective studies on risk factors of body dissatisfaction are rare up to now (Stice & Whitenton, 2002), this construct should be focused on from a longitudinal perspective. Different aspects of body dissatisfaction as well as gender-specific characteristics should be taken into account.