Obezite Bulmacası: Beslenme Bilgisi, Yeme Davranışı, Zayıflık ve Yemeği Kısıtlama Beklentisini Çözme

Öz

Bu kesitsel çalışma, fazla kilolu ve obez kadınlarda beslenme bilgisi, bağımlılık benzeri yeme davranışları ve zayıflık ve diyet beklentileri arasındaki ilişkileri incelemiştir. Araştırma, Ocak-Haziran 2024 tarihleri arasında gerçekleştirilmiş ve 447 katılımcıyı kapsamıştır. Çalışmada “Beslenme Bilgisi Ölçeği” (BBÖ), “Bağımlılık Benzeri Yeme Davranışları Ölçeği” (BBYDÖ) ve “Zayıflıktan ve Yemeyi Kısıtlamaktan Beklentiler Ölçeği” (T-TREI) kullanılmıştır. Bulgular, obez kadınların anlamlı şekilde daha düşük BBÖ puanlarına sahip olduğunu ve bu puanların vücut ağırlığı (-0.416, p<0.001) ve BKİ (-0.430, p<0.001) ile ters orantılı olduğunu göstermiştir. BBYDÖ puanları ve iştah dürtüleri obez kadınlarda daha yüksek bulunmuş ve vücut ağırlığı (0.362, p<0.001) ve BKİ (0.340, p<0.001) ile pozitif ilişki göstermiştir. Hafif kilolu kadınlar ise daha yüksek T-TREI puanlarına ve daha iyi diyet kontrolüne sahiptir. Yetersiz beslenme bilgisi ve bağımlılık benzeri yeme davranışları etkili vücut ağırlığı yönetimini zorlaştırırken, zayıflığa yönelik gerçekçi olmayan beklentiler durumu karmaşıklaştırmaktadır. Sürdürülebilir vücut ağırlığı yönetimi sağlamak için beslenme bilgisini artırmaya yönelik yeme davranışlarını ele alan kanıta dayalı müdahaleler geliştirilmelidir.

Anahtar Kelimeler

• obezite
• beslenme bilgisi
• yeme davranışları
• zayıflık beklentisi

The Obesity Puzzle: Unraveling Nutrition Knowledge, Eating Behaviors, Thinness and Restricting Expectancy

Abstract

This cross-sectional study examined the associations between nutritional knowledge, addiction-like eating behaviors, and expectations of thinness and dieting in overweight and obese women. The study was conducted between January and June 2024 and included 447 participants. It utilized the “Nutrition Knowledge Scale” (NKS), “Addiction-like Eating Behavior Scale” (ALEBS) and “Thinness and Restriction Expectation Inventory” (T-TREI). Results showed that obese women had significantly lower NKS scores, inversely correlated with body weight (-0.416, p<0.001) and BMI (-0.430, p<0.001). ALEBS scores and appetite drives were higher among obese women and positively associated with body weight (0.362, p<0.001) and BMI (0.340, p<0.001). Overweight women had higher T-TREI scores and better diet control. Insufficient nutritional knowledge and addiction-like behaviors hinder effective body weight management, while unrealistic expectations regarding thinness complicate outcomes. Evidence-based interventions addressing eating behaviors to increase nutritional knowledge should be developed to ensure sustainable body weight management.

Keywords

• obesity
• Nutritional Knowledge
• Eating Behaviors
• Thinness Expectancy

References

1. Akkartal, Ş., & Gezer, C. (2020). is nutrition knowledge related to diet quality and obesity? Ecology of Food and Nutrition, 59(2), 119–129. https://doi.org/10.1080/03670244.2019.1675654
2. Ayaz, A., Nergiz-Ünal, R., Dedebayraktar, D., Akyol, A., Pekcan, A. G., Besler, H. T., & Büyüktuncer, Z. (2018). How does food addiction influence dietary intake profile?. PloS one, 13(4), e0195541. https://doi.org/10.1371/journal.pone.0195541
3. Blüher, M., Aras, M., Aronne, L. J., Batterham, R. L., Giorgino, F., Ji, L., Pietiläinen, K. H., Schnell, O., Tonchevska, E., & Wilding, J. P. H. (2023). New insights into the treatment of obesity. Diabetes, obesity & metabolism, 25(8), 2058–2072. https://doi.org/10.1111/dom.15077
4. Bozkurt, O., Çamlı, A., & Kocaadam‐Bozkurt, B. (2024). Factors affecting food addiction: emotional eating, palatable eating motivations, and BMI. Food Science & Nutrition, 12(9), 6841-6848. https://doi.org/10.1002/fsn3.4333
5. Busetto, L., Bettini, S., Makaronidis, J., Roberts, C. A., Halford, J. C. G., & Batterham, R. L. (2021). Mechanisms of weight regain. European journal of internal medicine, 93, 3–7. https://doi.org/10.1016/j.ejim.2021.01.002
6. Canuto, R., Garcez, A., de Souza, R. V., Kac, G., & Olinto, M. T. A. (2021). Nutritional intervention strategies for the management of overweight and obesity in primary health care: A systematic review with meta-analysis. Obesity reviews: an official journal of the International Association for the Study of Obesity, 22(3), e13143. https://doi.org/10.1111/obr.13143 Chao, A. M., Wadden, T. A., Tronieri, J. S., Pearl, R. L., Alamuddin, N., Bakizada, Z. M., Pinkasavage, E., Leonard, S. M., Alfaris, N., & Berkowitz, R. I. (2019). Effects of addictive-like eating behaviors on weight loss with behavioral obesity treatment. Journal of behavioral medicine, 42(2), 246–255. https://doi.org/10.1007/s10865-018-9958-z
7. Constant, A., Moirand, R., Thibault, R., & Val-Laillet, D. (2020). Meeting of minds around food addiction: insights from addiction medicine, nutrition, psychology, and neurosciences. Nutrients, 12(11), 3564. https://doi.org/10.3390/nu1211356
8. Contreras, R. E., Schriever, S. C., & Pfluger, P. T. (2019). Physiological and epigenetic features of yoyo dieting and weight control. Frontiers in genetics, 10, 1015. https://doi.org/10.3389/fgene.2019.01015

9. Cui, L., Chen, T., Li, Z., Yu, Z., Liu, X., Li, J., Guo, Y., Xu, D., & Wang, X. (2022). Association between dietary related factors and central obesity among married women: China Health and Nutrition Survey. Appetite, 168, 105785. https://doi.org/10.1016/j.appet.2021.105785
10. Dancey, C. P., & Reidy, J. (2004). Statistics without Maths for Psychology (3rd ed.). Harlow: Pearson Education.
11. De Ceglia, M., Decara, J., Gaetani, S., & Rodríguez de Fonseca, F. (2021). Obesity as a condition determined by food addiction: Should brain endocannabinoid system alterations be the cause and its modulation the solution?. Pharmaceuticals, 14(10), 1002. https://doi.org/10.3390/ph14101002
12. Demir, D., Bektaş, M., Demir, S. & Bektaş, İ. (2021). Psychometric properties of the Turkish version of the addiction-like eating behavior scale for university students. Curr Psychol 40, 2590–2598. https://doi.org/10.1007/s12144-020-00664-w
13. Ekici, E.M., Yıldırım, Z., & Erdem, S. (2024). Understanding the role of perfectionism in adult expectations of dietary restriction and thinness. Gulhane Medical Journal, 66(4), 203-210. https://doi.org/10.4274/gulhane.galenos.2024.16046
14. Hohlstein, L. A., Smith, G. T., & Atlas, J. G. (1998). An application of expectancy theory to eating disorders: Development and validation of measures of eating and dieting expectancies. Psychological Assessment, 10(1), 49. https://doi.org/10.1037/1040-3590.10.1.49
15. LaFata, E. M., & Gearhardt, A. N. (2022). Ultra-processed food addiction: An epidemic?. Psychotherapy and psychosomatics, 91(6), 363–372. https://doi.org/10.1159/000527322
16. Levinson, J. A., Kinkel-Ram, S., Myers, B., & Hunger, J. M. (2024). A systematic review of weight stigma and disordered eating cognitions and behaviors. Body image, 48, 101678. https://doi.org/10.1016/j.bodyim.2023.101678
17. Lin, X., & Li, H. (2021). Obesity: epidemiology, pathophysiology, and therapeutics. Frontiers in endocrinology, 12, 706978. https://doi.org/10.3389/fendo.2021.70697
18. Lobstein, T., Jackson-Leach, R., Powis, J., Brinsden. H., & Gray, M. (2023). World obesity atlas 2023. World obesity
19. Lustig, R. H., Collier, D., Kassotis, C., Roepke, T. A., Kim, M. J., Blanc, E., ... & Heindel, J. J. (2022). Obesity I: Overview and molecular and biochemical mechanisms. Biochemical pharmacology, 199, 115012. https://doi.org/10.1016/j.bcp.2022.115012
20. Morgan-Bathke, M., Raynor, H. A., Baxter, S. D., Halliday, T. M., Lynch, A., Malik, N., Garay, J. L., & Rozga, M. (2023). Medical nutrition therapy interventions provided by dietitians for adult overweight and obesity management: An academy of nutrition and dietetics evidence-based practice guideline. Journal of the Academy of Nutrition and Dietetics, 123(3), 520–545.e10. https://doi.org/10.1016/j.jand.2022.11.014
21. O’Brien, K. S., Puhl, R. M., Latner, J. D., Lynott, D., Reid, J. D., Vakhitova, Z., Hunter, J. A., Scarf, D., Jeanes, R., Bouguettaya, A., & Carter, A. (2020). The effect of a food addiction explanation model for weight control and obesity on weight stigma. Nutrients, 12(2), 294. https://doi.org/10.3390/nu12020294
22. Olson, E. A., Visek, A. J., McDonnell, K. A., & DiPietro, L. (2012). Thinness expectations and weight cycling in a sample of middle-aged adults. Eating behaviors, 13(2), 142–145. https://doi.org/10.1016/j.eatbeh.2011.11.013
23. Öngun-Yılmaz, H., Aydın-Haklı, D., Toğuç, H., Çobanoğlu, Z., Önel-Sayar, C., Erkul, C., Murat-Günal, A. (2021). Nutrition knowledge scale (NKS): Development, factor structure, and validation for healthy adults. Prog. Nutr., 23, e2021104. https://doi.org/10.23751/pn.v23i3.11030
24. Özdemir, A., Serin, E. K., & Şahin, T. (2021). The relationship between eating behaviors and learned helplessness among the people with overweight and affected by obesity: A cross-sectional study. Türkiye Diyabet ve Obezite Dergisi, 5(2), 217-225. https://doi.org/10.25048/tudod.970776
25. Pegington, M., French, D. P., & Harvie, M. N. (2020). Why young women gain weight: A narrative review of influencing factors and possible solutions. Obesity reviews: An official journal of the International Association for the Study of Obesity, 21(5), e13002. https://doi.org/10.1111/obr.13002
26. Pursey, K. M., Skinner, J., Leary, M., & Burrows, T. (2021). The Relationship between addictive eating and dietary intake: A systematic review. Nutrients, 14(1), 164. https://doi.org/10.3390/nu14010164
27. Romano, K. A., Heron, K. E., & Henson, J. M. (2021). Examining associations among weight stigma, weight bias internalization, body dissatisfaction, and eating disorder symptoms: Does weight status matter?. Body image, 37, 38–49. https://doi.org/10.1016/j.bodyim.2021.01.006
28. Ruddock, H. K., Christiansen, P., Halford, J. C. G., & Hardman, C. A. (2017). The development and validation of the Addiction-like Eating Behaviour Scale. International journal of obesity (2005), 41(11), 1710–1717. https://doi.org/10.1038/ijo.2017.158
29. Sapmaz-Yurtsever, S., & Tekinsav-Sütçü, G. S. (2022). Yemeden Beklentiler Ölçeği ile Zayıflıktan ve Yemeyi Kısıtlamaktan Beklentiler Ölçeğinin türkçeye uyarlanması ve psı̇kometrı̇k özellı̇klerı̇nı̇n incelenmesi. Studies in Psychology, 42(1), 133-164. https://doi.org/10.26650/SP2022-884579
30. TÜİK (Turkish Statistical Institute) (2024). İstatistiklerle kadın, 2023. https://data.tuik.gov.tr/Bulten/Index?p=Istatistiklerle-Kadin-2023-53675 adresinden erişildi.
31. Vainik, U., García-García, I., & Dagher, A. (2019). Uncontrolled eating: a unifying heritable trait linked with obesity, overeating, personality and the brain. The European journal of neuroscience, 50(3), 2430–2445. https://doi.org/10.1111/ejn.14352
32. WHO (World Health Organization) (2024). Obesity and overweight. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight#:~:text=For%20adults%2C%20WHO%20defines%20overweight,than%20or%20equal%20to%2030 adresinden erişildi.
33. Wiss D. (2022). Clinical considerations of ultra-processed food addiction across weight classes: An eating disorder treatment and care perspective. Current addiction reports, 9(4), 255–267. https://doi.org/10.1007/s40429-022-00411-0
34. Wu, Y. K., & Berry, D. C. (2018). Impact of weight stigma on physiological and psychological health outcomes for overweight and obese adults: A systematic review. Journal of advanced nursing, 74(5), 1030–1042. https://doi.org/10.1111/jan.13511
35. Zhou, L., Zeng, Q., Jin, S., & Cheng, G. (2017). The impact of changes in dietary knowledge on adult overweight and obesity in China. PloS one, 12(6), e0179551. https://doi.org/10.1371/journal.pone.0179551