Are Stress Levels, Hedonic Hunger, and Emotional Eating Effective on Obesity?

Year 2023, , 695 - 708, 31.12.2023

Bahar Ata , Esra Kutsal Mergen , Aylin Açıkgöz Pınar

https://doi.org/10.21020/husbfd.1312040

Abstract

Objectives: This study was planned to investigate the effects of perceived stress level, hedonic hunger, and emotional eating on obesity and their relationships with each other in adults.
Materials and Methods: A questionnaire form prepared online due to the Covid-19 pandemic was applied to 212 adult individuals (18-65 years). The questionnaire form consisted of general characteristics and eating habits of the individuals, Perceived Stress Scale (PSS) to determine the stress level along with Power of Food Scale (PFS) for hedonic hunger level, and Emotional Eating Scale (EES) to determine emotional eating states.
Results: It was determined that stress levels of female individuals were high. It was determined that individuals with high-stress levels had higher body mass indexes (BMI) (p=0.046). At the same time, it was determined that the total scores of women in PSS, PFS, and EES were significantly higher. It was observed that total scores of obese individuals from all three scales were higher (p<0.05).
A moderately positive relationship was found between emotional eating and BMI (r=0.483; p<0.001), and also hedonic hunger (r=0.594; p<0.001), while a weak but positive relationship was found between emotional eating and stress level (r=0.290; p<0.001).
Conclusion: Positive relationships between stress, hedonic hunger, and emotional eating triad may contribute to unhealthy eating patterns by triggering food intake in individuals, thus may be a risk factor for obesity. Therefore, understanding the underlying mechanisms and considering the effects of interventions, strategies to promote healthier eating behaviors in individuals may contribute to prevention of obesity.

Keywords

stress level, hedonic hunger, emotional eating

Stres Düzeyi, Hedonik Açlık ve Duygusal Yeme Obezite Üzerinde Etkili mi?

Abstract

Amaç: Bu çalışma, yetişkin bireylerde algılanan stres düzeyi, hedonik açlık ve duygusal yemenin obezite üzerindeki etkilerini ve birbirleri ile olan ilişkilerini araştırmak amacıyla planlamıştır.
Gereç ve Yöntem: 18-65 yaş aralığındaki 212 yetişkin bireye, Covid-19 pandemisi nedeniyle çevrim içi (online) olarak hazırlanan anket formu uygulanmıştır. Anket formu, bireylerin genel özellikleri ve beslenme alışkanlıkları ile birlikte stres düzeyini belirlenmesi için Algılanan Stres Düzeyi Ölçeği (ASÖ), hedonik açlık düzeyi için Besin Gücü Ölçeği (BGÖ) ve duygusal yeme durumlarının belirlenmesi için Duygusal Yeme Ölçeği (DYÖ)’nden oluşmuştur.
Bulgular: Kadın bireylerin stres düzeylerinin yüksek olduğu saptanmıştır (sırasıyla; K: %28.8, E: %3.6, p=0.04). Stres düzeyi yüksek olan bireylerin beden kütle indekslerinin (BKİ) daha yüksek olduğu belirlenmiştir (p=0.046). Aynı zamanda kadınların ASÖ, BGÖ ve DYÖ’den aldıkları toplam puanların anlamlı şekilde daha yüksek olduğu saptanmıştır (p<0.05). BKİ grupları değerlendirildiğinde, obez bireylerin her üç ölçekten aldıkları toplam puanların daha yüksek olduğu görülmüştür (p<0.05). Duygusal yeme ile BKİ (r=0.483; p<0.001) ve hedonik açlık (r=0.594; p<0.001) arasında orta düzeyde pozitif yönlü, duygusal yeme ve stres düzeyi arasında da zayıf, ancak pozitif yönlü bir ilişki saptanmıştır (r=0.290; p<0.001).
Sonuç: Stres, hedonik açlık ve duygusal yeme üçlemesi arasındaki pozitif yönlü ilişkiler, bireylerde besin alımını tetikleyerek, sağlıksız beslenme modellerine katkıda bulunabilir ve dolayısıyla obezite için risk faktörü olabilir. Bu nedenle altta yatan mekanizmaları anlamak, bireylerde daha sağlıklı yeme davranışlarını teşvik etmek için yapılan müdahale ve stratejilerin etkilerini göz önünde bulundurmak, obezitenin önlenmesine katkı sağlayabilir

Keywords

stres düzeyi, hedonik açlık, duygusal yeme

References

• Albert, K., Pruessner, J., ve Newhouse, P. (2015). Estradiol levels modulate brain activity and negative responses to psychosocial stress across the menstrual cycle. Psychoneuroendocrinology, 59, 14-24. https://doi.org/10.1016/j.psyneuen.2015.04.022.
• Al-Musharaf, S. (2020). Prevalence and predictors of emotional eating among healthy young Saudi women during the COVID-19 pandemic. Nutrients, 12(10), 2923. https://doi.org/10.3390/nu12102923
• Aliasghari, F., Asghari Jafarabadi, M., Lotfi Yaghin, N., ve Mahdavi, R. (2020). Psychometric properties of Power of Food Scale in Iranian adult population: gender-related differences in hedonic hunger. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 25, 185-193. https://doi.org/10.1007/s40519-018-0549-3
• Arslantaş, H., Dereboy, F., Yüksel, R., ve İnalkaç, S. (2019). Duygusal yeme ölçeği’nin türkçe çevirisinin geçerlik ve güvenirlik çalışması. Türk Psikiyatri Dergisi, 30, 1-10. https://doı.org/ 10.5080/u23520.
• Barbosa‐Leiker, C., Kostick, M., Lei, M., McPherson, S., Roper, V., Hoekstra, T., ve Wright, B. (2013). Measurement invariance of the perceived stress scale and latent mean differences across gender and time. Stress and Health, 29(3), 253-260. https://doi.org/10.1002/smi.2463.
• Barcın-Güzeldere, H. K., ve Devrim-Lanpir, A. (2022). The association between body mass index, emotional eating and perceived stress during COVID-19 partial quarantine in healthy adults. Public Health Nutrition, 25(1), 43-50. https://doi.org/10.1017/S1368980021002974.
• Bergquist, J. M. (1992). German Americans. J. D. Buenker & L. A. Ratner (Eds.), Multiculturalism in the United States: A comparative guide to acculturation and ethnicity (pp. 53-76). Greenwood.
• Berthoud, H-R. (2011). Metabolic and hedonic drives in the neural control of appetite: who is the boss? Current Opinion in Neurobiology, 21(6), 888-896. https://doi.org/10.1016/j.conb.2011.09.004.
• Burnatowska, E., Surma, S., ve Olszanecka-Glinianowicz, M. (2022). Relationship between mental health and emotional eating during the COVID-19 pandemic: A systematic review. Nutrients, 14(19), 3989. https://doi.org/10.3390/nu14193989.
• Cappelleri, J. C., Bushmakin, A. G., Gerber, R. A., Leidy, N. K., Sexton, C. C., Karlsson, J., ve Lowe, M. R. (2009). Evaluating the Power of Food Scale in obese subjects and a general sample of individuals: development and measurement properties. International Journal of Obesity, 33(8), 913-922. https://doi.org/10.1038/ijo.2009.107.
• Chao, A. M., Jastreboff, A. M., White, M. A., Grilo, C. M., ve Sinha, R. (2017). Stress, cortisol, and other appetite‐related hormones: Prospective prediction of 6‐month changes in food cravings and weight. Obesity, 25(4), 713-720. https://doi.org/10.1002/oby.21790.
• Choi, O., Kim, J., Lee, Y., Lee, Y., ve Song, K. (2021). Association between stress and dietary habits, emotional eating behavior and insomnia of middle-aged men and women in Seoul and Gyeonggi. Nutrition Research and Practice, 15(2), 225-234. https://doi.org/10.4162/nrp.2021.15.2.225.
• Cohen, J. (1977). CHAPTER 1 - The Concepts of Power Analysis. In J. Cohen (Ed.), Statistical Power Analysis for the Behavioral Sciences (pp. 1-17). Academic Press. https://doi.org/https://doi.org/10.1016/B978-0-12-179060-8.50006-2
• Cohen, S., Kamarck, T., ve Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 385-396. https://doi.org/10.2307/2136404.
• Consultation, W. H. O. "Obesity: preventing and managing the global epidemic." World Health Organization technical report series 894 (2000): 6-15.
• Costa, C., Briguglio, G., Mondello, S., Teodoro, M., Pollicino, M., Canalella, A., Verduci, F., Italia, S., ve Fenga, C. (2021). Perceived stress in a gender perspective: a survey in a population of unemployed subjects of Southern Italy. Frontiers in Public Health, 9, 640454. https://doi.org/10.3389/fpubh.2021.640454.
• Eskin, M., Harlak, H., Demirkıran, F., ve Dereboy, Ç. (2013). Algılanan stres ölçeğinin Türkçeye uyarlanması: güvenirlik ve geçerlik analizi. New/Yeni Symposium Journal, 51(3), 132-140.
• Feig, E. H., Piers, A. D., Kral, T. V., ve Lowe, M. R. (2018). Eating in the absence of hunger is related to loss-of-control eating, hedonic hunger, and short-term weight gain in normal-weight women. Appetite, 123, 317-324. https://doi.org/10.1016/j.appet.2018.01.013.
• Frayn, M., ve Knäuper, B. (2022). Emotional eating and weight in adults: a review. Key Topics in Health, Nature, and Behavior, 1-10. https://doi.org/10.1007/s12144-017-9577-9.
• Garaulet, M., Canteras, M., Morales, E., López-Guimerà, G., Sánchez-Carracedo, D., ve Corbalán-Tutau, M. (2012). Validation of a questionnaire on emotional eating for use in cases of obesity; the Emotional Eater Questionnaire (EEQ). Nutrición Hospitalaria, 27(2), 645-651. DOI:10.3305/nh.2012.27.2.5659.
• Graves, B. S., Hall, M. E., Dias-Karch, C., Haischer, M. H., ve Apter, C. (2021). Gender differences in perceived stress and coping among college students. PloS One, 16(8), e0255634. https://doi.org/10.1371/journal.pone.0255634.
• Harding, J. L., Backholer, K., Williams, E. D., Peeters, A., Cameron, A. J., Hare, M. J., Shaw, J. E., ve Magliano, D. J. (2014). Psychosocial stress is positively associated with body mass index gain over 5 years: evidence from the longitudinal AusDiab study. Obesity, 22(1), 277-286. https://doi.org/10.1002/oby.20423.
• Hildebrandt, B. A., Racine, S. E., Keel, P. K., Burt, S. A., Neale, M., Boker, S., Sisk, C. L., ve Klump, K. L. (2015). The effects of ovarian hormones and emotional eating on changes in weight preoccupation across the menstrual cycle. International Journal of Eating Disorders, 48(5), 477-486. https://doi.org/10.1002/eat.22326.
• Hill, D., Conner, M., Clancy, F., Moss, R., Wilding, S., Bristow, M., ve O’Connor, D. B. (2022). Stress and eating behaviours in healthy adults: a systematic review and meta-analysis. Health Psychology Review, 16(2), 280-304. https://doi.org/10.1080/17437199.2021.1923406.
• Ilktac, H. Y., Savci, C., ve Akinci, A. C. (2022). Nutritional behavior during the COVID-19 pandemic: the association of fear and sleep quality with emotional eating. Eating and Weight Disorders: EWD, 27(7), 2673-2683. https://doi.org/10.1007/s40519-022-01409-3.
• Klump, K. L., Keel, P. K., Racine, S. E., Burt, S. A., Neale, M., Sisk, C. L., Boker, S., ve Hu, J. Y. (2013). The interactive effects of estrogen and progesterone on changes in emotional eating across the menstrual cycle. Journal of Abnormal Psychology, 122(1), 131. https://doi.org/10.1037/a0029524.
• Konttinen, H., Van Strien, T., Männistö, S., Jousilahti, P., ve Haukkala, A. (2019). Depression, emotional eating and long-term weight changes: a population-based prospective study. International Journal of Behavioral Nutrition and Physical Activity, 16(1), 1-11. https://doi.org/10.1186/s12966-019-0791-8.
• Lin, Y.-S., Tung, Y.-T., Yen, Y.-C., ve Chien, Y.-W. (2020). Food addiction mediates the relationship between perceived stress and body mass index in Taiwan young adults. Nutrients, 12(7), 1951. https://doi.org/10.3390/nu12071951.
• Lowe, M. R., Butryn, M. L., Didie, E. R., Annunziato, R. A., Thomas, J. G., Crerand, C. E., Ochner, C. N., Coletta, M. C., Bellace, D., ve Wallaert, M. (2009). The Power of Food Scale. A new measure of the psychological influence of the food environment. Appetite, 53(1), 114-118. https://doi.org/10.1016/j.appet.2009.05.016.
• Nashwan, A. J., Villar, R. C., Al-Qudimat, A. R., Kader, N., Alabdulla, M., Abujaber, A. A., Al-Jabry, M. M., Harkous, M., Philip, A., ve Ali, R. (2021). Quality of life, sleep quality, depression, anxiety, stress, eating habits, and social bounds in nurses during the coronavirus disease 2019 pandemic in Qatar (The PROTECTOR Study): a Cross-Sectional, Comparative Study. Journal of Personalized Medicine, 11(9), 918. https://doi.org/10.3390/jpm11090918.
• O’Connor, D., VE Conner, M. (2011). Effects of stress on eating behavior the handbook of stress science: Biology, psychology, and health (pp. 275–286). In: Springer Publishing Company.
• O'Neill, J., Kamper-DeMarco, K., Chen, X., ve Orom, H. (2020). Too stressed to self-regulate? Associations between stress, self-reported executive function, disinhibited eating, and BMI in women. Eating Behaviors, 39, 101417. https://doi.org/10.1016/j.eatbeh.2020.101417.
• Oyola, M. G., ve Handa, R. J. (2017). Hypothalamic–pituitary–adrenal and hypothalamic–pituitary–gonadal axes: sex differences in regulation of stress responsivity. Stress, 20(5), 476-494. https://doi.org/10.1080/10253890.2017.1369523.
• Rabiei, S., Sedaghat, F., ve Rastmanesh, R. (2019). Is the hedonic hunger score associated with obesity in women? A brief communication. BMC Research Notes, 12(1), 1-4. https://doi.org/10.1186/s13104-019-4351-8.
• Ribeiro, G., Camacho, M., Santos, O., Pontes, C., Torres, S., ve Oliveira-Maia, A. J. (2018). Association between hedonic hunger and body-mass index versus obesity status. Scientific Reports, 8(1), 1-9. https://doi.org/10.1038/s41598-018-23988-x.
• Slavich, G. M., ve Sacher, J. (2019). Stress, sex hormones, inflammation, and major depressive disorder: Extending Social Signal Transduction Theory of Depression to account for sex differences in mood disorders. Psychopharmacology, 236(10), 3063-3079. https://doi.org/10.1007/s00213-019-05326-9.
• Sproesser, G., Schupp, H. T., ve Renner, B. (2014). The bright side of stress-induced eating: eating more when stressed but less when pleased. Psychological Science, 25(1), 58-65. https://doi.org/10.1177/0956797613494849.
• Street, A. E., ve Dardis, C. M. (2018). Using a social construction of gender lens to understand gender differences in posttraumatic stress disorder. Clinical Psychology Review, 66, 97-105. https://doi.org/10.1016/j.cpr.2018.03.001.
• Suglia, S. F., Pamplin II, J. R., Forde, A. T., ve Shelton, R. C. (2017). Sex differences in the association between perceived stress and adiposity in a nationally representative sample. Annals of Epidemiology, 27(10), 626-631. https://doi.org/10.1146/annurev-psych-010418-102936.
• Sumalla-Cano, S., Forbes-Hernández, T., Aparicio-Obregón, S., Crespo, J., Eléxpuru-Zabaleta, M., Gracia-Villar, M., Giampieri, F., ve Elío, I. (2022). Changes in the Lifestyle of the Spanish University Population during Confinement for COVID-19. International Journal of Environmental Research and Public Health, 19(4), 2210. https://doi.org/10.3390/ijerph19042210.
• Tomiyama, A. J. (2019). Stress and obesity. Annual Review of Psychology, 70, 703-718. https://doi.org/10.1146/annurev-psych-010418-102936.
• Torres, S. J., ve Nowson, C. A. (2007). Relationship between stress, eating behavior, and obesity. Nutrition, 23(11-12), 887-894. https://doi.org/10.1016/j.nut.2007.08.008.
• Ulker, I., Ayyildiz, F., ve Yildiran, H. (2021). Validation of the Turkish version of the power of food scale in adult population. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 26, 1179-1186. https://doi.org/10.1007/s40519-020-01019-x.
• Vainik, U., Neseliler, S., Konstabel, K., Fellows, L. K., ve Dagher, A. (2015). Eating traits questionnaires as a continuum of a single concept. Uncontrolled eating. Appetite, 90, 229-239.
• Wheatley, S. D., ve Whitaker, M. J. (2019). Why do people overeat? Hunger, psychological eating and type 2 diabetes. Practical Diabetes, 36(4), 136-139e. https://doi.org/10.1002/pdi.2232.
• Worly, B., Verbeck, N., Walker, C., ve Clinchot, D. M. (2019). Burnout, perceived stress, and empathic concern: differences in female and male Millennial medical students. Psychology, Health & Medicine, 24(4), 429-438. https://doi.org/10.1080/13548506.2018.1529329.
• Yoshikawa, T., Orita, K., Watanabe, Y., ve Tanaka, M. (2012). Validation of the Japanese version of the power of food scale in a young adult population. Psychological reports, 111(1), 253-265. https://doi.org/10.2466/08.02.06.15.PR0.111.4.253-265.