Emotion dysregulation and pediatric obesity: investigating the role of Internet addiction and eating behaviors on this r
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ORIGINAL ARTICLE
Emotion dysregulation and pediatric obesity: investigating the role of Internet addiction and eating behaviors on this relationship in an adolescent sample Helin Yilmaz Kafali1 · Seyit Ahmet Uçaktürk2 · Eda Mengen2 · Serap Akpinar1 · Merve Erguven Demirtas1 · Ozden Sukran Uneri1,3 Received: 3 June 2020 / Accepted: 27 August 2020 © Springer Nature Switzerland AG 2020
Abstract Objective The first aim was to investigate whether there was a mediator role of Internet addiction or uncontrolled/emotional eating on the association between emotion dysregulation and body mass index-standard deviation score (BMI-SDS). The second aim was to detect which of these variables (emotion dysregulation, Internet addiction, and uncontrolled/emotional eating) significantly affect the presence of obesity (OB). Methods A total of 123 adolescents (OB (n = 65, 57% of girls, mean age = 15 ± 1.9, BMI percentile between 95 and 99) and healthy control (HC) (n = 58; 53% of girls, mean age = 15.5 ± 1.8, BMI percentile between 1 and 84) aged between 11 and 18 were recruited. Difficulties in Emotion Regulation Scale (DERS) and Internet Addiction Test (IAT) were completed by adolescents. Uncontrolled and emotional eating behaviors were measured by Three Factors Eating Questionnaire (TFE-Q)’s sub-domains. Results There was no significant direct effect of DERS on BMI-SDS, whereas the indirect effect of DERS on BMI-SDS which was mediated by both IAT and TFE-Q was statistically significant. In logistic regression analysis, an increase by 1 point in DERS total score escalated the odds of being OB by 2%. Moreover, a 22-fold increased risk of OB has been detected in moderate/severe Internet addiction compared to no addiction. Conclusion This cross-sectional study showed that the association between emotion dysregulation and BMI-SDS was totally mediated by internet addiction and uncontrolled/emotional eating. In addition, emotion dysregulation and Internet addiction were significant determinants of OB. A prospective study is needed to detect the causal relationship between these variables. Level of evidence Level III, case–control analytic study. Keywords Childhood obesity · Internet addiction · Eating behaviors · Emotion dysregulation
Introduction
* Helin Yilmaz Kafali [email protected] 1
Department of Child and Adolescent Psychiatry, Ministry of Health Ankara City Hospital, Bilkent, Üniversiteler, Bilkent Blv. No:1, 06800 Ankara, Turkey
2
Department of Child Endocrinology, Ministry of Health Ankara City Hospital, Ankara, Turkey
3
Department of Child and Adolescent Psychiatry, Ankara Yildirim Beyazit University, Ankara, Turkey
World Health Organization (WHO) has been declared that childhood obesity (OB) is one of the most serious public health challenges of the twenty-first century and has become an epidemic globally [1]. Childhood OB tends to persist in adulthood, and is linked to psychological consequences and noncommunicable diseases like diabetes and cardiovascular diseases [2]. To reverse this epidemi
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