Pathways linking BMI trajectories and mental health in an adult population-based cohort: role of emotional eating and body dissatisfaction
Bibliographic record
Abstract
BACKGROUND: Overweight and obesity are associated with poor mental health, and the association is bidirectional. Few studies have examined the association between weight change and mental health over time. We aimed to provide further insight into the association between weight gain and mental health, with a focus on emotional eating and body dissatisfaction as mediating factors. METHODS: Height and weight were self-reported upon registration, and in Spring 2022, 2023, and 2024 in the Specchio cohort (Geneva, Switzerland). BMI trajectories were estimated by (1) mixed-effects models to calculate participants' personal slopes (increase in BMI score per year), and (2) testing the odds of an upward BMI category transition from baseline to last follow-up. The associations of behavioural and psychosocial factors with BMI trajectories (slopes and transitions), and BMI trajectories with mental health outcomes were estimated using regressions adjusted for age, sex, education, and physical health condition. Structural equation modelling was used to test mediating pathways. RESULTS: Among 7388 participants (59% women, mean age 51 years), factors associated with increasing BMI over 4 years included financial hardship, short sleep duration, less physical activity, more leisure screen time, depressive and anxiety symptoms, and emotional eating (β range [95% CI] = 0.03 [0, 0.05]-0.12 [0.09, 0.15]). Increasing BMI was associated with body dissatisfaction (β = 0.36 [0.33, 0.38]) and poorer quality of life (β = -0.06 [-0.09, -0.03]) at 4-year follow-up after adjustment for anxiety and depressive symptoms at baseline. Emotional eating partly mediated the association between anxiety and depressive symptoms at baseline and increasing BMI, and between financial hardship and increasing BMI. Body dissatisfaction and poorer self-rated health partly mediated the association between increasing BMI and quality of life at follow-up. CONCLUSIONS: Emotional eating and body dissatisfaction contribute to the association between BMI trajectories and mental health and should be considered in weight management and mental health promotion strategies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".