Syömiskäyttäytymisen ja painonhallinnan psykologiaa

Pj. Hanna Konttinen

Pystyvyyden merkitys onnistuneessa painonhallinnassa läpi elämänkulun

Anu Joki1, Johanna Mäkelä2, Hanna Konttinen1, Mikael Fogelholm1

1Elintarvike- ja ravitsemustieteiden osasto, Helsingin yliopisto, 2Kasvatustieteiden osasto, Helsingin yliopisto

Current obesogenic environment challenges weight management. However, some people succeed to maintain normal weight. This study explored lifelong weight management from the life course perspective with the qualitative methods. We aimed to understand issues related to normal weight individuals’ pathways from childhood to adulthood and how the experienced events and their social connections have regulated their weight management. Two age groups (30-45; 55-70 years, men and women) with a total of 39 individuals participated in theme interviews. The content analysis found two main categories, adoption, and maintenance of the lifestyle, which presented some similarities in interviewees’ pathways. Childhood family played a central role in the formation of the lifestyle: food-upbringing created the basis for interviewees’ current diet, and an active lifestyle have always characterized their lives. High perceived self-efficacy was vital in weight management. Informants were confident of their routines and trusted their capabilities to recognize and handle situations threatening their lifestyle. They had skills to adjust their lifestyle to altered environments which referred to their high coping self-efficacy. Besides, interviewees highlighted the importance of habits in weight management. They improved the adopted lifestyle through constant learning. New routines became more automatic with active use and finally turning to the habitual practices, which simplified weight management. The present study concluded that childhood was important in the development of the health-promoting lifestyle of our interviewees. However, weight management was a journey over life course and success also urged skills to identify risks and adjust actions for coping the challenging situations.

Masennus, tunnesyöminen ja painonmuutokset: tuloksia 7 vuoden seurantatutkimuksesta

Hanna Konttinen1, Tatjana van Strien2, Satu Männistö3, Pekka Jousilahti3, Ari Haukkala1

1Helsingin yliopisto, 2Radboud University Nijmegen and Vrije Universiteit Amsterdam, 3Terveyden ja hyvinvoinnin laitos

Background: Emotional eating has been suggested to be one mechanism linking depression and subsequent development of obesity, but studies have rarely tested this hypothesis in a prospective setting. We aimed to examine whether emotional eating partly mediated the relationships between symptoms of depression and 7-year weight changes and whether gender, night sleep duration and physical activity moderated these associations.

Methods: Participants were Finnish 25- to 74-year-olds who attended the DILGOM study at baseline in 2007 (n=5024) and follow-up in 2014 (n=3735). Body mass index (BMI) and waist circumference (WC) were based on measured or self-reported information. Depression, emotional eating, physical activity and sleep duration were self-reported. Age- and gender-adjusted structural equation models were used as the main analysis technique.

Results: Depression and emotional eating were positively associated and they both predicted higher 7-year increase in BMI (R2=0.048) and WC (R2=0.045). The effects of depression on change in BMI and WC were partly mediated by emotional eating. Sleep duration moderated the associations of emotional eating: more specifically, emotional eating predicted higher BMI (P=0.007 for the interaction) and WC (P=0.026, respectively) increase in shorter sleepers (7 hours or less per night), but not in longer sleepers (9 hours or more).

Conclusions: Our findings provide support for the hypothesis that emotional eating is one behavioural mechanism between symptoms of depression and development of obesity and abdominal obesity. Adults with shorter sleep duration and higher emotional eating may be particularly vulnerable to weight gain, which should be taken into account in weight management interventions.

Painoon liittyvät ihanteet, käyttäytymiset ja pitkän aikavälin terveys nuorilla aikuisilla

Ulla Kärkkäinen1, Anna Keski-Rahkonen1, Jaakko Kaprio1

1Kansanterveystieteen osasto, Helsingin yliopisto

Background: Obesity with its comorbidities has become a major public health concern worldwide. Young adulthood is a particularly critical period developing overweight or obesity. However, weight-related ideals and behaviors in young adulthood remain poorly understood.

Aims: First, to explore associations of weight-related ideals and behaviors with weight change over ten years. Second, to explore whether disordered eating behaviors have long-term health consequences in young adults. Participants were young adults from FinnTwin16 (N=5236), a nationwide longitudinal study of Finnish twins born between 1975-79, assessed at mean ages 24 and 34 years. Height, weight and waist circumference and actual-ideal weight discrepancy were based on self-report. Weight maintenance was defined as weight maintained within ±5% of baseline body mass index. Disordered eating behaviors were assessed using three subscales of the Eating Disorder Inventory-2 at age 24. Physical and psychological health was assessed using self-rated health and the General Health Questionnaire at ages 24 and 34.

Results: Overall, young adults gained weight over ten years. Actual-ideal weight discrepancy was not associated with future weight change. Yet, a majority of the young women and almost half of the young men were dissatisfied with their weight. Over ten years, only about a quarter of young adults were able to maintain their weight at the baseline level. Two factors emerged as significant determinants for long-term weight maintenance in both sexes: regular eating and having no history of intentional weight loss. Disordered eating behaviors were associated with long-term health-related consequences, particularly psychological distress.

DSM-5 syömishäiriöiden esiintyvyys ja ilmaantuvuus suomalaisilla nuorilla

Yasmina Silén1, Anu Raevuori1, Pyry Sipilä1, Linda Mustelin1, Anna Keski-Rahkonen1

Objective: To estimate the lifetime prevalence and 10-year incidence of eating disorders adolescents and young adults in Finland using criteria described in the Fifth Diagnostic and Statistic Manual (DSM-5).

Method:In the FinnTwin12 cohort, all Finnish twins born from 1983–87 (n=5,600) were followed prospectively from the age of 12. A subsample of participants (n=1347, 27.7% with family history of alcoholism) were diagnostically interviewed in their early twenties. Eating disorder diagnoses were validated by three medical doctors.

Results:The combined lifetime eating disorder prevalence was 19.3% for women, 2.4% for men and 11.3% for both. Lifetimeprevalenceestimates for women and men, respectively, were 6.2% and 0.3% for Anorexia Nervosa (AN), 3% and 0.16% for Bulimia Nervosa (BN), 0.6% and 0.3% for Binge Eating Disorder (BED), 4.7% and 0.16% for Other Specified Feeding or Eating Disorder (OSFED) and 5.2% and 1.6%for Unspecified Feeding or Eating Disorder (UFED). In women, the prevalence of OSFED Atypical AN, Purging Disorder, BN (low frequency/limited duration) and BED (low frequency/limited duration) were 2.3%, 1.3%, 0.4% and 0.7%, respectively. The 10-year incidence rate per 100 000 person-years was 320 for AN, 120 for BN, 45 for BED, 250 for OSFED and 285 for UFED.

Discussion: Eating disorders among adolescents are much more frequent than previously thought. Nearly every fifth female had experienced DSM-5 eating disorders by the time they had reached young adulthood. Given the considerable burden of eating disorders, adequate screening efforts, prevention programmes and treatment facilities are needed.