Psychopathology, body uneasiness and self-identity in patients with non-BED obesity compared to healthy controls

Introduction: Obesity represents a major public health problem associated with medical and psychological impairment. Obesity is frequently studied with Binge Eating Disorder (BED) comorbidity. Less evidence is available for non-BED obesity, in spite of its correlation with psychological impairment and body image disturbance. In this study, we explored psychopathological features, eating behaviors, body image disturbance and self-identity impairment in patients with obesity and a control group. In patients, we also studied the relation between specific eating/body features and psychopathological symptoms. Finally, we explored the latent factorial structure that describes these features. Material and methods: The clinical sample was composed by twenty patients suffering from obesity without BED (16 females). The control group included twenty-eight healthy and normal-weight subjects (20 females) enrolled from the general population. All participants underwent a clinical interview and filled out questionnaires about body image and psychopathological symptoms. Statistics: The Student t test was applied to compare obese patients and healthy controls in all psychological dimensions. In the clinical sample, gender differences were tested through multivariate analyses of variance (MANOVA). Then, correlational analyses explored the relation between specific eating/body features and psychopathological symptoms. Lastly, a principal-components factor analysis was performed to explore the existence of a latent factorial structure emerging from assessment evaluation in obese population. Results: Obese patients reported significantly higher scores than healthy controls in several psychopathological dimensions, i.e. Somatization, Obsessive-Compulsive, Depression, Hostility, Phobic Anxiety, and Psychoticism. Patients also reported higher body uneasiness and self-identity impairment resulting from some scores on Body Uneasiness Test and Identity and Eating Disorders questionnaire. Avoidant behaviours were more frequently reported in men whereas women reported higher body distress/dissatisfaction. In the clinical sample the questionnaires were correlated and a three-factor structure emerged: “Weight and body control”, “Weakness of Self-Identity”, and “Psychopathological distress”. Discussion: The present study found that obese patients might present several disturbances in body image, self- perception and general psychopathological distress. Clinicians should be aware of these issues to improve therapeutic strategy in the treatment of obesity.