Cheung, Pauline

H. Pakpour, Amir

imani, vida

Ying Lin, Chung

Qazvin University of Medical Sciences Repository

nutrientsArticleThe Mediating Effects of Eating Disorder,Food Addiction, and Insomnia in the Associationbetween Psychological Distress and BeingOverweight among Iranian AdolescentsChung-Ying Lin 1 , Pauline Cheung 1, Vida Imani 2, Mark D. Griffiths 3 andAmir H. Pakpour 4,5,*1 Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong PolytechnicUniversity, Hung Hom, Hong Kong; cylin36933@gmail.com (C.-Y.L.); paulinekaka@hotmail.com (P.C.)2 Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz 5166/15731, Iran;dr.v.imani@gmail.com3 Nottingham Trent University, International Gaming Research Unit, Psychology Department,Nottingham NG1 4FQ, UK; mark.griffiths@ntu.ac.uk4 Social Determinants of Health Research Center, Research Institute for Prevention of Non-CommunicableDiseases, Qazvin University of Medical Sciences, Qazvin 3419759811, Iran5 Department of Nursing, School of Health and Welfare, Jönköping University, SE-551 11 Jönköping, Sweden* Correspondence: Pakpour_Amir@yahoo.com; Tel.: +98-28-33239259Received: 22 March 2020; Accepted: 8 May 2020; Published: 11 May 2020Abstract: With obesity and excess weight remaining a serious concern worldwide, investigatingthe mechanisms underlying this is of great importance. Psychological distress is a possible triggercontributing to excess weight for adolescents. Moreover, the association between psychologicaldistress and excess weight may be mediated by eating disorder, food addiction, and insomnia.The present study utilized parallel mediation analysis to assess the aforementioned associations andpossible mediation effects among Iranian adolescents. Through stratified and clustered sampling,adolescents (N = 861; mean ± SD age = 15.9 ± 3.2; 372 males) participated and were followed fora one-year period. Excess weight (standardized body mass index, z-BMI); psychological distress(Depression, Anxiety, and Stress Scale-21); eating disorder attitudes (Eating Attitude Test-26); foodaddiction (Yale Food Addiction Scale for Children); and insomnia (Insomnia Severity Index) wereassessed. Eating disorder attitudes, food addiction, and insomnia were significant mediators in theassociation of psychological distress and z-BMI. Additionally, psychological distress had direct effectson z-BMI. Given that eating disorder attitudes, food addiction, and insomnia showed mediated effectsin the temporal association of psychological distress and excess weight, healthcare providers areencouraged to design programs on improving these three mediators to help adolescents overcomeexcess weight problems.Keywords: eating disorder; food addiction; insomnia; psychological distress; excess weight gain1. IntroductionThe issue of childhood obesity and excessive weight gain is of great concern worldwide althoughplateaued prevalence of childhood overweight has been reported in some countries, especially in thedeveloped countries [1,2]. More specifically, the prevalence of childhood overweight is still high althoughnot necessarily increasing. Recent statistics from the Centers for Disease Control and Prevention (CDC) inthe U.S. reported that 13.9% of 2- to 5-year-olds; 18.4% of 6- to 11-year-olds; and 20.6% of 12- to 19-year-oldsNutrients 2020, 12, 1371; doi:10.3390/nu12051371 www.mdpi.com/journal/nutrients

The Mediating Effects of Eating Disorder,

Food Addiction, and Insomnia in the Association

between Psychological Distress and Being

Overweight among Iranian Adolescents

http://eprints.qums.ac.ir/10399/1/The%20Mediating%20Effects%20of%20Eating%20Disorder%2C.pdf

The Mediating Effects of Eating Disorder, Food Addiction, and Insomnia in the Association between Psychological Distress and Being Overweight among Iranian Adolescents

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