青少年超重肥胖与饮食失调的关系:一个有调节的中介模型
The Relationship between Overweight and Obesity and Eating Disorders in Adolescents: A Moderated Mediating Model
DOI: 10.12677/ap.2026.161054, PDF,    科研立项经费支持
作者: 田嘉文:西南大学心理学部,重庆
关键词: 青少年超重肥胖饮食失调症状限制性饮食性别Adolescents Overweight and Obesity Eating Disorder Symptoms Restrained Eating Gender
摘要: 为考察青少年超重肥胖、限制性饮食、性别和饮食失调的关系,采用身高与体重的自我报告、饮食失调诊断量表、限制性饮食量表对392名青少年进行调查。结果显示:1) 身体质量指数(BMI)显著正向预测限制性饮食、饮食失调症状;2) 超重肥胖青少年具有更高的限制性饮食、饮食失调水平;3) 限制性饮食在BMI与饮食失调之间起到部分中介作用;4) 性别对中介效应的后半段起调节作用,在超重肥胖女性群体内,限制性饮食对饮食失调的正向预测作用更强。研究结果揭示了超重肥胖个体发展为饮食失调可能的心理作用机制,帮助识别超重肥胖群体可能的饮食失调风险因素,能够为针对超重肥胖群体的体重管理提供一定的实证依据,具有重要的现实意义。
Abstract: To explore the relationship between overweight and obesity, restrained eating, gender, and eating disorders in adolescents. A sample of 392 adolescents was surveyed using self-reports of height and weight, the Eating Disorder Diagnose Scale, and the Restraint Scale. Results showed that: 1) Body mass index (BMI) significantly positively predicted both restrained eating and disordered-eating symptoms; 2) Overweight and obese adolescents have higher levels of restrained eating and eating disorders; 3) Restrained eating played a partial mediating role between BMI and eating disorders; 4) Gender moderated the second half of the mediating effect, and in the overweight and obese female group, the positive predictive effect of restrained eating on eating disorders was stronger. The findings outline a plausible psychological pathway from excess weight to eating pathology, highlight sex-specific risk factors, and supply empirical guidance for weight-management interventions targeting overweight/obese youth.
文章引用:田嘉文 (2026). 青少年超重肥胖与饮食失调的关系:一个有调节的中介模型. 心理学进展, 16(1), 494-505. https://doi.org/10.12677/ap.2026.161054

参考文献

[1] American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders: DSM-5 (5th ed.). American Psychiatric Publishing.
[2] Balakrishnan, B., Selvaraju, V., Chen, J., Ayine, P., Yang, L., Ramesh Babu, J. et al. (2021). Ethnic Variability Associating Gut and Oral Microbiome with Obesity in Children. Gut Microbes, 13, Article 1882926.[CrossRef] [PubMed]
[3] Bernabe, A., Bernotiene, G., Bettiol, H., Bhagyalaxmi, A., Bharadwaj, S. et al. (2017). Worldwide Trends in Body-Mass Index, Underweight, Overweight, and Obesity from 1975 to 2016: A Pooled Analysis of 2416 Population-Based Measurement Studies in 128.9 Million Children, Adolescents, and Adults. The Lancet, 390, 2627-2642.[CrossRef] [PubMed]
[4] Chen, K., Shen, Z., Gu, W., Lyu, Z., Qi, X., Mu, Y. et al. (2023a). Prevalence of Obesity and Associated Complications in China: A Cross-Sectional, Real‐World Study in 15.8 Million Adults. Diabetes, Obesity and Metabolism, 25, 3390-3399.[CrossRef] [PubMed]
[5] Chen, X., Dong, D., Zhou, F., Gao, X., Liu, Y., Wang, J. et al. (2023b). Connectome-Based Prediction of Eating Disorder-Associated Symptomatology. Psychological Medicine, 53, 5786-5799.[CrossRef] [PubMed]
[6] Da Luz, F. Q., Hay, P., Gibson, A. A., Touyz, S. W., Swinbourne, J. M., Roekenes, J. A. et al. (2015). Does Severe Dietary Energy Restriction Increase Binge Eating in Overweight or Obese Individuals? A Systematic Review. Obesity Reviews, 16, 652-665.[CrossRef] [PubMed]
[7] Da Luz, F. Q., Hay, P., Touyz, S., & Sainsbury, A. (2018). Obesity with Comorbid Eating Disorders: Associated Health Risks and Treatment Approaches. Nutrients, 10, Article 829.[CrossRef] [PubMed]
[8] Da Luz, F. Q., Sainsbury, A., Mannan, H., Touyz, S., Mitchison, D., & Hay, P. (2017). Prevalence of Obesity and Comorbid Eating Disorder Behaviors in South Australia from 1995 to 2015. International Journal of Obesity, 41, 1148-1153.[CrossRef] [PubMed]
[9] Darby, A., Hay, P., Mond, J., Quirk, F., Buttner, P., & Kennedy, L. (2009). The Rising Prevalence of Comorbid Obesity and Eating Disorder Behaviors from 1995 to 2005. International Journal of Eating Disorders, 42, 104-108.[CrossRef] [PubMed]
[10] Davies, A., Wellard-Cole, L., Rangan, A., & Allman-Farinelli, M. (2020). Validity of Self-Reported Weight and Height for BMI Classification: A Cross-Sectional Study among Young Adults. Nutrition, 71, Article 110622.[CrossRef] [PubMed]
[11] De Man Lapidoth, J., Ghaderi, A., & Norring, C. (2006). Eating Disorders and Disordered Eating among Patients Seeking Non-Surgical Weight-Loss Treatment in Sweden. Eating Behaviors, 7, 15-26.[CrossRef] [PubMed]
[12] De Zwaan, M., Mitchell, J. E., Howell, L. M., Monson, N., Swan-Kremeier, L., Crosby, R. D. et al. (2003). Characteristics of Morbidly Obese Patients before Gastric Bypass Surgery. Comprehensive Psychiatry, 44, 428-434.[CrossRef] [PubMed]
[13] Dong, D., Wang, Y., Jackson, T., Chen, S., Wang, Y., Zhou, F. et al. (2016). Impulse Control and Restrained Eating among Young Women: Evidence for Compensatory Cortical Activation during a Chocolate-Specific Delayed Discounting Task. Appetite, 105, 477-486.[CrossRef] [PubMed]
[14] Duncan, A. E., Ziobrowski, H. N., & Nicol, G. (2017). The Prevalence of Past 12‐Month and Lifetime DSM-IV Eating Disorders by BMI Category in us Men and Women. European Eating Disorders Review, 25, 165-171.[CrossRef] [PubMed]
[15] Dymek-Valentine, M., Rienecke-Hoste, R., & Alverdy, J. (2004). Assessment of Binge Eating Disorder in Morbidly Obese Patients Evaluated for Gastric Bypass: SCID versus QEWP-R. Eating and Weight Disorders—Studies on Anorexia, Bulimia and Obesity, 9, 211-216.[CrossRef] [PubMed]
[16] Fairburn, C. G., & Harrison, P. J. (2003). Eating Disorders. The Lancet, 361, 407-416.[CrossRef] [PubMed]
[17] Field, A. E., Austin, S. B., Taylor, C. B., Malspeis, S., Rosner, B., Rockett, H. R. et al. (2003). Relation between Dieting and Weight Change among Preadolescents and Adolescents. Pediatrics, 112, 900-906.[CrossRef] [PubMed]
[18] Fisher, M., Golden, N. H., Katzman, D. K., Kreipe, R. E., Rees, J., Schebendach, J. et al. (1995). Eating Disorders in Adolescents: A Background Paper. Journal of Adolescent Health, 16, 420-437.[CrossRef] [PubMed]
[19] Flament, M. F., Buchholz, A., Henderson, K., Obeid, N., Maras, D., Schubert, N. et al. (2015). Comparative Distribution and Validity of DSM‐IV and DSM‐5 Diagnoses of Eating Disorders in Adolescents from the Community. European Eating Disorders Review, 23, 100-110.[CrossRef] [PubMed]
[20] Galmiche, M., Déchelotte, P., Lambert, G., & Tavolacci, M. P. (2019). Prevalence of Eating Disorders over the 2000-2018 Period: A Systematic Literature Review. The American Journal of Clinical Nutrition, 109, 1402-1413.[CrossRef] [PubMed]
[21] Gearhardt, A. N., Yokum, S., Orr, P. T., Stice, E., Corbin, W. R., & Brownell, K. D. (2011). Neural Correlates of Food Addiction. Archives of General Psychiatry, 68, 808-816.[CrossRef] [PubMed]
[22] Goldschmidt, A. B., Wall, M. M., Loth, K. A., & Neumark-Sztainer, D. (2015). Risk Factors for Disordered Eating in Overweight Adolescents and Young Adults: Table I. Journal of Pediatric Psychology, 40, 1048-1055.[CrossRef] [PubMed]
[23] Hayes, J. F., Fitzsimmons-Craft, E. E., Karam, A. M., Jakubiak, J., Brown, M. L., & Wilfley, D. E. (2018). Disordered Eating Attitudes and Behaviors in Youth with Overweight and Obesity: Implications for Treatment. Current Obesity Reports, 7, 235-246.[CrossRef] [PubMed]
[24] He, J., Cai, Z., & Fan, X. (2017). Prevalence of Binge and Loss of Control Eating among Children and Adolescents with Overweight and Obesity: An Exploratory Meta‐Analysis. International Journal of Eating Disorders, 50, 91-103.[CrossRef] [PubMed]
[25] Herman, C. P., & Mack, D. (1975). Restrained and Unrestrained Eating. Journal of Personality, 43, 647-660.[CrossRef] [PubMed]
[26] Jebeile, H., Lister, N. B., Baur, L. A., Garnett, S. P., & Paxton, S. J. (2021). Eating Disorder Risk in Adolescents with Obesity. Obesity Reviews, 22, e13173.[CrossRef] [PubMed]
[27] Kim, K. B., & Shin, Y. A. (2020). Males with Obesity and Overweight. Journal of Obesity & Metabolic Syndrome, 29, 18-25.[CrossRef] [PubMed]
[28] Kong, F., Zhang, Y., & Chen, H. (2013). The Construct Validity of the Restraint Scale among Mainland Chinese Women. Eating Behaviors, 14, 356-360.[CrossRef] [PubMed]
[29] Lemstra, M., Bird, Y., Nwankwo, C., Rogers, M., & Moraros, J. (2016). Weight-Loss Intervention Adherence and Factors Promoting Adherence: A Meta-Analysis. Patient Preference and Adherence, 10, 1547-1559.[CrossRef] [PubMed]
[30] Lister, N. B., Baur, L. A., Paxton, S. J., & Jebeile, H. (2023). Eating Disorders in Weight-Related Therapy (EDIT) Collaboration: Rationale and Study Design. Nutrition Research Reviews, 37, 32-42.
[31] Loth, K., Wall, M., Larson, N., & Neumark‐Sztainer, D. (2015). Disordered Eating and Psychological Well-Being in Overweight and Nonoverweight Adolescents: Secular Trends from 1999 to 2010. International Journal of Eating Disorders, 48, 323-327.[CrossRef] [PubMed]
[32] McClelland, J., Robinson, L., Potterton, R., Mountford, V., & Schmidt, U. (2020). Symptom Trajectories into Eating Disorders: A Systematic Review of Longitudinal, Nonclinical Studies in Children/Adolescents. European Psychiatry, 63, e60.[CrossRef] [PubMed]
[33] Mitchison, D., Mond, J., Bussey, K., Griffiths, S., Trompeter, N., Lonergan, A. et al. (2020). DSM-5 Full Syndrome, Other Specified, and Unspecified Eating Disorders in Australian Adolescents: Prevalence and Clinical Significance. Psychological Medicine, 50, 981-990.[CrossRef] [PubMed]
[34] Müller, T. D., Greene, B. H., Bellodi, L., Cavallini, M. C., Cellini, E., Di Bella, D. et al. (2012). Fat Mass and Obesity-Associated Gene (FTO) in Eating Disorders: Evidence for Association of the rs9939609 Obesity Risk Allele with Bulimia Nervosa and Anorexia Nervosa. Obesity Facts, 5, 408-419.[CrossRef] [PubMed]
[35] Neumark-Sztainer, D. (2009). Preventing Obesity and Eating Disorders in Adolescents: What Can Health Care Providers Do? Journal of Adolescent Health, 44, 206-213.[CrossRef] [PubMed]
[36] Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2014). Prevalence of Childhood and Adult Obesity in the United States, 2011-2012. Journal of the American Medical Association, 311, 806-814.[CrossRef] [PubMed]
[37] Quek, Y. H., Tam, W. W. S., Zhang, M. W. B., & Ho, R. C. M. (2017). Exploring the Association between Childhood and Adolescent Obesity and Depression: A Meta‐Analysis. Obesity Reviews, 18, 742-754.[CrossRef] [PubMed]
[38] Rancourt, D., & McCullough, M. B. (2015). Overlap in Eating Disorders and Obesity in Adolescence. Current Diabetes Reports, 15, Article No. 78.[CrossRef] [PubMed]
[39] Sanders, R. H., Han, A., Baker, J. S., & Cobley, S. (2015). Childhood Obesity and Its Physical and Psychological Co-Morbidities: A Systematic Review of Australian Children and Adolescents. European Journal of Pediatrics, 174, 715-746.[CrossRef] [PubMed]
[40] Sim, L. A., Lebow, J., & Billings, M. (2013). Eating Disorders in Adolescents with a History of Obesity. Pediatrics, 132, e1026-e1030.[CrossRef] [PubMed]
[41] Spear, B. A. (2006). Does Dieting Increase the Risk for Obesity and Eating Disorders? Journal of the American Dietetic Association, 106, 523-525.[CrossRef] [PubMed]
[42] Stice, E., & Agras, W. S. (1998). Predicting Onset and Cessation of Bulimic Behaviors during Adolescence: A Longitudinal Grouping Analysis. Behavior Therapy, 29, 257-276.[CrossRef
[43] Stice, E., Presnell, K., & Spangler, D. (2002). Risk Factors for Binge Eating Onset in Adolescent Girls: A 2-Year Prospective Investigation. Health Psychology, 21, 131-138.[CrossRef] [PubMed]
[44] Stice, E., Presnell, K., Shaw, H., & Rohde, P. (2005). Psychological and Behavioral Risk Factors for Obesity Onset in Adolescent Girls: A Prospective Study. Journal of Consulting and Clinical Psychology, 73, 195-202.[CrossRef] [PubMed]
[45] Stice, E., Telch, C. F., & Rizvi, S. L. (2000). Development and Validation of the Eating Disorder Diagnostic Scale: A Brief Self-Report Measure of Anorexia, Bulimia, and Binge-Eating Disorder. Psychological Assessment, 12, 123-131.[CrossRef
[46] Wang, K., Liang, R., Ma, Z., Chen, J., Cheung, E. F. C., Roalf, D. R. et al. (2018). Body Image Attitude among Chinese College Students. PsyCh Journal, 7, 31-40.[CrossRef] [PubMed]
[47] Zachrisson, H. D., Vedul‐Kjelsas, E., Götestam, K. G., & Mykletun, A. (2008). Time Trends in Obesity and Eating Disorders. International Journal of Eating Disorders, 41, 673-680.[CrossRef] [PubMed]