[Truncated abstract] Obesity is rapidly increasing in prevalence and has significant physical and mental health implications. Stress, a general term referring to factors indicative of psychological strain such as depression and anxiety, has been identified as both a cause and consequence of weight gain and obesity in some individuals. In previous research, overeating in response to stress has been investigated as either a means of mood regulation or as a response to strict dietary restraint. Cortisol, a steroid hormone that increases in response to stress, has also been linked with increased food intake in both animal and human studies. Thus, cortisol may be an additional factor contributing to overeating and weight gain in response to stress. If stress does lead to overeating and weight gain, it is also likely that stress will inhibit attempts made by obese individuals at weight loss. The first study of this thesis was a repeated measures treatment study in which the associations of stress and cortisol levels with baseline body mass index and subsequent weight loss were investigated among females participating in a cognitive behavioural weight management programme. A cross-sectional analysis prior to treatment commencement showed that the association of stress and depression with body mass index was moderated by the severity of obesity. Dichotomous thinking, a cognitive style in which events are viewed in polarised 'black and white' terms, mediated the associations of both depression and eating disorder symptomatology with BMI. ... The second study of this thesis was a controlled laboratory-based examination of food intake following an acute psychological stressor. It was hypothesised that high baseline levels of psychological stress, such as depression and anxiety, would be associated with greater increases in negative mood and cortisol levels in response to the acute stressor, both of which, in turn, would be associated with greater food intake. Contrary to the hypothesis, baseline levels of psychological stress were not associated with the extent to which negative mood and cortisol levels increased following the acute stressor. The extent to which negative mood, but not cortisol, increased following acute stress was significantly positively associated with food intake. The results do not support the hypothesis that high cortisol levels are predictive of increased food intake in human females, although the results may have been affected by the broad participant inclusion criteria. The results suggest that increases in negative mood lead to increases in food intake, although it is argued that this is unlikely to be a general effect and suggestions for future research are made. The overall aim of this research was to examine whether stress and cortisol were associated with weight status, acute changes in eating behaviour and changes in weight in the medium-term. The results are discussed in relation to this aim, wth particular focus on the differences between treatment-seeking and community samples, implications for the treatment of obesity (especially when the individual is also experiencing high levels of depression), prevention of weight gain and possible future studies of the effects of stress and depression on weight change and eating behaviour.
|Qualification||Doctor of Philosophy|
|Publication status||Unpublished - 2007|