A Network Analysis of Cognitive and Affective Dimensions in Overweight and Obesity

Overweight and obesity are a growing public health concern with few effective long-term treatments. While excess weight has been associated with difficulties in cognitive and affective processes, their interplay has not been thoroughly explored. This study examines the network structure of anxiety/depression, emotion regulation (ER), cognitive flexibility, and eating pathology with a dimensional approach to body mass index (BMI).The sample consisted of 174 individuals (n = 48 males) with normal weight (n = 48), overweight (n = 26), and obesity (n = 100). The mean BMI was 32.80 (SD = 9.68). We estimated a regularized partial correlation network. Bootstrapping was used to assess network stability with the correlation stability (CS) coefficient. A sensitivity analysis was conducted by comparing the full sample network to participants with overweight/obesity only.The three highest Expected Influence (EI) values were Lack of ER Strategies (EI = 1.19), Eating Concerns (EI = 1.15) and Overvaluation of Weight and Shape (EI = 1.11). The most central bridge node was Depression (BEI = 0.37). Binge Eating was connected to Lack of ER strategies in both networks. Cognitive Rigidity was connected to Overvaluation of Weight and Shape in network 1. BMI was significantly more central in the full sample, compared to the sensitivity network (p < .01).Our results point to the importance of incorporating alternative ER strategies in treatment, in addition to weight, shape, and eating concerns. Depressive symptoms bridged ER difficulties, BMI and eating pathology, highlighting the relevance of evaluating and treating depression in routine clinical care.