Longitudinal patterns of comorbidity between anxiety, depression and binge eating symptoms among patients with obesity: A path analysis

Background: Depression, anxiety, and binge eating are common psychiatric symptoms among people with obesity. Although many studies seek to understand the mechanisms of association between these psychiatric symptoms, there is no still consensus about the longitudinal association.

Methods: 155 patients (124 women) were recruited from a university-based bariatric center and evaluated over three waves (T0-T1-T2). In the last period the sample comprised 126 (104 women) participants. Trained clinicians assessed psychiatric symptoms by telephone interview using measurement scales. Partial Least Squares (PLS) was applied to investigate the path effects between anxiety, depression and binge eating symptoms over time.

Results: The results of path coefficients (β) showed that the effect of anxiety on depression was constantly significant in all periods T0 (β = 0.74), T1 (β = 0.71), and T2 (β = 0.67). Anxiety had an effect on binge eating in T0 (β = 0.39) and T2 (β = 0.26) but not in T1. Binge eating affected depressive symptoms only in T2 (β = 0.22). Two carry-over-effects were significant binge eating in T0-T1 (β = 0.41) and T1-T2 (β = 0.19).

Limitations: Telephone interviews, social isolation due to the pandemic and the social desirability may have contributed to collection and information biases.

Conclusion: Anxiety has significant path effects on depression and binge eating. Binge eating was shown to be the most unstable symptom over time. The time factor seems to contribute to path effects between the psychiatric symptoms. The results draw attention to the fact that psychiatric symptoms must be evaluated and treated in association with each other, and investigated over time.