Independent role of alexithymia on weight loss outcomes in obese women: a six month follow-up study

Abstract Background The relationship between difficulties in emotion regulation and obesity has received a great deal of attention. This study aimed to investigate whether alexithymia affects the success of weight loss in obese women, and whether this is mediated by depression. Methods This prospective longitudinal study was conducted at an obesity centre, where female patients were enrolled in a six-month diet and education programme. At the beginning of the programme, the Toronto Alexithymia Scale (TAS-20) and the Beck Depression Inventory (BDI) were used to assess levels of alexithymia and depression, respectively. Body mass index (BMI) was also calculated. At the end of six months, BMI was calculated again. The mediating role of the depressive symptoms in the association between the alexithymia and the rate of change in BMI(cBMI) was examined using the Process v4.2 package by Andrew F. Hayes, with model 4 being employed. The bootstrap method was used to test the indirect effect. Results The study included 49 obese women. There was a statistically significant negative correlation between cBMI and TAS-20 score at baseline (ρ= -0.756; p < 0.001), whereas there was no statistically significant correlation between BDI score and cBMI (ρ = 0.037; p = 0.802). In the regression model, alexithymia was independently associated with cBMI (p < 0.001), while depressive symptoms were not independently associated with changes in BMI (p = 0.690). The indirect effect of the TAS-20 score on cBMI via depression was not statistically significant. Conclusion Higher levels of alexithymia were associated with poorer weight loss outcomes in obese women, independent of depressive symptom severity.