Impulsivity, ınternalizing symptoms, and disordered eating as predictors of adolescents' body mass ındex: a structural equation modeling study in adolescents with overweight and obesity and their mothers

Abstract

Obesity in children and adolescents, a global health concern with serious cardiometabolic and psychosocial impacts, requires understanding BMI risk factors to inform effective prevention and intervention strategies. This study aimed to compare the sociodemographic and clinical characteristics of adolescents with normal weight, overweight, and obesity to identify the main predictors of BMI. Methods: This crosssectional study included adolescents with normal weight (n = 100), overweight (n = 100), or obesity (n = 100) and their mothers. Adolescents were evaluated through semi-structured clinical interviews, and only those without comorbid psychiatric or medical conditions were included. Both adolescents and their mothers completed selfreport measures assessing disordered eating behaviors, impulsivity, and comorbid psychiatric symptoms. Structural equation modeling was used to examine the factors associated with adolescents' BMI. Adolescents with overweight and obesity and their mothers exhibited higher levels of comorbid anxiety and depressive symptoms, greater engagement in restrictive, emotional, and external eating behaviors, and increased impulsivity compared to those with normal weight (p < .05). The analysis shows that adolescents' BMI is directly predicted by adolescents' impulsivity (beta = .842) and gender (beta = .073). Maternal impulsivity indirectly influences adolescents' BMI through multiple pathways, including both maternal (beta = .360) and adolescent (beta = .629) disordered eating behaviors and adolescents' impulsivity (beta = .120). Additionally, maternal BMI, maternal and adolescent disordered eating behaviors further contribute to these indirect effects. This study demonstrates the dynamic relationship between adolescent and maternal factors in predicting adolescent BMI. The findings emphasize the importance of targeting both adolescent and maternal factors, particularly impulsivity, to develop effective obesity prevention and intervention strategies.