A cross sectional study of the behavioural differences between obesity-resistant and obesity-susceptible individuals

Abstract

Background: Over the last 30 years, the prevalence of obesity has steadily increased into the global epidemic that it is today (1). The number of overweight and obese individuals has increased sharply; however, there is still a substantial sector of the population who have remained lean, despite living within an obesogenic environment.

Objective: The aim of the present study was to identify potential behavioural differences between obesity-resistant individuals (ORI) and obesity-susceptible individuals (OSI).

Design: The current cross-sectional study used data from the 2010 Ice Tea Study (Cohort 1) and the 2008 Born to Be Lean Study (Cohort 2). Participants from both cohorts were screened with a pre-tested tool to classify individuals who appear resistant or susceptible to obesity. Study participants were recruited through advertisements placed in the local paper, and invitations sent out to consenting participants from previous studies.

Cohort 1 consisted of 117 participants (58 males and 59 females), aged between 19-55 years old, who completed the Dutch Eating Behavior Questionnaire (DEBQ) and the Intuitive Eating Scale (IES). The results from these two questionnaires were scored and analysed with STATA version 12 and were adjusted for sex and body mass index (BMI).

Cohort 2 consisted of 105 participants (52 males and 53 females) aged between 19-56 years old, who completed a 60-part qualitative and quantitative pretested questionnaire (Lifestyle Questionnaire). Twenty-three questions were selected from the Lifestyle Questionnaire for analysis as they had particular relevance to behavioural and environmental influences. Statistical analyses were conducted using STATA version 12 and results were adjusted for sex and BMI.

Results: Cohort 1: ORI scored significantly lower than OSI on the restrained eating scale of the DEBQ (p<0.001). There were no significant differences between ORI and OSI for the emotional (p=0.116) or external eating (p=0.881) scales of the DEBQ. Obesity-resistant individuals had significantly higher total IES scores than obesity-susceptible individuals (p<0.001). Obesity-resistant individuals also scored significantly higher than obesity-susceptible individuals for the unconditional permission to eat (p<0.001), eating for physical reasons (p=0.042) and reliance on internal hunger and satiety cues subscales (p=0.001).

Cohort 2: ORI were significantly less likely than OSI to attempt weight loss (p=0.002), and significantly more likely to attempt to gain weight through dietary modification (p<0.001). Obesity-susceptible individuals were significantly more likely to recall their body weight in relation to significant life events in comparison to obesity-resistant individuals (p=0.001). In addition, obesity-resistant individuals were significantly more likely than obesity-susceptible individuals to eat when they were hungry (p=0.006) and feel energetic (p=0.019) and significantly less likely to feel tense (p=0.049) and exercise for weight control (p<0.001).

Conclusions: Obesity-resistant individuals were significantly less likely than obesity-susceptible individuals to engage in restrictive eating behaviours, while also demonstrating higher intuitive eating behaviours and energy levels. Obesity-susceptible individuals were more likely than obesity-resistant individuals to restrict and modify their dietary intake to induce weight loss and report feeling tense. Cognitive behavioural interventions that incorporate intuitive eating should be recommended as part of weight management and maintenance techniques for individuals who are struggling to control their body weight.