Impact of Illness Perception in Overweight and Obesity on Bio-Functional Age and Eating/Movement Behavior-A Follow-Up Study.

Background: Despite the widespread prevalence of obesity and its potential adverse impacts on health, the majority of interventions aimed at weight loss stay ineffective. This study aimed to assess illness perception in people with overweight/obesity and its impact on bio-functional age (BFA) and cognitive patterns governing eating and movement behavior.

Methods: A total of 40 subjects from the original overweight/obesity subcohort of the Bern Cohort Study 2014 (BeCS14) were included and assessed for a follow-up from 2019-11-29 to 2020-07-14. The subjects completed a validated "bio-functional status" test battery with calculation of BFA, as well as validated questionnaires for eating and movement behavior and illness perception.

Results: Participants were overall bio-functionally younger than their chronological age (mean 4.3 ± 6.9 year equivalents) but aging was more pronounced than anticipated. Mental occupation with illness cause was moderate to high with psychosocial (PS) factors being more pronounced than naturalistic (NT) factors. There was a shift from defined theory with focus clearly on PS theories to diffuse theory with consideration of both PS and NT theories. Participants with good sense of coherence (SOC) were less likely to be mentally preoccupied with illness cause (p < 0.05, r_s = -0.404), especially with PS factors. PS theories on illness cause correlated with pathological eating behavior (emotional eating: p > 0.05, r_s = 0.378; temptation: p < 0.01, r_s = 0.486).

Conclusions: Illness perception does affect cognitive patterns and integrating it into therapeutic management for people with obesity can enhance outcomes. Strengthening of SOC is important to decrease PS stress and achieve better subjective health, less mental preoccupation, and less dysfunctional eating behavior.