Psychosocial aspects

Psychological predictors and postpartum weight retention – The role of body image during pregnancy and postpartum (Dr. Michaela Nagl, Prof. Dr. Anette Kersting)

Pregnancy-related weight retention is a major risk factor of long-term maternal obesity and increases the risk of perinatal complications in subsequent pregnancies. Hence, limiting postpartum weight retention (PWR) should be a major target in health care. Understanding the factors that contribute to PWR is essential to design effective interventions.

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Missed chances for cancer prevention in women? Attitudes towards cancer prevention and screening women with obesity and health care professionals (Prof. Dr. Claudia Luck-Sikorski, Prof. Dr. Steffi Riedel-Heller)

Women with obesity experience a higher risk of cancers, but it has been documented that this patient clientele is less likely to undergo screening and preventive measures. The reasons for this reluctance and delay remain unknown. As data for Germany are lacking, this study aims to explore screening behavior for cancers in women with obesity, perceived causes for or against screening among women with obesity and assessing the provider perspective quantitatively and qualitatively.

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Near infrared spectroscopy neurofeedback for binge-eating disorder and obesity (NIRSBED) (Prof. Dr. Anja Hilbert)

Individuals with binge-eating disorder (BED), a highly prevalent condition in treatment-seeking individuals with obesity, exhibit recurrent binge eating and pronounced difficulty in the long-term maintenance of weight loss after behavioral weight loss (BWL) treatment. These difficulties are likely related to impairments in self-regulation, including a heightened reactivity to food, reduced inhibitory control, and increased reward sensitivity, which is reflected in differential neurophysiological activation in response to food cues in areas related to inhibitory control and reward. Addressing these underlying neurobehavioral difficulties could alleviate binge-eating symptomatology and enhance weight loss maintenance (WLM).

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Five A’s counseling in weight management of obese patients in primary care: A cluster-randomized controlled trail (INTERACT) (Prof. Dr. Steffi Riedel-Heller, completed)

Recent studies show that the medical attendance and counseling of obese patients by general practitioners (primary care) can be intensified. Similar to smoking cessation programs the Canadian Obesity Network developed and adapted the five As for the treatment of adiposity (Ask, Assess, Advise, Agree, Assist). The 5 As-approach aims at improving the interaction between provider / MD and patient.

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Bearing obesity – psychological risk factors for excessive weight gain during pregnancy (Prof. Dr. Anette Kersting, completed)

The study examines psychological risk factors, which are closely associated with the development of obesity, and the risk factors’ impact on excessive weight gain during pregnancy. Traumatic life events, childhood neglect and maltreatment, and mental problems including eating disorders, impulsivity, and mental health problems (e. g. depression) are the examined risk factors for excessive weight gain during pregnancy.

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Cognitive remediation therapy for adults with obesity – a randomized-controlled efficacy study (CRT) (Prof. Dr. Anja Hilbert)

MObese individuals show difficulties in decision-making, planning, problem-solving, and in controlling behaviors. This is called a deficit in executive functioning. These difficulties are associated with a smaller weight loss in the conservative and surgical obesity treatment. Despite the relevance of restricted executive functioning in obesity, the research of this phenomenon has only now begun to develop therapeutic approaches to improve these functions in obese patients. Cognitive remediation therapy comprises mental trainings to improve the executive functions.

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Internalized stigma as stressor – pathophysiological and psychological consequences for intervention development (Prof. Dr. Claudia Luck-Sikorski)

The stigmatization and discrimination obese people are facing, have a negative stress-like impact on their health – especially if the negative external image becomes the self-image (self-stigma). Study participants (probands) with a high level and with a low level of self-stigma are interviewed, saliva- and blood samples and tested for cortisol, a hormone that is associated with stress. Based on previous research on stigma complemented by the results of this study the scientists will develop a new intervention approach in cognitive behavioral therapy, which enables the patients to better cope with stigmatization.

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Behavioral correlates and discrimination in weight bias – an experimental approach (Prof. Dr. Claudia Luck-Sikorski)

People with obesity are confronted with negative opinions and rejection (stigmatization). Scientists assume that stigmatization leads to discrimination e. g. in work life. Yet, so far there is too few scientific data on this phe-nomenon. This study investigates the causes and mechanisms of discrimination. In a specific experiment the reactions of study participants towards obese persons within social interaction will be scrutinized. Furthermore, judgments and reactions referring to health care issues of obese patients are being tested via questionnaires and notional portrayals of individuals. Also trial lessons in a fitness center of normal- and overweight persons will be analyzed. Moreover, the income differences of these groups in work life are being examined.

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Frequency and Nature of Discrimination Experiences and Internalized Stigma (Prof. Dr. Claudia Luck-Sikorski, completed)

Persons with obesity face prejudices, rejection and discrimination within society. The researchers of this project examine the kind and degree of discrimination by interviewing about 1000 men and women with obesity. The experience of discrimination as public stigmatization plays most probably a role in transferring the stigma into an internalized or self stigma. The internalized stigma and the experience of discrimination are stressors which are adverse especially for the psychological health. The results of this study may improve therapy approaches by giving obese patients help in coping with these stressors.

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The cycle of violence throughout the life-span: Prevalence and relationship of pregnancy obesity and childhood traumatic experiences (Prof. Dr. phil. Birgit Wagner, completed)

Adverse childhood experiences, such as sexual, physical and emotional abuse, are highly prevalent in the general population. Many studies show an association between obesity and traumatic childhood experiences. Yet, obese women were barely examined in this context. Although the development of obesity depends on different individual, environmental and genetic factors the experience of adverse childhood events can be a pivotal moment. Emotional eating behavior and a negative body image due to the abuse experience can contribute the emerging and maintaining of obesity and can foil attempts of loosing weight. This study examines in obese pregnant woman a background of abuse and its influence on eating behavior. Likewise, approaches for treatment are to be derived.

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Modulation of adipocyte differentiation, adipocytokine production and other metabolic parameters by psychopharmacological agents in vitro (Prof. Dr. Hubertus Himmerich, completed)

Adiposity is a frequent problem in psychiatric patients, and vice versa, obese patients often suffer from psychiatric disorders. Individuals who take psychotropic drugs often gain weight due to the stimulating effect of the medication on the appetite center of the hypothalamus. This study examines for the first time the metabolic effects on body and fat cells while administrating certain psychopharmacological agents which are associated with loosing or gaining weight. This interdisciplinary study has the objective to understand the weight gain by intake of diverse psychopharmacological agents and their metabolic consequences on a cellular level.

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Social Facilitation Maintenance Treatment for Adults - A Randomized-Controlled Feasibility Study (SFM) (Prof. Anja Hilbert / Prof. Dr. Swen Hesse, completed)

Many people regain weight in the long term after successful weight reduction. This study uses a therapy for maintaining the reduced weight and for a healthier life style. The focus of the treatment is on strengthening the social network. Participants are overweight and obese adults after a conservative weight reduction treatment. It is the objective to examine if this maintenance therapy is feasible and efficient in contrast to regular therapies. Probands will be selected randomly for one of the two therapy forms. Furthermore, two partial studies examine if biological markers change in the participants. That includes the concentration of diverse messenger substances of the immune system in blood (cytokine) and the availability of certain transmitters in the brain (serotonin transporters).

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Attitudes of health care professionals towards bariatric surgery – identifying barriers to referral from primary care physicians and other relevant sectors (Prof. Dr. Steffi G. Riedel-Heller, completed)

The study examines the knowledge and attitudes of five different health care professionals’ groups (general practitioners, internists, orthopaedists, paediatricians, nutritionists) on loosing weight: by changing one’s life style and by bariatric surgery. Additionally, data about attitudes towards obese patients in general are collected. The results of the surveys will help to develop a brochure that supports HCPs in their work with obese patients.

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Suicidal tendency, trauma prevalence, and post-traumatic stress syndrome after bariatric surgery (Prof. Dr. phil. Birgit Wagner / Prof. Dr. Anette Kersting, completed)

Although bariatric surgery is the most effective therapy for adipose patients some will gain weight again. A long term study tries to find the reasons for this. Preoperatively psychosomatic and psychiatric risk factors such as depression or eating disorders are being evaluated. Also, it is tested to which degree impulsivity, stigmatization, auto aggressive behavior, traumatic experiences and suicidal tendencies influence the weight loss.

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