title: Effect of psychological distress on weight concern and weight control behaviors.
abstract: BACKGROUND
  Obesity is associated with chronic disorders like coronary artery diseases, metabolic syndrome, cancers, and psychiatric disorders. Stress may contribute to weight gain by disrupting weight concern, and lead to uncontrolled eating behavior. This study aimed to investigate the effects of stress on weight concern and control behaviors in normal weight and obese adults.
  
  
  METHODS
  A total of 9544 subjects were selected by multi-stage random sampling from three provinces in central Iran. Information related to weight concern and control behavior was registered in normal weight and obese participants. Psychological distress was measured by a 12-item General Health Questionnaire (GHQ-12) and subjects were divided into high and low stress groups. Logistic regression was used for analysis.
  
  
  RESULTS
  The mean age of participants was 38.7 ± 15.5 years and 50% (4772) of them were males. The adjusted odds ratio (OR) for age, sex and education of high stress to low stress level for weight concern, weight control behavior and acceptable physical activity behavior was more than 1; but the OR was less than 1 for waist circumference, obesity and healthy diet behavior. Among obese participants, higher levels of stress were associated with lower weight concern with OR, 95%CI: 0.821, (0.682 - 0.988), lower acceptable physical activity with OR = 0.833, 95%CI: (0.624 - 0.912), but higher rates of healthy diet behavior with OR = 1.360, 95% CI: (1.040 - 1.780).
  
  
  CONCLUSIONS
  Individuals with high stress level have lower weight concern and lower physical activity; therefore, they are prone to weight gain and obesity. It could be concluded that stress management should be considered as a crucial component of obesity prevention and control programs.
authors.affiliation: Mental Health Department, Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran. m_sadeghi@crc.mui.ac.ir, aikabir@yahoo.com.
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Roohafza
authors.affiliation: Minimally Invasive Surgery Research Center; Iran University of Medical Sciences, Tehran, Iran, Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Kabir
authors.affiliation: Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Masoumeh
authors.initials: M
authors.lastname: Sadeghi
authors.affiliation: Hypertension Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Pedram
authors.initials: P
authors.lastname: Shokouh
authors.affiliation: Nikan Health Researchers Institute, Tehran, Iran, 6Department of Epidemiology; Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Seyed Hossein
authors.initials: SH
authors.lastname: Aalaei-Andabili
authors.affiliation: Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Yadollah
authors.initials: Y
authors.lastname: Mehrabi
authors.affiliation: Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Nizal
authors.initials: N
authors.lastname: Sarrafzadegan
mesh_terms: D000328:Adult; D001835:Body Weight; D004038:Diet, Reducing / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D009043:Motor Activity; D009765:Obesity / Q000523:psychology; D013315:Stress, Psychological / Q000453:epidemiology*; D015431:Weight Loss