{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T05:11:00Z","timestamp":1779340260250,"version":"3.51.4"},"reference-count":59,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aimed to examine the mediating role of digital obesity in the association between hedonic hunger and type 2 diabetes self-management among adults with type 2 diabetes mellitus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study was conducted in Turkey between April 28 and August 1, 2025. Data were collected using an online questionnaire, and 400 adults with type 2 diabetes mellitus were recruited through snowball sampling. The questionnaire included the Personal Information Form, the Power of Food Scale, the Digital Obesity Scale, and the Type 2 Diabetes Self-Management Scale. Multiple regression analysis was used to examine the associations of hedonic hunger and digital obesity with type 2 diabetes self-management. The mediating role of digital obesity was assessed using Hayes\u2019 PROCESS macro (Model 4) with bootstrapping.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Hedonic hunger was positively associated with digital obesity and negatively associated with type 2 diabetes self-management. Digital obesity was also negatively associated with type 2 diabetes self-management. Mediation analysis indicated that digital obesity significantly mediated the association between hedonic hunger and type 2 diabetes self-management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Hedonic hunger was negatively associated with type 2 diabetes self-management, and digital obesity partially mediated this relationship. These findings highlight the potential importance of addressing both psychological eating tendencies and digital lifestyle behaviors in strategies aimed at improving diabetes self-management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1825423","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T04:40:07Z","timestamp":1779338407000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations among hedonic hunger, digital obesity, and type 2 diabetes self-management"],"prefix":"10.3389","volume":"13","author":[{"given":"Ay\u015fe","family":"\u00c7amli","sequence":"first","affiliation":[{"name":"Department of Nutrition and Dietetics, Graduate School of Health Sciences, Hacettepe University","place":["Ankara, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aylin","family":"Acikgoz Pinar","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University","place":["Ankara, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Merve","family":"Terzi","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, Faculty of Health Sciences, Istanbul Yeni Yuzyil University","place":["Istanbul, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,21]]},"reference":[{"key":"ref1","volume-title":"IDF Diabetes Atlas, 11th edition","year":"2025"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"50","DOI":"10.2337\/dc25-S003","article-title":"3. Prevention or delay of diabetes and associated comorbidities: standards of care in diabetes\u20142025","volume":"48","year":"2024","journal-title":"Diabetes Care"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1135","DOI":"10.1111\/jdi.12800","article-title":"Association between hedonic hunger and glycemic control in non-obese and obese patients with type 2 diabetes","volume":"9","author":"Cheung","year":"2018","journal-title":"J Diabetes Investig"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.pmedr.2018.09.002","article-title":"The associations of sedentary time and breaks in sedentary time with 24-hour glycaemic control in type 2 diabetes","volume":"12","author":"Paing","year":"2018","journal-title":"Prev Med Rep"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1016\/j.physbeh.2007.04.006","article-title":"Hedonic hunger: a new dimension of appetite?","volume":"91","author":"Lowe","year":"2007","journal-title":"Physiol Behav"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"106146","DOI":"10.1016\/j.appet.2022.106146","article-title":"Brain regulation of hunger and motivation: the case for integrating homeostatic and hedonic concepts and its implications for obesity and addiction","volume":"177","author":"Morales","year":"2022","journal-title":"Appetite"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"2099","DOI":"10.1111\/ppc.13036","article-title":"Hedonic hunger status and related factors in adults","volume":"58","author":"\u015earahman Kahraman","year":"2022","journal-title":"Perspect Psychiatr Care"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"564","DOI":"10.1111\/jhn.13280","article-title":"The relationship between hedonic hunger and self-stigmatisation in terms of weight and self-esteem in adult people living with obesity","volume":"37","author":"\u00c7akir","year":"2024","journal-title":"J Hum Nutr Diet"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"9","DOI":"10.33076\/2021.bdd.1465","article-title":"Hedonik a\u00e7l\u0131k ve yeme davran\u0131\u015f\u0131 ili\u015fkisinin farkl\u0131 beden k\u00fctlelerine yans\u0131mas\u0131","volume":"49","author":"Ayy\u0131ld\u0131z","year":"2021","journal-title":"J Nutr Diet"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"396","DOI":"10.4239\/wjd.v14.i4.396","article-title":"Management of diabesity: current concepts","volume":"14","author":"Michaelidou","year":"2023","journal-title":"World J Diabetes"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1883","DOI":"10.1007\/s40200-022-01085-1","article-title":"Efficacy of the holistic, psychonutritional approach of Centro DAI e Obesit\u00e0 di Citt\u00e0 della Pieve in the management of type 2 diabetes among patients with obesity and dysfunctional eating","volume":"21","author":"Barana","year":"2022","journal-title":"J Diabetes Metab Disord"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1093","DOI":"10.1007\/s00592-020-01519-3","article-title":"Associations of food addiction with metabolic control, medical complications and depression among patients with type 2 diabetes","volume":"57","author":"Nicolau","year":"2020","journal-title":"Acta Diabetol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"990","DOI":"10.1038\/s41366-020-0530-x","article-title":"Changes in weight control behaviors and hedonic hunger in a commercial weight management program adapted for individuals with type 2 diabetes","volume":"44","author":"Schulte","year":"2020","journal-title":"Int J Obes"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"792","DOI":"10.1007\/s12529-015-9478-y","article-title":"Dietary adherence, Glycemic control, and psychological factors associated with binge eating among indigenous and non-indigenous Chileans with type 2 diabetes","volume":"22","author":"Herbozo","year":"2015","journal-title":"Int J Behav Med"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1080\/09603123.2024.2438122","article-title":"The effect of eating motivation on adherence to the Mediterranean diet, glycemia and lipid profile in individuals with type 2 diabetes","volume":"35","author":"\u00d6zt\u00fcrk \u00d6zkan","year":"2025","journal-title":"Int J Environ Health Res"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1038\/s41387-023-00234-6","article-title":"A scalable, virtual weight management program tailored for adults with type 2 diabetes: effects on glycemic control","volume":"13","author":"Apolzan","year":"2023","journal-title":"Nutr Diabetes"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"959","DOI":"10.2337\/dc22-1929","article-title":"An integrated digital health care platform for diabetes management with AI-based dietary management: 48-week results from a randomized controlled trial","volume":"46","author":"Lee","year":"2023","journal-title":"Diabetes Care"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"72","DOI":"10.3390\/diabetology3010006","article-title":"Diet and management of type II diabetes mellitus in the United Kingdom: a narrative review","volume":"3","author":"Rajput","year":"2022","journal-title":"Diabetologia"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1177\/10497323231223367","article-title":"\"I haven't told anyone but you\": experiences and biopsychosocial support needs of people with type 2 diabetes and binge eating","volume":"34","author":"Lindgreen","year":"2024","journal-title":"Qual Health Res"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1186\/s40337-022-00666-y","article-title":"Managing type 2 diabetes or prediabetes and binge eating disorder: a qualitative study of patients' perceptions and lived experiences","volume":"10","author":"Salvia","year":"2022","journal-title":"J Eat Disord"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1464542","DOI":"10.3389\/fpsyg.2024.1464542","article-title":"Psychosocial factors influencing dietary management in patients with type 2 diabetes and healthy adults: an ecological momentary assessment approach","volume":"15","author":"Saito","year":"2024","journal-title":"Front Psychol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"110","DOI":"10.2174\/0115733998283436231207093250","article-title":"Psychosocial facilitators and barriers to type 2 diabetes Management in Adults: a Meta-synthesis","volume":"20","author":"Lekha","year":"2024","journal-title":"Curr Diabetes Rev"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"286","DOI":"10.3390\/diabetology5030022","article-title":"Emotional eating is associated with T2DM in an urban Turkish population: a pilot study utilizing social media","volume":"5","author":"Kristo","year":"2024","journal-title":"Diabetologia"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1016\/j.pcd.2025.01.009","article-title":"Investigation of food cravings in individuals with type 2 diabetes: a hierarchical regression analysis","volume":"19","author":"\u00c7avu\u015fo\u011flu","year":"2025","journal-title":"Prim Care Diabetes"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1186\/s40359-024-01680-2","article-title":"Cross-sectional association study of hedonic hunger, self-control, cognitive distortion, and well-being with adiposity measures among a sample of urban Malaysian adults","volume":"12","author":"Say","year":"2024","journal-title":"BMC Psychol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"672","DOI":"10.1007\/s10865-024-00483-5","article-title":"The role of emotion dysregulation in self-management behaviors among adults with type 2 diabetes","volume":"47","author":"Kollin","year":"2024","journal-title":"J Behav Med"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"e44814","DOI":"10.7759\/cureus.44814","article-title":"Not hungry, but still snacking: the association between hedonic hunger and snacking behaviour among young adults in Vadodara, Gujarat","volume":"15","author":"Mankad","year":"2023","journal-title":"Cureus"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"452","DOI":"10.38079\/igusabder.1268123","article-title":"The relationship of mental health continuum with hedonic hunger and dietary habits in adults","volume":"20","author":"Yald\u0131z","year":"2023","journal-title":"\u0130stanbul Geli\u015fim \u00dcniversitesi Sa\u011fl\u0131k Bilimleri Dergisi"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"e15179","DOI":"10.1111\/dme.15179","article-title":"Exploration of the individual, social and environmental factors influencing dietary behaviour in shift workers with type 2 diabetes working in UK healthcare-the shift-diabetes study: a qualitative study using the theoretical domains framework","volume":"41","author":"Gibson","year":"2024","journal-title":"Diabet Med"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1992","DOI":"10.1111\/jhn.13198","article-title":"Individual, social and environmental factors influencing dietary behaviour in shift workers with type 2 diabetes working in UK healthcare: a cross-sectional survey","volume":"36","author":"Rubner","year":"2023","journal-title":"J Hum Nutr Diet"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"117","DOI":"10.30918\/AERJ.102.21.021","article-title":"The digital obesity scale: a scale development study","volume":"10","author":"Ko\u00e7o\u011flu","year":"2022","journal-title":"Afr Educ Res J"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"24","DOI":"10.4103\/jfcm.jfcm_335_21","article-title":"Prevalence of screen time use and its relationship with obesity, sleep quality, and parental knowledge of related guidelines: a study on children and adolescents attending primary healthcare Centers in the Makkah region","volume":"29","author":"Alqarni","year":"2022","journal-title":"J Family Community Med"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"207","DOI":"10.24171\/j.phrp.2018.9.4.10","article-title":"Joint Association of Screen Time and Physical Activity with obesity: findings from the Korea media panel study","volume":"9","author":"Shin","year":"2018","journal-title":"Osong Public Health Res Perspect"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1037\/a0014399","article-title":"Priming effects of television food advertising on eating behavior","volume":"28","author":"Harris","year":"2009","journal-title":"Health Psychol"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1708","DOI":"10.1111\/obr.12929","article-title":"Media food marketing and eating outcomes among pre-adolescents and adolescents: a systematic review and meta-analysis","volume":"20","author":"Qutteina","year":"2019","journal-title":"Obes Rev"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"e13441","DOI":"10.1111\/obr.13441","article-title":"The influence of unhealthy food and beverage marketing through social media and advergaming on diet-related outcomes in children-a systematic review","volume":"23","author":"Mc Carthy","year":"2022","journal-title":"Obes Rev"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"27613","DOI":"10.1007\/s12144-024-06350-5","article-title":"Elucidating the role of social media usage on eating behavior and hedonic hunger in college students: a cross-sectional design","volume":"43","author":"Dumlu Bi\u0307lgi\u0307n","year":"2024","journal-title":"Curr Psychol"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"2109","DOI":"10.1093\/jn\/nxac098","article-title":"Smartphone usage patterns and dietary risk factors in adolescents","volume":"152","author":"Ryu","year":"2022","journal-title":"J Nutr"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1186\/s12875-022-01761-4","article-title":"Screen time increases overweight and obesity risk among adolescents: a systematic review and dose-response meta-analysis","volume":"23","author":"Haghjoo","year":"2022","journal-title":"BMC Prim Care"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"69","DOI":"10.18043\/ncm.80.2.69","article-title":"Examining the association between screen time, beverage and snack consumption, and weight status among eastern North Carolina youth","volume":"80","author":"Hicks","year":"2019","journal-title":"N C Med J"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17249375","article-title":"Longitudinal prospective association between hedonic hunger and unhealthy food and drink intake in adolescents","volume":"17","author":"Mason","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"e12","DOI":"10.1111\/j.1467-789X.2010.00772.x","article-title":"Modern sedentary activities promote overconsumption of food in our current obesogenic environment","volume":"12","author":"Chaput","year":"2011","journal-title":"Obes Rev"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"1325265","DOI":"10.3389\/fnut.2023.1325265","article-title":"The food and beverage cues in digital marketing model: special considerations of social media, gaming, and livestreaming environments for food marketing and eating behavior research","volume":"10","author":"Maksi","year":"2023","journal-title":"Front Nutr"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"1700","DOI":"10.3390\/encyclopedia4040111","article-title":"Negative influence of social media on children\u2019s diets: a systematic review","volume":"4","author":"Prybutok","year":"2024","journal-title":"Encyclopedia"},{"key":"ref45","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17082861","article-title":"Adolescents' addictive phone use: associations with eating Behaviors and adiposity","volume":"17","author":"Domoff","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1186\/s40337-022-00698-4","article-title":"The relationships between social media exposure, food craving, cognitive impulsivity and cognitive restraint","volume":"10","author":"Filippone","year":"2022","journal-title":"J Eat Disord"},{"key":"ref47","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2018-2554","article-title":"Social media influencer marketing and children's food intake: a randomized trial","volume":"143","author":"Coates","year":"2019","journal-title":"Pediatrics"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1111\/1467-8721.ep10768783","article-title":"Statistical power analysis","volume":"1","author":"Cohen","year":"1992","journal-title":"Curr Dir Psychol Sci"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1016\/j.appet.2009.05.016","article-title":"The power of food scale. A new measure of the psychological influence of the food environment","volume":"53","author":"Lowe","year":"2009","journal-title":"Appetite"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"1179","DOI":"10.1007\/s40519-020-01019-x","article-title":"Validation of the Turkish version of the power of food scale in adult population","volume":"26","author":"Ulker","year":"2021","journal-title":"Eat Weight Disord"},{"key":"ref51","volume-title":"SPSS-AMOS-META uygulamal\u0131 istatistiksel analizler","author":"Karag\u00f6z","year":"2019"},{"key":"ref52","first-page":"33","article-title":"Tip 2 Diyabet \u00d6z Y\u00f6netimi \u00d6l\u00e7e\u011finin Geli\u015ftirilmesi","volume":"34","author":"Ko\u00e7","year":"2024","journal-title":"Sa\u011fl\u0131k ve Toplum"},{"key":"ref53","volume-title":"Using Multivariate Statistics","author":"Tabachnick","year":"2013"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1080\/03637750903310360","article-title":"Beyond baron and Kenny: statistical mediation analysis in the new millennium","volume":"76","author":"Hayes","year":"2009","journal-title":"Commun Monogr"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"983","DOI":"10.1016\/j.numecd.2019.06.006","article-title":"Dysfunctional eating in type 2 diabetes mellitus: a multicenter Italian study of socio-demographic and clinical associations","volume":"29","author":"Petroni","year":"2019","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"ref56","doi-asserted-by":"publisher","DOI":"10.1210\/jendso\/bvad090","article-title":"Physical activity, sedentary behavior, and type 2 diabetes: mendelian randomization analysis","volume":"7","author":"Yuan","year":"2023","journal-title":"J Endocr Soc"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"1715","DOI":"10.1186\/s12889-024-19227-w","article-title":"Association between sedentary behavior, screen time and metabolic syndrome among Chinese children and adolescents","volume":"24","author":"Cheng","year":"2024","journal-title":"BMC Public Health"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"2065","DOI":"10.2337\/dc16-1728","article-title":"Physical activity\/exercise and diabetes: a position statement of the American Diabetes Association","volume":"39","author":"Colberg","year":"2016","journal-title":"Diabetes Care"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"2175","DOI":"10.1038\/oby.2011.57","article-title":"Inhibiting food reward: delay discounting, food reward sensitivity, and palatable food intake in overweight and obese women","volume":"19","author":"Appelhans","year":"2011","journal-title":"Obesity (Silver Spring)"}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1825423\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T04:40:25Z","timestamp":1779338425000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1825423\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,21]]},"references-count":59,"alternative-id":["10.3389\/fnut.2026.1825423"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2026.1825423","relation":{},"ISSN":["2296-861X"],"issn-type":[{"value":"2296-861X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,21]]},"article-number":"1825423"}}