{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:12:22Z","timestamp":1792789942693,"version":"4.5.0"},"reference-count":70,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Coordenac\u0327\u00e3o de Aperfeic\u0327oamento de Pessoal de N\u00edvel Superior","award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"https:\/\/ror.org\/00x0ma614","id-type":"ROR","asserted-by":"crossref"}]},{"award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"https:\/\/ror.org\/00x0ma614","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","id":[{"id":"https:\/\/ror.org\/03swz6y49","id-type":"ROR","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/03swz6y49","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003810","name":"Hospital de Cl\u00ednicas de Porto Alegre","doi-asserted-by":"publisher","award":["Fipe\/HCPA 22-0551"],"award-info":[{"award-number":["Fipe\/HCPA 22-0551"]}],"id":[{"id":"10.13039\/501100003810","id-type":"DOI","asserted-by":"publisher"}]},{"award":["Fipe\/HCPA 22-0551"],"award-info":[{"award-number":["Fipe\/HCPA 22-0551"]}],"id":[{"id":"https:\/\/ror.org\/010we4y38","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Generalized Anxiety Disorder (GAD) and obesity are highly prevalent and often co-occur, yet it remains unclear how the presence of both conditions relates to biological, behavioral, and psychological outcomes compared with either condition alone. Understanding this subgroup is crucial to improving assessments and treatment outcomes. Objective: To characterize biological, psychological, and behavioral parameters among individuals living with obesity (LWO) and GAD (GAD + LWO), compared with those with only one condition (GAD or LWO) and healthy controls. The primary outcome was to characterize binge eating severity, assessed using the Binge Eating Scale (BES). All remaining behavioral, psychological, and biological outcomes were considered secondary evaluated outcomes. Methods: This cross-sectional study included 232 adults: GAD + LWO (n = 73), GAD only (n = 52), LWO only (n = 53), and controls (n = 54). Participants completed validated psychological measurements and eating behavior assessments and underwent clinical and metabolic evaluations, including insulin resistance (HOMA-IR) and C-Reactive Protein (CRP). Statistical analyses were performed using analysis of covariance (ANCOVA) for group comparisons and additional interaction analyses between GAD diagnosis and obesity status, adjusted for age and sex. Results: Binge eating severity was significantly higher in the GAD + LWO group than in all other groups, with the group mean exceeding the screening threshold for moderate binge eating. This group also showed significantly higher levels of depressive symptoms, emotional eating and impulsivity compared to all other groups. Factorial analyses showed a significant GAD diagnosis \u00d7 obesity interaction only for depressive symptom severity. Compared to the LWO group, individuals with GAD + LWO also exhibited higher emotional dysregulation, neuroticism, and shame. Biologically, this group showed elevated insulin resistance and higher proportions of systemic inflammation (CRP &gt; 3.0 mg\/L) in comparison with the GAD group, but similar to the LWO group. Conclusions: The co-occurrence of GAD and LWO was associated with greater severity across several behavioral and psychological outcomes compared with either condition alone. These findings highlight the potential role of tailored, integrated interventions that extend beyond standard obesity treatment to address eating behavior and self-regulation difficulties. Future prospective studies are needed to confirm these exploratory findings and determine their relevance for long-term treatment outcomes and relapse risk.<\/jats:p>","DOI":"10.3390\/nu18193115","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T10:21:48Z","timestamp":1790072508000},"page":"3115","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Behavioral, Psychological, and Metabolic Characteristics of Adults with Co-Occurring Generalized Anxiety Disorder and Obesity: A Cross-Sectional Study"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4661-5740","authenticated-orcid":false,"given":"Natasha Kim de Oliveira da","family":"Fonseca","sequence":"first","affiliation":[{"name":"Anxiety Disorders Program (PROTAN), Hospital de Cl\u00ednicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90035-903, Brazil"},{"name":"Graduate Program in Psychiatry and Behavioral Sciences, Hospital de Cl\u00ednicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90035-903, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3942-4929","authenticated-orcid":false,"given":"Gabriela Rocha","family":"dos Santos","sequence":"additional","affiliation":[{"name":"Anxiety Disorders Program (PROTAN), Hospital de Cl\u00ednicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90035-903, Brazil"},{"name":"Graduate Program in Psychiatry and Behavioral Sciences, Hospital de Cl\u00ednicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90035-903, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Gabrielle Terezinha","family":"Foppa","sequence":"additional","affiliation":[{"name":"Anxiety Disorders Program (PROTAN), Hospital de Cl\u00ednicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90035-903, Brazil"},{"name":"Graduate Program in Psychiatry and Behavioral Sciences, Hospital de Cl\u00ednicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90035-903, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Gabriella Nunes da Luz","family":"Morelo","sequence":"additional","affiliation":[{"name":"Anxiety Disorders Program (PROTAN), Hospital de Cl\u00ednicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90035-903, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Artur Zanelatto","family":"Santos","sequence":"additional","affiliation":[{"name":"Anxiety Disorders Program (PROTAN), Hospital de Cl\u00ednicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90035-903, 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Med. Assoc. J."},{"key":"ref_2","unstructured":"World Obesity Federation (2026, June 30). World Obesity Atlas. Available online: https:\/\/www.worldobesity.org\/resources\/resource-library\/world-obesity-atlas-2023."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2395","DOI":"10.1038\/s41591-024-03095-3","article-title":"A new framework for the diagnosis, staging and management of obesity in adults","volume":"30","author":"Busetto","year":"2024","journal-title":"Nat. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e000175","DOI":"10.1136\/bmjopen-2011-000175","article-title":"Obesity, orbitofrontal structure and function are associated with food choice: A cross-sectional study","volume":"1","author":"Cohen","year":"2011","journal-title":"BMJ Open"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.neubiorev.2014.12.017","article-title":"Is there a \u201cmetabolic-mood syndrome\u201d? A review of the relationship between obesity and mood disorders","volume":"52","author":"Mansur","year":"2015","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1696","DOI":"10.1016\/j.neuroimage.2010.05.059","article-title":"Body mass correlates inversely with inhibitory control in response to food among adolescent girls: An fMRI study","volume":"52","author":"Batterink","year":"2010","journal-title":"NeuroImage"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.ebiom.2019.03.051","article-title":"A biologically-informed polygenic score identifies endophenotypes and clinical conditions associated with the insulin receptor function on specific brain regions","volume":"42","author":"Dass","year":"2019","journal-title":"EBioMedicine"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.neubiorev.2017.03.011","article-title":"Hippocampal insulin resistance and altered food decision-making as players on obesity risk","volume":"77","author":"Mucellini","year":"2017","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1007\/s12144-017-9577-9","article-title":"Emotional Eating and Weight in Adults: A Review","volume":"37","author":"Frayn","year":"2017","journal-title":"Curr. Psychol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1016\/j.psychres.2018.11.070","article-title":"Anxiety symptoms and emotional eating are independently associated with sweet craving in young adults","volume":"271","author":"Minelli","year":"2019","journal-title":"Psychiatry Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.eatbeh.2013.05.008","article-title":"Eating pathology, emotion regulation, and emotional overeating in obese adults with Binge Eating Disorder","volume":"14","author":"Gianini","year":"2013","journal-title":"Eat. Behav."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1037\/a0023660","article-title":"Revisiting the affect regulation model of binge eating: A meta-analysis of studies using ecological momentary assessment","volume":"137","author":"Keel","year":"2011","journal-title":"Psychol. Bull."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.appet.2009.09.019","article-title":"Negative mood increases selective attention to food cues and subjective appetite","volume":"54","author":"Hepworth","year":"2010","journal-title":"Appetite"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.neubiorev.2014.12.008","article-title":"Emotion regulation model in binge eating disorder and obesity\u2014A systematic review","volume":"49","author":"Leehr","year":"2015","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"105706","DOI":"10.1016\/j.appet.2021.105706","article-title":"Dynamic associations between anxiety, stress, physical activity, and eating regulation over the course of a behavioral weight loss intervention","volume":"168","author":"Smith","year":"2022","journal-title":"Appetite"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1016\/j.nut.2016.01.008","article-title":"A comparison of a behavioral weight loss program to a stress management program: A pilot randomized controlled trial","volume":"32","author":"Webber","year":"2016","journal-title":"Nutrition"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/S0193-953X(05)70204-5","article-title":"The epidemiology of generalized anxiety disorder","volume":"24","author":"Kessler","year":"2001","journal-title":"Psychiatr. Clin. North Am."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1111\/obr.12052","article-title":"A systematic review of variables associated with the relationship between obesity and depression","volume":"14","author":"Preiss","year":"2013","journal-title":"Obes. Rev."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1038\/ijo.2009.252","article-title":"The association between obesity and anxiety disorders in the population: A systematic review and meta-analysis","volume":"34","author":"Gariepy","year":"2010","journal-title":"Int. J. Obes."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e16210111489","DOI":"10.33448\/rsd-v10i1.11489","article-title":"Comorbidade entre depress\u00e3o, ansiedade e obesidade e complica\u00e7\u00f5es no tratamento","volume":"10","author":"Casselli","year":"2021","journal-title":"Res. Soc. Dev."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.brat.2009.09.009","article-title":"Childhood anxiety associated with low BMI in women with anorexia nervosa","volume":"48","author":"Dellava","year":"2010","journal-title":"Behav. Res. Ther."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"102294","DOI":"10.1016\/j.eclinm.2023.102294","article-title":"Life expectancy and years of potential life lost in people with mental disorders: A systematic review and meta-analysis","volume":"65","author":"Chan","year":"2023","journal-title":"eClinicalMedicine"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1016\/j.physbeh.2015.04.007","article-title":"Anorexia nervosa as a motivated behavior: Relevance of anxiety, stress, fear and learning","volume":"152","author":"Guarda","year":"2015","journal-title":"Physiol. Behav."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1268","DOI":"10.1038\/ijo.2012.204","article-title":"The associations of anxiety and depression symptoms with weight change and incident obesity: The HUNT Study","volume":"37","author":"Brumpton","year":"2013","journal-title":"Int. J. Obes."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1111\/obr.12415","article-title":"Personality disorders and obesity: A systematic review","volume":"17","author":"Gerlach","year":"2016","journal-title":"Obes. Rev."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1037\/a0019921","article-title":"Control yourself or just eat what you like? Weight gain over a year is predicted by an interactive effect of response inhibition and implicit preference for snack foods","volume":"29","author":"Nederkoorn","year":"2010","journal-title":"Health Psychol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1111\/obr.12156","article-title":"Mindfulness-based interventions for obesity-related eating behaviours: A literature review","volume":"15","author":"Cook","year":"2014","journal-title":"Obes. Rev."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1037\/a0025407","article-title":"Executive control resources and frequency of fatty food consumption: Findings from an age-stratified community sample","volume":"31","author":"Hall","year":"2012","journal-title":"Health Psychol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1717","DOI":"10.1038\/nn.3561","article-title":"Regulation of dietary choice by the decision-making circuitry","volume":"16","author":"Rangel","year":"2013","journal-title":"Nat. Neurosci."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1038\/s41398-023-02447-w","article-title":"Obesity as pleiotropic risk state for metabolic and mental health throughout life","volume":"13","author":"Leutner","year":"2023","journal-title":"Transl. Psychiatry"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Castro, A., Roca, M., Ricci-Cabello, I., Garc\u00eda-Toro, M., Riera-Serra, P., Coronado-Simsic, V., P\u00e9rez-Ara, M.\u00c1., and Gili, M. (2021). Adherence to Lifestyle Interventions for Treatment of Adults with Depression: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph182413268"},{"key":"ref_32","first-page":"22","article-title":"The Mini-International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10","volume":"59","author":"Sheehan","year":"1998","journal-title":"J. Clin. Psychiatry"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1590\/S1516-44462000000300003","article-title":"Mini International Neuropsychiatric Interview (MINI): Validation of a short structured diagnostic psychiatric in-terview","volume":"22","author":"Amorim","year":"2000","journal-title":"Br. J. Psychiatry"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5), American Psychiatric Association. [5th ed.].","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.psychres.2017.07.065","article-title":"Active suicidal ideation during clinical antidepressant trials","volume":"257","author":"Ballard","year":"2017","journal-title":"Psychiatry Res."},{"key":"ref_36","unstructured":"ABEP (2023, February 01). Associa\u00e7\u00e3o Brasileira de Empresas de Pesquisa: Crit\u00e9rio de Classifica\u00e7\u00e3o Econ\u00f4mica Brasil 2008. Available online: www.abep.org\/novo\/FileGenerate.ashx?id=250."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: The GAD-7","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch. Intern. Med."},{"key":"ref_38","first-page":"367","article-title":"Factor structure, reliability, and item parameters of the Brazilian-Portuguese version of the GAD-7 questionnaire","volume":"24","author":"Moreno","year":"2016","journal-title":"Trends Psychol."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Kroenke, K., Spitzer, R.L., and Williams, J.B.W. (1999). Patient Health Questionnaire-9 (PHQ-9), APA.","DOI":"10.1037\/t06165-000"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1111\/j.1744-6163.2009.00224.x","article-title":"Study of the discriminative validity of the PHQ-9 and PHQ-2 in a sample of Brazilian women in the context of primary health care","volume":"45","author":"Crippa","year":"2009","journal-title":"Perspect. Psychiatr. Care"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"115","DOI":"10.15689\/ap.2015.1401.13","article-title":"Constru\u00e7\u00e3o de uma escala reduzida de Cinco Grandes Fatores de personalidade","volume":"14","author":"Passos","year":"2015","journal-title":"Avalia\u00e7\u00e3o Psicol\u00f3gica"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/s41155-018-0111-2","article-title":"Validity evidence of two short scales measuring the Big Five personality factors","volume":"31","author":"Laros","year":"2018","journal-title":"Psicol. Reflex Crit."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1016\/0191-8869(94)90150-3","article-title":"An exploration of shame measures: II: Psychopathology","volume":"17","author":"Allan","year":"1994","journal-title":"Pers. Individ. Dif."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.paid.2014.09.037","article-title":"The Other As Shamer Scale\u20132: Development and validation of a short version of a measure of external shame","volume":"74","year":"2015","journal-title":"Personal. Individ. Differ."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1023\/B:JOBA.0000007455.08539.94","article-title":"Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the Difficulties in Emotion Regulation Scale","volume":"26","author":"Gratz","year":"2004","journal-title":"J. Psychopathol. Behav. Assess."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1590\/S0101-60832010000400001","article-title":"The Portuguese version of the Difficulties in Emotion Regulation Scale and its relationship with psychopathological symptoms","volume":"37","author":"Coutinho","year":"2010","journal-title":"Rev. Psiq. Cl\u00edn."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1002\/1097-4679(199511)51:6<768::AID-JCLP2270510607>3.0.CO;2-1","article-title":"Factor structure of the Barratt impulsiveness scale","volume":"51","author":"Patton","year":"1995","journal-title":"J. Clin. Psychol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1590\/S0047-20852010000200004","article-title":"Translation and cultural adaptation of the Barratt Impulsiveness Scale (BIS-11) for administration in Brazilian adults","volume":"59","author":"Mattos","year":"2010","journal-title":"J. Bras. Psiquiatr."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/0306-4603(82)90024-7","article-title":"The assessment of binge eating severity among obese persons","volume":"7","author":"Gormally","year":"1982","journal-title":"Addict. Behav."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1590\/S1516-44462001000400008","article-title":"Translation and adaptation into Portuguese of the Binge Eating Scale","volume":"23","author":"Freitas","year":"2001","journal-title":"Braz. J. Psychiatry"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/0022-3999(85)90010-8","article-title":"The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger","volume":"29","author":"Stunkard","year":"1985","journal-title":"J. Psychosom. Res."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1590\/S1415-52732011000300002","article-title":"The Three-Factor Eating Questionnaire\u2014R21: Tradu\u00e7\u00e3o para o portugu\u00eas e aplica\u00e7\u00e3o em mul-heres brasileiras","volume":"24","author":"Natacci","year":"2011","journal-title":"Rev. Nutr."},{"key":"ref_53","doi-asserted-by":"crossref","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":"ref_54","doi-asserted-by":"crossref","first-page":"575","DOI":"10.20344\/amp.6517","article-title":"Translation, cultural adaptation and validation of the power of food scale for use by adult populations in Portugal","volume":"28","author":"Ribeiro","year":"2015","journal-title":"Acta Medica Port."},{"key":"ref_55","unstructured":"Minist\u00e9rio da Sa\u00fade (BR) (2020). Vigitel Brasil 2019: Vigil\u00e2ncia de Fatores de Risco e Prote\u00e7\u00e3o para Doen\u00e7as Cr\u00f4nicas por Inqu\u00e9rito tele-F\u00f4nico: Estimativas Sobre frequ\u00cancia e Distribui\u00e7\u00e3o Sociodemogr\u00e1fica de Fatores de Risco e Prote\u00e7\u00e3o para Doen\u00e7as Cr\u00f4nicas nas Capitais dos 26 Estados Brasileiros e no Distrito Federal em 2019."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Orsolini, L., Pompili, S., Valenta, S.T., Salvi, V., and Volpe, U. (2022). C-reactive protein as a biomarker for major depressive disorder?. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23031616"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"2182","DOI":"10.1017\/S1368980015001068","article-title":"Prevalence of and risk factors for binge eating behaviour in 6930 adults starting a weight loss or maintenance programme","volume":"19","author":"Bertoli","year":"2016","journal-title":"Public Health Nutr."},{"key":"ref_58","first-page":"247","article-title":"Power and sample size for health re-searchers: A tool for calculating sample size and statistical power designed for health researchers","volume":"40","author":"Borges","year":"2020","journal-title":"Clin. Biomed Res."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"108419","DOI":"10.1016\/j.appet.2025.108419","article-title":"Worry wart: A preregistered, experimental investigation of worry-induced emotional eating and associated psychological characteristics","volume":"219","author":"Dixit","year":"2026","journal-title":"Appetite"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1002\/cpp.2615","article-title":"Shame and binge eating pathology: A systematic review","volume":"29","author":"Grant","year":"2022","journal-title":"Clin. Psychol. Psychother."},{"key":"ref_61","first-page":"101541","article-title":"Mindfulness-based eating in obesity and anxiety: A randomized controlled trial and feasibility assessment","volume":"59","author":"Fonseca","year":"2026","journal-title":"Lancet Reg. Health Am."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1038\/ijo.2009.2","article-title":"A proposed clinical staging system for obesity","volume":"33","author":"Sharma","year":"2009","journal-title":"Int. J. Obes."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1001\/jamainternmed.2023.8526","article-title":"Approach to Obesity Treatment in Primary Care: A Review","volume":"184","author":"Yanovski","year":"2024","journal-title":"JAMA Intern. Med."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"2885","DOI":"10.1017\/S0033291722002446","article-title":"Characterizing eating behavioral phenotypes in mood disorders: A narrative review","volume":"52","author":"Koning","year":"2022","journal-title":"Psychol. Med."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1016\/j.genhosppsych.2010.09.010","article-title":"Association between change in depression and change in weight among women enrolled in weight loss treatment","volume":"32","author":"Simon","year":"2010","journal-title":"Gen. Hosp. Psychiatry"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"2641","DOI":"10.1017\/S0033291712000554","article-title":"Generalized anxiety and C-reactive protein levels: A prospective, longitudinal analysis","volume":"42","author":"Copeland","year":"2012","journal-title":"Psychol. Med."},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Fonseca, N.K.d.O.d., Brietzke, E., and Manfro, G.G. (2026). Obesity and Mental Health: A Missing Piece in the Puzzle. Obes. Rev., e70205.","DOI":"10.1111\/obr.70205"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"e078029","DOI":"10.1136\/bmjopen-2023-078029","article-title":"Common practices for sociodemographic data reporting in digital mental health intervention research: A scoping review","volume":"14","author":"Kissinger","year":"2024","journal-title":"BMJ Open"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"102446","DOI":"10.1016\/j.cpr.2024.102446","article-title":"Sociodemographic representation in randomized controlled trials for anxiety-related disorders in the U.S.: A systematic review (1993\u20132023)","volume":"111","author":"Ong","year":"2024","journal-title":"Clin. Psychol. Rev."},{"key":"ref_70","first-page":"e20240826","article-title":"Is digital psychiatry really for all? A cross-sectional analysis from two randomized clinical trials","volume":"47","author":"Gallois","year":"2025","journal-title":"Trends Psychiatry Psychother."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/19\/3115\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T04:35:51Z","timestamp":1790224551000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/19\/3115"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,22]]},"references-count":70,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["nu18193115"],"URL":"https:\/\/doi.org\/10.3390\/nu18193115","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,22]]}}}