Background: Impulsivity, defined as "a predisposition toward rapid unplanned reactions to internal or external stimuli without regard to negative consequences", has been linked with obesity, unhealthy and disordered eating1,2, and quality-of-life (QOL)2 in a general population and less weight loss after bariatric surgery3. Whether impulsivity is linked with other obesity-related factors is unknown. This study examines the association between impulsiveness and eating habits, QOL, physical activity, internalized weight bias, disordered eating, food addiction, perceived ability to resist food and weight loss.
Methods: Patients attending a tertiary weight loss clinic between March 2021 and June 2024 completed the Barrett Impulsiveness Scale (BIS) short form at baseline. Obesity-related factors were assessed by questionnaires. Anthropometry was self-reported. ANOVA and Pearson's correlation were used for data analysis.
Results: 363 patients completed the BIS, mean (SD) age 48.3 years (13.6), BMI 46.2 kg/m2 (10.2), BIS score 31.3 (6.7) and 71.6% females. Females reported more fatigue and less confidence in losing weight at baseline.
Impulsiveness was weakly but significantly positively correlated ( r range 0.169 to 0.313) with baseline BMI, dietary fats score, grazing, sleepiness, food addiction symptoms, EDEQ global score and the EDEQ subscales of weight, body shape and eating, disinhibition scores, and susceptibility to hunger. BIS score was weakly negatively correlated ( r range 0.109 to 0.285) with age, ability to resist food under different circumstances, cognitive restraint, internalized weight bias, leisure and sport physical activity scores, confidence in own ability to lose weight, QOL measures, and percentage weight loss at six and 12 months.
Conclusion: Impulsiveness is associated with higher BMIs, poorer diets, eating pathology, less leisure time activity, poorer perceived ability to resist foods and less confidence in losing weight. While modifying a personality trait is challenging, there is some evidence that incretin therapy may be helpful and worth exploring.