The Cortisol Stress Response in Youth with Overweight and Obesity: Influence of Psychosocial Variables.

Background: Despite previous research pointing out a bifurcation in cortisol stress reactivity, it is not yet clear if all variables explaining inter-individual differences in stress responses are captured. Objectives: To explore which (psychosocial and demographic) variables predict the cortisol response after a standardized stress-and affective state (SAS)-induction in youth with overweight and obesity. Methods: As part of a randomized control trial (SRCTN83822934) investigating the effects of emotion regulation (ER)-training on top of a 10-month inpatient multidisciplinary obesity treatment, 79 children and adolescents (9-15 years) with moderate obesity (M adjusted BMI = 154.35% overweight, SD = 24.57) completed a SAS-induction before leaving the clinic. Results: Those whose cortisol levels decreased (N = 59.5%) from baseline to reactivity showed higher levels of alexithymia than increasers (p = 0.049). Attachment avoidance was a significant positive predictor of relative cortisol decrease after SAS-induction (p = 0.001). Age was significantly related to less cortisol decrease (p = 0.006). No significant effect of ER-intervention group on relative cortisol change was found. ConclusionsThe current study provides evidence for a bifurcation in cortisol stress reactivity in youth with obesity. Our data further suggested that psychosocial variables (alexithymia and attachment avoidance) influence the cortisol stress response. Future research should further explore whether the attenuators are a more vulnerable group.