Mapping the Mind-Body Connection in Obesity: What Changes When Metabolic Health Differs

Dr. Jayaditya Ghosh, Consultant Endocrinologist, Yashoda Hospital, Malakpet, Hyderabad.

Network analysis in young adults with overweight or obesity found that stress functions as the central connecting factor in those who are metabolically healthy. At the same time, a diet high in fat and sodium takes on that role in those who are metabolically unhealthy.

Individuals with obesity can also be classified as either "metabolically healthy obese" (MHO) or "metabolically unhealthy obese" (MUO), based on the presence or absence of cardio-metabolic risk factors. Despite this classification being commonly used, evidence on how nutritional habits, physical measures, and psychological features relate to one another differs between these two groups.

To address this, a study applied network analysis to examine the relationships among physical measures, dietary patterns, and psychological variables in young adults with overweight or obesity. Researchers identified the nodes with the highest centrality indices and explored their empirical modularity, generating stratified networks for the MHO and MUO subsamples separately to compare differences by metabolic status. The analysis was based on data from 188 university students, both men and women, aged 18 to 25, all classified as overweight or obese.

The two subgroups showed different bridge nodes. In the MHO group, stress was the bridge node, with the strongest connections to other psychological features (depression and anxiety), physical measures (BMI, triacylglycerol, hypertension, and glucose), and a dietary pattern characterized by intake of carbohydrates, fat, and sodium. In the MUO group, a dietary pattern characterized by high consumption of fats and sodium, closely followed by cholesterol levels, served as the bridge node, with strong links to other nutritional habits and variables.

The authors conclude that identifying the most influential nodes in individuals with and without cardio-metabolic risk factors offers valuable insight for designing targeted treatment strategies. They note that combining classical approaches — such as dietary changes, physical activity, anti-obesity drugs, and bariatric surgery — with psychotherapy, particularly cognitive-behavioral strategies focused on stress management and problem-solving, is especially important for MHO patients.

(Reference: Reivan Ortiz GG, Granero R, Icaza D, Maraver-Capdevila L. Network study of the nutritional patterns, the metabolic and the psychological status among overweight-obese young adults. Frontiers in Nutrition. 2025 Sep 19;12:1666688.)