Ikwuagwu 1

Joshua Ikwuagwu

Professor Nolen

ENGL 1301

November 4 2021

Analysis of

As rates of obesity increase in America, so does a decline in mental wellness. 5 highly

qualified researchers at the University of Minnesota wrote a peer reviewed study titled

“Depression, Anxiety and Severity of Obesity in Adolescents: Is Emotional Eating the Link?” In

it they study the behavior of adolescents who are overweight and facing mental troubles, such as

depression and anxiety. While the researchers are following the rules of the scientific method,

they made a potentially large mistake in their research, which in could invalidate this entire

study.

The purpose of this research study was to “characterize the impact of depression and

anxiety on the severity of obesity among youth seeking weight management treatment and to

determine the extent to which emotional eating mediates the relationship between depression

and/or anxiety and degree of obesity” (Pg.1). They found this through clinical trials conducted on

obese teenagers between the ages of 12-18 during January 2012 through October 2013.

Of the researchers involved in this study, 1 is the head of the Pediatrics Department at

The University of Minnesota. 4 of them work in the Pediatrics Department of the university, and

the 1 that isn’t belongs to the Division of Biostatistics. The Pediatrics Department has a direct

link to this study since it involves children, and each of the researchers themselves have their

own specializations in the department. Allison Foy is a major in Clinical Behavioral

Neuroscience, with a focus on pediatrics. Aaron Kelly and Claudia Fox are the Co-Directors for
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Minnesota Universities’ Center for Pediatric Obesity Medicine (CPOM). Amy Gross is the

Associate Director for Clinical Care in the Center for Pediatric Obesity Medicine at the

University of Minnesota, and is a member of the Association for Behavior Analysis and The

Obesity Society (Medical School - University of Minnesota). These qualifications demonstrate

their expertise in both mental, physical health, and statistical analysis. This adds an extra layer of

validity by showing its author are credible.

On the first page of the article there is a disclaimer at the bottom of the page, stating “Dr.

Kelly serves as a consultant for Takeda Pharmaceuticals and Novo Nordisk Pharmaceuticals and

is the signatory author for a pediatric obesity clinical trial sponsored by Novo Nordisk

Pharmaceuticals; he does not accept personal or professional income for his services. Dr. Kelly

also receives research support from Astra Zeneca Pharmaceuticals in the form of drug/placebo.

Dr. Fox is a site principal investigator for a pediatric obesity clinical trial sponsored by Novo

Nordisk Pharmaceuticals. None of the other authors have disclosures” (Pg.1). Takeda

Pharmaceuticals is a Japanese pharmaceutical company. It is the largest pharmaceutical company

in Asia and one of the top 20 largest pharmaceutical companies in the world by revenue. In 2014,

just 1 year after this study was published, they released a drug called Contrave. One of the

ingredients for that drug is bupropion, which is known as an anti-depressant. This study is about

proving the link between depression, anxiety, and obesity, and one of its 5 PhD’s also happened

to be working for Takeda during his time researching the study. It could be possible that his

purpose in assisting this study was to perform the research for Takeda and sell them the

information before it was published. After all the study concluded in 2013, but this research was

published 3 years later. Their acknowledgement of this possible conflict of interest shows they
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are not worried about how people view their motivations behind the study. This gives a comfort

that their research is unbiased in anyway.

On page 3 of the study, under the measures section, there is mentions to how they came

to receive the data. “Depression was assessed with the Patient Health Questionnaire (PHQ-9), a

9-item, self-report survey on a 4-point Likert scale (0=’not at all’ to 3=’nearly every day’).

Anxiety was assessed with the Generalized Anxiety Disorder Scale (GAD-7), a 7-item self-

report survey on a 4-point Likert scale (0=’not at all’ to 3=’nearly every day’). A PHQ-9 score

cut point of ≥11 was considered positive for detecting depression15 and a GAD-7 score cut point

of ≥ 10 was considered positive for detecting anxiety. […] Emotional eating was measured by

patient self-report on the Child Eating Behavior Questionnaire (CEBQ), Emotional Over-Eating

subscale.18 The CEBQ was originally designed as a parent report of child eating behavior, yet

precedent has been made for using a modified version of the CEBQ as an adolescent self-report

measure.19 As such, prefix statements were modified from ‘My child…’ to ‘I…’ The four items

comprising the Emotional Over-Eating subscale are: ‘eat more when anxious,’ ‘eat more when

annoyed,’ ‘eat more when worried,’ and ‘eat more when nothing else to do.’ Each item was rated

on a 5-point Likert scale (1=never to 5=always). The mean of the four items was used as the

emotional eating score”. Seeing as this is a self-report, a question can be brought up to the

researchers. How can they trust their reports? It is no secret that teenagers lie to cover their

tracks, but this study ranged from 12-18, with a mean of 15. A study conducted by the Victoria

W. Dykstra, Teena Willoughby, Angela D. Evans for The Journal of Adolescence, titled “Lying

to friends: Examining lie-telling, friendship quality, and depressive symptoms over time during

late childhood and adolescence”, lie telling in proportionate with having poor mental health,
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which we know the majority of their experiment base has. Even with the researcher’s credibility,

how can users of their research trust children to speak the truths of their situation.

Most of the researcher’s involved in this study each had a specialization in

pediatrics and mental wellness. They well all professors at The University of Minnesota, both co-

directors of the Center for Pediatric Obesity Medicine were on this team. There was even a large

chance that this research was used in the production of antidepressant-based diet pill. Yet, the

downfall of this study was their reliance on the words of children to be the bridge between reality

and their hypothesis. It is possible the children told the truth, but other researchers cannot rely on

the possibility of the truth. A peer reviewed study is supposed to be thoroughly done in order to

guarantee its data can be trusted, and with that being said, this study cannot be trusted.
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Citations

https://med.umn.edu/bio/pediatrics-a-z/amy-gross Accessed November, 4

https://med.umn.edu/bio/pediatrics-by-division/claudia-fox Accessed November, 4

https://experts.umn.edu/en/persons/allison-foy/publications/ Accessed November, 4

https://directory.sph.umn.edu/bio/sph-a-z/kyle-rudser Accessed November, 4

“Aaron Kelly, Phd.” Medical School - University of Minnesota,

https://med.umn.edu/bio/pediatrics-a-z/aaron-kelly. Accessed November, 4

Fox, Claudia K, et al. “Depression, Anxiety, and Severity of Obesity in Adolescents: Is

Emotional Eating the Link?” Clinical Pediatrics, U.S. National Library of Medicine, Oct. 2016,

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5958895/. Accessed November, 4

“Takeda and Orexigen Announce FDA Approval of Contrave® (Naltrexone HCI and

Bupropion HCI) Extended-Release Tablets for Chronic Weight Management.” Takeda and

Orexigen Announce FDA Approval of Contrave® (Naltrexone HCI and Bupropion HCI)

Extended-Release Tablets for Chronic Weight Management,

https://www.takeda.com/newsroom/newsreleases/2014/takeda-and-orexigen-announce-fda-

approval-of-contrave-naltrexone-hci-and-bupropion-hci-extended-release-tablets-for-chronic-

weight-management/.

Lying to friends: Examining lie-telling, friendship quality, and depressive symptoms over

time during late childhood and adolescence

Dykstra, Victoria W;Willoughby, Teena;Evans, Angela D

Journal of Adolescence 84:123

Academic Press 2020-10-01

01401971
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10.1016/j.adolescence.2020.08.003