Exploring the Potential Mediating Role of Impulsivity in the Relationship Between Body Mass Index and Alexithymia in Children and Adolescents

Aim: Interventions targeting childhood obesity require identification of psychological correlates and potential behavioral mechanisms. Because BMI varies by age and sex during childhood and adolescence, this study examined associations among alexithymia, UPPS-P impulsivity dimensions, and age- and sex-standardized BMI z-scores in youth.Material and Methods: A total of 270 children and adolescents aged 10-14 completed the Toronto Alexithymia Scale and the UPPS-P Impulsive Behavior Scale for Children (UPPS-P-C). Height and weight were measured by a physician using standard procedures. BMI-for-age z-scores and percentiles were calculated using the WHO Growth Reference 2007. Regression-based mediation analyses were conducted with PROCESS Macro Model 4, with age and sex as covariates.Results: BMI z-score was positively and significantly correlated with alexithymia and all UPPS-P-C subscales. Lack of perseverance, lack of premeditation, and negative urgency showed the strongest correlations with BMI z-score. After adjustment for age and sex, the total effect of TAS score on BMI z-score was significant (B = 0.044, SE = 0.006, p < .001). Significant indirect effects were observed through lack of premeditation (indirect effect = 0.013, 95% BootCI [0.006, 0.020]) and lack of perseverance (indirect effect = 0.013, 95% BootCI [0.006, 0.021]). Indirect effects through negative urgency, sensation seeking, and positive urgency were not significant.Conclusion: Alexithymia is associated with higher BMI z-scores in children and adolescents, partly through difficulties in premeditation and perseverance. Given the cross-sectional design, findings should be interpreted as associations rather than causal mediation. Longitudinal and interventional studies are required before intervention recommendations can be made.