Examination of gender differences: Causal attributions of treatment-seeking individuals with overweight and obesity

Background: Addressing patients' perceptions of the causes of their overweight and obesity may be a promising approach to enhance treatment motivation and success. Previous research suggests that there are gender differences in these aspects. The objective of this study was to investigate gender differences in causal attributions among individuals with overweight and obesity who participated in a cognitive-behavioral mobile health (mHealth) intervention. Method: Causal attributions were assessed using the revised Illness Perceptions Questionnaire, which included a rated and open answering section. An ANCOVA was conducted for each causal factor (behavioral, psychological, risk, external) as a dependent variable to determine gender differences, which were analysed with chi-squared tests for open-ended responses. Results: The most frequently mentioned and highly rated cause was behavior for both genders (59.8% of 639 responses). The results indicated that women rated psychological causes, particularly stress-related causes, significantly higher (F(1,211)=14.88, p<.001, η²=.07), and were more likely to cite emotional eating than men (Chi²(1, N=639)=15.06, p<.001). Men rated alcohol stronger as cause than women (t(125.05)=3.79, p<.001). Conclusion: The findings of this study contribute to the understanding of the gender differences in causal attributions among individuals with overweight or obesity. Implementing stress management interventions with a focus on emotion regulation is pivotal, especially for females. Interventions should focus on sensitizing males to the association between emotions and eating behavior. The causal attributions should be assessed with different survey methods in order to match the patient’s view of their condition.