Investigation of the relationship between eating behaviors, nutritional status, body image and depression in adults diagnosed with hypothyroidism

Thyroid dysfunctions can lead to not only physiological but also psychological consequences. This study was conducted to evaluate eating behaviors, depression status, and body image perception in patients with hypothyroidism and in a healthy control group. The research was carried out between September 2024 and February 2025 with 120 individuals aged between 18 and 64 who applied to the Endocrinology Outpatient Clinic of Mersin City Training and Research Hospital. This is a cross-sectional, case-control study. Participants were divided into two groups: a hypothyroid patient group (n=60), consisting of 20 overt, 20 subclinical, and 20 euthyroid individuals, and a healthy control group (n=60). During face-to-face interviews with the participants, data were collected using a structured questionnaire. The questionnaire included sociodemographic characteristics, anthropometric measurements and body composition, three-day dietary intake records, physical activity levels, and selected biochemical parameters. To assess eating behaviors, the Revised Three-Factor Eating Questionnaire (TFEQ-R18) was used. Nutritional attitudes were evaluated using the Healthy Nutrition Attitude Scale, depressive symptoms with the Beck Depression Inventory (BDI), and body image with the Stunkard Figure Rating Scale. According to the total scores of the Healthy Nutrition Attitude Scale, the control group (67,95±9,10) and the euthyroid group (69,25±9,65) had significantly higher scores than the subclinical hypothyroid group (61,20±8,89) (p<0,05). A strong positive correlation was found between body weight, Body Mass Index (BMI), and Stunkard Scale scores in both the patient and control groups (p<0,01). A moderate positive correlation was identified between serum TSH levels and selenium intake in the subclinical hypothyroid and euthyroid groups (respectively r=0,482, p=0,032; r=0,482, p=0,032). As body image perception worsened, depressive symptoms increased. Conversely, individuals with a more positive attitude toward healthy eating had more favorable body image perceptions. In conclusion, further large-scale scientific studies are needed to better understand the relationship between eating behaviors, depressive symptoms, and body dissatisfaction in individuals with hypothyroidism.