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Volume 15
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Article

Worry, Rumination, and Metacognitive Beliefs in Adolescents with Obesity Associated with Binge Eating Disorder (BED) vs. Age-Matched Adolescents with Essential Obesity: A Cross-Sectional Study

by
Anna Guerrini Usubini
1,*,
Maria Gobetti
2,
Sara Ducale
2,
Adele Bondesan
1,
Diana Caroli
1,
Francesca Frigerio
1,
Laura Abbruzzese
3,
Nicoletta Marazzi
1,
Gianluca Castelnuovo
2,4 and
Alessandro Sartorio
1
1
Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 28824 Piancavallo-Verbania, Italy
2
Psychology Research Laboratory, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 28824 Piancavallo-Verbania, Italy
3
Division of Auxology, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 28824 Piancavallo-Verbania, Italy
4
Department of Psychology, Catholic University of Milan, 20123 Milan, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2026, 15(2), 573; https://doi.org/10.3390/jcm15020573 (registering DOI)
Submission received: 9 December 2025 / Revised: 5 January 2026 / Accepted: 8 January 2026 / Published: 10 January 2026
(This article belongs to the Section Mental Health)
Versions Notes

Abstract

Background/Objectives: The study aimed to investigate the presence of worry, rumination, and metacognitive beliefs in adolescents with maladaptive eating behaviours. Methods: The study involved 37 adolescents (10 males, 27 females, mean age ± SD: 15.4 ± 1.53 years) with obesity (Body Mass Index, BMI > 97th centile) associated with binge eating disorder (BED) (BES score ≥ 17) and 30 age-matched adolescents (13 males, 17 females, mean age ± SD: 15.2 ± 1.98 years) with essential obesity (i.e., without BED, BES score < 17). Participants completed self-report questionnaires—Penn State Worry Questionnaire (PSWQ), Ruminative Response Scale (RRS), Anger Rumination Scale (ARS), and Metacognitions Questionnaire for Children (MCQ-C)—to assess binge eating, worry, rumination, and metacognitive beliefs, respectively. Results: Patients with obesity and BED showed higher scores on the PSWQ (p = 0.006), RRS (p < 0.001), ARS (p < 0.001), negative Metaworry (p = 0.011), and total MCQ-C (p = 0.027) than those with essential obesity, with a medium-to-large effect size, indicating that the differences between subgroups were meaningful. Conclusions: Our findings highlight that BMI alone is not associated with metacognitive processes and beliefs. The presence of BED in adolescents with obesity is linked to increased levels of worry, rumination, and maladaptive metacognitive beliefs, in comparison with age-matched adolescents with essential obesity. The results of the study underline the need for different psychological approaches in these clinical conditions going forward.
Keywords: worry; rumination; metacognitive beliefs; metacognition; adolescence; obesity; binge eating disorder worry; rumination; metacognitive beliefs; metacognition; adolescence; obesity; binge eating disorder

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MDPI and ACS Style

Guerrini Usubini, A.; Gobetti, M.; Ducale, S.; Bondesan, A.; Caroli, D.; Frigerio, F.; Abbruzzese, L.; Marazzi, N.; Castelnuovo, G.; Sartorio, A. Worry, Rumination, and Metacognitive Beliefs in Adolescents with Obesity Associated with Binge Eating Disorder (BED) vs. Age-Matched Adolescents with Essential Obesity: A Cross-Sectional Study. J. Clin. Med. 2026, 15, 573. https://doi.org/10.3390/jcm15020573

AMA Style

Guerrini Usubini A, Gobetti M, Ducale S, Bondesan A, Caroli D, Frigerio F, Abbruzzese L, Marazzi N, Castelnuovo G, Sartorio A. Worry, Rumination, and Metacognitive Beliefs in Adolescents with Obesity Associated with Binge Eating Disorder (BED) vs. Age-Matched Adolescents with Essential Obesity: A Cross-Sectional Study. Journal of Clinical Medicine. 2026; 15(2):573. https://doi.org/10.3390/jcm15020573

Chicago/Turabian Style

Guerrini Usubini, Anna, Maria Gobetti, Sara Ducale, Adele Bondesan, Diana Caroli, Francesca Frigerio, Laura Abbruzzese, Nicoletta Marazzi, Gianluca Castelnuovo, and Alessandro Sartorio. 2026. "Worry, Rumination, and Metacognitive Beliefs in Adolescents with Obesity Associated with Binge Eating Disorder (BED) vs. Age-Matched Adolescents with Essential Obesity: A Cross-Sectional Study" Journal of Clinical Medicine 15, no. 2: 573. https://doi.org/10.3390/jcm15020573

APA Style

Guerrini Usubini, A., Gobetti, M., Ducale, S., Bondesan, A., Caroli, D., Frigerio, F., Abbruzzese, L., Marazzi, N., Castelnuovo, G., & Sartorio, A. (2026). Worry, Rumination, and Metacognitive Beliefs in Adolescents with Obesity Associated with Binge Eating Disorder (BED) vs. Age-Matched Adolescents with Essential Obesity: A Cross-Sectional Study. Journal of Clinical Medicine, 15(2), 573. https://doi.org/10.3390/jcm15020573

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