Alexithymia among patients with obesity - systematic review

Obesity is an increasingly prevalent health concern across all age groups. In addition to genetic and environmental-cultural determinants, psychological factors like alexithymia may play a significant role in the pathogenesis of excessive eating behaviors that contribute to overweight and obesity. The aim of this study is to conduct a systematic review of the literature to explore the potential role of alexithymia as a predisposing factor for excessive weight and to evaluate how it may influence the course and outcomes of obesity treatment. In accordance with PRISMA guidelines, a systematic review was conducted using the PubMed, Medline, Scopus, and ClinicalTrials databases, as well as gray literature (top 100 results in Google Scholar). The search covered publications from inception to September 2024 (updated 13.08.25), using the keywords: "obesity" OR "overweight" AND "alexithymia". After application inclusion and exclusion criteria a total of 33 articles were analyzed. The included studies explored the relationship between alexithymia and obesity, including comorbid depression, binge eating disorder, emotional eating, bariatric surgery outcomes, and conservative obesity treatment. The majority of studies indicated that alexithymia is a significant psychological factor associated with the onset and maintenance of obesity and may adversely affect treatment outcomes. Nonetheless, the findings across studies were not entirely consistent, indicating the need for further empirical validation. Given the global rise in the number of individuals affected by excessive body weight, a more comprehensive inclusion of psychological factors in obesity treatment may enable a more individualized approach to the prevention and management of this condition.