Emotional eating in healthy individuals and patients with an eating disorder: evidence from psychometric, experimental and naturalistic studies

Emotional eating has traditionally been defined as (over)eating in response to negative emotions. Such overeating can impact general health because of excess energy intake and mental health, due to the risks of developing binge eating. Yet, there is still significant controversy on the validity of the emotional eating concept and several theories compete in explaining its mechanisms. The present paper examines the emotional eating construct by reviewing and integrating recent evidence from psychometric, experimental and naturalistic research. Several psychometric questionnaires are available and some suggest that emotions differ fundamentally in how they affect eating (i.e. overeating, undereating). However, the general validity of such questionnaires in predicting actual food intake in experimental studies is questioned and other eating styles such as restrained eating seem to be better predictors of increased food intake under negative emotions. Also, naturalistic studies, involving the repeated assessment of momentary emotions and eating behaviour in daily life, are split between studies supporting and studies contradicting emotional eating in healthy individuals. Individuals with clinical forms of overeating (i.e. binge eating) consistently show positive relationships between negative emotions and eating in daily life. We will conclude with a summary of the controversies around the emotional eating construct and provide recommendations for future research and treatment development.

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Application of three different coaching strategies through a virtual coach for people with emotional eating: a vignette study

Journal of Eating Disorders ◽

10.1186/s40337-020-00367-4 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Aranka Dol ◽

Christina Bode ◽

Hugo Velthuijsen ◽

Tatjana van Strien ◽

Lisette van Gemert-Pijnen

Keyword(s):

Emotion Regulation ◽

Emotional Eating ◽

Negative Emotions ◽

Eating Behaviour ◽

Self Esteem ◽

Adult Women ◽

Food Cravings ◽

Vignette Study ◽

Coaching Strategies ◽

Applied Design

Abstract Background Around 13% of the world’s population suffers from obesity. More than 40% of people with obesity display emotional eating behaviour (eating in response to negative emotions or distress). It is an alternate to more effective coping strategies for negative emotions. Our study explored the opportunities for helping adults with emotional overeating using a virtual coach, aiming to identify preferences for tailored coaching strategies applicable in a personal virtual coach environment. Three different coaching strategies were tested: a validating, a focus-on-change, and a dialectical one – the latter being a synthesis of the first two strategies. Methods A qualitative study used vignettes reflecting the two most relevant situations for people with emotional eating: 1. experiencing negative emotions, with ensuing food cravings; and 2. after losing control to emotional eating, with ensuing feelings of low self-esteem. Applied design: 2 situations × 3 coaching strategies. Participants: 71 adult women (Mage 44.4/years, range 19–70, SD = 12.86) with high scores on the DEBQ-emotional eating scale (Memo 3.65, range 1.69–4.92, SD = .69) with mean BMI 30.1 (range 18–46, SD = 6.53). They were recruited via dieticians’ practices, were randomly assigned to the conditions and asked how they would face and react to the presented coaching strategies. Data were transcribed and a thematic analysis was conducted. Results Qualitative results showed that participants valued both the validating coaching strategy and the focus-on-change strategy, but indicated that a combination of validation and focus-on-change provides both mental support and practical advice. Data showed that participants differed in their level of awareness of the role that emotions play in their overeating and the need for emotion-regulation skills. Conclusion The design of the virtual coach should be based on dialectical coaching strategies as preferred by participants with emotional eating behaviour. It should be tailored to the different stages of awareness of their emotions and individual emotion-regulation skills.

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Do Emotions Cause Eating? The Role of Previous Experiences and Social Context in Emotional Eating

Current Directions in Psychological Science ◽

10.1177/0963721419837685 ◽

2019 ◽

Vol 28 (3) ◽

pp. 234-240 ◽

Cited By ~ 6

Author(s):

Gizem Altheimer ◽

Heather L. Urry

Keyword(s):

Social Context ◽

Emotional Eating ◽

Negative Emotion ◽

Negative Mood ◽

Experimental Studies ◽

Future Research ◽

Discrete Emotions ◽

Future Studies ◽

Desire To Eat

Emotional eating is defined as an increase in eating following negative emotion. Self-reported emotional eating has been associated with physical-health concerns. However, experimental studies indicate that negative-mood inductions do not reliably lead to increased eating in healthy eaters, not even among those with a high desire to eat when emotional. We argue that experimental studies will help us understand emotional eating only if they account for the following ideas: (a) Emotional eating may require that people learn to associate emotion with eating, (b) emotional eating may follow only specific discrete emotions, and (c) emotional eating may depend on social context. Each of these points suggests a fruitful direction for future research. Specifically, future studies must acknowledge, identify, and account for variations in the extent to which people have learned to associate emotions with eating; assess or elicit strong discrete emotions; and systematically examine the effect of social context on emotional eating.

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Consumption of fruit, vegetables, sweets and soft drinks are associated with psychological dimensions of eating behaviour in parents and their 12-year-old children

Public Health Nutrition ◽

10.1017/s1368980008002371 ◽

2008 ◽

Vol 11 (9) ◽

pp. 914-923 ◽

Cited By ~ 73

Author(s):

Kristina Elfhag ◽

Sanna Tholin ◽

Finn Rasmussen

Keyword(s):

Food Intake ◽

Emotional Eating ◽

Soft Drink ◽

Eating Behaviour ◽

Self Esteem ◽

Soft Drinks ◽

Restrained Eating ◽

Food Cues ◽

Clear Cut ◽

Psychological Dimensions

AbstractObjectiveWe investigated associations between consumption of fruits, vegetables, sweets and soft drinks and the psychological dimensions of eating in parents and their children. The role of the parent’s characteristics for their children’s food intake was also explored.DesignFood intake patterns were assessed by self-reported consumption of the respective foods. Eating behaviour was measured by the Dutch Eating Behaviour Questionnaire and self-esteem by Harter self-perception scale. The participants were 1441 families (mother, father and their 12-year-old child), and additionally 354 mothers and thirty fathers.ResultsAmong parents, reported intake of fruit and vegetables were associated with restrained eating, higher self-esteem, and higher education and age. Intake of sweets was related to more external and less restrained eating, and for mothers also emotional eating. Parent’s intake of soft drink was foremost related to a younger age, and also weakly associated with psychological characteristics. The food intake of parents was more important for the children’s food intake than any other characteristics. However, children’s intake of sweets showed clear-cut positive associations with external eating.ConclusionsPsychological dimensions of eating behaviour are associated with patterns of food intake, in particular for consumption of sweets, and are most prominent in the parents. The children’s food intake mirrored their parents’ intake. Being sensitive to external food cues may increase unhealthy food consumption in our society, whereas more restrained eating may indicate proneness or intention to healthier food choices among parents. Emotional eating may imply a proneness to consume sweets for comfort, in particular among mothers.

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Uncontrolled, Repetitive Eating of Small Amounts of Food or ‘Grazing’: Development and Evaluation of a New Measure of Atypical Eating

Behaviour Change ◽

10.1017/bec.2013.6 ◽

2013 ◽

Vol 30 (2) ◽

pp. 57-73 ◽

Cited By ~ 23

Author(s):

Brigitte Lane ◽

Marianna Szabó

Keyword(s):

Binge Eating ◽

Negative Emotion ◽

Temporal Stability ◽

Eating Behaviour ◽

Self Report ◽

Future Research ◽

Loss Of Control ◽

Eating Pattern ◽

Study Questionnaire ◽

Report Measure

Grazing, or the uncontrolled, repetitive eating of small amounts of food is being increasingly recognised as an important eating behaviour associated with obesity. In spite of the need for a better understanding of this eating behaviour for improved obesity treatment, currently there is no empirically validated self-report measure to assess grazing. Therefore, to contribute to a better understanding of this relatively understudied eating pattern, a new self-report questionnaire of grazing was developed in this study. Questionnaire items were designed to reflect previous empirical descriptions of grazing. A group of 248 university students completed the Grazing Questionnaire, other measures of eating-related behaviours and cognitions, and negative emotion. Sixty-two participants completed the Grazing Questionnaire a second time to calculate its temporal stability. Exploratory factor analysis revealed a clear two-factor solution for the questionnaire, reflecting repetitive eating behaviour and a perception of loss of control. Scores on the Grazing Questionnaire were positively associated with other measures of disordered eating, especially with binge eating. Initial psychometric properties of the new questionnaire are promising. Future research is now needed to examine the prevalence of this eating behaviour in more diverse populations, including those with binge eating disorder and obesity.

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A systematic review of the association between emotions and eating behaviour in normal and overweight adult populations

Journal of Health Psychology ◽

10.1177/1359105317697813 ◽

2017 ◽

Vol 24 (1) ◽

pp. 3-24 ◽

Cited By ~ 24

Author(s):

Tracey J Devonport ◽

Wendy Nicholls ◽

Christopher Fullerton

Keyword(s):

Systematic Review ◽

Standard Deviation ◽

Emotional Eating ◽

Eating Behaviour ◽

Quality Analysis ◽

Future Research ◽

Eating Behaviours ◽

Overweight Adult ◽

Methodological Considerations ◽

Meta Analyses

A systematic review was completed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search of four electronic databases (2004–2015) yielded 60,017 articles, of which 29 met inclusion criteria. Included studies performed poorly on data quality analysis in terms of randomisation and controlling for confounding factors. Participant’s body mass index scores range from 19.73 (standard deviation = 1.54) to 28.4 (standard deviation = 1.4) kg/m2. Where positive and negative affects were compared, food was more likely to be consumed in response to positive affect. With regard to discrete emotions; stress, depression and sadness consistently elicited eating behaviours that fall outside of nutritional recommendations (e.g. increased food intake or poor nutritional food choices). The role of moderators including individual differences in dietary restraint and emotional eating, as well as methodological considerations, such as means of eliciting and measuring emotions, may account for equivocality with regard to some emotion and eating associations. This article concludes with recommendations for future research and implications for practice.

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Increased emotional eating during COVID-19 associated with lockdown, psychological and social distress

10.31219/osf.io/z28sd ◽

2020 ◽

Author(s):

Cinzia Cecchetto ◽

Marilena Aiello ◽

Silvio Ionta ◽

Claudio Gentili ◽

Sofia Adelaide Osimo

Keyword(s):

Binge Eating ◽

Emotional Eating ◽

Online Survey ◽

Phase 1 ◽

Eating Behaviour ◽

Phase 2 ◽

Emotional Wellbeing ◽

Negative Effects ◽

The Impact

Due to the spread of COVID 2019, the Italian government imposed a lockdown on the national territory. Initially, citizens were required to stay at home and not to mix with others outside of their household (Phase 1); eventually, some of these restrictions were lifted (Phase 2). To investigate the impact of lockdown on emotional and binge eating, an online survey was conducted to compare measures of self-reported physical (BMI), psychological (Alexithymia), affective (anxiety, stress, and depression) and social (income, workload) state during Phase 1 and Phase 2. Data from 365 Italian residents showed that increased emotional eating was predicted by higher depression, anxiety, quality of personal relationships, and quality of life, while the increase of bingeing was predicted by higher stress. Moreover, we showed that higher alexithymia scores were associated by increased emotional eating and higher BMI scores were associated with both increased emotional eating and binge eating. Finally, we found that from Phase 1 to Phase 2 binge and emotional eating decreased. These data provide evidence of the negative effects of isolation and lockdown on emotional wellbeing, and, relatedly, on eating behaviour.

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Eating Behavior, Physical Activity and Exercise Training: A Randomized Controlled Trial in Young Healthy Adults

Nutrients ◽

10.3390/nu12123685 ◽

2020 ◽

Vol 12 (12) ◽

pp. 3685

Author(s):

Wendy D. Martinez-Avila ◽

Guillermo Sanchez-Delgado ◽

Francisco M. Acosta ◽

Lucas Jurado-Fasoli ◽

Pauline Oustric ◽

...

Keyword(s):

Physical Activity ◽

Binge Eating ◽

Sedentary Behaviour ◽

Emotional Eating ◽

Exercise Intervention ◽

Controlled Trial ◽

Eating Behaviour ◽

Healthy Adults ◽

Vigorous Intensity ◽

Uncontrolled Eating

Regular physical activity (PA) is an important part of the treatment of several medical conditions, including overweight and obesity, in which there may be a weakened appetite control. Eating behaviour traits influence weight control and may be different in active and sedentary subjects. This paper reports the relationships between the time spent in sedentary behaviour and physical activity (PA) of different intensity, and eating behaviour traits in young, healthy adults. Additionally, it reports the results of a six-month-long, randomized, controlled trial to examine the effect of an exercise intervention on eating behaviour traits. A total of 139 young (22.06 ± 2.26 years) healthy adults (68.35% women) with a Body Mass Index (BMI) of 24.95 ± 4.57 kg/m2 were enrolled. Baseline assessments of habitual PA were made using wrist-worn triaxial accelerometers; eating behaviour traits were examined via the self-reported questionnaires: Binge Eating, Three-Factor Eating Questionnaire-R18 and Control of Eating Questionnaire. The subjects were then randomly assigned to one of three groups: control (usual lifestyle), moderate-intensity exercise (aerobic and resistance training 3¨C4 days/week at a heart rate equivalent to 60% of the heart rate reserve (HRres) for the aerobic component, and at 50% of the 1 repetition maximum (RM) for the resistance component), or vigorous-intensity exercise (the same training but at 80% HRres for half of the aerobic training, and 70% RM for the resistance training). At baseline, sedentary behaviour was inversely associated with binge eating (r = −0.181, p < 0.05) and with uncontrolled eating (r = −0.286, p = 0.001). Moderate PA (MPA) was inversely associated with craving control (r = −0.188, p < 0.05). Moderate-to-vigorous PA (MVPA) was directly associated with binge eating (r = 0.302, p < 0.001) and uncontrolled eating (r = 0.346, p < 0.001), and inversely associated with craving control (r = −0.170, p < 0.015). Overall, PA was directly associated with binge eating (r = 0.275, p = 0.001), uncontrolled eating (r = 0.321, p < 0.001) and emotional eating (r = 0.204, p < 0.05). Additionally, only emotional eating was modified by the intervention, increasing in the vigorous-intensity exercise group (p < 0.05). In summary, we observed that time spent in sedentary behaviour/PA of different intensity is associated with eating behaviour traits, especially binge eating in young adults. In contrast, the six-month exercise intervention did not lead to appreciable changes in eating behaviour traits.

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Partial sleep deprivation and food intake in participants reporting binge eating symptoms and emotional eating: preliminary results of a quasi-experimental study

Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity ◽

10.1007/s40519-018-0547-5 ◽

2018 ◽

Vol 23 (5) ◽

pp. 561-570

Author(s):

Silvia Cerolini ◽

Rachel F. Rodgers ◽

Caterina Lombardo

Keyword(s):

Experimental Study ◽

Food Intake ◽

Binge Eating ◽

Sleep Deprivation ◽

Emotional Eating ◽

Preliminary Results ◽

Quasi Experimental ◽

Partial Sleep Deprivation

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Emotional eating and obesity in adults: the role of depression, sleep and genes

Proceedings of The Nutrition Society ◽

10.1017/s0029665120000166 ◽

2020 ◽

Vol 79 (3) ◽

pp. 283-289 ◽

Cited By ~ 5

Author(s):

Hanna Konttinen

Keyword(s):

Weight Gain ◽

Emotional Eating ◽

Negative Emotions ◽

Eating Behaviour ◽

Depression And Anxiety ◽

Night Sleep ◽

Treatment Interventions ◽

Internal States ◽

Behavioural Mechanism

Stress and other negative emotions, such as depression and anxiety, can lead to both decreased and increased food intake. The term ‘emotional eating’ has been widely used to refer to the latter response: a tendency to eat in response to negative emotions with the chosen foods being primarily energy-dense and palatable ones. Emotional eating can be caused by various mechanisms, such as using eating to cope with negative emotions or confusing internal states of hunger and satiety with physiological changes related to emotions. An increasing number of prospective studies have shown that emotional eating predicts subsequent weight gain in adults. This review discusses particularly three lines of research on emotional eating and obesity in adults. First, studies implying that emotional eating may be one behavioural mechanism linking depression and development of obesity. Secondly, studies highlighting the relevance of night sleep duration by showing that adults with a combination of shorter sleep and higher emotional eating may be especially vulnerable to weight gain. Thirdly, an emerging literature suggesting that genes may influence body weight partly through emotional eating and other eating behaviour dimensions. The review concludes by discussing what kind of implications these three avenues of research offer for obesity prevention and treatment interventions.

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