Fear Drives Emotional Eating and Weight Gain, Studies Study

Fear Drives Emotional Eating and Weight Gain, Studies Study

Researchers are discovering how emotional eating and body dissatisfaction silently shape our weight and well-being, offering critical insights for better obesity and mental health strategies.

In a recent studyInternational Journal of ObesityResearchers examined the role of emotional eating and dissatisfaction with weight change and mental health. The study included 7,388 adult participants who were followed over four years and used mixed effects and regression models for data analysis.

Financial hardship predicted increasing BMI not only through reduced activity but also by increasing emotional eating - a link revealed in structural equation modeling.

The study results showed that both emotional eating and body dissatisfaction independently mediate suboptimal outcomes. Emotional eating partially mediated the association between baseline anxiety and depressive symptoms and increasing body mass index (BMI), while body dissatisfaction and self-rated health partially mediated the association between increasing BMI and decreased quality of life (QOL).

Interestingly, after controlling for underlying mental health, BMI trajectories were not associated with anxiety and depressive symptoms, although they were associated with body dissatisfaction and lower quality of life.

The association between emotional eating and BMI trajectories was stronger in women and those with low levels of physical activity.

These results suggest the existence of a potential bidirectional relationship in which emotional eating and body dissatisfaction contribute to BMI increases, which in turn further influences these mediators and negatively influences quality of life.

background

Self-rated health acted as a hidden player: worsening BMI trajectories reduced participants' perceptions of their own health and indirectly lowered quality of life.

Overweight and obesity represent significant public health concerns. While the World Health Organization (WHO) estimates that 20% of the world's population will be obese by 2025, current prevalence estimates suggest that over 1 billion people live with an excessive body mass index (BMI). These conditions are often associated with chronic diseases, including type 2 diabetes (T2D), cardiovascular diseases (CVDs), and certain cancers. These associations were referenced in a public health context but were not directly examined in the study.

Mental health concerns are another significant public health issue, with depression and anxiety affecting an estimated 970 million people worldwide. Previous research using large population-wide datasets and long follow-up periods has established the positive bidirectional relationship between obesity and adverse mental health outcomes. Recent research has further validated the role of biological mediators (inflammation and gut microbiota) in promoting these outcomes.

Unfortunately, these studies could not examine the effects of psychosocial and behavioral mediators such as emotional eating and dissatisfaction in changing BMI and mental health.

About the study

The present study aims to address these gaps in the literature by using a large, long-term adult follow-up cohort to provide insight into:

• Die psychosozialen und verhaltensbezogenen Prädiktoren für BMI -Trajektorien,
• Die Auswirkungen dieser BMI -Flugbahnen auf die psychische Gesundheit und
• Wie emotionales Essen und Körperunzufriedenheit die Ergebnisse der BMI und der psychischen Gesundheit beeinflussen.

Study data were obtained from the Specchio cohort, a digital follow-up study of Geneva (Switzerland) CoVID-19 serosurvey participants. The study was launched in December 2020 and included 13,260 participants who completed an inclusion questionnaire at baseline. Participants who included their heights and weights in the baseline questionnaire were included in the present study.

Screen time quietly emerged as a major driver - the extra hour daily correlated with a BMI increase of 0.2kg/m², rivaling the effects of poor sleep.

BMI measurements were calculated from participants' baseline and repeat height and weight data. WHO guidelines were used to classify participants into: 1. Underweight (BMI <18.5 kg/m ), 2. Healthy (BMI 18.5–2.9 kg/m ), obsolete (BMI 18.5–2.9 kg/m ), obsolete. 4. obesity (BMI 30-39.9 kg/m²) and 5. severe obesity (BMI ≥ 40 kg/m²).

Habitual questionnaires were used to record participants' behavioral factors (physical activity, diet, alcohol consumption, sleep patterns, leisure time, antidepressant use, and emotional eating) and psychosocial factors (social and psychological resources and risks). The questionnaire also included the WHO Wellbeing Survey to measure participants' mental and general health outcomes.

The Oslo Social Support scale was used to translate perceived resources and risks into analyzable data. In addition, Rosenberg's short scale Self-Eveem Scale was used to assess participants' perceptions of self-esteem. Statistical analyzes included mixed effects models estimating BMI trajectories and regression models for both sets of association determinations (behavioral/psychosocial factors and BMI trajectories and BMI trajectories and mental health). The models were adjusted for participants' age, gender, education, and pre-existing health conditions.

Structural equation modeling was used to test mediation pathways and assess indirect effects.

Trends in BMI over time for the overall study sample and by gender, age group, and financial difficulty (n = 7388).

Study results

Of the 13,260 participants in the Specchio cohort, 7,388 (59% female) met the inclusion criteria and were included in downstream analyses. The average age of included participants was 51 years with an average estimated BMI of 24.5 kg/m².

Study results showed that participants' BMI increased slightly (0.4 kg/m²) throughout the study (4 years) across the sample cohort scale.

"The majority of the sample (86%) had the same BMI classification at follow-up as at baseline. 8% of the sample had an upward BMI classification, transitioning from healthy weight to overweight (5%), from overweight to overweight to obese, or from obese (3%) to obesity."

The Oslo Social Support Scale revealed a surprise: Strong social ties did not increase body dissatisfaction worsen body dissatisfaction.

Mixed effects models showed that the leading psychosocial and behavioral causes of change in BMI trajectories included reductions in physical activity, financial difficulties, reduced sleep, increased sieving time, depression/anxiety, and emotional eating.

The increased BMI was in turn associated with an increase in participants' body dissatisfaction and lower quality of life (QoL). These results remained robust even after accounting for mental illness. Notably, BMI increases at follow-up were not significantly associated with anxiety or depressive symptoms after adjusting for baseline values.

Structural equation modeling revealed that emotional eating partially mediated the effect of baseline anxiety and depressive symptoms on increasing BMI, as well as the association between financial hardship and BMI trajectories. Body dissatisfaction and poorer self-rated health partially mediated the relationship between increasing BMI and reduced quality of life.

The authors found that these mediation effects were statistically significant but modest in size.

The relationship between emotional eating and BMI was greater in women and those reporting lower levels of physical activity, suggesting potential targets for tailored interventions.

Conclusions

The present study highlights the impact of emotional eating and body dissatisfaction to contribute to increasing BMI and negative mental health outcomes, which in turn may promote further emotional eating and dissatisfaction. While the data support the directional mediation pathways, the study does not establish a formal feedback loop.

Importantly, the authors noted several limitations, including the observational design, reliance on self-reported BMI and emotional eating data, and the lack of clinical mental health measures. These factors may limit the ability to make causal inferences.

These findings are essential for developing prevention and intervention strategies against these public health concerns (obesity and mental illness).

“Our study highlights emotional eating satisfaction and body dissatisfaction as important factors associated with BMI trajectories and mental health and are considered in weight management and mental health promotion strategies.”

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