Emotional eating is considered as the propensity to eat in response to emotions. It is considered a critical risk factor for recurrent weight gain. Such overeating is able to affect general health due to excess energy intake and mental health.
1. Introduction
Obesity has grown into a major public health issue worldwide. Obesity increases the risk of several diseases, including diabetes type 2, high blood pressure and cholesterol, musculoskeletal issues, and several types of cancer
[1]. The factors that render individuals prone to overeating have been investigated comprehensively. Recent evidence suggests that there is an association between psychological factors and the etiology of obesity
[2]. The existing literature research suggests that deficits in emotion dysregulation and a high level of negative emotions are crucial in the progression and prolongation of obesity
[3]. Thus, there is a bidirectional correlation: obesity could not only result in physical diseases, but also occur in addition to psychological disorders and social problems, such as low self-esteem, depression, and social stigma
[4].
Moreover, stress and emotional conditions affect the eating behavior
[5]. Stress and negative mood are able to influence appetite inversely, prompting several people to eat more and others to eat less
[6][7]. These behaviors, known as emotional overeating and emotional undereating, have been associated to the beginning of body weight complications and eating disorders
[8][9]. Nevertheless, concerning a significant subgroup of people of both sexes, negative emotions, and stress render them to overeat—a kind of eating known as emotional eating
[10][11]. In addition, abnormal emotional functioning means difficulty in appropriately recognizing, understanding, and coping with emotions and a long-term experience of elevated levels of harmful emotions
[3]. Notably, elevated negative affectivity, body dissatisfaction, self-objectification, and lower self-esteem were predictive of persistent engagement in regular binge eating and inappropriate weight compensatory behaviors
[8][9]. Self-objectification (thinking and monitoring the body’s outward appearance from a third-person perspective) emerged as the largest contributor of both the initiation and persistence of all behavioral symptoms
[8][9].
Emotional eating is not a separate eating disorder, but an eating behavior that is influenced by behaviors, stress, emotions, and individual feelings in relation to eating. However, it must be clear that emotional eating, unlike specific eating disorders, is not related with a total failure of keeping under control the quantity and quality of food consumed
[12]. Emotional or comfort eating, as well as stress-induced eating, leads to the predisposition to eat in response to negative emotions, with the preferred foods being mainly energy-dense, poor in nutrients and tasty
[13][14][15]. These types of eating act as a coping mechanism to control and decrease negative emotions, such as depressed mood, anxiety, and stress
[16]. As it concerns the prevalence of emotional eating, based on the Stress survey in America performed by the American Psychological Association, 38% of adults stated that they have been implicated in emotional eating during the past month, with 49% of them engaging in it weekly
[17]. Furthermore, it is frequently considered as a main factor in models of eating disorders and pathological eating attitudes such as overeating and binge eating
[9][18], and could lead to substantial psychological distress and health issues
[19]. Hence, it is important to interpret its fundamental mechanisms
[16].
Emotional eating has a positive relationship with increase in weight gain over time and difficulty of losing weight. These can be attributed to the fact that emotional eaters are more prone to greater consumption of sugary and high-fat foods, eat in response to stressors, and snack more frequently compared to non-emotional eaters
[20]. Notably, a cross-sectional analysis of the NutriNet-Santé cohort conducted on 7378 men and 22,862 women reported that greater emotional eating was related with elevated consumption of energy-dense snacks, such as sweet and fatty foods, and these associations were predominantly stronger in women suffering from depression
[21]. Moreover, an association between excessive alcohol consumption and emotional eating (binge eating disorder) has been reported
[22]. These eating habits combined with increased body weight put emotional eaters at a higher risk of diabetes and heart disease
[23]. Furthermore, emotional eaters activate the relationship of eating motive and reward, supporting evidence that food exerts a reward effect and therefore can alleviate or lessen negative mood conditions
[13]. In addition, emotional eaters frequently feel negative emotions concerning their physical appearance right after the eating events. Practically, every person has experienced the impact of emotions on eating attitudes. On the contrary, eating behavior is also able to affect influence body image, resulting in body dissatisfaction, which implies to the body-related negative self-assessment of a person
[17].
2. Emotional Eating and Obesity
Obesity is a serious threat to human health, and its prevalence has almost tripled since 1975. Moreover, the etiology of obesity is multifactorial and eating behavior exerts a crucial role
[2]. Stigma and weight prejudice are associated with psychological issues and unhealthy eating behaviors (such as emotional eating). The main findings of the studies that examined the relationship between emotional eating and obesity are presented in
Table 1.
Table 1. Clinical studies evaluating the association of emotional eating with obesity.
3. Emotional Eating and Depression
Depression is a heterogeneous syndrome that is gradually increasing in general population at an alarming rate. It raises the risk of several chronic disorders, including cardiovascular disease (CVD), diabetes mellitus and body weight gain over time. In addition, it contributes significantly to the financial burden and disability of the public
[35]. Depression is characterized by repeated, severe, and overwhelming negative emotions and impacts
[36].
Moreover, it is also characterized by appetite loss and subsequent weight reduction, yet there is also a subtype of depression characterized by the atypical vegetative symptomatology of an elevated appetite and increase in body weight. Emotional eating has been proposed as an indicator of atypical depression, because it shares with this depression subtype the atypical feature of enhanced appetite in response to distress
[37]. The clinical studies that examined the association between emotional eating and depression are presented in
Table 2.
Table 2. Clinical studies evaluating the association of emotional eating with depression.
4. Emotional Eating and Anxiety/Stress
The concept of stress is directly related with higher probability of chronic health disorders and accelerated the rates of disease development. Over the past 25 years, the association between stress and eating behavior is well recognized worldwide, and many studies have indicated that stress is related with alterations in food consumption of adults
[42]. Stress-stimulated eating is characterized by an enhanced consumption of energy-dense, highly tasty food for coping with stress
[43].
However, there are various mechanisms through which such an effect could operate. Taking into consideration that stress could influence appetite by both physiological and psychological mechanisms, relaxation could exert a comparable opposite effect in both respects
[43]. However, the dysregulation of bio-behavioral responses to food intake under stress has focused the highest research interest, taking into consideration the longer-term implications for physical disease risk
[42]. The main findings of the studies that examined the relationship between emotional eating and stress are presented in
Table 3.
Table 3. Clinical studies evaluating the association of emotional eating with anxiety/stress.