Search Results (41)

Background/Objectives: The aim was to identify patterns of autonomic and neuroendocrine reactivity to an immersive virtual reality (VR) social-emotional stressor and explore their associations with perceived stress and eating behavior. Methods: This one-group pretest–posttest study included 30 children and adolescents with obesity (15 boys and 15 girls), aged 8 to 17 years. The VR protocol consisted of two consecutive phases: a 5 min relaxation phase using the Forest application and a 5 min stimulation phase using a cognitively engaging VR game designed to elicit social-emotional stress. Physiological responses were measured using heart rate variability (HRV) indices and salivary stress biomarkers, including cortisol and alpha amylase. Subjective stress and eating responses were assessed via visual analogue scales (VAS) administered immediately post-exposure. The Three-Factor Eating Questionnaire (TFEQ-R21C) was used to evaluate cognitive restraint (CR), uncontrolled eating (UE), and emotional eating (EE). Results: The cortisol reactivity was blunted and may reflect both the attenuated HPA axis responsiveness characteristic of pediatric obesity and the moderate psychological challenge of the VR stressor used in this study. Two distinct autonomic response patterns were identified via exploratory factor analysis: (1) parasympathetic reactivity, associated with increased RMSSD and SDNN and decreased LF/HF, and (2) sympathetic activation, associated with increased heart rate and alpha-amylase levels and reduced RR intervals. Parasympathetic reactivity was correlated with lower perceived stress and anxiety, but also paradoxically with higher uncontrolled eating (UE). In contrast, sympathetic activation was associated with greater cognitive restraint (CR) and higher anxiety ratings. Conclusions: This study demonstrates that immersive VR game exposure elicits measurable autonomic and subjective stress responses in children and adolescents with obesity, and that individual differences in physiological reactivity are relevantly associated with eating behavior traits. The findings suggest that parasympathetic and sympathetic profiles may represent distinct behavioral patterns with implications for targeted intervention. Full article

Background/Objectives: Emotional eating (EE) is the tendency to overeat in response to negative emotions. Food consumption is influenced by both personal and environmental factors. Emotions are personal factors that can affect food consumption. The objective of this study is to assess the association between Mediterranean diet (MD), a dietary pattern promoting mental health, and emotional eating via the Three-Factor Eating Questionnaire (TEFQ). Methods: This is a cross-sectional survey including 328 adults aged 18–75 years. Appropriate questionnaires were applied for evaluating adherence to the Mediterranean diet (MedDiet score) and types of feeding and the expression of emotional food consumption (TFEQ). Results: A mean MedDiet score equal to 30.97 ± 4.93 and a total TFEQ score equal to 45.40 ± 6.31 were noted. MedDiet score was significantly inversely associated with TFEQ total score (r = 0.23, p = 0.026) as well as with TFEQ emotional score (r = 0.37, p < 0.0001). Fruits and vegetables consumption was positively associated with TFEQ emotional score (r = 0.25, p = 0.014, and r = 0.20, p = 0.049, respectively). Conclusions: In order to produce data showing improvements in eating behavior, our findings have highlighted the significance of conducting large, prospective, well-designed, randomized, interventional clinical studies to confirm the inverse association of MD with EE. The interpretation of the results is complicated due to cross-sectional design, the social desirability bias and the self-report nature of both dietary and emotional assessments. Full article

Background/Objective: Emotional eating is a significant health problem associated with increased obesity and mental health among children and adolescents. Investigating emotional eating and its associated factors is critical, as it coincides with key developmental periods during which eating patterns are formed. This study assessed the contribution of anxiety and sleep quality to emotional eating among 232 Hispanic girls (n = 124, with a mean age of 10.23 years, SD = 1.40) and boys (n = 108, with a mean age of 10.36 years, SD = 1.57). Methods: This study used a correctional research design. Participants completed a series of surveys including demographics, acculturation, McKnight Risk Factor Survey-IV emotional eating subscale, Multidimensional Anxiety Scale for Children, and Pittsburgh Sleep Quality Index. Participants also had their objective body height and weight measured. Results: Descriptive analyses showed that most girls (84%) and boys (87%) were born in the United States and were either overweight (n = 24, 19% girls; n = 18, 17% boys) or with obesity (n = 61, 49% girls; n = 61, 56% boys). The hierarchical regression analyses revealed that, for girls, poor sleep quality was the sole significant factor associated with EE (β = 350, p < 0.001), controlling for age and BMI. For boys, poor sleep quality (β = 0.302, p < 0.01) and anxiety (β = 0.247, p < 0.05) were significant. Conclusions: The study’s findings suggest that emotional eating interventions may need to focus on reducing anxiety levels and improving sleep quality in Hispanic children and early adolescents Full article

Background/Objectives: Obesity is a major public health challenge of the 21st century, with prevalence rates steadily rising globally. Disordered eating behaviors, particularly emotional eating (EE), complicate the clinical management of obesity and hinder long-term outcomes, such as maintaining weight loss after bariatric surgery. Studies reveal that EE affects 65–75% of overweight or obese adults, and such behavior may stem from a disrupted brain reward system linked to emotional dysregulation and impulsivity. Impulsivity in obesity involves deficient cognitive inhibitory control, creating an imbalance between impulsive and reflective systems. While problematic eating behaviors and obesity are well studied, the role of affective temperaments—innate traits influencing mood, energy, and responses to stimuli—remains underexplored. This study aims to examine the interplay between emotional eating, impulsivity, and affective temperaments in obese patients preparing for bariatric surgery. Methods: A total sample of 304 obese outpatients was consecutively enrolled at the Psychiatry Clinic of the Department of Clinical and Experimental Medicine of the University of Pisa during the presurgical mental health evaluation routinely performed before the bariatric intervention. Sociodemographic and clinical data were collected by psychiatrists during a single consultation. Assessments also included the following psychometric tests: the Structured Clinical Interview (SCID-5), the Emotional Eating Scale (EES), the Barratt Impulsivity Scale-Version 11 (BIS-11), and the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Auto-questionnaire (TEMPS-A). Results: A significant correlation was observed between the EES total score and the BIS total score (p = 0.003), as well as with the sub-dimensions of attentional impulsivity (p < 0.001) and motor impulsivity (p = 0.024). In addition, a significant correlation has been found between the total score of EES and the cyclothymic (p < 0.001), depressive (p < 0.001), irritable (p = 0.013), and anxious (0.020) temperaments. When comparing obese patients with EE and without EE (No-EE), higher rates of both current (p = 0.007) and lifetime (p = 0.024) psychiatric comorbidities were observed in the EE group, namely for anxiety disorders (p = 0.008) and eating disorders (p = 0.014). Conclusions: Our study highlights a significant association between EE in obese patients with the cyclothymic, irritable, anxious, and depressive temperaments, and impulsivity dimension. Thus, problematic eating behaviors and temperamental traits may have a bidirectional psychopathological influence in obese patients and need to be carefully evaluated in subjects seeking bariatric surgery. Full article

Objectives: This study aimed to evaluate the effect of a counseling approach based on Mindful Eating on the eating behavior of individuals living with overweight and obesity. Methods: A 16-week randomized clinical trial was conducted to compare an online group intervention (IG) with individual online nutritional counseling (TAU). Volunteers (n = 61), aged 18 or older with BMI ≥ 25 kg/m², were randomly assigned to the two groups and invited to participate in eight biweekly sessions. Eating behavior was assessed using the Three-Factor Eating Questionnaire (TFEQ-21), and anthropometric measures were collected through self-report. Comparison between the groups was performed using generalized linear models and Poisson models with robust variance estimators. A sensitivity analysis was conducted to evaluate the group-by-time interaction. The study was approved by the UFCSPA Ethics Committee. Results: At baseline, the eating behavior domain with the highest mean score was emotional eating (EE) in both groups. At the end of the study, all domains decreased, while an increase in cognitive restraint (CR) was observed in the TAU group, showing a difference between the groups (−23.1; 95%CI −37.7 to −8.5; p = 0.004). A group-by-time interaction difference was noted only in the CR domain, explained by the change in the TAU group for the CR comparison before and after treatment and by the difference between the IG and TAU groups at the end of the treatment period. Conclusions: A Mindful Eating approach may aid in managing dysfunctional cognitive restraint, a key component for sustainable excess weight treatment. The protocol can be found on ClinicalTrials.gov (NCT05845411). Full article

Background/Objective: Eating behaviors (EB) correlate with weight loss after bariatric surgery (BS). Therefore, the investigation of EB could guide interventions to prevent insufficient weight outcomes. Method: A prospective cohort of 85 patients undergoing Roux-en-Y Gastric Bypass (RYGB; 84.7% female, mean age 44.7 ± 9.3 years) was included. Six months after undergoing RYGB, EB patterns, including cognitive restraint (CR), uncontrolled (UE), and emotional eating (EE), were assessed using the Three-Factor Eating Questionnaire R21 (TFEQ-R21). History, physical examination, and anthropometric assessments were collected pre- and 12 months postoperative. Patients were divided based on the percentage of excess weight loss (%EWL < 80% or ≥80%) and EB patterns were correlated with weight outcomes at 12 months. Results: The %EWL ≥ 80% group demonstrated significantly higher scores in CR and EE compared to %EWL < 80% (p < 0.001 and p = 0.01, respectively). UE scores were similar between groups (p = 0.41). At 12 months postoperative, the %EWL ≥ 80% group had negative correlations between CR and BMI and positive correlations between CR and EWL (rho = −0.33 and rho = 0.29; p = 0.04). Multiple logistic regression considering %EWL ≥ 80% as the aim outcome revealed that CR had a significant influence (OR = 1.037; p = 0.058), while age (OR = 0.962; p = 0.145), sex (OR = 2.984; p = 0.135), UE (OR = 0.995; p = 0.736), and EE (OR = 1.017; p = 0.296) did not. Conclusions: EBs influence outcomes after BS, and a model using TFEQ-R21 predicted them. CR six months post-surgery was the strongest predictor of higher EWL at 12 months. Further research is needed to understand the relationship between restrictive EB and BS outcomes, possibly identifying strategies to prevent disordered EB in patients with higher scores. Full article

Background: There has been recent evidence to suggest that people who suffer from eating disorders (EDs) or other eating behavior disturbances, such as emotional eating (EE), are particularly vulnerable post-COVID-19. This narrative literature review aims to comprehensively analyze and scrutinize the existing clinical studies regarding the effects of the COVID-19 pandemic on people with EDs or EE. Moreover, due to the COVID-19 pandemic, it is very important to find out whether a person’s emotional state may lead them to wrongly confront their emotional behavior with food consumption. Methods: A thorough search of several databases (PubMed, Scopus, Web of Science, Public Library of Science, Google Scholar, CINAHL Complete, PsycINFO, and Academic Search Complete) was performed to identify available clinical studies on the COVID-19 pandemic published between 2020 and 2024 using relevant keywords. Results: There is substantial evidence that the COVID-19 pandemic exerted negative effects on persons suffering from EDs, including those who are symptomatic, those who are in remission, and those with an EE behavior. Characteristically, people diagnosed with anorexia nervosa (AN), bulimia nervosa (BN), or binge eating disorder (BED) showed considerable symptomatic worsening after the first wave of the COVID-19 pandemic. Clinical studies investigating the effects of the COVID-19 pandemic on persons suffering from EE have also clearly demonstrated that their mood disturbances negatively affected their eating behaviors. These studies have also shown that vulnerable people were at greater risk of EE development and progression during the COVID-19 pandemic. Conclusion: The COVID-19 pandemic seems to have exerted a significant deleterious effect on people who have a history of suffering from EDs or EE. The COVID-19 pandemic has been related to the frequency of dysfunctional eating behaviors, thus decreasing therapeutic intervention efficiency in people with EDs as well as in those with disturbed eating behaviors such as EE. In this aspect, further clinical studies are strongly recommended to investigate the exact effects of the COVID-19 pandemic as well as to explore their potential long-term deleterious complications in the post-pandemic period. Public strategies and policies should be applied to provide special healthcare for this group of patients. Full article

Background: Emotional eating is associated with adverse health outcomes in children, including elevated weight status. Currently, there is not a well-validated parent-report measure of emotional eating for young children. This study assessed the reliability and validity of the 10-item parent version of the Emotional Eating Scale Adapted for Children and Adolescents (EES-C) Short-Form. Methods: The participants were 207 parents and 144 children from the southern United States. They completed the parent- and child-report EES-C Short-Form and responded to measures related to child eating behaviors, mood, and gratitude. Results: The parent-report EES-C Short-Form demonstrated good internal consistency reliability (Cronbach’s alpha = 0.94). Test–retest reliability was also supported, as evidenced by a medium correlation (ICC = 0.56, p < 0.001) between parent-rated emotional eating across two time points. Additionally, the measure demonstrated a significant correlation with a scale of emotional overeating (r = 0.25, p < 0.001)—a theoretically related construct. Supporting discriminant validity, the measure was not significantly related to a measure of parent-reported gratitude (r = 0.07, p = 0.30). A unidimensional model provided good fit for the data (CFI = 0.997, SRMR = 0.046). Conclusions: The results from the current study provide preliminary evidence supporting the reliability and validity of the parent version of the EES-C Short-Form. For the purpose of screening children in school or primary care settings, the EES-C Short-Form may be practical and helpful in identifying children who may be at risk of developing adverse health outcomes or more-severe eating disorder pathology. Full article

This cross-sectional study investigated interactions among sugar-related dietary patterns (DPs), personality traits, and cognitive–behavioural and emotional functioning. The study involved working-age women aged 18–54. Data were collected between Winter and Spring of 2020/21. The survey was conducted using anonymised questionnaires. The ten-item personality inventory (TIPI-PL) was used to examine personality traits based on the Big Five personality trait model. A three-factor eating questionnaire (TFEQ-13) was used to measure the following eating behaviours: cognitive restraint (CR), uncontrolled eating (UE), and emotional eating (EE). The KomPAN questionnaire collected the frequency of the intake. Dietary patterns (DPs) were derived by principal component analysis (PCA). A logistic regression (OR) was applied to verify the associations among the DPs, personality traits, and cognitive–behavioural and emotional functioning. Three DPs were identified: sweet-Western (SWDP), pro-healthy (PHDP), and dairy (DDP). Women with high conscientiousness were less likely, by 33%, to adhere to the upper tercile of the SWDP and 80% more likely to the upper tercile of the PHDP. Elevated CR intensity increased by almost twofold (OR: 1.93; p < 0.001) the likelihood of high adherence to the SWDP. The high intensity in the EE decreased by 37% (OR: 0.63; p < 0.01) the likelihood of increased adherence to the SWDP. Personality traits and eating behaviours significantly correlated with the extracted SWDP. Full article

Background: Proper nutrition has a positive impact on health. Paradoxically, excessive preoccupation with healthy eating may lead to the emergence of abnormal eating behaviours and increase the risk of developing disorders. The aim of this study was to assess the risk of orthorexia (ON) and the prevalence of emotional eating (EE) in military flying personnel of the Polish Air Force in relation to BMI and sociodemographic factors. Methods: This study included 760 soldiers (including 60 females) taking part in the National Health Programme 2021–2025. The ORTO-15 questionnaire and EEQ were used to assess the risk of ON and EE. Results: The risk of ON occurred in 28.9% of military flying personnel and was significantly more frequent in soldiers with a normal weight (46.4%), under 40 years of age (42.7%), and with higher education (42.7%). The prevalence of EE was found in approximately 12.3% of the respondents and was significantly more common in soldiers with diagnosed obesity (17.5%), women (21.7%), and soldiers with higher education (13.6). Other sociodemographic variables did not differentiate the results of the ORTO-15 questionnaire and EEQ. Conclusions: The obtained results indicate that the problem of eating disorders also occurs in military populations. The necessity of continuing research in this area is discussed. Full article

This study aimed to investigate the role of the psychological impact of environments rich in palatable foods on three aspects of eating behavior: cognitive restraint (CR), uncontrolled eating (UE), and emotional eating (EE). The hypotheses were as follows: (a) The psychological impact (i.e., motivation to eat) of an environment rich in palatable foods will positively predict CR, UE, and EE; (b) dieting will predict CR, UE, and EE; and (c) CR, UE, and EE will positively predict body mass index (BMI). This study had a cross-sectional design in which data were collected online from 413 subjects. The psychological impact of food-rich environments (food available, food present, and food tasted) was assessed using the Power of Food Scale (PFS), and CR, UE, and EE were assessed using the Three-Factor Eating Questionnaire (TFEQ-R18). Both instruments were tested for confirmatory factor analysis. The relationship between constructs was measured using partial least-square structural equation modeling (PLS-SEM). “Food available” positively predicted all TFEQ-R18 factors (p < 0.01). “Food present” positively predicted UE (p < 0.001) and EE (p = 0.01). People currently on a diet showed higher levels of CR (p < 0.001) and EE (p = 0.02). UE and EE positively predicted BMI. Thus, CR, UE, and EE were positively predicted by the motivation to consume palatable foods in varying proximity, suggesting that the presence of food and, more importantly, its general availability may be important determinants of eating behavior, particularly UE and EE. Health strategies should consider the influence of the food environment to prevent and better manage impairments in eating behavior. Sex differences suggest that special attention should be paid to women. Furthermore, dieting was associated with higher levels of EE, which in turn was associated with higher BMI. Weight loss interventions should consider this vulnerability. Full article

Background and Objectives: Emotional eating (EE), or eating in response to negative emotions or stress, can be understood as a manifestation of difficulties regulating emotions among individuals with eating disorders. To date, many virtual reality treatments for eating disorders have focused on body image or exposure methods and have not exclusively targeted EE. There has been a call made by experts in the field for a “new generation” of virtual reality interventions, capable of utilizing virtual reality’s potential more fully. We developed a novel emotion regulation (ER) intervention based upon virtual reality to improve EE among adults with an eating disorder diagnosis. The study hypothesized that a novel ER protocol utilizing evidence-based strategies, as well as innovative techniques, would be feasible and acceptable and show preliminary signals of effectiveness for EE. Materials and Methods: Due to COVID-19, the study pivoted from the original completely immersive intervention to a 2-D intervention deliverable over telehealth. Twenty-one patients were recruited from the Adult Eating Disorders Program within Stanford University to receive seven weekly one-hour virtual experiences (VEs) focusing on ER. Participants were not randomized but, as part of a pragmatic study design, chose between the novel VE-Emotion Regulation (VE-ER) intervention or continuing their treatment as usual. Before and after the seven sessions, participants completed an assessment by filling out online questionnaires. Results: Overall, VE-ER treatment was feasible, and the participant and therapist acceptability of VE-ER treatment was fairly high. In terms of preliminary effectiveness, the results showed a significant reduction in the frequencies of disordered eating behaviors in both groups, but a greater improvement in EE in the VE-ER group and a significant reduction in emotion dysregulation after the treatment. Conclusions: This novel pilot study makes a valuable contribution to the scant literature by demonstrating the feasibility, acceptability, and preliminary effectiveness of combining somatic, multisensory, and cognitive manipulations delivered via telemedicine to help patients with EE to manage their emotions. The findings can serve as the basis for larger, controlled studies evaluating the translation of the somatic marker theory from the research literature into real-world U.S. clinic settings. Full article

Stress related to the outbreak of the COVID-19 pandemic may have caused substantial changes in eating behaviors, and may have been associated with emotional eating, especially in female individuals. The aim of the present study was to analyze the association between stress perceived during the COVID-19 pandemic and emotional eating in girls, within the third phase of the Polish Adolescents’ COVID-19 Experience (PLACE-19) Study. A nationwide sample of 818 Polish female adolescents, aged 15–20, was gathered. The adolescents were recruited to the study based on a random quota sampling procedure. Using a computer-assisted web interview (CAWI) survey, participants filled out the Emotional Eating Scale Adapted for Children and Adolescents (EES-C) to assess the urge to cope with negative emotions by eating, and the Adolescent Stress Questionnaire (ASQ) to assess perceived stress. Additionally, the data concerning body mass, height, as well as body mass change during the COVID-19 pandemic were verified. The groups most susceptible to emotional eating were excessive body mass female adolescents, those who gained weight during the COVID-19 pandemic and those experiencing high stress levels while facing negative emotions. In order to plan effective therapeutic interventions dealing with the issue of emotional eating, both psychological therapy and dietary strategy tailored to the individual should be considered for the indicated susceptible groups. Full article

Emotional eating (EE) is considered as the inclination to eat in response to emotions and is associated with certain syndromes. In this sense, we explored the indices of EE and its association with dietary patterns among female students at Qassim University in Saudi Arabia. A cross-sectional study of 380 participants (aged 18–29 years, female students) was performed. Anthropometric measurements of the participants were taken, such as height, body mass index, fat mass and hip–waist circumference as well as the Emotional Eating Scale (EES). The classification of the ESS included the thresholds of 44.7, 43.9 and 11.3% for low, moderate and high EE, respectively. Linear regression after adjustment showed that fat intake was a significant predictor of EE (p = 0.031) as well as feelings of enthusiasm. We also observed an interesting indication: fat intake (p = 0.011) and educational level (p < 0.05) were significantly associated with, and could be significant predictors of, EE. The results highlight the importance of emotional eating, its relationship with the consumption of foods that contain fat and understanding how it develops by raising awareness of the importance of healthy food for a healthy lifestyle. Full article

We aimed to explore the relationships between childhood maltreatment and changes in weight, depressive symptoms and eating behavior post-bariatric surgery (BS). Participants (n = 111, 85% females) were evaluated pre-surgery, and at 6 months (6 M) and 12 months (12 M) post-BS. History of maltreatment was assessed at baseline (Childhood Trauma Questionnaire), and depressive symptoms (Beck Depression Inventory-II) and eating behavior (Dutch Eating Behavior Questionnaire) were assessed at all time points. Participants’ mean age and median BMI were 45.1 ± 11.7 years and 46.7 (IQR 42.4–51.9) kg/m², respectively. Histories of emotional (EA), physical (PA) and sexual abuse (SA) and emotional (EN) and physical (PN) neglect were reported by 47.7%, 25.2%, 39.6%, 51.4% and 40.5%, respectively, with 78.4% reporting at least one form of maltreatment. Changes in weight and depressive symptoms were not different between patients with vs. without a history of maltreatment. However, those with vs. without SA demonstrated limited changes in emotional eating (EE) at 12 M, while those without showed improvements. Conversely, patients with vs. without EN showed greater improvements in external eating (ExE) at 6 M, but differences were no longer observed by 12 M. Results indicate that histories of SA and EN are associated with changes in eating behaviors post-BS and have implications for assessment, monitoring and potential intervention development. Full article