Depression, emotional eating and long-term weight changes: a population-based prospective study
Open accessAbstract
BACKGROUND: Emotional eating (i.e. eating in response to negative emotions) has been suggested to be one mechanism linking depression and subsequent development of obesity. However, studies have rarely examined this mediation effect in a prospective setting and its dependence on other factors linked to stress and its management. We used a population-based prospective cohort of adults and aimed to examine 1) whether emotional eating mediated the associations between depression and 7-year change in body mass index (BMI) and waist circumference (WC), and 2) whether gender, age, night sleep duration or physical activity moderated these associations. METHODS: Participants were Finnish 25- to 74-year-olds who attended the DILGOM study at baseline in 2007 and follow-up in 2014. At baseline (n = 5024), height, weight and WC were measured in a health examination. At follow-up (n = 3735), height, weight and WC were based on measured or self-reported information. Depression (Center for Epidemiological Studies - Depression Scale), emotional eating (Three-Factor Eating Questionnaire-R18), physical activity and night sleep duration were self-reported. Age- and gender-adjusted structural equation models with full information maximum likelihood estimator were used in the analyses. RESULTS: = 0.045). The effects of depression on change in BMI and WC were mediated by emotional eating. Night sleep duration moderated the associations of emotional eating, while age moderated the associations of depression. More specifically, emotional eating predicted higher BMI (P = 0.007 for the interaction) and WC (P = 0.026, respectively) gain in shorter sleepers (7 h or less), but not in longer sleepers (9 h or more). Depression predicted higher BMI (P < 0.001 for the interaction) and WC (P = 0.065, respectively) increase in younger participants, but not in older participants. CONCLUSIONS: Our findings offer support for the hypothesis that emotional eating is one behavioural mechanism between depression and development of obesity and abdominal obesity. Moreover, adults with a combination of shorter night sleep duration and higher emotional eating may be particularly vulnerable to weight gain. Future research should examine the clinical significance of our observations by tailoring weight management programs according to these characteristics.
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Emotion-based eating is associated with emotion dysregulation, poor emotion regulation skills, low distress tolerance, dietary restraint, loss of control of eating, poor awareness of hunger/fullness signals, body image dissatisfaction, internalized shame, and low self-compassion.
“In addition to depression, emotion-based eating is associated with many other factors, including emotion dysregulation, poor emotion regulation skills, low distress tolerance, dietary restraint, loss of control of eating, poor awareness of hunger/fullness signals, body image dissatisfaction, internalized shame, and low self-compassion (24–29).”
From Behavioral Interventions to Attenuate Driven Overeating and Weight Regain After Bariatric Surgery (2022) · cites this paper as [24]
The Background (page unavailable) describes confusion between hunger and satiety signals and emotion-related bodily changes as a possible mechanism of emotional eating. The Discussion (page unavailable) calls emotional eating a maladaptive emotion-regulation strategy and suggests that emotional eaters might benefit from regulation-skills training. Neither passage establishes associations with the other listed factors, including distress tolerance, body image dissatisfaction, internalized shame, and self-compassion. (LLM, conf=0.86)
Experimental — accuracy not yet measuredEmotion-based eating appears to be a plausible pathway between depression and the development of obesity.
“Indeed, a recent population-based study demonstrated that emotion-based eating appears to be a plausible pathway between depression and the development of obesity (24).”
From Behavioral Interventions to Attenuate Driven Overeating and Weight Regain After Bariatric Surgery (2022) · cites this paper as [24]
Food consumption and weight increased during the COVID-19 pandemic while physical activity decreased, particularly among those with higher BMI.
“Evidence suggests that food consumption and weight increased during the pandemic while physical activity decreased, particularly among those with higher BMI [2, 3, 4, 5, 6].”
From Supporting Weight Management during COVID-19: A Randomized Controlled Trial of a Web-Based, ACT-Based, Guided Self-Help Intervention (2022) · cites this paper as [5]
The Results describe weight changes from 2007 to 2014, and the Methods measure physical activity at baseline. No passage in our copy addresses food consumption, weight change, or declining physical activity during the COVID-19 pandemic, including among people with higher BMI (searched: COVID-19 pandemic and baseline BMI/activity changes). (LLM, conf=0.78)
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- Authors
- Konttinen, H., van Strien, T., Männistö, S., Jousilahti, P., & Haukkala, A.
- Affiliations
- University of Helsinki (FI)
- Finnish Institute for Health and Welfare (FI)
- Corresponding author
- Konttinen, Hanna
- Venue
- International Journal of Behavioral Nutrition and Physical Activity
- Published
- 2019-03-20
- Volume
- 16
- Issue
- 1
- Pages
- 28-28
- ISSN
- 1479-5868 (ISSN-L)
- PMC
- PMC6427874
- OpenAlex
- W2923007378
- Cited by
- 341
- References
- 67
- Citations by year
- 2026: 47 · 2025: 69 · 2024: 57 · 2023: 52 · 2022: 54 · 2021: 33 · 2020: 25 · 2019: 4
- FWCI
- 33.87
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Behavioral Nutrition and Physical Activity (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- VU Research Portal (publishedVersion, other-oa)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Työväentutkimus Vuosikirja (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- European Union (Funding of Tatjana van Strien was provided by the European Union FP7 MoodFood Project ‘Multi-country collaborative project on the role of Diet, Food-related behaviour, and Obesity in the prevention of Depression’ (grant agreement no. 613598).)
- Academy of Finland (265796 and 309157, 136895 and 263836, 118065, 118139 and 275033)
- Emil Aaltosen Säätiö (Not applicable)
- Yrjö Jahnssonin Säätiö (Not applicable)
- Juho Vainion Säätiö (Not applicable)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- depression, emotional eating, obesity, abdominal obesity, body mass index, waist circumference, weight gain, mediation, sleep duration, physical activity, age differences, gender differences
- MeSH terms
- Adult, Aged, Depression, Eating, Emotions, Feeding Behavior, Finland, Humans, Middle Aged, Prospective Studies, Surveys and Questionnaires, Weight Gain
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