In a recent study published in the Nutrients Journal, researchers determined the association between compensatory and regular restraints and body mass index (BMI). They also explore the mediating role of external and emotional eating in the association.

Study: Emotional Eating as a Mediator in the Relationship between Dietary Restraint and Body Weight. Image Credit: GroundPicture/Shutterstock.com

Background

Obesity is associated with several non-communicable diseases, including cardiovascular disorders and type 2 diabetes. In addition, obesity can reduce life expectancy and quality of life.

The development of effective weight management strategies is the cornerstone of obesity management. A positive energy balance, excess energy intake compared to energy expenditure, is mainly responsible for obesity.

Calorie intake is regulated, in part, by perceived hunger and satiety sensations. However, the choice and quantity of food intake are not determined by physiological requirements only. Social and psychological factors impact eating behaviors.

Previous studies showed that the psychological constructs of eating behaviors, such as external eating, emotional eating, and diet restraints, could impact diet and, therefore, result in obesity.

About the study

In the present cross-sectional study, researchers explored the association between different constructs of dietary restraint (i.e., compensatory and regular restraints) and BMI among adult individuals residing in China. They also assessed whether external and emotional eating could mediate between the dietary restraints and body mass index (BMI).

Adults with differing BMI values filled out web-based questionnaires. Compensatory and routine restraints and external and emotional eating were assessed using the Weight-Related Eating Questionnaire in the Chinese version (WREQ-C).

The team performed mediation analyses to test the mediation effects of external and emotional eating on the association between compensatory and routine restraints and BMI.

Individuals were recruited using convenience sampling via social media. The team excluded individuals who were pregnant or breastfeeding during the study; individuals with a prior history or concurrent eating disorders such as anorexia nervosa; and individuals who limited the intake of particular foods due to medical conditions such as hypertension, diabetes mellitus, cancer, and food allergies.

Body weight status was determined using World Health Organization (WHO) criteria for Asians. Individuals with BMI values below 18.50 kg/m² were considered underweight; individuals with BMI values ranging from 18.50 to 22.90 kg/m² were considered normal-weight; individuals with BMI values ranging from 23.0 to 24.90 kg/m² were considered overweight; and those with BMI values ≥25.0 kg/m² were considered obese.

Results

Nine hundred forty-nine individuals (74% female) responded to the survey. The mean values for age (years) and BMI (kg/m2) were 33 and 22, respectively. Among the study participants, 54%, 32%, and 15% of the participants were normal weight, overweight/obese, and underweight, respectively.

The mean regular restraint scores for overweight/obese, underweight, and normal-weight participants were 2.13, 1.72, and 2.08, respectively. The mean compensatory restraint scores in the corresponding groups were 2.75, 2.88, and 2.62, respectively.

Regular restraint and emotional eating were positively associated with the body mass index values of the study participants. However, no statistically significant associations were observed between external eating or compensatory restraint and BMI values.

Regular restraint was indirectly and directly associated with greater BMI values via emotional food consumption, whereas compensatory restraint showed only indirect associations with greater BMI values via emotional food intake. The sensitivity analysis, excluding older individuals aged >60.0 years, yielded similar findings.

Further, younger individuals aged <40.0 years had greater scores for external (2.6) and emotional eating (2.1) compared to middle-aged (1.9) and older individuals (2.3). The dietary restraints and eating habits scores were significantly greater among women than men.

Among men, restraints and eating behaviors positively correlated with body mass index values. However, only emotional eating and regular restraint correlated positively with female BMI values.

Conclusions

Overall, the study findings showed that emotional eating mediated the association between regular restraint and BMI, whereas external eating did not mediate the association. In addition, emotional eating, not external eating, mediated the association between compensatory restraint and BMI.

Stringent control (regular restraint) was associated with greater BMI values or gain of weight, which may be because restrained eaters may lose their dietary control and eat excessive amounts of food (disinhibition), leading to greater BMI values.

Individuals with greater BMI values could also be more likely to limit food intake to control body weight. In line with previous studies, the findings indicated that regular restraint might not effectively reduce weight.

Emotional food intake partially regulated the relationship between regular restraint and body mass index, indicating that the greater BMI values among regular restraint eaters could be due to emotional-type eating.

The findings could have been observed since restrained diet consumers may overeat due to negative-type emotions. Compensatory-type restraint may not be associated with weight, probably because of the flexibility in diet restraints, that would offset external-type eating’s negative effects.

In addition, compensatory diet restraints permit calorie intake adjustments, preventing the negative consequences of regular (rigid) restraints.

A new finding is that individuals following compensatory dietary restraints could have greater BMI values, likely due to emotional eating. Healthcare professionals must evaluate emotional eating and diet restraint levels among obese or overweight individuals and incorporate sex-based and flexible dietary approaches that address emotional eating in weight reduction programs.

Written by

Pooja Toshniwal Paharia

Dr. based clinical-radiological diagnosis and management of oral lesions and conditions and associated maxillofacial disorders.