In a recent study published in Nutrients Journal, researchers determined the association between compensatory and regular restrictions 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 restriction and body weight. Image Credit: GroundPicture/Shutterstock.com
Obesity is associated with several non-communicable diseases, including cardiovascular disorders and type 2 diabetes. Additionally, obesity can reduce life expectancy and quality of life.
Developing effective weight management strategies is the cornerstone of obesity management. A positive energy balance, an excess of energy intake over energy expenditure, is the main cause of obesity.
Caloric intake is governed, in part, by perceived feelings of hunger and satiety. However, the choice and quantity of food eaten are not determined only by physiological needs. Social and psychological factors influence eating behaviors.
Previous studies have shown that psychological constructs of eating behaviors, such as outside eating, emotional eating, and dietary restrictions, could impact diet and, therefore, result in obesity.
About the study
In the present cross-sectional study, the researchers explored the association between different constructs of dietary restriction (ie, compensatory and regular restrictions) and BMI among adult individuals residing in China. They also investigated whether external and emotional eating could mediate between dietary restrictions and body mass index (BMI).
Adults with different BMI values filled out web-based questionnaires. Compensatory and routine restrictions and external and emotional eating were assessed using the Chinese version Weight-Related Eating Questionnaire (WREQ-C).
The team performed mediation analyzes to test the mediating effects of external and emotional eating on the association between compensatory and routine restrictions and BMI.
Individuals were recruited using convenience sampling via social media. The team excluded people who were pregnant or breastfeeding during the study; individuals with a prior history of or concurrent eating disorders such as anorexia nervosa; and individuals who have restricted their 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 between 18.50 and 22.90 kg/m2 they were considered to be of normal weight; individuals with BMI values between 23.0 and 24.90 kg/m2 were considered overweight; and those with BMI values ≥25.0 kg/m2 they were considered obese.
Nine hundred and forty-nine people (74% women) responded to the survey. The mean values for age (years) and BMI (kg/m2) were 33 and 22, respectively. Among study participants, 54%, 32%, and 15% of participants were of 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 matched groups were 2.75, 2.88, and 2.62, respectively.
Regular moderation and emotional eating were positively associated with study participants’ BMI values. However, no statistically significant associations were observed between external feeding or compensatory restraint and BMI values.
Regular restraint was indirectly and directly associated with higher BMI values through emotional food intake, whereas compensatory restraint showed only indirect associations with higher BMI values through emotional food intake. Sensitivity analysis, excluding older individuals >60.0 years of age, yielded similar results.
In addition, younger individuals aged <40.0 years had higher scores for external (2.6) and emotional (2.1) feeding than middle-aged (1.9) and older (2. 3). Scores relating to dietary restrictions and eating habits were significantly higher among women than men.
Among men, eating restrictions and behaviors correlated positively with BMI values. However, only emotional eating and regular restraint correlated positively with female BMI values.
Overall, the study results showed that emotional eating mediated the association between regular moderation and body mass index, whereas external eating did not mediate the association. Furthermore, emotional eating, not external eating, mediated the association between compensatory restraint and BMI.
Strict control (regular restraint) has been associated with higher BMI values or weight gain, which may be because moderate eaters may lose dietary control and eat excessive amounts of food (disinhibition), leading to higher BMIs.
Individuals with higher BMI values may also be more likely to limit food intake to control body weight. Consistent with previous studies, the findings indicated that regular restraint may not effectively reduce weight.
Emotional food intake partially regulated the relationship between regular restraining and body mass index, indicating that higher BMI values among habitual restraining consumers may be due to emotional eating.
The findings may have been observed as consumers of a restricted diet may overeat due to negative emotions. Compensatory restraint may not be associated with weight, possibly due to flexibility in dietary limits, which would compensate for the negative effects of external restraint.
Furthermore, compensatory dietary restrictions allow for adjustments in caloric intake, preventing the negative consequences of regular (hard) restrictions.
A new finding is that individuals on compensatory dietary restrictions may have higher BMI values, possibly as a result of emotional eating. Healthcare providers need to evaluate levels of emotional eating and dietary restraint among obese or overweight individuals and incorporate gender-based and flexible dietary approaches that address emotional eating into weight reduction programs.