Psychosocial Correlates of Emotional Eating and Their Interrelations: Implications for Obesity Treatment Research and Development

  • James J. AnnesiEmail author
Original Paper


We tested the effects of emotional eating in long-term weight-loss so that both treatment processes and theory could be improved. Women with obesity participated in treatments of either high interpersonal contact and behavioral methods (n = 39) or low interpersonal contact and educational methods (n = 36) through community-based settings. We assessed mood, emotional eating, self-regulation, self-efficacy, and weight. Changes in the psychosocial measures were significantly greater in the high interpersonal contact/behavioral methods group. That group had a mean weight reduction of 6.5% and 6.8% over 6 and 24 months, respectively, which was significantly greater than the 2.9% and 1.8% loss in the low interpersonal contact/educational methods group at the same time points. Using aggregate data, change in eating self-regulation significantly mediated the prediction of reduced anxiety- and depression-related emotional eating over 6 months by improvements in tension and depression, respectively. The emotional eating reductions were significantly associated with weight loss over both 6 and 24 months. Increased physical activity was significantly associated with reduced tension and depression. We also found that the relationship between changes in physical activity and tension was significantly mediated by a change in exercise-related self-efficacy. Increased exercise self-regulation significantly predicted improved eating regulation, with eating-related self-efficacy change being a significant mediator. Our findings suggest an array of psychosocial targets for behavioral weight-management treatments that have large-scale applications.


Self-regulation Eating behavior Obesity Treatment Mood 



This research was funded in part by a grant from Blue Cross Blue Shield of Georgia.

Compliance With Ethical Standards

Conflict of Interest

The author declares that they have no conflict of interest.

Ethical Approval

All study procedures involving human participants were in accordance with the ethical standards of the institution and/or national research committee, and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study protocol was approved by the Institutional Review Board of Kennesaw State University, Kennesaw, Georgia, Study #13173.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


  1. Abraham, C., & Michie, S. (2008). A taxonomy of behavior change techniques used in interventions. Health Psychology,27, 379–387. Scholar
  2. Altaman, D. G., & Bland, J. M. (1999). Treatment allocation in controlled trails: Why randomise? British Medical Journal,318, 1209. Scholar
  3. Andrews, R. A., Lowe, R., & Clair, A. (2011). The relationship between basic need satisfaction and emotional eating in obesity. Australian Journal of Psychology,63, 207–213. Scholar
  4. Annesi, J. J. (2012). Supported exercise improves controlled eating and weight through its effects on psychosocial factors: Extending a systematic research program toward treatment development. Permanente Journal,16(1), 7–18. Scholar
  5. Annesi, J. J., & Johnson, P. H. (2017). Contrasting university-based and older-age samples on weight-loss effects and their behavioral and psychosocial predictors associated with the weight loss for life protocol. Clinical Health Promotion,7, 5–11. Scholar
  6. Annesi, J. J., & Marti, C. N. (2011). Path analysis of cognitive-behavioral exercise treatment-induced changes in psychological factors leading to weight loss. Psychology and Health,26, 1081–1098. Scholar
  7. Annesi, J. J., Unruh, J. L., Marti, C. N., Gorjala, S., & Tennant, G. (2011). Effects of The Coach Approach intervention on adherence to exercise in obese women: Assessing mediation of social cognitive theory factors. Research Quarterly for Exercise and Sport,82, 99–108. Scholar
  8. Annesi, J. J., & Vaughn, L. L. (2011). Relationship of exercise volume with change in depression and its association with self-efficacy to control emotional eating in severely obese women. Advances in Preventive Medicine. Scholar
  9. Arnow, B., Kenardy, J., & Agras, W. S. (1995). The Emotional Eating Scale: The development of a measure to assess coping with negative affect by eating. International Journal of Eating Disorders,18, 79–90.;2-V.CrossRefPubMedGoogle Scholar
  10. Baker, C. W., & Brownell, K. D. (2000). Physical activity and maintenance of weight loss: Physiological and psychological mechanisms. In C. Bouchard (Ed.), Physical activity and obesity (pp. 311–328). Champaign, IL: Human Kinetics.Google Scholar
  11. Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice Hall.Google Scholar
  12. Bandura, A. (1997). Self-efficacy: The exercise of control. New York, NY: Freeman.Google Scholar
  13. Bandura, A. (2005). The primacy of self-regulation in health promotion. Applied Psychology: An International Review,54, 245–254. Scholar
  14. Baranowski, T., Cerin, E., & Baranowski, J. (2009). Steps in the design, development and formative evaluation of obesity prevention-related behavior change trials. International Journal of Behavioral Nutrition and Physical Activity,6, 6. Scholar
  15. Baranowski, T., Lin, L. S., Wetter, D. W., Resnicow, K., & Hearn, M. D. (1997). Theory as mediating variables: Why aren’t community interventions working as desired? Annals of Epidemiology,7(Suppl), S89–S95. Scholar
  16. Baumeister, R. F., Vohs, K. D., & Tice, D. M. (2008). The strength model of self-control. Current Directions in Psychological Science,16, 351–355. Scholar
  17. Brownell, K. D. (2004). The LEARN program for weight management (10th ed.). Dallas, TX: American Health Publishing.Google Scholar
  18. Clark, M. M., Abrams, D. B., Niaura, R. S., Eaton, C. A., & Rossi, J. S. (1991). Self-efficacy in weight management. Journal of Consulting and Clinical Psychology,59, 739–744. Scholar
  19. Cohen, J., Cohen, P., West, S. G., & Aiken, L. S. (2003). Applied multiple regression/correlation analysis for the behavioral sciences (3rd ed.). Mahwah, NJ: Erlbaum.Google Scholar
  20. Cooper, Z., Doll, H. A., Hawker, D. M., Byrne, S., Bonner, G., Eeley, E., et al. (2010). Testing a new cognitive behavioural treatment for obesity: A randomized controlled trial with three-year follow-up. Behavior Research and Therapy,48, 706–713. Scholar
  21. Cromwell, J. B., Hannan, M. J., Labys, W. C., & Terraza, M. (1994). Multivariate tests for time series models. Thousand Oaks, CA: Sage.CrossRefGoogle Scholar
  22. Eldredge, K. L., & Agras, W. S. (1996). Weight and shape overconcern and emotional eating in binge eating disorder. International Journal of Eating Disorders,19, 71–82.;2-T.CrossRefGoogle Scholar
  23. Franz, M. J., VanWormer, J. J., Crain, L., Boucher, J. L., Histon, T., Caplan, W., et al. (2007). Weight-loss outcomes: A systematic review and meta-analyses of weight-loss clinical trials with a minimum of 1-year follow-up. Journal of the American Dietetic Association,107, 1755–1767. Scholar
  24. Gendolla, G. H. E., & Brinkman, K. (2005). The role of mood states in self-regulation: Effects on action preferences and resource mobilization. European Psychologist,10, 187–198. Scholar
  25. Gianini, L. M., White, M. A., & Masheb, R. M. (2013). Eating pathology, emotion regulation, and emotional overeating in obese adults with binge eating disorder. Eating Behavior,14, 309–313. Scholar
  26. Godin, G. (2011). The Godin-Shephard Leisure-Time Physical Activity Questionnaire. Health and Fitness Journal of Canada,4(1), 18–22.Google Scholar
  27. Green, L. W., Sim, L., & Breiner, H. (Eds.). (2013). Evaluating obesity prevention efforts: A plan for measuring progress. Washington, DC: National Academies Press.Google Scholar
  28. Grogan, S. (2006). Body image and health: Contemporary perspectives. Journal of Health Psychology,11, 523–530. Scholar
  29. Hales, C. M., Carroll, M. D., Fryar, C. D., & Ogden, C. L. (2017). Prevalence of obesity among adults and youth: United States, 2015–2016. In: NCHS data brief, Number 288. Hyattsville, MD: National Center for Health Statistics. Retrieved May 15, 2019 from
  30. Halmi, K. A. (2013). Perplexities of treatment resistance in eating disorders. BMC Psychiatry,13, 292. Scholar
  31. Jacobs, D. R., Ainsworth, B. E., Hartman, T. J., & Leon, A. S. (1993). A simultaneous evaluation of 10 commonly used physical activity questionnaires. Medicine and Science in Sports and Exercise,25, 81–91.CrossRefGoogle Scholar
  32. Jeffery, R. W., Drewnowski, A., Epstein, L. H., Stunkard, A. J., Wilson, G. T., Wing, R. R., et al. (2000). Long-term maintenance of weight loss: Current status. Health Psychology,19(Suppl. 1), 5–16. Scholar
  33. Jetté, M., Sidney, K., & Blumchen, G. (1990). Metabolic equivalents (METs) in exercise testing, exercise prescription and evaluation of functional capacity. Clinical Cardiology,13, 555–565. Scholar
  34. Johnson, S. S., Paiva, A. L., Mauriello, L., Prochaska, J. O., Redding, C., & Velicer, W. F. (2014). Coaction in multiple behavior change interventions: Consistency across multiple studies on weight management and obesity prevention. Health Psychology,33, 475–480. Scholar
  35. Kaiser Permanente Health Education Services. (2008). Cultivating Health weight management kit (8th ed.). Portland, OR: Kaiser Permanente.Google Scholar
  36. Kiernan, M., Brown, S. D., Schoffman, D. E., Lee, K., King, A. C., Taylor, B., et al. (2013). Promoting healthy weight with “stability skills first”: A randomized trial. Journal of Consulting and Clinical Psychology,81, 336–346. Scholar
  37. Landers, D. M., & Arent, S. M. (2001). Physical activity and mental health. In R. N. Singer, H. A. Hausenblas, & C. M. Janelle (Eds.), Handbook of research on sport psychology (2nd ed., pp. 740–765). New York, NY: Wiley.Google Scholar
  38. MacLean, P. S., Wing, R. R., Davidson, T., Epstein, L., Goodpaster, B., Hall, K. D., et al. (2015). NIH working group report: Innovative research to improve maintenance of weight loss. Obesity,23, 7–15. Scholar
  39. Maes, S., & Karoly, P. (2005). Self-regulation assessment and intervention in physical health and illness: A review. Applied Psychology,54, 245–277. Scholar
  40. Mann, T., Tomiyama, J., Westling, E., Lew, A. M., Samuels, B., & Chatman, J. (2007). Medicare’s search for effective obesity treatments: Diets are not the answer. American Psychologist,62, 220–233. Scholar
  41. Marcus, B. H., Selby, V. C., Niaura, R. S., & Rossi, J. S. (1992). Self-efficacy and the stages of exercise behavior change. Research Quarterly for Exercise and Sport,63, 60–66. Scholar
  42. Mata, J., Silva, M. N., Vieira, P. N., Carraça, E. V., Andrade, A. M., Coutinho, S. R., et al. (2009). Motivational “spill-over” during weight control: Increased self-determination and exercise intrinsic motivation predict eating self-regulation. Health Psychology,28, 709–716. Scholar
  43. McNair, D. M., & Heuchert, J. W. P. (2009). Profile of Mood States technical update. North Tonawanda, NY: Multi-Health Systems.Google Scholar
  44. McNair, D. M., Lorr, M., & Droppleman, L. F. (1992). POMS manual: Profile of Mood States. San Diego, CA: Educational and Industrial Testing Service.Google Scholar
  45. Oaten, M., & Cheng, K. (2006). Longitudinal gains in self-regulation from regular physical exercise. British Journal of Health Psychology,11, 717–733.CrossRefGoogle Scholar
  46. Paul, K., & van Strien, T. (2011). Emotional eating, rather than lifestyle behavior, drives weight gain in a prospective study in 1562 employees. Journal of Occupational and Environmental Medicine,53, 1287–1293. Scholar
  47. Penéau, S., Ménard, E., Méjean, C., Bellisle, F., & Hercberg, S. (2013). Sex and diet modify the association between emotional eating and weight status. American Journal of Clinical Nutrition,97, 1307–1313. Scholar
  48. Pereira, M. A., FitzGerald, S. J., Gregg, E. W., Joswiak, M. L., Ryan, W. J., Suminski, R. R., et al. (1997). A collection of physical activity questionnaires for health-related research. Medicine and Science in Sports and Exercise,29(Suppl. 6), S1–S205.PubMedGoogle Scholar
  49. Polivy, J., & Herman, C. (2006). An evolutionary perspective on dieting. Appetite,47, 30–35. Scholar
  50. Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods,40, 879–891. Scholar
  51. Rideout, C. A., & Barr, S. I. (2009). “Restrained eating” vs “trying to lose weight”: How are they associated with body weight and tendency to overeat among postmenopausal women? Journal of the American Dietetic Association,109, 890–893. Scholar
  52. Schafer, J. L., & Graham, J. W. (2002). Missing data: Our view of the state of the art. Psychological Methods,7, 147–177. Scholar
  53. Schneider, K. L., Panza, E., Appelhans, B. M., Whited, M. C., Oleski, J. L., & Pagoto, S. L. (2012). The Emotional Eating Scale: Can a self-report measure predict observed emotional eating? Appetite,58, 563–566. Scholar
  54. Teixeira, P. J., Carraça, E. V., Marques, M. M., Rutter, M. M., Oppert, J.-M., De Bourdeaudhuij, I., et al. (2015). Successful behavior change in obesity interventions in adults: A systematic review of self-regulation mediators. BMC Medicine,13, 84. Scholar
  55. Trost, S. G., Owen, N., Bauman, A. E., Sallis, J. F., & Brown, W. (2002). Correlates of adults’ participation in physical activity: Review and update. Medicine and Science in Sports and Exercise,34, 1996–2001. Scholar
  56. U.S. Department of Health and Human Services. (2008). 2008 Physical activity guidelines for Americans. Washington, DC: U.S. Department of Health and Human Services.Google Scholar
  57. van Strien, T. (2018). Causes of emotional eating and matched treatment of obesity. Current Diabetes Reports,18(6), 1–8. Scholar
  58. Wang, Y., Beydoun, M. A., Liang, L., Caballero, B., & Kumanyika, S. (2008). Will all Americans become overweight or obese? Estimating the progression and cost of the US obesity epidemic. Obesity,16, 2323–2330. Scholar
  59. Wang, L., Zhang, Z., McArdle, J. J., & Salthouse, T. A. (2009). Investigating ceiling effects in longitudinal analysis. Multivariate Behavioral Research,43, 476–496. Scholar
  60. Warziski, M. T., Sereika, S. M., Styn, M. A., Music, E., & Burke, L. E. (2008). Changes in self-efficacy and dietary adherence: The impact on weight loss in the PREFER study. Journal of Behavioral Medicine,31, 81–92. Scholar
  61. White, I. R., Horton, N. J., Carpenter, J., & Pocock, S. J. (2011). Strategy for intention to treat data in randomized trials with missing outcome data. British Medical Journal,342, d40. Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2020

Authors and Affiliations

  1. 1.YMCA of Metro AtlantaAtlantaUSA
  2. 2.Kennesaw State UniversityKennesawUSA

Personalised recommendations