Validation and Factor Structure of the French-Language Version of the Emotional Appetite Questionnaire (EMAQ)

The relation between questionnaire-measured self-reported emotional eating and disordered eating behaviors: A meta-analysis of nearly three decades of research

Extensive research exists on the association between self-reported emotional eating (EE) and disordered eating (DE) behaviors. Heterogeneity exists by type (e.g., unidimensional vs. multidimensional) and valence (e.g., negative vs. positive) of self-reported EE, and no previous meta-analyses have examined the association between self-reported EE and DE behaviors. A total of 67 studies (N = 26,289; 43 reporting relations in one model, and 24 reporting relations in more than one model) met inclusion criteria; ranges for age and publication date were 18.0-61.8 years old and 1995 to 2022. Five models quantified relations between DE behaviors and 1) broad negative EE, 2) EE in response to depression, 3) EE in response to anger and anxiety, 4) EE in response to boredom, and 5) EE in response to positive emotions. Using random-effects models, pooled Cohen's d effect sizes suggested small, positive relations between DE behaviors and self-reported broad negative EE (d = 0.40, p < 0.001), EE-depression (d = 0.41, p < 0.001), EE-anger/anxiety (d = 0.35, p < 0.001), and EE-boredom (d = 0.38, p < 0.001). A significant, but very small, positive relation was observed between DE behaviors and self-reported EE-positive (d = 0.08, p = 0.01). Subgroup analyses suggested a medium, positive relation between self-reported broad negative EE and binge eating (d = 0.53, p < 0.001) and a small, positive relation between self-reported broad negative EE and dietary restraint (d = 0.20, p < 0.001). Significant heterogeneity was identified across all models except for the EE-boredom and DE behaviors model. Higher BMI, but not age, clinical status, or type of DE behavior strengthened the positive relation between self-reported broad negative EE and DE behaviors. Findings support previous research suggesting that negative and positive EE are distinct constructs, with negatively valenced EE being more closely associated with DE behaviors, especially binge eating.

Emotional Appetite Questionnaire: psychometric properties in Brazilian adult samples before and after the COVID-19 pandemic onset

Background

Appetite represents a desire of a person to eat specific food in order to reach satisfaction and pleasure states. This desire may be associated with the experience of negative or positive emotions (emotional appetite). Emotional appetite can influence eating behavior, and its investigation is relevant to avoid possible damage to health resulting from a disordered eating.

Objectives

To adapt the Emotional Appetite Questionnaire (EMAQ) to the Portuguese language; to assess the validity and reliability of the data; and to assess emotional appetite in three samples of adults collected before and after the outbreak of the COVID-19 pandemic.

Methods

This is a cross-sectional study with non-probabilistic convenience sampling. The Portuguese version of the EMAQ was presented after translation, back-translation, and content analysis. Two studies were conducted, the first before and the second after the pandemic onset. Three samples were formed (2019: Sample 1 (age = 19.7 ± 1.5 years) n = 323; 2020: Sample 2 (age = 21.3 ± 1.8 years) n = 1,011; and Sample 3 (age = 28.9 ± 3.1 years) n = 909). An exploratory strategy with parallel analysis was performed. The analyses were conducted in FACTOR and R (lavaan and semTools packages) software. After determining the best-fit model for the data, emotional appetite was examined considering decrease, non-alteration, and increase in appetite in the face of positive and negative emotions/situations. The profile of emotional appetite was determined using a circumplex model.

Results

The two-factor model described by the valence of emotions/situations fitted the samples (Comparative Fit Index_{minimum-maximum} = 0.95-0.98; Tucker-Lewis Index = 0.94-0.98; Root Mean Square Error of Approximation = 0.03-0.08; α_ord = 0.78-0.88). Increases in appetite were more frequent for positive emotions/situations (52.0-57.5%), and both decreases (35.4-44.5%) and increases (50.0-56.2%) in appetite were observed for negative emotions/situations. Emotions with negative valence and activation were more relevant to appetite reduction, while a significant increase in appetite was observed with anxiety (negative valence and positive activation).

Conclusion

Different emotions and situations may influence appetite in people, and such an investigation may be useful in preparing eating protocols.

The Psycho-Affective Roots of Obesity: Results from a French Study in the General Population

The aim of the study was to examine the extent to which obese people differ in their emotionally driven and addictive-like eating behaviors from normal-weight and overweight people. A total of 1142 participants were recruited from a general population, by a web-based cross-sectional survey assessing anxiety/depression (Hospital Anxiety and Depression Scale), emotional eating (Emotional Appetite Questionnaire), food addiction (modified Yale Food Addiction Scale), and intuitive eating (Intuitive Eating Scale-2). The statistical design was based on analyses of (co)variance, correlograms, and mediations. A set of Body Mass Index (BMI) group comparisons showed that obese people reported higher levels of depression and emotional eating and that they experienced more severe and frequent food addiction symptoms than overweight and normal-weight people. Associations between anxiety, depression, food addiction symptoms’ count, and the difficulties to rely on hunger and satiety cues were found across all weight classes, suggesting that addictive-like eating may represent a unique phenotype of problematic eating behavior that is not synonymous with high BMI or obesity. Conversely, the interrelation between anxiety/depression, emotional eating, and the difficulties to rely on hunger and satiety cues was found only among obese participants, and negative emotional eating mediated the association between depression and anxiety and the difficulties to rely on hunger and satiety cues. This study emphasizes the necessity to develop more comprehensive approaches integrating emotional dysregulation and addictive-like eating behaviors to improve weight management and quality of life of obese people.

Patterns of negative emotional eating among Chinese young adults: A latent class analysis

There is ample evidence suggesting that negative emotional eating is closely related to disordered eating behaviors. However, most previous studies on the topic focused only on emotional over-eating, but neglected emotional under-eating. Moreover, previous studies also mainly used variable-oriented methods by reducing negative emotional eating to a single dimension, which limits our understanding of individual differences in negative emotional eating. In this study, we used a person-oriented approach, latent class analysis (LCA), to examine the negative emotional eating patterns and to characterize these patterns in a sample of 1,068 Chinese young adults (52.6% females, aged 17-24 years). Negative emotional eating was measured by the Emotional Over-Eating and Emotional Under-Eating subscales of the Adult Eating Behavior Questionnaire. Four patterns, namely, "non-emotional eating" (38.9%), "emotional over- and under-eating" (15.4%), "emotional over-eating" (14.7%), and "emotional under-eating" (31.0%), were identified. Sex and BMI were found to be statistically significant predictors for negative emotional eating patterns. The identified four patterns showed significant differences in eating disorder symptoms and psychological distress. Particularly, participants in emotional over- and under-eating exhibited the highest level of eating disorder symptoms and psychological distress. Overall, this study identified four distinct negative emotional eating patterns, among which, the emotional over- and under-eating was the most problematic. Future studies regarding negative emotional eating and its impact on mental health may benefit from focusing not only on individuals with emotional over-eating, but also on those showing a mixed pattern of negative emotional eating.

Investigating phenotypes of emotional eating based on weight categories: A latent profile analysis

OBJECTIVE

We aimed to investigate the phenotypes of individuals with emotional eating (EE) based on their levels of positive and negative EE, body mass index (BMI), and preoccupation with weight, and to assess differences in eating pathology and emotion regulation (ER) difficulties among them.

METHOD

A community sample of 605 women (mean age = 29.8 years, SD = 9.6; mean BMI = 23.4 kg/m² , SD = 4.7) filled out the Positive-Negative Emotional Eating Scale, Eating Disorders Assessment Scale, and Difficulties in Emotion Regulation Scale. Data of BMI, positive EE, negative EE, and preoccupation with body weight were submitted to a latent profile analysis.

RESULTS

A four-profile model was discovered with normal weight individuals without EE (63%), normal weight individuals with EE (23%), overweight individuals without EE (9%), and obese individuals with EE (5%). A five-profile model was also included, as a class of normal weight individuals with positive EE was found. Obese and normal weight individuals with EE showed the highest level of ER difficulties and eating pathology. Overweight individuals without EE showed moderate levels of eating pathology and low levels of ER difficulties, suggesting that high BMI itself might not be related to eating disorder (ED) psychopathology. Normal weight individuals with positive EE showed low levels of eating pathology, but moderate levels of ER difficulties.

DISCUSSION

Our results suggest that negative EE could be an important risk factor for disordered eating, independent of BMI. Further, individuals with EE could benefit from learning adaptive ER strategies to prevent the onset or maintenance of ED or weight gain.

Development and Preliminary Validation of the Salzburg Emotional Eating Scale

Existing self-report questionnaires for the assessment of emotional eating do not differentiate between specific types of emotions and between increased or decreased food intake in response to these emotions. Therefore, we developed a new measure of emotional eating-the Salzburg Emotional Eating Scale (SEES)-for which higher scores indicate eating more than usual in response to emotions and lower scores indicate eating less than usual in response to emotions. In study 1, a pool of items describing 40 emotional states was used. Factor analysis yielded four factors, which represented both positive (happiness subscale) and negative emotions (sadness, anger, and anxiety subscales). Subsequently, the scale was reduced to 20 items (5 items for each subscale) and its four-factor structure was replicated in studies 2 and 3. In all three studies, internal consistencies of each subscale were α > 0.70 and mean subscale scores significantly differed from each other such that individuals reported the strongest tendency to eat more than usual when being sad and the strongest tendency to eat less than usual when being anxious (sadness > happiness > anger > anxiety). Higher scores on the happiness subscale related to lower scores on the negative emotions subscales, lower body mass index (BMI), and lower eating pathology. In contrast, higher scores on the negative emotions subscales related to lower scores on the happiness subscale, higher BMI, and higher eating pathology. The SEES represents a useful measure for the investigation of emotional eating by increasing both specificity (differentiation between specific emotional states) and breadth (differentiation between increase and decrease of food intake) in the assessment of the emotion-eating relationship.