Emotional eating and cardiometabolic health: mechanisms, evidence, and clinical implications

Obesity is a major global health issue and a leading contributor to cardiovascular disease (CVD). While traditional research has emphasized diet and physical inactivity, psychological factors, particularly emotional eating, are increasingly recognized as important contributors to metabolic and cardiovascular health. Emotional eating, defined as eating in response to negative emotions, represents a maladaptive coping mechanism that promotes excessive caloric intake, visceral fat accumulation, and metabolic dysregulation. Chronic stress activates the hypothalamic-pituitary-adrenal axis, leading to increased cortisol secretion and appetite, while recurrent emotional eating behaviors reinforce this biological pathway and contribute to insulin resistance, dyslipidemia, hypertension, and systemic inflammation. Together, these mechanisms link psychological stress to cardiometabolic dysfunction and ultimately to increased CVD risk. Although direct evidence linking emotional eating to clinical CVD outcomes remains limited, accumulating evidence supports its role as a behavioral mediator connecting psychological stress, metabolic abnormalities, and cardiovascular risk. Effective management of emotional eating requires an integrated approach that combines cognitive behavioral therapy, mindfulness-based strategies, stress management, healthy lifestyle modification, and pharmacological treatment for obesity when indicated. Recognizing emotional eating as a modifiable behavioral risk factor may open new opportunities for early prevention and holistic management of CVD.