Unravelling the Ties: How Attachment Styles and Emotion Regulation Fuel Emotional Eating in Youth With Obesity—A Clinical Sample Study

Emotional eating is critical in the development and maintenance of obesity among children and adolescents. While attachment's influence on emotional eating is increasingly recognised, little is known about how emotion regulation strategies mediate this, particularly in samples with obesity. This study examined how attachment dimensions affect emotional eating through different emotion regulation strategies in youths with obesity. 772 children and adolescents (ages 7-19) with obesity participated. Key variables were measured using validated questionnaires. Mediation effects were analysed through Structural Equation Modelling, with exploratory analyses assessing the role of the emotion regulation strategies diversity index and specific emotion regulation strategies. Higher attachment anxiety and avoidance were associated with greater emotional eating, both directly and indirectly through maladaptive emotion regulation strategies. Adaptive strategies did not show mediating effects. Attachment anxiety and avoidance increased the diversity of emotion regulation strategies, which was associated with higher emotional eating. Interventions may benefit from prioritising the effectiveness of these strategies and addressing maladaptive ones. Excessive diversity of emotion regulation strategies could reflect underlying difficulties and may be associated with higher emotional eating. A deeper understanding of the interplay between attachment and emotion regulation could inform more targeted approaches for preventing and treating obesity in youth.