Stress, coping and food addiction: the mediating role of coping strategies among university students

This study aims to address a critical gap in literature by examining the mediating role of coping strategies in the relationship between mental health issues and food addiction among university students, contributing to the understanding of how stress management mechanisms affect addictive eating behaviours during this vulnerable period. A cross-sectional, quantitative study was conducted with 1947 students enrolled at a university in Istanbul during the 2024-2025 academic year. Data were collected online, using a Personal Information Form, the Depression-Anxiety-Stress-21 Scale (DASS-21), the Coping Orientation to Problems Experienced Inventory (Brief COPE) and the Modified Yale Food Addiction Scale 2.0 (mYFAS 2.0). Data were analysed using Pearson's correlation analysis, multiple regression analysis and PROCESS Macro Model 4. Moderate, positive and statistically significant correlations were observed between depression, anxiety and stress levels and food addiction (<i>r</i> = 0·398-0·417; <i>P</i> < 0·001). Multiple regression analysis demonstrated that mental health issues explained 20·8 % of the variance in food addiction scores. Mediation analyses indicated that adaptive coping strategies (e.g. humour, acceptance and using instrumental social support) and maladaptive coping strategies (e.g. restraint coping, behavioural disengagement and suppression of competing activities) significantly mediated the relationship between mental health issues and food addiction. Mental health issues represent a substantial risk factor for food addiction among university students in metropolitan areas, influenced by their coping strategies. Promoting adaptive coping strategies and reducing maladaptive ones are essential for preventing food addiction. These findings underscore the need to integrate psychological support and stress management into intervention programmes targeting university students.