Emotional eating behaviour and obesity in adolescents: a cross-sectional survey in Taizhou, China

BACKGROUND: Emotional eating behaviours have not received much attention in the treatment and management of adolescent obesity in China. This study aimed to clarify the association between emotional eating and adolescents' obese status. METHODS: This school-based cross-sectional study was conducted in Taizhou, an eastern coastal city in China. Obese status was assessed using BMI Z-score (BMIZ) or waist-to-height ratio (WHtR). The Emotional Eating Scale for Chinese Adolescents (EES-CA) was used to assess emotional eating behaviours, including the dimensions of depression, anger/rage, and anxiety. Linear regression analysis was performed to examine this relationship. Multinomial logistic regression was used for graded weight status (non-overweight as reference), and binary logistic regression for abdominal obesity. RESULTS: Of the 1,061 registered teenagers, 881 (83.0%) completed the survey. The EES-CA score increased across non-overweight (45.33 ± 12.20), overweight (60.33 ± 9.08), and obesity (69.27 ± 15.08) (p < 0.001) groups. The EES-CA score was also higher in the abdominal obesity than in the no abdominal obesity (62.92 ± 13.18 vs. 45.88 ± 12.56, p < 0.001). The EES-CA score of participants was positively correlated with BMIZ and WHtR (p < 0.001). After adjusting for potential covariates, the EES-CA score was significantly associated with BMIZ (β = 0.054, p < 0.001) and WHtR (β = 0.002, p < 0.001). The adjusted R² for BMIZ and WHtR was 53.6% and 40.5%, respectively. The EES-CA score was significantly associated with overweight (aOR = 1.098, 95%CI: 1.078-1.118, p < 0.001), obesity (aOR = 1.153, 95% CI: 1.123-1.183, p < 0.001), and abdominal obesity (aOR = 1.111, 95% CI: 1.092-1.130, p < 0.001). CONCLUSIONS: Our study demonstrated that emotional eating was associated with both BMIZ and WHtR in adolescents. Furthermore, emotional eating behaviors are more pronounced among overweight/obese adolescents as well as those with abdominal obesity.