The interplay between ruminative thinking, stress and emotional eating

Ruminative thinking, a repetitive focus on negative emotions, may prolong stress responses and promote maladaptive eating, yet stress, ruminative thinking, and eating behaviour are usually studied in isolation. This study examined factors independently associated with ruminative thinking, focusing on perceived stress, emotional eating, and emotional appetite in community-based adults.This cross-sectional study recruited 626 adults aged 18 years or older from public settings in Izmir, Türkiye, from January to May 2023. Face-to-face questionnaires used four validated instruments, the Ruminative Thought Scale (RTS), the Perceived Stress Scale (PSS), the Turkish Emotional Eating Scale (TR-EES), and the Emotional Appetite Questionnaire (EMAQ), alongside sociodemographic and lifestyle data. Participants were categorised as ruminative or non-ruminative by the median RTS score. Multivariable binary logistic regression showed independent correlates of ruminative thinking, adjusting for gender, body mass index, smoking, alcohol use, perceived stress, emotional eating, and EMAQ subscale scores, with age included as a covariate rather than a primary variable of interest.Overall, 48.2% were ruminative and 35.5% emotional eaters. Both perceived stress and emotional eating were significantly associated with ruminative thinking in bivariate analyses. After adjustment, emotional eating stayed the strongest correlate, with emotional eaters showing over threefold higher odds (odds ratio 3.44, 95% confidence interval 2.28-5.19; p < 0.001), while perceived stress was no longer significant (odds ratio 1.36, 95% confidence interval 0.93-1.97; p = 0.111). Among the covariates, older age was independently associated with lower odds of ruminative thinking (odds ratio 0.96, 95% confidence interval 0.94-0.98; p = 0.001). Eating in positive situations was positively associated (odds ratio 1.09, 95% confidence interval 1.05-1.15; p < 0.001) and eating in negative situations inversely associated (odds ratio 0.96, 95% confidence interval 0.92-0.99; p = 0.047) with ruminative thinking.Emotional eating, rather than perceived stress, was the principal factor independently associated with ruminative thinking. Because the cross-sectional design cannot prove temporal order, longitudinal studies should figure out whether emotional eating precedes or follows ruminative thinking and clarify the unexpected inverse association between eating in negative situations and ruminative thinking. Such studies should add direct dietary intake assessment, which body mass index cannot capture, and include clinical populations to test whether targeting emotional eating interrupts the cycle linking stress to disordered eating.