Eating-Related Profiles in Multiple Sclerosis: Associations with Coping, Health Locus of Control, and Self-Management

Background/Objectives: Eating-related difficulties in people with multiple sclerosis (MS) may reflect different behavioural and psychological processes, including emotional responses to illness-related stress, habitual overeating, attempts to control food intake, and broader self-management routines. Variable-centred analyses may obscure this heterogeneity by examining eating-related tendencies separately. This study aimed to examine whether habitual overeating, emotional overeating, and dietary restraint in adults with MS are better represented as one general continuum of eating-related difficulty or as distinct person-centred profiles that differ in coping styles, health locus of control, and MS self-management. Methods: This cross-sectional secondary analysis included 382 adults with definite MS. Latent class analysis used 30 binary My Eating Habits Questionnaire items. One-step latent class regression models examined coping and health locus of control. Linear regression compared self-management scores. The models were adjusted for sex, age, disease duration, and Expanded Disability Status Scale score. Results: A five-class solution was retained (BIC = 11,067.60; entropy = 0.920), comprising low difficulties, moderate mixed tendencies, two emotional eating/restraint profiles, and dysregulated overeating. Emotional eating with moderate restraint was associated with lower task-oriented coping and internal health control, and with higher emotion-oriented and avoidance-oriented coping and external health-control beliefs. Dysregulated overeating was associated with lower task-oriented coping, higher avoidance-oriented coping, and stronger powerful-others health beliefs. Self-management was higher for emotional eating with moderate restraint (B = 5.3, 95% CI 1.8 to 8.9; p = 0.003) and high emotional eating and restraint (B = 6.0, 95% CI 1.8 to 10.3; p = 0.005), versus low difficulties. Sensitivity analyses gave similar findings. Conclusions: Eating-related tendencies in MS formed distinct profiles rather than a single continuum. These profiles differed in coping and health-control patterns, suggesting that similar eating-related difficulties may occur in different psychological and self-management contexts. The higher self-management scores observed in restraint-related profiles should be interpreted cautiously and should not be taken to indicate that restrictive eating is adaptive. This study does not establish clinical classification or treatment recommendations. Instead, it provides a descriptive empirical basis for future studies testing whether these profiles are stable and whether they predict dietary, nutritional, psychological, and clinical outcomes.