Reduction of High Emotional Eating via Increased Physical Activity: Assessing a Path Informed by Multiple Behavioral Theories Within Community-Based Obesity Interventions

Emotional eating (EE; eating in response to negative emotions) is a considerable problem in adults with obesity. Recent meta-analyses of behavioral treatments for those with elevated body mass index (BMI) have demonstrated inconsistent, but generally minimal, effects for dealing with EE. This might largely be due to inappropriate sampling, cross-sectional research designs, and a lack of understanding of theory-driven psychosocial mechanisms of EE change. This study aimed to inform mental health, medical, and health behavior-change professionals on methods to address EE within obesity treatments. Within the present field-based research, women with high EE participated in 6-month community-based obesity treatments emphasizing either weight-management education + attention on EE (n = 34), self-regulatory skills-no attention on EE (n = 43), or self-regulatory skills + attention on EE (n = 42). Each condition incorporated physical activity for its mood-change potentials. Significant improvements in physical activity, mood, eating-related self-regulation and self-efficacy, EE, and weight were found in all groups, with greater advances occurring in the self-regulation vs. educationally focused conditions. Incorporating aggregated data, significant theory- and previous research-derived paths from changes in physical activity -> mood -> self-regulation -> self-efficacy -> EE change over 6 months, and over 12 months, were identified. Reductions in EE over 6 and 12 months predicted weight loss over 6, 12, and 24 months. Findings supported tenets of social cognitive theory, self-regulation theory, the mood-behavior model, and self-efficacy theory, and informed future behavioral obesity treatments on evidence-driven methods to better-address EE within scalable settings.