International Journal of Mental Health & PsychiatryISSN: 2471-4372

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Research Article, Int J Ment Health Psychiatry Vol: 2 Issue: 2

What affects Emotional Eating? The Self-Control, Life Events and Coping among Adolescents

Ai Xie and Taisheng Cai*
Medical Psychological Institute of The Second Xiangya Hospital, Central South University, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Hunan Province Technology Institute of Psychiatry, China
Corresponding author : Taisheng Cai
Medical Psychological Institute of The Second Xiangya Hospital, Central South University, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Hunan Province Technology Institute of Psychiatry, Middle Ren-Min Road 139, Changsha, Hunan 410011, China
E-mail: [email protected]
Received: March 28, 2016 Accepted: April 12, 2016 Published: April 16, 2016
Citation: Xie A, Cai T (2016) What affects Emotional Eating? The Self-control, Life events and Coping among Adolescents. Int J Ment Health Psychiatry 2:2. doi:10.4172/2471-4372.1000121

Abstract

The current study investigated the relationship between self-control, coping style, life events and emotional eating, and examined the effects of these variables on emotional eating. Self-control, coping style, life events and emotional eating were measured in 932 high school students. Compared to non-emotional eating group, emotional eating group reported more use of emotion-oriented coping style and more life events. Both emotion-oriented coping style and life events were strongly related to emotional eating. To determine which of several variables best predicted emotional eating, we conducted step regression. The results indicated that life events was the primary predictor for emotional eating. As an unhealthy eating behavior, emotional eating may affect individual physical and mental health, but due to the particularity of Chinese society and the speciality of adolescence period, little attention has been paid to emotional eating among adolescents. To prevent emotional eating, it is necessary to train efficient coping strategy and screen for unhealthy eating behaviors when a adolescent reports adverse life events.

Keywords: Adolescents; Self-control; Coping; Life events; Emotional eating

Keywords

Adolescents; Self-control; Coping; Life events; Emotional eating

Introduction

“The tendency to eat in response to a range of negative emotions such as anxiety, depression, anger and loneliness, to cope with negative effects” is emotional eating [1],which has been considered as an ‘inapt’ response and problematic eating style as emotional eating is linked to higher body weight [2] and more unhealthy diet pattern [3]. In addition, emotional eating is an important predictor for binge eating among preadolescents and adults; they may use food as an emotional defense in the face of negative emotions [4].
Previous studies have found that emotional eating is influenced by environment (stress, negative life events, etc.) and individual factors (such as ability of self-control, coping style and personality). Few studies have simultaneously investigated the effects of these factors on emotional eating. This study will discuss these factors and ascertain to what extent self-control, life events and coping predict emotional eating.
Self-control
Self-control is the ability to refrain one’s inner responses, which including undesirable thoughts, emotion and impulsive behavioral tendencies [5]. Generally, high level of self-control is related to successful behavior and healthy life style. Conversely, low level of selfcontrol is characterized by failure of planning, impulsive decisionmaking and act without thinking [6], which may lead to many social problems, such as obesity, substance abuse, criminality [7,8]. Therefore, self-control played an important role in the development and maintenance of psychological health and well-being [9]. A study between self-control and eating style conducted by Elfhag and Morey, found that higher impulsiveness was related to higher levels of disinhibition and emotional eating [2]. When experiencing aversive emotions or negative life events, people with poor self-control and lower self-discipline were more likely to be affected by food as an external stimulis. They usually chose “eating” as a way to escape from the pressure, suggesting that difficulty to control individual behaviors and the impulse of eating are major aspects of eating behaviors [2]. Similarly, research among 594 high school students also found that low level of self-control was strongly related to high level of emotional eating, and self-control have a mediational effect between negative emotion and emotional eating in adolescents [10]. Therefore, training adolescents’ self-control can help to prevent emotional eating. By experiment, subjects with high and low impulsivity were randomly divided into either a negative or a neutral mood induction. Bekker et al. well-demonstrates the relationship between impulsivity and emotional eating: high impulsive individuals are easier to be affected by negative emotions in their emotional eating [11]. Moreover, selfcontrol not only influences eating style but also has an impact on food consumption. Study conducted by Haws and Redden reveales that compared to those with high self-control, people with low self-control are more likely to overeat [12]. As a result, increasing food intake may lead to obesity over time. Keller and Siegrist also agree that self-control enables individual to override the temptations of food and to keep their weight under normal status [13]. In addition, people who possess high self-control probably will enjoy better interpersonal relationship, bigger academic success and better psychological health [5,14,15]. Therefore, self-control is intimately related to a wide range of behaviors. A better understanding of the adolescent’s self-control will contribute to preventing undesirable activities.
Life events
Adolescent is the critical period of physiological and psychological development,and is also at high risk of mental conflict, emotion and behavior problems [16]. Some previous studies have investigated the relationship among life events, emotion and behavior,and states that life events indeed significantly affect adolescents’ emotion and behavior problems [17,18]. Jacobi et al. concluded in their review that, compared with healthy samples, patients with anorexia and bulimia experienced more life events before the onset of their eating disorder [19]. Study of Horesh et al. confirmed this result that certain life events may lead to eating disorder [20]. Through a longitudinal study, participants were measured during childhood, adolescence, and early adulthood. Johnson et al. found that individuals who experienced adverse life events, such as sexual abuse, physical neglect and socioeconomic variables during childhood, were at higher risk of eating disorder. They also reported weight fluctuations during adolescence [21]. However, in another longitudinal study, of which the subjects’ data were traced over 6 years, revealed that there were no differences in weight change between people who had experienced adverse life events and who had not [22]. Furthermore, extensive evidences suggested that adversity like stress was associated with bigger drive to eat, binge eating and invalid attempts to control eating [23,24]. Up to now, the majority literature on life events has focused on eating disorder, but few research investigated the relation between life events and emotional eating. Emotional eating means eating in response to the negative emotions such as depression, anxiety and disappointment. Life events includes substantial negative life events, like academic pressure, companion relationship, healthy growth and so on. In facing with this negative life events, individuals who cannot adopt appropriate methods to get rid of this adversity may turn to other different ways to relief themselves and food as a soothing and satisfying resource, which may have great appeal for a lot of people.Thus life events have an impact on emotional eating to some degree. Akkermann et al. has pointed out that the adverse life events are not only a specific factor to eating disorder but also to depression and anxiety related disorders [25].
Coping
The relationship between coping style and eating has always interested researchers. This relationship varies on the distinctive coping strategies of the individual. Problem-oriented coping and emotion-oriented coping are two different coping strategies. Problemoriented coping involves managing or solving the problems which have caused distress; emotion-oriented coping comprises ameliorating the negative emotions or ignoring the problem [26]. Lazarus and Folkman consider that this two coping styles are neither adaptive nor maladaptive [27], but some studies claimed that emotion-oriented coping approaches significantly predicted psychological distress and physical illness [28,29]. Some cross-sectional studies indicates that woman who suffers from eating disorder are reported more use of inefficient coping strategy than normal controls [30,31]. Also, a study about coping and eating among adolescents demonstrated that twentyfive percent of the sample chose food as a coping mechanism [32]. Avoidant coping were related to unhealthy eating behavior and using more problem-oriented coping may prevent unhealthy eating. About emotional eating, the majority of investigations support the point that emotion-oriented coping is associated with emotional eating, while problem-oriented coping is not [33,34]. When feeling uncomfortable, emotional eaters are more likely to evade the problems through some emotion-oriented coping strategies such as escaping, avoidance and fantasy. Eating as a easily available way to ease stress naturally becomes a preferred choice for many people. Emotional eaters may have fewer emotion-regulation strategies and not be able to successfully deal with aversive emotion. Once they learned eating can alleviate negative emotions, they will keep this seemingly useful skill. As Nguyen- Rodriguez et al. points out in their research, emotional eating is likely to be a learned response to stress by the phase when children become adolescents [35], and emotion eating is continuous [36], which means children who shows high scores on emotional overeating at 4 years old are more prone to have high levels at 11 years. Eating itself has been considered as a maladaptive coping used to lighten the stress [37], and the effect of the stressful life events on disturbed eating might be dependent on how person cope with this stressors [33,38]. Therefore, the role of coping in emotional eating might advances our understanding of eating pathology.
The present investigation
In summary, it is established that self-control and coping style are related to emotional eating, and life events are also associated with eating behavior. However, important questions still remain about the effects of self-control, life events and coping style on emotional eating among Chinese adolescents. Findings presented that major life events or daily hassles might be less important to physical and psychological well-being than coping processes [39]. Most previous studies have explored from eating disorder perspective, but have not touched emotional eating, especially in Chinese adolescents. To our knowledge, this is the first study that examines the correlation between selfcontrol, life events, coping style and emotional eating among adolescents in China. A better understanding of these factors would facilitate the development of eating behavior.
Individual often seek efficient coping strategy to manage stressful life events, and have sufficient control in the face of food. However, with respect to emotional eating, it is supposed that emotion-oriented coping style might be the main choice to escape adverse life events, and poor control to emotional eating may lead to eating disorder and obesity. Thus, it is predicated in this study that self-control and life events are both associated with emotional eating, emotion-oriented coping style is positively related to emotional eating and problemoriented coping style has no relation with emotional eating. Besides, these factors can also predict emotional eating. Promoting the selfcontrol of individuals and learning more valid coping strategies may prevent emotional eating and enhance physical and psychological health.

Methods

Sample
Participants were 932 students between 11 and 17 years of age (M=14.55, SD=1.218), of whom 401 were boys and 531 were girls. Body mass index (BMI) ranged from 15 to 37, with an average of 19.95 (SD = 3.307). The study sample was achieved by random selection of classes from a middle school in Changsha, Hunan. After being informed of the purpose of the study, subjects completed questionnaires during class time. All participants provided written informed consent, and the ethical committee of Central South University has approved the study.
Instruments
Emotional Eating: Eating behavior was measured by The Dutch Eating Behavior Questionnaire’s (DEBQ) subscale for emotional eating [40]. 13 items were used to assess the desire to eat when experiencing different emotions on a 5-point Likert scale ranging from 0 (No desire) to 4 (A strong desire). Higher scores mean that the individual has a stronger desire to eat. The subscale used in this study has shown high internal consistency, with a Cronbach's alpha of 0.90.
Self-Control: The Self-Control Scale (SCS) has been widely used to measure the individual’s level of self-control and previous studies indicated that lower self-control scores were related to more eating disturbed. We employed a Chinese version of the Self-Control Scale for adolescents [5], which contains 36 items. Participants were asked to rate on a 5-point Likert scale (1=not at all to 5=very much), higher scores mean higher levels of self-control. In the current study, Cronbach's alpha was 0.89, indicating good internal consistency.
Life Events: The instrument used to assess life events was the Adolescents Self-Rating Life Events Checklist (ASRLEC) [41]. The questionnaire designed by Liu et al. which was uesd to measure the frequency and influence of the negative life events happened in the past year, containing 27 items and 5-point Likert scale (1=no effect, 5=heavy effect). With higher score indicating greater reported life stress. The ASRLEC is of acceptable psychometric properties and applicable among Chinese adolescents .For the current study, the scale was presented a Cronbach's alpha of 0.90.
Coping: The Survey of Coping Style Scale for Middle School Students,which measured middle School Students’ general coping style [42]. These 36 items instrument used a 4-point Likert scale (1=none, 4=always), and assessed two main coping styles: problem-oriented and emotion-oriented. This scale attained satisfactory reliability and validity when applied to adolescents. In the present study, Cronbach alpha coefficients was 0.80.
Body mass index: According to the Group of China Obesity Task Force [43], the BMI ≥ 20.3 and 21.1 for 11-year-old boys and girls will be respectively defined overweight; and the cutoff points for boys and girls aged 12 are respectively 21.0 and 21.9;21.9 and 22.6 for boys and girls at the age of 13; 22.6 and 23.0 for boys and girls, respectively, at the age of 14; 23.1 and 23.5 for 15 and 16 years old boys respectively; 23.4 and 23.7 for 15 and 16 years old girls respectively; 23.8 for both genders at the age of 17. Overweight and obese participants were pair wise matched by sex and age.
Data analysis
The data were entered into statistical software package SPSS 21.0, and all missing data were removed. Descriptive statistics of the sample were processed with by computing means and frequencies of demographic data. Two-tailed t test were used to tested the significant mean score differences. Correlational analyses were conducted to detect the relationship among emotional eating, self-control, life events, coping style and BMI. Multiple regression analyses were used to further explore the relationship among variables.

Results

Descriptive statistics
Sex, age, BMI, education of parents, family income and emotional eating were obtained by self-report. The associations between participant characteristics and eating behaviors indicated that compared to students aged 11-13 years, students who were at the age of 14-17 reported more emotional eating. However, on other variables, there were no significant differences (Table 1).
Table 1: Descriptive statistics (N=932).
Mean differences
Emotional eating are categorized as two group: non-emotional eating group and emotional eating group (top and bottom 27% in 932 samples). Strong differences in mean scores were found between two groups. The emotional eating group reported more use of emotionoriented coping and higher scores on life events. However, there were no differences of self -control and problem-oriented coping between emotional eating group and non-emotional eating group (Table 2).
Table 2: Means, standard deviations and mean score differences between two groups.
Correlations
Means, standard deviations and the Pearson correlation coefficients of variables are shown in Table 3. Life events and emotion-oriented was positively associated with emotional eating. While BMI, selfcontrol and problem-oriented have no significant relation with emotional eating.
Table 3: Pearson correlations among BMI, self-control, life events, problem-oriented, emotion-oriented and emotional eating.
Stepwise regression
To explore whether these variables were the predictor for emotional eating, we conducted stepwise regression, regressing all of the predictor variables, age, self-control, life events and coping style on the dependent variables. As presented in Table 4, life events was the primary predictor for emotional eating, followed by emotion-oriented and self-control. Self-control together with life events and emotionoriented coping style could explain 45% of the variance in emotional eating, which means adolescents with more life events, lower self-control and use more emotion-oriented coping style had higher levels of emotional eating.
Table 4: Stepwise regression analysis for variables predicting emotional eating.

Discussion

The present study advanced our understanding of the association between self-control, life events, coping style and emotional eating in some respects. First, our findings demonstrated that more stressful life events and emotion-oriented coping style were tend to be relate to higher risk of emotional eating among adolescents. These results were consistent with the association found between life events and emotionoriented with disturbed eating behavior and also correspond to the study that problem-oriented coping was not associated with emotional eating [32,33,44]. Further, compared to 11-13 years old students, students who were at the age of 14-17 showed more emotional eating, which in accordance with Hou [44]. This may partly explained by the fact that early adolescence students who have just entered high school from primary school and the most important thing for them might be getting used to new school life or make more friends, and parents are strict with their daily regimen, while students who at the middle of adolescence have more academic pressure and greater initiative on food choice, which is easy for them to rely on food to escape from uncomfortable situation. Compared to non-emotional eating person, we found that emotional eating person experienced more life events and use more emotion-oriented coping. There are many problems with life events, such as drinking, smoking and eating. Related to drinking and smoking these sort of addicted behaviors, unhealthy eating behaviors of adolescents are more socially acceptable in China. The most important task of young people is learning, school and parents have strict demands on them. Once problems that seriously affect life and study arise, they will surely meet with punishment by school or parents. In this situation, adolescents sought to find ways of reducing stress, which are accepted by society and also comforting themselves. We also found that emotional eaters use more emotion-oriented coping strategies. This results indicate that when coming across difficulties emotional eaters lack adequate skills and courages to deal with. They have relieved themselves through escaping from the problems. Being short of effective coping strategies or dependent on emotion-oriented coping strategies may be a reason for emotional overeating. Additionally, we found that life events, emotion-oriented coping and self-control were predictors for emotional eating, and life events was the strongest predictor among others for emotional eating, suggesting that life events played an important role for unhealthy eating behavior.
However, our findings didn't find self-control has a significant relation to emotion eating, which was different from previous studies [2]. In Elfhag and Morey’s study, the participants were 17 to 70 years old obesity patients and the measurement of self-control was Big Five personality traits, which may lead to different outcomes. Many research revealed that obese people tend to be more impulsive than lean people [45-47]. Due to inhibitory control deficits, obese individuals couldn't keep themselves under normal situation and were more prone to trigger inappropriate behaviors such as alcohol abuse, substance addiction, especially in the face of negative emotions. There was a correlation between unhealthy eating behaviors. Some previous research revealed that emotional eating was significantly related to external eating and restrained eating [2,48]. This complicated relationship among eating behaviors may influence the assessment of emotional eating, which may draw the inconsistent conclusion of emotional eating and self-control. Moreover, the different instruments used to measure emotional eating like the Three Factor Eating Questionnaire (TFEQ), Dutch Eating Behavior Questionnaire (DEBQ) and Emotional Eating Scale (EES), might be another reason for the absence of a relationship between emotional eating and self-control.
According to escape theory [1], emotional overeating is the consequence of inadequate affect regulation and escaping from negative emotions. It is considered that emotional eaters have less emotion-regulation strategies that effectively solve negative emotions. In order to avoid the aversive implications and discomfort, they seek to shift and focus their attention on salient external stimuli (like available food, especially snacks), because they believe or have learned that eating can really reduce negative emotions. Therefore, emotional eating may serve as a coping function as it is used to relieve negative effects. In the present study, there was a strong support for the association of emotion-oriented coping with emotional eating, but the association with problem-oriented coping was not found, which was consistent with the escape theory and the affect regulation models [49]. The more emotion-oriented coping strategies adopted by individuals, the lower ability to regulate the negative emotions is and the higher risk for emotional eating is. This is to say, the reliance on emotionoriented coping is related to high risk of emotional eating. This explained the Folk’s conclusion to some extent that encountering uncontrollable or chronically high levels of stress, people tend to use emotion-oriented coping style, like eating and drinking to get rid of adversity [50]. It may aggravate the individual's depression and anxiety and could later on create a vicious circle. For many people, it is a quite common behavior to eat when confronted with negative or stressful life events, which might be considered as an emotion relief and a form of maladaptive coping [33,38,51]. These maladaptive coping strategies probably do not successfully manage stress and maintain well-being, and even lead to relying on certain behavior, in the long run [52-54]. Kalimo and Mejman points out in their study that it is not stress itself that has unfavorable consequences for the individual, but failure of effective coping in stressful situations [55], suggesting that emotional eating is the result of being unable to successfully cope with stress. Therefore, it is important to prevent this kind of maladaptive coping style from developing into addictive behaviors.
A study of eating disorders of animal model reported that a stressful experience in early life could lead to the development of eating disorders when animals were challenged by social or metabolic stress later in life [56]. Similarly, a longitudinal investigation among mothers and their offspring also indicated that substantial childhood adversities were related to increased risk for eating disorders and problems to eating or weight in adolescence [22]. In our study, we found that life events was the strongest predictor for emotional eating and played an influential role in emotional eating, which was in accordance with the research above. On the basis of psychosomatic theory [57], emotional overeating results from that the obese individuals fail to distinguish hunger from other internal negative states; they have learnt to eat in response to distress as well as to hunger. Food is used as an emotional defense when experiencing aversive effects, which caused overconsumption and, in turn, leads to obesity. Adolescence is the critical period characterized by increased vulnerability to stressor [58], and at this age teenagers are under different kinds of stressors like academic pressure, interpersonal relationship, adaptation problems and others. Failing to handle these problems effectively once could seriously affects adolescents and causes lasting harm to their physical and mental health. For example, teasing appearance could increase body dissatisfaction [59], being bullied and poor academic performance may result in eating disorders [60,61]. Stressful life events are usually associated with anxiety and depression. The more stress experienced [62,63], the more anxiety and depression are reported. These anxiety and depression symptoms significantly increase the risk of unhealthy eating behaviors including emotional eating, it is possible that emotional eating serve to coping the negative emotions that along with adverse life events. Moreover, there is a close link between stressful life events and other psychiatric disorders, that is, more higher negative life events were correlated with personality disorder [64], depression disorders and anxiety disorders [65], suggesting that stressful life events adversely impact multiple areas of psychosocial functioning. With the heavy burden of academic and the fact that the only child in the family, most teenagers in China face great pressure from various aspects, thus it is necessarily to screen for unhealthy eating behaviors when a adolescent reports adverse life events.
According to previous study, emotional eating is caused by the interactions among multi factors, such as self-esteem, parenting style and so on. In the present study, we found both coping style and life events have impacts on emotional eating. Enough attention has not been paid to the issue of emotional eating in China, which could be explained by some reasons. Emotional eating is a slow and gradual process that could be usually ignored. Because emotional eating are different from other noticeable behavior like fighting and truancy, which are more likely to draw attention. Moreover, Chinese students carry great pressure, too much attention of parents and schools has been focus on academic performance to neglect the development of other aspects. You will be understood by parents and school even if overeat when anxiety or depression, as long as you get excellent grades. Emotional eating is influenced by many factors, environment, life events and personality of individuals both have certain effects on it, but the most concerned thing for Chinese adolescents is learning and the society usually overlook the mental health of adolescents. Therefore, to prevent emotional eating, we should attach a great importance to other aspects of the adolescents besides their academic performance.
There are several limitations that must be acknowledged. Firstly, this study was cross-sectional design and depended on self-reported questionnaire, which may affect the casual association in these variables, further longitudinal studies should be conducted. Secondly, our research used the DEBQ to assess the unhealthy eating behaviors, which may be different from the actually situation, an experiment design could help us better understand the eating behaviors among adolescents. Finally, the neuropsychological mechanisms of emotional eating was not investigated in this study, so more MRI and ERP studies needed to be explore.

Conclusion

In conclusion, findings of this research shows a association between life events, emotion-oriented coping with emotional eating and the life events serve as a powerful predictor of emotional eating. On the whole, these results highlight the effects of stressful life events on emotional eating. Adolescents and their parents should pay attention to stressful life events, learn how to face and handle stress, reduce emotionoriented coping and adopt appropriate coping strategies such as asking for help instead of seeking relief in food. In addition, school can take intervention project toward reducing pressure and training effective coping style in order to prevent emotional eating.

Acknowledgments

Funding for this study was provided by XJK014BXL007 Grant 13YBA340. XJK014BXL007 had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication. Author Cai contributed to the design of the study, Author Xie conducted the statistical analysis and wrote the first draft of the manuscript.

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