Obesity is associated with many consequences on physical and psychological health that tend to increase with its severity. Emotional eating, as the tendency to eat to alleviate negative emotions, has been identified as a major risk factor of weight gain and maintenance. By increasing the amount and the intensity of negative emotions, emotion dysregulations as well as anxious and depressive symptoms would increase the risk of emotional eating in obesity. While we know that higher rates of depression and anxiety are found in more severe forms of obesity (Andrei et al., 2018), we currently don’t know if the processes involved in emotional eating are the same between various severities of obesity. Therefore, the aim of the present study was to compare the links between emotion dysregulations, anxiety, depression and emotional eating in patients suffering from moderate and severe form of obesity.

120 adult participants with obesity were recruited in bariatric surgery and diabetology centers of the north of France. According to their BMI, participants were assigned either to the group “moderate obesity” (MO) (N=60; 30≤BMI<40) or “severe obesity” (SO) (N=60; BMI≥40). They completed a set of self-report questionnaires assessing their emotion dysregulations (CERQ; DERS), their levels of anxiety and depression (BDI-SF; STAI-T) and their emotional eating (DEBQ; TFEQ). A partial least path modeling (PLS-PM) and a multi group analysis (PLS-MGA) were used to investigate relationships between the variables and group comparisons respectively.

In the MO group, emotion dysregulations were associated with more emotional eating only through more anxiety (β=.43; P=.00), but not directly or through more depression. In the SO group, emotion dysregulations were associated with more emotional eating directly (β=.49; P=.00), and indirectly through more depression (β=.29; P=.00), but not through more anxiety. The multi group analysis revealed significant differences between MO and SO groups regarding the direct links between anxiety and emotional eating (P=.00), depression and emotional eating (P=.01) and emotion dysregulations and emotional eating (P=.01).

Emotion dysregulations, anxiety, depression and their associations are involved in the emotional eating of adult suffering from obesity. Given the differences between MO and SO regarding risk factors of emotional eating, it may be interesting for clinicians to focus on the management of anxiety related affect and symptoms in moderate obesity and on the management of depressive related affects and symptoms in severe obesity.