A latent class analysis of negative emotional eating in bariatric surgery candidates

Abstract

The Behavioral Susceptibility Theory posits that food approach/avoidance traits are key genetic contributors to obesity and disordered eating. The genetic tendency to approach/avoid food may manifest with emotional eating (i.e., over or under eating in response to emotional cues). Research indicates that emotional eating (EE) affects long-term success after bariatric surgery, but findings focus mainly on the tendency to overeat in response to negative emotions. The current study examined the role of both emotional over- and under-eating within a pre-bariatric sample, and their association with psychosocial outcomes. Using Latent Class Analysis, responses from 446 participants (74.3% female; 71.5% White, 12.1% African American, 10.3% Hispanic, 4.1% multiracial, 1.1% Other/Unreported; M_Age = 42.38, M_BMI = 49.15 kg/m²) on the emotional eating subscales of the Adult Eating Behavior Questionnaire were analyzed to identify EE patterns. Participants also responded to measures of emotional distress, quality of life, and disordered eating (e.g., night eating, binge eating, and avoidant/restrictive food intake disorder). A four-class solution emerged: (a) emotional over- and undereating (EOE-EUE; 14.4%), (b) emotional overeating (EOE; 25.3%), (c) emotional undereating (EUE; 26.0%), and (d) non-emotional eating (non-EE; 34.3%). Consistent with previous research, the EOE-EUE class exhibited high levels of psychosocial impairment, and emotional eating classes exhibited higher levels of disordered eating compared to the non-emotional eating class. These findings provide a more nuanced understanding of EE within a pre-bariatric population by identifying patterns of both over- and under-eating within individuals and differentially identifying risk factors associated with such patterns. Limitations include the lack of a non-surgery seeking comparison group, potential for response biases, and the reliance on cross-sectional data.