Nolan Laurence J, Barnhart Wesley R, Diorio Gabriela, Gallo Veronica, Geliebter Allan
Department of Psychology, Wagner College, Staten Island, 10301, NY, USA.
Department of Psychology, Bowling Green State University, Bowling Green, 43403, OH, USA; Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, 47599, NC, USA.
Appetite. 2025 May 1;209:107966. doi: 10.1016/j.appet.2025.107966. Epub 2025 Mar 13.
Questionnaire measures of negative emotional eating (NEE) have been associated with elevated body mass index (BMI). Relatively fewer studies have examined positive emotional eating (PEE) and they report that PEE is associated with lower BMI or is not associated with BMI. To examine whether NEE and PEE are linked to BMI, we conducted a systematic review and meta-analysis of studies that used the Emotional Appetite Questionnaire (EMAQ) and the Salzburg Emotional Eating Scale (SEES), which assess change in eating associated with positive and negative emotions, and measured BMI in adults with a range of BMIs. A search of databases (CINAHL Medline, and PsycINFO), citations (Google Scholar) and dissertations (Proquest), and a preprint registry (Open Science Framework, OSF) was conducted independently by three screeners. Forty-three cross-sectional studies were eligible for inclusion. Correlations between BMI and NEE scales and PEE scales were extracted. Age and sex were examined as potential moderators. We found statistically significant (ps < .001) and small mean effect sizes with random-effects models. Higher EMAQ NEE (d = .152 [.11, .19], N = 18,576) and SEES NEE scales (sadness, d = .209 [.168, .250]; angry, d = .096 [.047, .144]; anxiety, d = .169 [.124, .211], N = 4141) were associated with higher BMI. The EMAQ PEE (d = -.073 [-.106, -.041], N = 18,806) and the SEES happy (d = -.157 [-.100, -.114], N = 4141) scales were associated with lower BMI. There was significant heterogeneity in effect sizes for PEE and NEE; however, there was no statistically significant moderation by age or sex. There was also no evidence for publication bias except for SEES sadness. This analysis is limited to cross-sectional questionnaire-based studies. NEE may be associated more strongly than PEE with emotional regulation difficulties and overeating of energy-dense foods which may be why it is associated with higher BMI.
负面情绪性进食（NEE）的问卷调查结果与较高的体重指数（BMI）相关。相对较少的研究探讨了正面情绪性进食（PEE），这些研究报告称PEE与较低的BMI相关或与BMI无关。为了研究NEE和PEE是否与BMI有关，我们对使用情绪食欲问卷（EMAQ）和萨尔茨堡情绪性进食量表（SEES）的研究进行了系统综述和荟萃分析，这两个量表评估与正负情绪相关的进食变化，并测量了一系列BMI的成年人的BMI。三位筛选者独立对数据库（CINAHL、Medline和PsycINFO）、参考文献（谷歌学术）和学位论文（Proquest）以及预印本注册库（开放科学框架，OSF）进行了检索。43项横断面研究符合纳入标准。提取了BMI与NEE量表和PEE量表之间的相关性。将年龄和性别作为潜在的调节因素进行了检验。我们发现随机效应模型具有统计学显著性（p值<0.001）且平均效应量较小。较高的EMAQ NEE（d = 0.152 [0.11, 0.19]，N = 18576）和SEES NEE量表（悲伤，d = 0.209 [0.168, 0.250]；愤怒，d = 0.096 [0.047, 0.144]；焦虑，d = 0.169 [0.124, 0.211]，N = 4141）与较高的BMI相关。EMAQ PEE（d = -0.073 [-0.106, -0.041]，N = 18806）和SEES快乐量表（d = -0.157 [-0.100, -0.114]，N = 4141）与较低的BMI相关。PEE和NEE的效应量存在显著异质性；然而，年龄或性别没有统计学上的显著调节作用。除了SEES悲伤量表外，也没有证据表明存在发表偏倚。该分析仅限于基于横断面问卷的研究。与PEE相比，NEE可能与情绪调节困难和高能量密度食物的暴饮暴食联系更紧密，这可能就是它与较高BMI相关的原因。
