Willig Meeah, Cabeza de Baca Tomás, J Stinson Emma, M Treviño-Alvarez Andrés, Rodzevik Theresa, B Votruba Susanne, C Lameman Coley, Krakoff Jonathan, Gluck Marci E
Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA.
Department of Neurology, School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico.
BMC Public Health. 2025 Apr 11;25(1):1365. doi: 10.1186/s12889-025-22444-6.
The COVID-19 pandemic significantly impacted global mental health, leading to increased levels of fear, stress, and anxiety [1]. Previous research has suggested associations between functional fear of detrimental mental health outcomes and psychological stressors which may drive maladaptive eating behaviors. This study explored the associations between COVID-19 fear during later stages of the pandemic, psychological distress (anxiety, depression, and stress), maladaptive eating behaviors (emotional, uncontrolled, binge, and nighttime eating), and self-reported body weight.
This was a global cross-sectional survey conducted from February 2022 to February 2024, involving 4390 adults (70% female) from 25 countries. The survey collected information on demographics, psychosocial impact, eating behaviors, and COVID-19 related behaviors. General linear models, multinomial logistic regression modes, and structural equation modeling were used to analyze the data.
Higher fear of COVID-19 was significantly associated with increased emotional and uncontrolled eating, even after adjusting for psychological distress and other covariates. Specifically, each unit increase in fear of COVID-19 scores was associated with a corresponding increase in emotional eating (β = 0.018) and uncontrolled eating (β = 0.029) behaviors (p-values < 0.0001). Furthermore, fear of COVID-19 was linked to higher odds of engaging in binge eating (OR = 1.05, 95% CI: 1.03, 1.07, p-value < 0.0001) and nighttime eating behaviors (OR = 1.04, 95% CI: 1.03, 1.06, p-value < 0.0001) in models adjusted for covariates; however, these associations were no longer significant when psychological distress variables were included. Fear of COVID-19 was also associated with body weight (β = 0.18) and BMI (β = 0.08) even with adjustments of covariates and psychological distress variables (p-values < 0.01). Structural equation modeling showed that fear of COVID-19 was related to current body weight through its impact on psychological distress and maladaptive eating behaviors.
Maladaptive eating behaviors influenced by the psychological distress experienced during the COVID-19 pandemic have persisted into the later stages of the pandemic. These results underscore an interconnectedness between functional fear and its influence on maladaptive eating behaviors and body weight. Understanding this link is crucial and has the potential to inform the development of public health policies.
Clinical Trials.gov NCT04896060 Date of Registration: May 21, 2021.
新冠疫情对全球心理健康产生了重大影响，导致恐惧、压力和焦虑水平上升[1]。先前的研究表明，对有害心理健康结果的功能性恐惧与可能导致适应不良饮食行为的心理压力源之间存在关联。本研究探讨了疫情后期对新冠的恐惧、心理困扰（焦虑、抑郁和压力）、适应不良饮食行为（情绪化、无节制、暴饮暴食和夜间进食）以及自我报告的体重之间的关联。
这是一项于2022年2月至2024年2月进行的全球横断面调查，涉及来自25个国家的4390名成年人（70%为女性）。该调查收集了有关人口统计学、心理社会影响、饮食行为和与新冠相关行为的信息。使用一般线性模型、多项逻辑回归模型和结构方程模型对数据进行分析。
即使在调整了心理困扰和其他协变量后，对新冠的更高恐惧与情绪化和无节制饮食的增加显著相关。具体而言，新冠恐惧得分每增加一个单位，与情绪化饮食（β = 0.018）和无节制饮食（β = 0.029）行为的相应增加相关（p值<0.0001）。此外，在调整协变量的模型中，对新冠的恐惧与暴饮暴食（OR = 1.05，95% CI：1.03，1.07，p值<0.0001）和夜间进食行为（OR = 1.04，95% CI：1.03，1.06，p值<0.0001）的更高几率相关；然而，当纳入心理困扰变量时，这些关联不再显著。即使调整了协变量和心理困扰变量，对新冠的恐惧也与体重（β = 0.18）和BMI（β = 0.08）相关（p值<0.01）。结构方程模型表明，对新冠的恐惧通过其对心理困扰和适应不良饮食行为的影响与当前体重相关。
受新冠疫情期间经历的心理困扰影响的适应不良饮食行为一直持续到疫情后期。这些结果强调了功能性恐惧与其对适应不良饮食行为和体重的影响之间的相互联系。理解这种联系至关重要，并且有可能为公共卫生政策的制定提供信息。
ClinicalTrials.gov NCT04896060 注册日期：2021年5月21日。
