Baek Kwangyeol
School of Biomedical Convergence Engineering, Pusan National University, Busan 50612, Republic of Korea.
Nutrients. 2025 Aug 27;17(17):2774. doi: 10.3390/nu17172774.
Chronic stress contributes to obesity through maladaptive eating behaviors, including emotional eating (eating due to negative emotions) and binge eating (consuming large amounts of food with a loss of control). A theoretical model suggests that emotional eating can escalate to binge eating along a severity continuum, but this sequential pathway from stress to higher body mass index (BMI) has remained empirically untested. Therefore, this study examined a serial mediation model in which perceived stress predicts BMI sequentially through emotional eating and then binge eating. In this cross-sectional study, 272 Korean adults completed the Perceived Stress Scale, the Dutch Eating Behavior Questionnaire (emotional eating subscale), and the Binge Eating Scale. The serial mediation model was tested using PROCESS macro model 6, with age, gender, and education as covariates. The serial mediation pathway (stress → emotional eating → binge eating → BMI) was statistically significant (indirect effect = 0.071, 95% CI [0.041, 0.112]). A separate simple mediation path through binge eating alone was also significant (B = 0.056, 95% CI [0.018, 0.102]), whereas the path through emotional eating alone was not significant. The total indirect effect (B = 0.108, 95% CI [0.052, 0.172]) was significant, indicating that the influence of stress on BMI was fully mediated by the eating behaviors modeled. This study provides the first empirical evidence supporting a sequential pathway from stress to elevated BMI via the progression from emotional to binge eating. The findings support the overeating continuum model and highlight binge eating as a pivotal mediator. This behavioral progression suggests that emotional and binge eating are distinct stages, offering crucial opportunities for tailored prevention and intervention.
慢性应激通过不良饮食行为导致肥胖，这些行为包括情绪化进食（因负面情绪而进食）和暴饮暴食（在失控状态下大量进食）。一个理论模型表明，情绪化进食可能会沿着严重程度连续体升级为暴饮暴食，但从压力到更高体重指数（BMI）的这一连续路径在实证研究中尚未得到验证。因此，本研究检验了一个序列中介模型，其中感知到的压力通过情绪化进食进而通过暴饮暴食依次预测BMI。在这项横断面研究中，272名韩国成年人完成了感知压力量表、荷兰饮食行为问卷（情绪化进食子量表）和暴饮暴食量表。使用PROCESS宏模型6检验序列中介模型，将年龄、性别和教育程度作为协变量。序列中介路径（压力→情绪化进食→暴饮暴食→BMI）具有统计学意义（间接效应 = 0.071，95%置信区间[0.041, 0.112]）。单独通过暴饮暴食的一条简单中介路径也具有统计学意义（B = 0.056，95%置信区间[0.018, 0.102]），而单独通过情绪化进食的路径则不具有统计学意义。总间接效应（B = 0.108，95%置信区间[0.052, 0.172]）具有统计学意义，表明压力对BMI的影响完全由所建立模型的饮食行为介导。本研究提供了首个实证证据，支持从压力通过从情绪化进食到暴饮暴食的进展导致BMI升高的连续路径。研究结果支持暴饮暴食连续体模型，并突出了暴饮暴食作为关键中介因素的作用。这种行为进展表明，情绪化进食和暴饮暴食是不同阶段，为针对性预防和干预提供了关键机会。
