Links between changes in BMI and mental health in a cohort of adults: the role of emotional eating and body dissatisfaction

Stephanie Schrempft, Cecilia Jiménez-Sánchez, Hélène Baysson, María-Eugenia Zaballa, Julien Lamour, Silvia Stringhini, Idris Guessous & Mayssam Nehme for the Specchio study group. 
Pathways linking BMI trajectories and mental health in an adult population-based cohort: role of emotional eating and body dissatisfaction.International Journal of Obesity, 7 April 2025, doi: 10.1038/s41366-025-01772-y

Abstract

Context : Overweight and obesity are associated with poorer mental health, and this relationship works both ways. Few studies have examined how changes in weight influence mental health over time. This study seeks to better understand the link between weight gain and mental health, by focusing on the role of emotional eating and body dissatisfaction.

Methods: Participants in the Specchio cohort (Geneva, Switzerland) reported their height and weight at the time of enrolment, and again in spring 2022, 2023 and 2024. Changes in BMI (body mass index) were analysed in two ways: first, by calculating for each person the rate of change in BMI score per year, and then by observing whether a person moved to a higher weight category between the start and end of the study.

The researchers then estimated the extent to which certain behavioural and psychosocial factors could influence changes in BMI, as well as the links between changes in BMI and mental health, using statistical analyses adjusted for age, sex, level of education and physical condition. A structural equation modelling method was also used to analyse the indirect relationships between these factors.

Results : Among the 7388 participants (59% women, mean age 51), an increase in BMI was associated with several factors over a 4-year period: financial difficulties, few hours of sleep, low physical activity, high recreational screen time, depressive and anxiety symptoms, and emotional eating. Increased BMI was also associated with body dissatisfaction and poorer quality of life at the 4-year follow-up from the start of the study, after adjusting for any baseline depressive or anxiety symptoms.

Emotional eating played a role in the relationship between depressive and anxiety symptoms at the start of the study and weight gain, as well as between financial difficulties and weight gain. Body dissatisfaction and a negative perception of one's health partly explained the decline in quality of life associated with weight gain at follow-up.

Conclusions : Emotional eating and body dissatisfaction play a role in the relationship between weight gain and mental health. These factors should be taken into account in weight management and psychological disorder prevention strategies.

Link to the article in English