Food Choice, Eating Behaviors, and Associations with Depression Levels and Body Mass Index: A Cross-Sectional Study
Abstract
Background: Depression is not only a mental health condition, but also a complex disorder that affects eating behaviors and food choices, leading to changes in body weight. This study aimed to evaluate the relationship between body mass index, eating behaviors, food choices, and depression levels in adults.
Methods: This cross-sectional study conducted in Istanbul from Apr to Jun 2022 included 208 adults aged 18 to 65 yr (mean 30.84±9.21 yr). A questionnaire consisting of sociodemographic information, Food Choice Questionnaire (FCQ), Dutch Eating Behavior Questionnaire (DEBQ) and Beck Depression Inventory (BDI) was applied. Height and body weight were measured.
Results: Of the participants were 9.6% underweight, 48.1% normal, 30.8% overweight, and 11.5% obese. Underweight individuals had significantly lower weight control scores compared to normal and overweight, and their restrictive eating scores were significantly lower than those of normal, overweight, and obese (P=0.001). Compliance scores affecting food choice were significantly lower in individuals with minimal depression than in those with mild and moderate depression (P=0.018). Emotional and external eating were higher in moderately depressed individuals than in those with minimal depression (P=0.001; P=0.018, respectively). Restrictive eating was significantly lower in individuals with minimal depression than in those with moderate and severe (P<0.001). Mood, appropriateness, natural content, weight control, and ethical concern affecting food choice were associated with eating behaviors (P<0.05).
Conclusion: Body weight and depression levels were important factors in food choice and eating behaviors in adults. Our findings emphasize the importance ofDepression considering eating behaviors and depression levels in individuals' food choice motivations.
1. Truman E, Bischoff M, Elliott C (2020). Which literacy for health promotion: health, food, nutrition or media? Health Promot Int, 35(2):432-444.
2. Adriaanse MA, de Ridder TD, Evers C (2011). Emotional eating: Eating when emotional or emotional about eating? Psychol Health, 26(1): 23-39.
3. Chen PJ, Antonelli M (2020). Conceptual models of food choice: ınfluential fac-tors related to foods, ındividual differ-ences, and society. Foods, 9(12):1898.
4. Shen W, Long LM, Shih CH, et al (2020). Humanities-based explanation for the effects of emotional eating and per-ceived stress on food choice motives during the covid-19 pandemic. Nutrients, 12(9):2712.
5. Bekker MH, Van de Meerendonk C, Molle-rus J (2004). Effects of negative mood induction and impulsivity on self‐perceived emotional eating. Int J Eat Disord, 36(4):461-469.
6. Konttinen H (2020). Emotional eating and obesity in adults: the role of depression, sleep and genes. Proc Nutr Soc, 79(3):283-289.
7. Gibson, E. L. (2006). Emotional influences on food choice: sensory, physiological and psychological pathways. Physiol Be-hav, 89(1):53-61.
8. Camilleri GM, Méjean C, Kesse-Guyot E, et al (2014). The Associations between Emotional Eating and Consumption of Energy-Dense Snack Foods Are Modi-fied by Sex and Depressive Sympto-matology. J Nutr, 144(8): 1264-1273.
9. Varela C, Andrés A, Saldaña C (2020). The behavioral pathway model to over-weight and obesity: coping strategies, eating behaviors and body mass index. Eat Weight Disord. 25(5):1277-1283.
10. Long LM (2017). Meaning-Centered Re-search in Food Studies. In: Food Culture: Anthropology, Linguistics and Food Studies. Eds, Chrzan J, Brett J. Berghahn Books, 2st New York, NY, USA, pp. 204-217.
11. Paans N, Bot M, van Strien T, et al (2018). Eating styles in major depressive disor-der: results from a large-scale study. J Psychiatr Res, 97: 38-46.
12. Wu J, Willner CJ, Hill C, et al (2018). Emo-tional eating and instructed food-cue processing in adolescents: An ERP study. Biol Psychol, 132: 27-36.
13. Tan CC, Chow CM (2014). Stress and emo-tional eating: The mediating role of eat-ing dysregulation. Pers Individ Dif, 66:1-4.
14. Norton KI (2018). Standards for anthro-pometry assessment. In Kinanthropometry and Exercise Physiology, Eds, Norton K, Es-ton RG. Routledge, 4th, London, Ox-fordshire, UK, pp. 68-137.
15. World Health Organization. BMI Classifi-cation. Cited 2023, October 8th, Availa-ble from: https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/body-mass-index
16. Steptoe A, Pollard TM, Wardle J (1995). Development of a measure of the mo-tives underlying the selection of food: the food choice questionnaire, Appetite, 25(3):267-284.
17. Dikmen D, İnan-Eroğlu E, Göktaş Z, et al (2016). Validation of a Turkish version of the food choice questionnaire. Food Qual Prefer, 52: 81-86.
18. Van Strien T, Frijters JE, Bergers GP, et al (1986). The Dutch Eating Behavior Questionnaire (DEBQ) for assessment of restrained, emotional, and external eating behavior. Int J Eat Disor, 5(2):295-315.
19. Bozan N. To Determine The DEBQ's Re-liability and Validity on Turkish Univer-sity Students. [Master’s thesis]. Institute of Medical Sciences, University of Başkent, Türkiye; 2009.
20. Beck AT, Ward CH, Mendelson M, et al (1961). An inventory for measuring de-pression. Arch Gen Psychiatry, 4:561-571.
21. Hisli N (1989). Beck depresyon envan-terinin universite ogrencileri icin gecerliligi, guvenilirligi (A reliability and validity study of beck depression inven-tory in a university student sample). J Psychol, 7 (23):3-13.
22. LaCaille, L (2020). Eating behavior. In: En-cyclopedia of Behavioral Medicine. Ed, MD Gellman. Springer, Cham. pp.711-712.
23. Pidgeon A, Lacota K, Champion J (2013). The moderating effects of mindfulness on psychological distress and emotional eating behaviour. Australian Psychologist, 48:262-269.
24. Rolls BJ (2009). The relationship between dietary energy density and energy in-take. Physiol Behav, 97(5):609-615.
25. Plichta M, Jezewska-Zychowicz M, Małachowska A (2020). Relationship be-tween psychosocial impairment, food choice motives, and orthorexic behav-iors among polish adults. Nutrients, 12(5):1218.
26. Azhar SBM, Vanoh D, Ganggaya KS (2023). Food choice motives, physical activity level and body mass ındex status among undergraduates students: a cross-sectional study. Mal J Med Health Sci, 19(6):151-156.
27. Yeşiltaş Ö. Adults' food label reading hab-its and the effects of these habits on food choice and diet quality. [Master’s Thesis]. University of Istanbul Bilgi, Tü-rkiye; 2022.
28. Bennett J, Greene G, Schwartz-Barcott D (2013). Perceptions of emotional eating behavior. A qualitative study of college students. Appetite, 60:187-192.
29. Benbaibeche H, Saidi H, Bounihi A, Koceir EA (2023). Emotional and external eat-ing styles associated with obesity. J Eat Disord, 11(1):67.
30. Fay SH, Finlayson G (2011). Negative af-fect-induced food intake in non-dieting women is reward driven and associated with restraineddisinhibited eating sub-type. Appetite, 56(3):682-688.
31. Bozoklu G. Eating behaviour and related factors in Edirne urban population. [Master’s Thesis]. University of Trakya, Türkiye; 2015.
32. Hryhorczuk C, Sharma S, Fulton SE (2013). Metabolic disturbances connecting obe-sity and depression. Front Neurosci, 7:177.
33. Muftuoglu S, Kiziltan G, Akcil Ok M (2018). Food cravings, nutritional status and physical activity in patients with major depression in Turkey. European J Psychol E, 1(2):61-70.
34. Bohon C, Stice E, Spoor S (2009). Female emotional eaters show abnormalities in consummatory and anticipatory food reward: A functional magnetic reso-nance imaging study. Int J Eat Disord, 42(3):210-221.
35. Goldschmidt AB, Crosby RD, Engel SG, et al (2014). Affect and eating behavior in obese adults with and without elevated depression symptoms. Int J Eat Disord, 47(3):281-286.
36. Werthmann J, Renner F, Roefs A, et al (2014). Looking at food in sad mood: do attention biases lead emotional eaters into overeating after a negative mood induction? Eat Behav, 15(2):230-236.
37. Mantau A, Hattula S, Bornemann T (2018). Individual determinants of emotional eating: A simultaneous investigation. Ap-petite, 130:93-103.
38. Betancourt-Núñez A, Torres-Castillo N, Martínez-López E, et al (2022). Emo-tional eating and dietary patterns: re-flecting food choices in people with and without abdominal obesity. Nutri-ents, 14(7):1371.
39. Cheng SH, Wong SE (2021). Stress, emo-tional eating and food choices among university students during the COVID-19. Malaysian J Soc Sci Humanitie, 6(9):335-346.
40. Benzerouk F, Guénin M, Gierski F, et al (2021). Contributing roles of depression, anxiety, and impulsivity dimensions in eating behaviors styles in surgery candi-dates. J Eat Disord, 9:148.
41. Elfhag K, Morey LC (2008). Personality traits and eating behavior in the obese: poor self-control in emotional and ex-ternal eating but personality assets in re-strained eating. Eat Behav, 9(3):285-293.
2. Adriaanse MA, de Ridder TD, Evers C (2011). Emotional eating: Eating when emotional or emotional about eating? Psychol Health, 26(1): 23-39.
3. Chen PJ, Antonelli M (2020). Conceptual models of food choice: ınfluential fac-tors related to foods, ındividual differ-ences, and society. Foods, 9(12):1898.
4. Shen W, Long LM, Shih CH, et al (2020). Humanities-based explanation for the effects of emotional eating and per-ceived stress on food choice motives during the covid-19 pandemic. Nutrients, 12(9):2712.
5. Bekker MH, Van de Meerendonk C, Molle-rus J (2004). Effects of negative mood induction and impulsivity on self‐perceived emotional eating. Int J Eat Disord, 36(4):461-469.
6. Konttinen H (2020). Emotional eating and obesity in adults: the role of depression, sleep and genes. Proc Nutr Soc, 79(3):283-289.
7. Gibson, E. L. (2006). Emotional influences on food choice: sensory, physiological and psychological pathways. Physiol Be-hav, 89(1):53-61.
8. Camilleri GM, Méjean C, Kesse-Guyot E, et al (2014). The Associations between Emotional Eating and Consumption of Energy-Dense Snack Foods Are Modi-fied by Sex and Depressive Sympto-matology. J Nutr, 144(8): 1264-1273.
9. Varela C, Andrés A, Saldaña C (2020). The behavioral pathway model to over-weight and obesity: coping strategies, eating behaviors and body mass index. Eat Weight Disord. 25(5):1277-1283.
10. Long LM (2017). Meaning-Centered Re-search in Food Studies. In: Food Culture: Anthropology, Linguistics and Food Studies. Eds, Chrzan J, Brett J. Berghahn Books, 2st New York, NY, USA, pp. 204-217.
11. Paans N, Bot M, van Strien T, et al (2018). Eating styles in major depressive disor-der: results from a large-scale study. J Psychiatr Res, 97: 38-46.
12. Wu J, Willner CJ, Hill C, et al (2018). Emo-tional eating and instructed food-cue processing in adolescents: An ERP study. Biol Psychol, 132: 27-36.
13. Tan CC, Chow CM (2014). Stress and emo-tional eating: The mediating role of eat-ing dysregulation. Pers Individ Dif, 66:1-4.
14. Norton KI (2018). Standards for anthro-pometry assessment. In Kinanthropometry and Exercise Physiology, Eds, Norton K, Es-ton RG. Routledge, 4th, London, Ox-fordshire, UK, pp. 68-137.
15. World Health Organization. BMI Classifi-cation. Cited 2023, October 8th, Availa-ble from: https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/body-mass-index
16. Steptoe A, Pollard TM, Wardle J (1995). Development of a measure of the mo-tives underlying the selection of food: the food choice questionnaire, Appetite, 25(3):267-284.
17. Dikmen D, İnan-Eroğlu E, Göktaş Z, et al (2016). Validation of a Turkish version of the food choice questionnaire. Food Qual Prefer, 52: 81-86.
18. Van Strien T, Frijters JE, Bergers GP, et al (1986). The Dutch Eating Behavior Questionnaire (DEBQ) for assessment of restrained, emotional, and external eating behavior. Int J Eat Disor, 5(2):295-315.
19. Bozan N. To Determine The DEBQ's Re-liability and Validity on Turkish Univer-sity Students. [Master’s thesis]. Institute of Medical Sciences, University of Başkent, Türkiye; 2009.
20. Beck AT, Ward CH, Mendelson M, et al (1961). An inventory for measuring de-pression. Arch Gen Psychiatry, 4:561-571.
21. Hisli N (1989). Beck depresyon envan-terinin universite ogrencileri icin gecerliligi, guvenilirligi (A reliability and validity study of beck depression inven-tory in a university student sample). J Psychol, 7 (23):3-13.
22. LaCaille, L (2020). Eating behavior. In: En-cyclopedia of Behavioral Medicine. Ed, MD Gellman. Springer, Cham. pp.711-712.
23. Pidgeon A, Lacota K, Champion J (2013). The moderating effects of mindfulness on psychological distress and emotional eating behaviour. Australian Psychologist, 48:262-269.
24. Rolls BJ (2009). The relationship between dietary energy density and energy in-take. Physiol Behav, 97(5):609-615.
25. Plichta M, Jezewska-Zychowicz M, Małachowska A (2020). Relationship be-tween psychosocial impairment, food choice motives, and orthorexic behav-iors among polish adults. Nutrients, 12(5):1218.
26. Azhar SBM, Vanoh D, Ganggaya KS (2023). Food choice motives, physical activity level and body mass ındex status among undergraduates students: a cross-sectional study. Mal J Med Health Sci, 19(6):151-156.
27. Yeşiltaş Ö. Adults' food label reading hab-its and the effects of these habits on food choice and diet quality. [Master’s Thesis]. University of Istanbul Bilgi, Tü-rkiye; 2022.
28. Bennett J, Greene G, Schwartz-Barcott D (2013). Perceptions of emotional eating behavior. A qualitative study of college students. Appetite, 60:187-192.
29. Benbaibeche H, Saidi H, Bounihi A, Koceir EA (2023). Emotional and external eat-ing styles associated with obesity. J Eat Disord, 11(1):67.
30. Fay SH, Finlayson G (2011). Negative af-fect-induced food intake in non-dieting women is reward driven and associated with restraineddisinhibited eating sub-type. Appetite, 56(3):682-688.
31. Bozoklu G. Eating behaviour and related factors in Edirne urban population. [Master’s Thesis]. University of Trakya, Türkiye; 2015.
32. Hryhorczuk C, Sharma S, Fulton SE (2013). Metabolic disturbances connecting obe-sity and depression. Front Neurosci, 7:177.
33. Muftuoglu S, Kiziltan G, Akcil Ok M (2018). Food cravings, nutritional status and physical activity in patients with major depression in Turkey. European J Psychol E, 1(2):61-70.
34. Bohon C, Stice E, Spoor S (2009). Female emotional eaters show abnormalities in consummatory and anticipatory food reward: A functional magnetic reso-nance imaging study. Int J Eat Disord, 42(3):210-221.
35. Goldschmidt AB, Crosby RD, Engel SG, et al (2014). Affect and eating behavior in obese adults with and without elevated depression symptoms. Int J Eat Disord, 47(3):281-286.
36. Werthmann J, Renner F, Roefs A, et al (2014). Looking at food in sad mood: do attention biases lead emotional eaters into overeating after a negative mood induction? Eat Behav, 15(2):230-236.
37. Mantau A, Hattula S, Bornemann T (2018). Individual determinants of emotional eating: A simultaneous investigation. Ap-petite, 130:93-103.
38. Betancourt-Núñez A, Torres-Castillo N, Martínez-López E, et al (2022). Emo-tional eating and dietary patterns: re-flecting food choices in people with and without abdominal obesity. Nutri-ents, 14(7):1371.
39. Cheng SH, Wong SE (2021). Stress, emo-tional eating and food choices among university students during the COVID-19. Malaysian J Soc Sci Humanitie, 6(9):335-346.
40. Benzerouk F, Guénin M, Gierski F, et al (2021). Contributing roles of depression, anxiety, and impulsivity dimensions in eating behaviors styles in surgery candi-dates. J Eat Disord, 9:148.
41. Elfhag K, Morey LC (2008). Personality traits and eating behavior in the obese: poor self-control in emotional and ex-ternal eating but personality assets in re-strained eating. Eat Behav, 9(3):285-293.
| Files | ||
| Issue | Vol 54 No 7 (2025) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v54i7.19151 | |
| Keywords | ||
| Body mass index Food choice Depression Emotional eating Obesity | ||
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How to Cite
1.
Anıl G, Çetin N, Seven Avuk H. Food Choice, Eating Behaviors, and Associations with Depression Levels and Body Mass Index: A Cross-Sectional Study. Iran J Public Health. 2025;54(7):1452-1461.
