Emotion regulation is a multifaced process entailing the ability to be aware and accept experienced emotions, as well as to behave following personal goals, even when negative emotions are present while controlling impulsive behaviors (Gratz & Roemer, 2004). Emotion regulation has a crucial involvement in both physical and mental health (Gross & Muñoz, 1995). Several studies showed that whereas adapted emotion regulation strategies play a protective role against negative emotions and help people to cope with stressful life events (Bonanno, 2004), failures in emotion regulation were found to be involved in a plethora of physical and psychological problems including, among others, psychological distress, anxiety disorders, depression (Forman et al., 2009; Mennin et al., 2002), post-traumatic stress disorder (Villalta et al., 2020), borderline personality disorder (Miano et al., 2017) and sleep disturbances (Vandekerckhove & Wang, 2018). Moreover, when emotions are dysregulated, people may indulge in impulsive eating behaviors, as eating in response to negative feelings. This process is based on emotional eating.

Emotional eating is defined as “the tendency to eat in response to negative emotions” (van Strien et al., 1986). Given its association with consuming high-calorie food (Pinaquy et al., 2003b), emotional eating has been related to physical problems, including weight gain, as well as poor psychological outcomes such as distress, depression, eating disorders, and poor psychological well-being (Bentham et al., 2017; Cecchetto et al., 2021; Chu et al., 2019; Nguyen-Rodriguez et al., 2009; Spinosa et al., 2019). As a disordered eating behavior and a strategy to cope with negative feelings, emotional eating has been associated with stressful or traumatic events. Not surprisingly, since the COVID-19 outbreak rates of emotional eating increased (Echeverri-Alvarado et al., 2020; Harrington et al., 2006; Scarmozzino & Visioli, 2020; van Strien, 2018). In Italy, a recent study showed that the high level of psychological distress experienced during the COVID-19 pandemic was a contributor to determining an increase in emotional eating, through emotional dysregulation (Guerrini Usubini et al., 2021). Unfortunately, no associations between emotional eating and increased Body Mass Index (BMI), registered in the Italian population during the COVID-19 lockdown (Di Renzo et al., 2020) were assessed. However, in many studies, emotional eating has been depicted as a reason for increased BMI or even, a barrier to weight loss over time (Sainsbury et al., 2019).

For this reason, the current study builds from and extends findings outlined in previous research concerning the impact of emotion dysregulation on poor physical and psychological outcomes and, specifically, deepening the relationship between emotional dysregulation, psychological distress, emotional eating, and BMI.

The current study was aimed to investigate the impact of emotion dysregulation on emotional eating, psychological distress, and BMI in a sample of Italian young adults. As expected, we found significant associations between all the study variables. In particular, we found significant associations between emotion dysregulation, psychological distress, emotional eating, and BMI. As expected, emotion dysregulation was found to be a significant factor in predicting levels of psychological distress and emotional eating. In addition, emotional eating was found to be a predictor of BMI. These findings were in line with previous studies, which suggested that difficulties in emotion regulation strategies were linked to greater perceived psychological distress (Abdi & Pak, 2019; Aldea & Rice, 2006; Kirwan et al., 2017; Squires et al., 2020) and emotional eating (Casagrande et al., 2020; McAtamney et al., 2021). Such results have been confirmed during the COVID-19 pandemic. According to Cecchetto and colleagues (Cecchetto et al., 2021), in Italy, there was an increase of emotional eating during lockdown that was predicted by increased levels of psychological distress, in particular anxiety and depression as well as poorer quality of relationships and quality of life.

Emotional eating was not only associated with poorer psychological outcomes but also with physical ones since it was found to be related to greater consumption of high energy-density food (Pinaquy et al., 2003a) and increased BMI (Casagrande et al., 2020). In our study, the association between emotional eating and BMI was confirmed, suggesting that the higher the level of emotional eating, the greater BMI.

Such evidence offers important clinical implications. First of all, our work exceeds the limits of previous research by exploring the link between emotion dysregulation and physical outcomes – as BMI – in addition to the psychological ones, which have been already studied. Furthermore, by elucidating the role of emotion dysregulation on physical and psychological outcomes and specifically highlighting the impact of emotion dysregulation on disordered eating, our findings could inform the development and implementation of psychological interventions aimed at promoting psychological well-being and weight loss by focusing on the promotion of emotion regulation strategies, in order to reduce emotional eating.

The present study is not free of limitations. First, the cross-sectional nature of the study cannot support causal conclusions. In addition, we involved a convenience sample of young adults from the general population in which participants have been included in the study on the basis of their willingness to participate. Even though a convenience sample is easy and affordable, it may not be representative of the population. Another limitation concerns the lack of clinical instruments aimed at assessing for possible eating disorders among participants..

Then, for our assessment, we only used self-report measures that could be affected by biases. In this regard, a recent study on emotional eating suggested that retrospective emotional eating, investigated via self-report forms is a different construct of momentary emotional eating assessed with innovative methodologies such as the Ecological Momentary Assessment (Chwyl et al., 2021). Direct, instead of retrospective measures could be free from biases such as one's current emotional state and provide an objectively assess the intended construct. Finally, quite small relations were found, suggesting that there could be additional factors we did not consider in our study that need to be addressed in future replications of the research such as alexithymia (Aldea & Rice, 2006; Kirwan et al., 2017) and interoceptive awareness (Spinosa et al., 2019). Future research should cover additional constructs, involve other measurement strategies, and test the same model in different subgroups (i.e., with eating disorders).

To sum up, our findings provide new additional evidence that how emotions are regulated influences eating behaviors. The results suggest emphasis in interventions to reduce emotional eating need to be placed on addressing functional emotion regulation strategies. Various psychological interventions, including mindfulness and acceptance-based interventions, have been examined for their effectiveness in emotion dysregulation. In particular, Acceptance and Commitment Therapy (ACT) includes a combination of acceptance, mindfulness, and behavior-change methods. ACT can be useful in helping people learn to be open to uncomfortable internal experiences, instead of reacting to them as in the case of emotional eating.

This work was supported by “Ricerca Corrente” funding from Italian Ministry of Health to IRCCS Istituto Auxologico Italiano.