The mediating role of food craving in the relationship between psychological distress and body mass index in adults: a cross-sectional analysis.

BACKGROUND

The etiology of obesity involves complex interactions between psychological distress and negative eating behaviors. However, the specific mechanisms by which negative emotional states physiologically translate into weight gain remain unclear.

OBJECTIVE

The aim of this study is to examine the association of depression, anxiety, and stress with body mass index (BMI) in adults and to investigate the mediating role of food craving in these relationships.

METHODS

This cross-sectional study included 252 adults aged 19-65. The Depression, Anxiety, and Stress Scale (DASS-21) and the Food Craving Questionnaire (FCQ) were used, and anthropometric measurements were recorded. Mediation analyses were performed using the Hayes PROCESS macro (Model 4) with 5,000 bootstrap samples.

RESULTS

The study found positive correlations between all psychological symptoms, excessive food cravings, and BMI (p < 0.05). Participants who consumed a carbohydrate-and fat-rich diet had significantly higher FCQ scores compared to those who consumed a plant-based or protein-rich diet. Mediation analyses revealed that excessive food cravings played a significant partial mediating role in the relationship between BMI and depression (indirect effect: 19.4%), anxiety (indirect effect: 19.7%), and stress (indirect effect: 19.0%).

CONCLUSION

In conclusion, our findings were consistent with a mediation model wherein psychological distress was associated with an increase in BMI both directly and indirectly through its link with elevated food cravings. A multidisciplinary approach that includes psychological interventions for emotion regulation and craving management, in addition to medical nutrition therapy, should be adopted for the treatment of obesity.