Weight‐loss interventions for improving emotional eating among adults with high body mass index: A systematic review with meta‐analysis and meta‐regression

Abstract

Objectives To evaluate the effectiveness of weight‐loss interventions on emotional eating among adults with high body mass index (BMI). Methods A systematic review, meta‐analysis and meta‐regression were performed on randomized controlled trials published from inception until 19 March 2021. Results Thirty‐one studies were included, representing 1203 participants with mean ages ranging from 21.8 to 57.3 years old and BMI 27.2–43.5 kg/m2. We found small‐to‐medium interventional effects on emotional eating (n = 18; Hedges' g = 0.22; p = 0.01, I2 = 61.7%), uncontrolled eating (n = 16; Hedges' g = 0.46; p < 0.001, I2 = 71.6%) and cognitive restraint (n = 18; Hedges' g = 0.42; p < 0.001, I2 = 75.8%). Small‐to‐medium interventional effects were only found for emotional eating (n = 8; Hedges' g = 0.45; p = 0.02, I2 = 74.3%) 3‐month post‐intervention, and on BMI (n = 4; Hedges' g = 0.43; p < 0.05, I2 = 33.4%) and weight (n = 6; Hedges' g = 0.36; p < 0.01, I2 < 10.4%) 12‐month post‐intervention. Age, male proportion, baseline BMI, attrition rate and intervention length were not significant moderators of the heterogeneity between studies. Conclusion Interventions improved emotional eating and weight loss along a year‐long trajectory.

Emotional eating among adults with healthy weight, overweight and obesity: a systematic review and meta‐analysis

“…In regards to managing EE, mindfulness and self‐compassion are important psychological approaches within weight‐loss interventions, associated with improvements in EE and weight loss outcomes 47–52 . Systematic review data have shown that interventions with a mixture of cognitive behaviour therapy (CBT), diet and exercise and mindfulness improved EE and weight loss outcomes 53 . Therefore, alongside dietary interventions, dietitians and nutrition professionals treating obesity should employ CBT and mindfulness interventions.…”

“…The present review highlights the need for further high‐quality studies to examine EE as a cause and/or consequence of obesity. Although CBT, diet and exercise and mindfulness interventions, combined, are shown to reduce emotional eating and enhance short‐term weight loss treatment outcomes, 53 the long‐term effectiveness of these interventions requires further research. Therefore, there is a need for RCTs and longitudinal studies to assess the long‐term effectiveness of EE interventions for weight management.…”

“…[47][48][49][50][51][52] Systematic review data have shown that interventions with a mixture of cognitive behaviour therapy (CBT), diet and exercise and mindfulness improved EE and weight loss outcomes. 53 Therefore, alongside dietary interventions, dietitians and nutrition professionals treating obesity should employ CBT and mindfulness interventions. However, lack of confidence and training in the application of techniques such as CBT have previously been reported by registered dietitians.…”

Randomised controlled trial of breast cancer and multiple disease prevention weight loss programmes vs written advice amongst women attending a breast cancer family history clinic

“…The use of intermittent dieting was also intended to help with relapse prevention [ 26 ] and use of prompts were employed to make the behaviour habitual [ 27 ]. Consideration of emotional eating was an important part of the intervention that is not well captured by the Health Action Process Approach [ 28 ].…”