The Relationship Between Physiological and Psychological Indicators of Stress in Emotional Eaters

Background: Obesity has become an increasing problem in the United States with obesity-related conditions growing in number over the last few decades. Growing evidence proposes that stress influences food intake and food choice which contributes to obesity in many people, particularly women. The purpose of this study was to examine how physiological and psychological indicators of stress are associated with emotional eating (EE) in obese women (OB). Hypotheses: (1) Perceived stress, anxiety, and cortisol are associated with EE; (2) Coping mediates the relationship between perceived stress, anxiety, and cortisol with EE. Methods: This study is a secondary analysis of data obtained from an experimental study investigating stress-related eating in OB. Thirty obese but otherwise healthy women who report that they eat in response to stress were included in the study. Average BMI was 40.21 kg/m2. Average age was 36.17. Self-report surveys included the Perceived Stress Scale (PSS), State Anxiety from the State-Trait Anxiety Inventory (state anxiety; S-ANX), and Eating and Appraisal Due to Emotions and Stress (EE and Coping; COP). Fasting serum cortisol was analyzed in-house. Pearson correlation was used to determine associations between EE with PSS, S-ANX, COP, and cortisol. Subjects were categorized as high or low in EE based on the mean value. Logistic regression was used to ascertain the ability of PSS, S-ANX, and cortisol to predict high EE. Results: EE was significantly correlated with S-ANX (r=-.514, p=.004) and COP (r=.614, p=.000) and approached significance with cortisol (r=.356, p=.058). Logistic regression for PSS, S-ANX, and cortisol significantly predicted high EE (X2=12.845, p=.005) and correctly classified 79.3% of the cases. S-ANX provided significant variance to the model (p=.02). The addition of COP improved the model (X2=23.212, p=.000) and classification rate (82.8%). S-ANX provided significant variance (p=.03) and variance accounted for by COP approached significance (p=.065). Conclusions: The extent of emotional eating in obese women appears to be significantly related to a combination of life stress, degree of transient anxiety, and cortisol levels. However, this relationship appears to be mediated by the utilization of healthy coping skills. Stress and anxiety appear to show promise as evidence based targets for emotional eating in obesity.