**Background:** Obesity has become a major public health issue worldwide, increasing the risk of type 2 diabetes, hypertension, musculoskeletal disorders, and several cancers. Recent evidence suggests a bidirectional relationship between psychological factors and obesity, with deficits in emotion dysregulation and high levels of negative emotions playing a crucial role in the progression and maintenance of obesity. Emotional eating—eating in response to negative emotions rather than hunger—is not a separate eating disorder but a behavior influenced by stress, emotions, and individual feelings. It is characterized by consumption of energy-dense, nutrient-poor, palatable foods as a coping mechanism. Based on the American Psychological Association's Stress in America survey, 38% of adults reported emotional eating in the past month, with 49% engaging in it weekly. This review aimed to provide a thorough overview of the interrelationships among emotional eating and overweight/obesity, depression, anxiety/stress, and dietary patterns from clinical studies published between 2013 and 2023.
**Methods:** A thorough literature search was conducted in PubMed, Scopus, Web of Science, and Google Scholar using keywords including emotional eating, overeating, psychological disorders, binge eating, depression, anxiety, stress, obesity, overweight, weight gain, BMI, and appetite. Inclusion criteria were longitudinal, cross-sectional, descriptive, and prospective clinical studies with Caucasian participants. Exclusion criteria included non-English studies, animal studies, review articles, case reports, commentaries, and abstracts. Only clinical human studies with a strong protocol design that applied a validated questionnaire to diagnose emotional eating were included.
**Key Results:** The review identified multiple studies demonstrating consistent associations between emotional eating and higher BMI. A case-control study by Varela et al. (2020) in 473 participants (mean age 32.7 years) found that overweight individuals scored significantly higher in emotional eating compared to normal-weight individuals. Madali et al. (2021) reported in 1626 adults that emotional eating was more common in obese individuals (43.5%) compared to normal weight (33.5%) and underweight (18.4%) individuals. A prospective study by Bénard et al. (2018) in 39,771 adults found emotional eating was positively associated with BMI in both men and women, with a stronger association in women. Regarding depression, Van Strien et al. (2016) showed in 592 adults that emotional eating mediated the relationship between depressive symptoms and future weight increase in women. Lazarevich et al. (2016) found in 1453 Mexican college students that emotional eating mediated the association between depression and BMI, with the indirect effect constituting 23.1% of the total effect in men and 25.0% in women. Konttinen et al. (2019) demonstrated in 3735 participants that emotional eating facilitated positive associations between depression and increases in BMI and waist circumference over 7 years. For anxiety/stress, Carpio-Arias et al. (2022) found in 2333 adults that individuals with perceived stress had a greater probability of being emotional eaters. Bemanian et al. (2020) reported in 24,968 participants that emotional eating was noted in 54% of the study population and was strongly associated with psychological distress and greater intake of high-sugar foods. Regarding dietary patterns, Betancourt-Núñez et al. (2022) found in 763 participants that emotional eaters with abdominal obesity followed a dietary pattern characterized by snacking and fast food. Carlos et al. (2020) reported low Mediterranean diet adherence (15.5%) and significant levels of emotional eating (29%) and anxiety (23.6%) among university students.
**Clinical Implications:** The findings suggest that emotional eating is a modifiable behavioral mechanism linking psychological distress to obesity and unhealthy dietary patterns. Interventions such as stress management, cognitive behavioral therapy, and promoting conscious access to healthier snacks should be considered. The review highlights the need for psychotherapeutic interventions targeting emotion dysregulation, which may be particularly effective for patients with severe obesity. However, the authors note significant limitations across studies, including heterogeneity of design, reliance on self-reported data, lack of balanced sex distribution, and predominantly cross-sectional designs that cannot establish causality. Well-designed prospective studies are strongly recommended to confirm these interrelationships and inform clinical practice.