Emotional eating and adolescents body weight: the mediating role of dietary patterns in Taizhou, China

Background/Objectives: Emotional eating has been linked to obesity. Although many studies have examined this association, the underlying mechanisms remain unclear . This study aimed to investigate whether dietary patterns mediate the relationship between emotional eating and body weight among adolescents. Subjects/Methods: This cross-sectional study utilized convenience sampling to recruit students from a middle school in Taizhou City, Zhejiang Province, China, between September 2022 and October 2022. This study adhered to the STROBE guidelines. Emotional eating was evaluated using the Emotional Eating Scale for Chinese Adolescents, and dietary patterns were derived through principal component analysis of data from the Food Frequency Questionnaire. Body mass index Z-scores (BMIZs) and waist-to-height ratios (WHtR) were used as indicators of body weight. Mediation analysis was applied to explore the indirect effects. Interventions: Not applicable. Results: Two dietary patterns were identified: traditional and modern. The modern pattern—characterised by high consumption of snacks, carbohydrate, fats, and sugars—was substantially linked to emotional eating and body weight (p < 0.001). Mediation analysis showed that this dietary pattern partially mediated the relationship between emotional eating and body weight, with indirect effects of 0.020 (95% confidence interval [CI] [0.016, 0.023]) for WHtR and 0.446 (95% CI [0.387, 0.509]) for BMIZ. Conclusions: Emotional eating in adolescents is associated with increased body weight, and this relationship is partially mediated by a modern dietary pattern rich in snacks, carbohydrates, fats, and sugars. These results suggest that clinical interventions targeting emotional eating should also consider underlying dietary behaviours to more effectively support healthy weight management in adolescents.