The mediating role of dichotomous thinking and emotional eating in the relationship between depression and BMI

Obesity and depression have important health implications. Although there is knowledge about the moderators of the depression-obesity association, our understanding of the potential behavioral and cognitive mediators that may explain the relationship between depression and obesity, is scarcely researched. The aim of this study is to investigate the mediating role of emotional eating and dichotomous thinking in the depression-obesity relationship. Data on 205 individuals from a community-based study conducted at Maastricht University, Netherlands were used. Self-reported data on depression, emotional eating and dichotomous thinking were collected and BMI scores were calculated in a cross-sectional research design. Correlations between variables were calculated. The primary analysis tested the hypothesis that depression has an effect on BMI through dichotomous thinking and emotional eating. A two-mediator model was used to predict the direct and indirect effects of emotional eating and dichotomous thinking on the depression-BMI relationship. Depression was positively correlated with BMI (r=0.21, p=0.005), emotional eating (r=0.38, p<0.001) and dichotomous thinking (r=0.49, p<0.001). Dichotomous thinking and emotional eating were positively correlated with BMI (r=0.35, p<0.001; and r=0.45, p<0.001 respectively). Both dichotomous thinking (Z=2.54, p=0.01, 95% confidence intervals=0.01-0.17) and emotional eating (Z=3.92 p<0.001, 95% confidence intervals=0.06-0.19) could explain the depression-BMI relationship. The assessment of emotional eating and dichotomous thinking might be useful in guiding assessment and treatment protocols for weight management. The present study adds to the existing literature on the role of dysfunctional cognitions and emotions on eating behavior, and particularly to the factors that may impede people's ability to control their eating.