Emotional Eating Associated with Poor Body Satisfaction in Women with Obesity: Theory-Based Psychosocial Mediators in Weight Management Treatment

Poor satisfaction with one’s body is associated with obesity and emotional eating (EmE), especially in women. To improve behavioral obesity treatments, this study aimed to identify the effects of targeting the mediators of the body satisfaction–EmE relationship to improve weight-reduction outcomes. Women with Class II obesity (body mass index [BMI] of 35–39.9 kg/m2) were randomized into 6-month treatments targeting either increased physical activity and self-regulation (TARGETED group, n = 44) or standard weight management education (STANDARD group, n = 33). Improvements over 6 months in EmE, body satisfaction, mood, eating-related self-efficacy and self-regulation, and physical activity, and in weight over 6, 12, and 24 months, were significantly greater in the TARGETED group. Mood and eating-related self-efficacy mediated the body satisfaction–EmE relationship at baseline and the group–EmE change relationship. In the consideration of the treatment targets, increased physical activity predicted reduced EmE, mediated by mood change, and increased self-regulation predicted reduced EmE, mediated by self-efficacy change. Reduced EmE predicted weight losses. This research (a) identified psychological/behavioral mediators of the body satisfaction–EmE relationship; (b) ascertained methods associated with the improvement of those variables, their correlates, and interrelations; and (c) confirmed the viability of the indicated behavioral targets on EmE within a community-based obesity treatment. Given the identified associations with short- and longer-term weight losses, treatments were effectively informed.