Association between test anxiety and eating behaviors among final-year high school students

Purpose This study aimed to examine the association between test anxiety and eating behaviors, including emotional, restrictive and external eating, among final-year high school students preparing for university entrance examinations in Türkiye. Design/methodology/approach This descriptive cross-sectional study was conducted between February and March 2022 in 21 public high schools in Türkiye. A total of 420 students completed the study questionnaire, and 408 were included in the final analyses after data screening. Data were collected using a sociodemographic questionnaire, the Dutch Eating Behavior Questionnaire (DEBQ), and the Westside Test Anxiety Scale (WTAS). Descriptive statistics, group comparisons, Spearman correlation analyses and multivariable linear regression analyses were performed. Findings Female students had higher DEBQ total scores than male students (87.4 ± 21.9 vs 77.0 ± 22.3, p < 0.001), as well as higher emotional eating (33.1 ± 14.2 vs 26.8 ± 14.0, p < 0.001), restrictive eating (21.4 ± 9.2 vs 19.8 ± 8.6, p = 0.029) and external eating scores (32.9 ± 9.6 vs 30.4 ± 9.5, p = 0.017). Male students had higher WTAS scores than female students (31.5 ± 10.3 vs 28.7 ± 9.7, p = 0.008). WTAS scores were weakly and negatively correlated with DEBQ total scores (ρ = −0.16, p = 0.001), emotional eating (ρ = −0.15, p = 0.003) and external eating (ρ = −0.14, p = 0.005), but not with restrictive eating (ρ = −0.04, p = 0.389). In adjusted models, DEBQ total score was inversely associated with WTAS score (ß = −0.05, SE = 0.02, p = 0.012), while WTAS score was inversely associated with emotional eating (ß = −0.20, SE = 0.07, p = 0.003) and external eating (ß = −0.13, SE = 0.05, p = 0.010), but not with restrictive eating (ß = −0.05, SE = 0.04, p = 0.243). Research limitations/implications The study is limited by its cross-sectional design, which precludes causal inference. Data were based on self-report measures, potentially introducing response bias. The sample was restricted to public high schools in a single national context, limiting generalizability. Future longitudinal and multi-country studies are recommended to further clarify causal pathways. Practical implications School-based health, nutrition and counseling services may benefit from monitoring eating-related behaviors together with test anxiety among students preparing for high-stakes examinations. Social implications In this sample, test anxiety was weakly and inversely associated with eating behavior scores, particularly emotional and external eating, and both constructs differed by gender. Because the study was cross-sectional and relied on self-report measures, the findings should be interpreted as associations rather than causal relationships. Originality/value This study contributes evidence from Turkish final-year high school students preparing for university entrance examinations, a population that has received limited attention in the literature on test anxiety and eating behaviors.