Understanding eating behaviors in obesity: a DEBQ-based analysis of clinical and demographic factors

Obesity is a multifactorial chronic disease influenced by metabolic, genetic, behavioral, and psychosocial factors. This study aimed to assess eating behaviors in treatment-seeking individuals with obesity using the Dutch Eating Behavior Questionnaire (DEBQ) and to explore the associations of its emotional, external, and restrained eating subscales with clinical and sociodemographic characteristics. This study included 220 individuals with obesity who were followed at the Etlik City Hospital Obesity Center. Psychiatric diagnoses were assessed using the Structured Clinical Interview for DSM-5 Disorders (SCID-5). Data were collected through face-to-face interviews using a sociodemographic form and the DEBQ. Regression analyses were conducted as exploratory, hypothesis-generating models to identify variables associated with DEBQ subscale scores, without implying causal relationships. Emotional eating was positively associated with years of education, depression, obsessive-compulsive disorder (OCD), and the presence of an eating disorder-related condition. The strongest association was observed for the presence of an eating disorder-related condition, which may partly reflect conceptual and measurement overlap with the emotional eating construct assessed by the DEBQ. Restrained eating was positively associated with duration of obesity and negatively associated with the presence of an eating disorder-related condition. External eating was positively associated with years of education and the presence of an eating disorder-related condition. Eating behaviors among treatment-seeking individuals with obesity appear heterogeneous and are associated with both psychiatric and sociodemographic factors. In particular, emotional eating was linked to depression, OCD, and the presence of an eating disorder-related condition; however, associations involving eating disorder-related condition should be interpreted cautiously due to potential construct overlap. These findings underscore the importance of assessing psychiatric comorbidities and eating behavior patterns in the individualized management of obesity. This study examined eating behaviors among treatment-seeking individuals with obesity attending a specialized obesity center. Eating patterns were linked not only to body weight but also to factors such as education, age, and psychiatric conditions. Emotional eating—eating in response to negative emotions—was associated with depression, obsessive-compulsive disorder, and the presence of an eating disorder-related condition. However, as this was a cross-sectional study, these findings do not establish causality. Because participants were recruited from a specialized obesity center, the findings may not fully generalize to all individuals with obesity. Overall, the results suggest that focusing solely on diet may be insufficient; incorporating psychological support and addressing eating behavior patterns may improve individualized obesity treatment.