Timing and sequence of the onset of overweight, dieting, and binge eating in overweight patients with binge eating disorder

OBJECTIVE: To examine the self-reported sequence and timing of onset of overweight, binge eating, and dieting in adult patients diagnosed with binge eating disorder (BED). METHOD: Participants were 284 treatment-seeking adults (73 men and 211 women) who met DSM-IV research criteria for BED. Patients were interviewed with structured diagnostic interviews and were queried regarding history of overweight, dieting, and binge eating behaviors. Questionnaires were also administered to assess current eating disturbances, body dissatisfaction, and general functioning. Participants were classified as Overweight First, Binge First, or Diet First, and the three groups were compared on developmental sequence and using the battery of measures. RESULTS: Sixty-three percent of the 284 participants reported becoming overweight prior to the onset of dieting or binge eating. Participants who reported they were overweight first had significantly greater BMI at the time of assessment. The 16% of the participants who reported binge eating first were significantly younger at the onset of BED diagnosis and reported significantly less dietary restraint. Onset order differed significantly by gender; proportionally more women (25%) than men (11%) reported that dieting preceded overweight or binge eating. CONCLUSION: Weight problems preceded dieting and binge eating behaviors for a majority of treatment-seeking overweight participants diagnosed with BED.     

Identifying clusters of college students at elevated health risk based on eating and exercise behaviors and psychosocial determinants of body weight

Weight gain and an increase in overweight and obesity in college students raise serious health concerns. Weight management interventions for college-age men and women might be more effective if they were tailored to subgroups of students with similar behavioral and psychosocial characteristics associated with body weight status. The purpose of this study was to use cluster analysis to identify homogenous subgroups of college-aged men and women enrolled in a weight gain prevention study (Project WebHealth) using baseline data collected in 2008. Project WebHealth was a 15-month nutrition and physical activity intervention designed to decrease the rate of unwanted weight gain in 1,689 college students at eight geographically diverse universities in the United States. Outcome measures included anthropometrics, fruit and vegetable intake, physical activity, cardiorespiratory fitness, and psychosocial variables associated with weight status in college students. Cluster analysis was performed separately by sex using a two-step clustering procedure using weight-related eating and exercise behaviors and psychosocial variables. Cluster groupings were validated against students' measured weight status and waist circumference as indicators of health risk. The study design was cross-sectional. Results showed that three similar clusters were identified for each sex. Validity of the cluster solution was supported by significant group differences in body mass index and waist circumference with the High Risk cluster at elevated health risk compared to the others. For men, variability in eating competence and cognitive restraint scores contributed most to the difference between clusters, whereas for women, emotional eating and uncontrolled eating scores did. These findings could be used to improve effectiveness of messages and interventions by tailoring them to subgroups of college students with similar behavioral and psychosocial characteristics associated with elevated health risk.     

饮食偏好及行为对中小学生超重或肥胖影响的病例对照研究

目的 探讨饮食偏好及行为对中小学生超重或肥胖的影响.方法 采用病例对照研究方法,病例为广州市28所中小学中年龄为6～19岁的所有超重或肥胖学生,对照为同校同年级随机抽取的1～2个班中所有体重正常者.饮食偏好和行为采用自编问卷调查,对饮食偏好和行为按由少到多或由不喜欢到喜欢分为4个水平;通过测胃身高和体重计算BMI并进行营养状况的分类;采用两分类logistic回归分析筛选中小学牛超重或肥胖的影响因素. 结果 共调查7136人,问卷有效者5755人中超重或肥胖者为1947人,体重正常者2136人.单因素分析超重或肥胖的风险,很喜炊吃蔬菜、水果或糖果及夜宵者是不喜欢者的0.60～0.69倍;对食物挑剔多者是极少挑剔者的0.50倍;而很喜炊吃猪肉、牛羊肉和油炸食物者分别是不喜欢者的1.84、1.30和1.26倍;以及吃饭速度快者足慢者的5.14倍(P值均<0.05).在控制年龄、性别、家庭社会经济因素、父母体型后,对蔬菜与夜宵的偏好、挑剔食物以及进食速度4个指标对超重或肥胖的影响依然具有统计学意义.与不喜欢蔬菜或夜宵、不挑剔食物或进食速度慢者相比,喜欢蔬菜或夜宵、挑剔食物、进食速度快者对超重或肥胖影响的比值比(OR)及95%CI分别为0.55(0.42～0.73),0.48(0.35～0.65),0.50(0.39～0.65)和4.32(3.23～5.80). 结论 减慢进食速度与多吃蔬菜有利于预防中小学生超重或肥胖.     

The COVID-19 pandemic and weight management: Effective behaviors and pandemic-specific risk factors

BackgroundObesity and comorbid conditions are associated with worse outcomes related to COVID-19. Moreover, social distancing adherence during the COVID-19 pandemic may predict weight gain due to decreased physical activity, increased emotional eating, and social isolation. While early studies suggest that many individuals struggled with weight management during the pandemic, less is known about healthy eating and weight control behaviors among those enrolled in weight loss programs.MethodsThe present study evaluated weight management efforts among weight loss program participants during the COVID-19 pandemic. Participants’ (N = 55, 90.9% female, 36% white, M_age = 49.8) demographics and body mass index were collected two months prior to the COVID-19 statewide shutdown. During the lockdown, an online survey assessed health behaviors, coping, COVID-19 experiences (e.g., social distancing, loneliness), and weight gain. Logistic regressions examined demographics, health behaviors, and COVID-19 factors as predictors of weight gain.ResultsMost participants (58%) reported gaining weight during COVID-19. Weight gain was predicted by challenges with the following health behaviors: physical activity, monitoring food intake, choosing healthy foods, and emotional eating. Loneliness and working remotely significantly related to emotional eating, physical activity, and choosing healthy foods.ConclusionsLoneliness and working remotely increased the difficulty of weight management behaviors during COVID-19 among weight loss program participants. However, staying active, planning and tracking food consumption, choosing healthy foods, and reducing emotional eating protected against weight gain. Thus, these factors may be key areas for weight management efforts during the pandemic.     

Preventing or improving obesity by addressing specific eating patterns.

The problem of obesity and overweight is an epidemic in the United States. Weight is a product of energy balance: energy intake versus energy expenditure. The purpose of this review is to identify adult eating behaviors that are known to strongly affect the energy intake side of the energy balance and that may be readily amenable to prevention and intervention efforts in primary care. Restaurant and fast food consumption, large portion sizes, and consumption of beverages with sugar added increase energy intake and are highly associated with weight gain and obesity. Conversely, consumption of low energy dense food, ie, fruits and vegetables, and routine healthy breakfast consumption can help to maintain or lose weight. These distinct behaviors represent concrete negative and positive eating patterns on which primary care providers can focus when counseling overweight and obese patients. They also represent behavioral targets for designing and testing clinical interventions.     

Leading Factors for Weight Gain during COVID-19 Lockdown in a Spanish Population: A Cross-Sectional Study

The increase in sedentary behaviors during the COVID-19-induced lockdown may have led to a significant weight gain. To investigate this hypothesis, a representative sample of the Spanish adult population comprising 1000 subjects was enrolled in a cross-sectional study between 26 May and 10 June 2020. Computer-assisted telephone interviews were conducted consisting of 29 questions on the topic of lifestyle habits during the lockdown. The cohort comprised 51.5% women and 51% overweight or obese subjects and had a mean age of 50 ± 18 years. Of the respondents, 44.5% self-reported weight gain during the lockdown; of these, 58.0% were women, 69.9% had previous excess weight, 44.7% lived with a relative who also gained weight, and 73.5 experienced increased appetite. Further, an increased consumption of energy-dense products was found relative to respondents who did not gain weight (p ≤ 0.016 for all). Additionally, respondents were unaware that obesity is a poor prognostic factor for COVID-19 infection, lived in smaller flats, and had a lower level of education and lower monthly income. The factors independently associated with weight gain were female gender, previous overweight or obesity, lack of food care, increased appetite, and increased consumption of sugar-sweetened beverages, alcoholic beverages, and snacks (p ≤ 0.023 for all). Should another lockdown be mandated, extra caution is warranted to prevent weight gain.     

The Effects of COVID-19 on the Eating Habits of Children and Adolescents in Italy: A Pilot Survey Study

Nutrition during childhood and adolescence is very important for growth and can have long-term health implications. The COVID-19 lockdown caused significant changes in everyday life, including in children and adolescents. This study evaluated the effects of the first COVID-19 lockdown on eating habits and body weight in children and adolescents. An online cross-sectional survey was carried out among the parents of children (5–9 years) and adolescents (10–14 years) living in Italy. The online self-administered questionnaire included demographic and anthropometric data (reported weight and height) weight and dietary habit changes during the COVID-19 lockdown in Italy (March to June 2020). A total of 439 participants were included. We found a change in eating habits with an increase in consumption of sweet packaged snacks (34%) and processed meat (25%), as well as bread, pizza and bakery products (47%). We also found an increase in vegetable, fresh fruit and legume intake (19%), and a reduction in sweet beverage and candy intake. A total of 59.7% of the participants reported body weight gain, with adolescents gaining more than children (67% vs. 55%, p = 0.010, respectively). In children, body weight gain was associated with a change in body height and increased consumption of dairy products and sweet packaged snacks, while in adolescents it was associated with an increased intake of comfort foods and processed meat. Our data highlighted the need to carefully monitor eating behaviors to avoid the establishment of unhealthy eating habits and prevent obesity in children and adolescents during periods of self-isolation.     

Relationship of weight and eating disorders in type 2 diabetic patients: a multicenter study

OBJECTIVE: Previous work suggested that the degree of psychiatric symptomatology evidenced in overweight individuals was related to the severity of binge eating problems and not related to the severity of overweight. In a multicenter study, we investigated the relationship between weight and eating disorders (EDs) in a sample of type 2 diabetic patients. METHODS: Three hundred twenty-two patients with type 2 diabetes were stratified to various weight categories. Glycemic control, eating and body-related psychological problems, self-esteem, depressive, and general psychopathology of diaetic patients with and without an ED were compared. RESULTS: Eighty-one percent of all type 2 diabetic patients were overweight or obese. Prevalence rates of EDs ranged from 6.5% to 9.0%. Binge eating disorder was the most diagnosed ED. There was a strong relationship between body mass index (BMI) and eating disturbance-related variables and a weak or no relationship between BMI and depression or general psychopathologic variables. Patients with an ED showed a greater psychopathology compared to patients without an ED. The diagnosis of an ED did not seem to have a specific influence on glycemic control. CONCLUSIONS: Our results in a type 2 diabetic sample indicate that weight might have an impact on body and eating-related psychological distress in type 2 diabetic patients, but is of minor or no importance for depressive symptomatology, lower self-esteem, and general psychiatric symptomatology. Type 2 diabetic patients with an ED, however, suffer from considerable psychiatric symptomatology.     

Perceived stress and eating behaviors in a community-based sample of African Americans

Previous studies have reported that psychological stress is associated with greater food consumption, particularly consumption of high fat foods. We are unaware of any studies that have examined stress-induced eating among African Americans (AAs). The goals of the current study were to examine the relationship between perceived stress and high fat eating behaviors in a sample of AAs, to examine whether this relationship is stronger among overweight and obese participants, and to examine whether haphazard meal planning mediates the relationship between perceived stress and high fat eating behaviors. One hundred fifty-nine adults from a metropolitan area completed the Perceived Stress Scale (PSS-10), the Eating Behaviors Pattern Questionnaire (EBPQ), a demographic questionnaire, and body mass was assessed with BMI. Perceived stress was associated with haphazard planning and emotional eating, but not related to other high fat eating domains in the overall sample. These findings held for overweight and obese participants with the addition of snacking on sweets. High fat eating behaviors were not mediated by haphazard meal planning. These findings are consistent with other studies which demonstrate a link between stress and eating. Long-term interventions for high fat consumption and obesity should include an examination of perceived stress among AAs.     

Psychosocial Concerns and Weight Control Behaviors Among Overweight and Nonoverweight Native American Adolescents

Objective To compare the psychosocial and weight-related concerns and weight control, eating, and exercise behaviors of overweight and nonoverweight Native American adolescents living on or near reservations.Study design A cross-sectional survey assessed psychosocial, health, and weight-specific concerns; disordered eating; and health-promoting behaviors.Study population The study population included 11,868 Native American youth in grades 7 through 12.Statistical analyses performed Analyses of variance and χ² tests were used to examine associations between weight status and psychosocial and weight-related concerns and behaviors. Stratified analyses were done by gender and by gender and age.Results Self-reported weights and heights indicated that 25% of the study population was overweight. Overweight youth were twice as likely to report health concerns as nonoverweight youth. Although a high percentage of nonoverweight youth expressed body- or weight-related concerns and reported engaging in disordered eating behaviors, prevalence rates for these concerns were significantly higher among overweight youth. Overweight youth were also somewhat less likely to engage in health-promoting behaviors. In contrast, differences in global psychosocial concerns were minimal.Applications Overweight Native American youth were concerned about their weight, but did not appear to have major psychosocial concerns associated with being overweight. Interventions aimed at obesity prevention and overall health promotion are essential, given the high prevalence of obesity and of psychosocial and weight-related concerns and behaviors among the study population as a whole. The challenge is to develop culturally appropriate interventions aimed at the promotion of healthful weight control behaviors that will not lead to negative psychosocial consequences.     

A brief assessment of eating habits and weight gain in a Mediterranean cohort

Assessment of eating habits (EH) through closed questions could be an alternative tool to assess diet as a predictor of weight change in epidemiological studies. The aim was to assess the association between baseline EH and the risk of weight gain or becoming overweight/obese in a Spanish dynamic prospective cohort (the Seguimiento Universidad de Navarra Project) of 10?509 participants. The baseline questionnaire included ten short questions with two possible answers: yes or no. We calculated a baseline EH score, categorised in quartiles, positively weighting answers on more fruit, vegetables, fish and fibre and less meat, sweets and pastries, fat, butter, fatty meats and added sugar in drinks. Reducing the consumption of meat or fat and removing fat from meat were significantly associated with lower weight gain. The partial correlation coefficient between EH score and weight change was -?0·033 (P?=?0·001). We observed 1063 cases of incident overweight/obesity among 7217 participants without overweight/obesity at baseline. Trying to eat more fruit, fish or fibre and less meat was inversely significantly associated with incident overweight/obesity. Those participants in the upper quartile of the score were at a 38?% (adjusted OR 0·62; 95?% CI 0·48, 0·81) lower risk of developing overweight/obesity during the follow-up compared with those in the lower quartile. However, the receiver-operating characteristic curves for the model with and without the EH score were materially identical. Despite the apparent significant inverse association, this score had a low predictive value for future weight gain and for incident overweight/obesity in a Mediterranean population, although some EH were independently and positively associated with weight gain.     

Impact of COVID-19 Lockdown in Eating Disorders: A Multicentre Collaborative International Study

Background. The COVID-19 lockdown has had a significant impact on mental health. Patients with eating disorders (ED) have been particularly vulnerable. Aims. (1) To explore changes in eating-related symptoms and general psychopathology during lockdown in patients with an ED from various European and Asian countries; and (2) to assess differences related to diagnostic ED subtypes, age, and geography. Methods. The sample comprised 829 participants, diagnosed with an ED according to DSM-5 criteria from specialized ED units in Europe and Asia. Participants were assessed using the COVID-19 Isolation Scale (CIES). Results. Patients with binge eating disorder (BED) experienced the highest impact on weight and ED symptoms in comparison with other ED subtypes during lockdown, whereas individuals with other specified feeding and eating disorders (OFSED) had greater deterioration in general psychological functioning than subjects with other ED subtypes. Finally, Asian and younger individuals appeared to be more resilient. Conclusions. The psychopathological changes in ED patients during the COVID-19 lockdown varied by cultural context and individual variation in age and ED diagnosis. Clinical services may need to target preventive measures and adapt therapeutic approaches for the most vulnerable patients.     

Vegetarianism and weight status: What are the differences in eating styles,impulsivity, and emotional competences? A preliminary study

Recent studies suggest that vegetarian diets may be recommended to promote weight loss in individuals living with obesity. However, limited studies have examined psychological factors (e.g., eating styles, impulsivity) among individuals who have adopted this type of diet, even though these factors are known to play a role in being overweight. The primary objective of the present study was to compare these characteristics in participants living with obesity or those with normal-weight across diet types. Participants were recruited from two hospital nutrition departments and the general population. They completed a diagnostic interview assessing the presence of an eating disorder, followed by self-administered questionnaires measuring dysfunctional eating styles (DEBQ), impulsivity (UPPS), and emotional competence (PEC). Vegetarian participants living with obesity engaged in more dysfunctional eating styles than did normal-weight omnivores and experienced more emotional difficulties than did both normal-weight omnivores and vegetarians. In contrast, there were no significant differences between omnivore participants living with obesity and those in the other groups. Moreover, participants living with obesity had comparable emotion regulation abilities to normal-weight participants. These results suggest that emotion regulation deficits can more likely be explained by the presence of psychopathological traits than by being overweight or one’s choice of diet.     

母亲养育实践与婴幼儿饮食行为对儿童超重肥胖影响的研究

目的 本研究探讨母亲养育实践与婴幼儿饮食行为对儿童超重肥胖的影响。方法 采用目的抽样法,选取徐州市2所医院及2个社区卫生服务中心的6 ~ 24月龄婴幼儿及其母亲为研究对象,母亲完成婴幼儿喂养类型和饮食行为问卷。根据儿童身长和体重,计算年龄别体质指数Z值（body mass index - for age z - score,BMIZ）,BMIZ + 2为儿童超重肥胖。采用二元logistic回归分析母亲养育实践与婴幼儿饮食行为对儿童超重肥胖的影响。结果 本研究共回收882份有效问卷,儿童超重肥胖发生率为15.65%。二元logistic回归结果表明,敏感型养育（OR = 0.234,95%CI:0.159 ~ 0.344）,饱腹反应（OR = 0.467,95%CI:0.336 ~ 0.649）和进食缓慢的饮食行为（OR = 0.737,95%CI:0.552 ~ 0.984）是儿童超重肥胖的保护因素;食物反应的饮食行为（OR = 2.369,95%CI:1.797 ~ 3.122）,限制（OR = 2.359,95%CI:1.530 ~ 3.640）和纵容型养育（OR = 1.743,95%CI:1.250 ~ 2.431）是儿童超重肥胖的危险因素。结论 敏感型养育,饱腹反应和进食缓慢的饮食行为降低儿童超重肥胖的发生风险;食物反应的饮食行为,限制和纵容型养育增加儿童超重肥胖的发生风险。     

Can Relaxation Training Reduce Emotional Eating in Women with Obesity? An Exploratory Study with 3 Months of Follow-Up

Stress and negative emotions have been shown to be critical factors in inducing overeating as a form of maladaptive coping in some patients with obesity. We evaluated the efficacy of a 3-week relaxation protocol enhanced by virtual reality and portable mp3 players in reducing emotional eating in a sample of 60 female inpatients with obesity who report emotional eating, using a three-arm exploratory randomized controlled trial with 3 months of follow-up. The intervention included 12 individual relaxation training sessions provided traditionally (imagination condition) or supported by virtual reality (virtual reality condition). Control participants received only standard hospital-based care. Weight, behavior and psychological data were collected and analyzed. Relaxation training was effective in reducing emotional eating episodes, depressive and anxiety symptoms, and in improving perceived self-efficacy for eating control at 3-month follow-up after discharge. The virtual reality condition proved better than the imagination condition in the reduction of emotional eating. Weight decreased in subjects in all three conditions without significant differences between them, probably due to the common treatment all inpatients received. We conclude that relaxation training supported by new technologies could be a useful tool for reducing emotional eating episodes and thereby reducing weight and obesity.     

Eight weeks of intermittent fasting versus calorie restriction does not alter eating behaviors,mood, sleep quality,quality of life and cognitive performance in women with overweight

Human trials that compare intermittent fasting (IF) to calorie restriction (CR) with psychological, behavioral and cognition outcomes are limited. We hypothesized that there would be no difference between CR and IF on perceived eating behaviors, mood, sleep quality, quality of life (QOL) and cognition in women with overweight and obesity. In this prespecified secondary analysis of an open-label, single center, parallel assignment, randomized controlled trial, healthy women with overweight or obesity (N = 46, mean [SD] age 50 [9] years, BMI 32.9 [4.4] kg/m²), without a diagnosed eating disorder and who were randomized into 2 weight loss groups (prescribed 70% of calculated energy requirements as IF or CR) were included. Measurements were assessed in both IF and CR groups following a 12-hour overnight fast during baseline and week 8 and additionally following a 24-hour fast in the IF group only at week 8. We observed that IF produced greater weight and body fat loss than CR (P < .001). We did not detect any statistical difference between groups for the change in dietary restraint, disinhibition, hunger, mood, sleep quality, and QOL. An increase in cognitive performance was found in both IF (P = .036) and CR (P = .006) groups in one of the cognitive tasks, but there was no statistical difference between groups. Perceived eating behaviors, mood, sleep quality and cognitive performance were not changed by an acute 24-hour fast within the IF group (all P > .05). IF may be a viable alternative to CR for weight loss, in the short-term, without adversely impacting eating behaviors, mood, sleep quality, QOL or cognition in healthy women with overweight or obesity. However, larger and long term trials are required.     

Loss of control over eating, adiposity, and psychopathology in overweight children

OBJECTIVE: To investigate the relationship between loss of control over eating, adiposity, and psychological distress in a nontreatment sample of overweight children. METHOD: Based on self-reports of eating episodes, 112 overweight children, 6-10 years old, were categorized using the Questionnaire of Eating and Weight Patterns-Adolescent Version into those describing episodes of loss of control over eating (LC), and those with no loss of control (NoLC). Groups were compared on measures of adiposity, dieting, and eating behavior, and associated psychological distress. RESULTS: LC children (33.1%) were heavier and had greater amounts of body fat than NoLC children. They also had higher anxiety, more depressive symptoms, and more body dissatisfaction. 5.3% met questionnaire criteria for BED. Episodes of loss of control occurred infrequently, were often contextual, and involved usual meal foods. DISCUSSION: As in adults, overweight children reporting loss of control over eating have greater severity of obesity and more psychological distress than those with no such symptoms. It remains unknown whether children who endorse loss of control over eating before adolescence will be those who develop the greatest difficulties with binge eating or obesity in adulthood.     

学龄前儿童饮食行为与超重/肥胖的相关性研究

目的 探讨学龄前儿童饮食行为与超重/肥胖间的关系,为学龄前儿童超重/肥胖防治措施的制订提供参考依据。方法 采用学龄前儿童饮食行为试用量表对387名3~6岁儿童的饮食行为进行调查,同时,测量儿童的身高、体重,并计算体质指数(body mass index,BMI);依据BMI将儿童分为正常体重、超重和肥胖组。运用单因素方差分析比较不同体重组间饮食行为的差异;采用阶层线性回归分析检验学龄前儿童饮食行为与BMI间的相关性。结果 单因素分析结果显示,不良进食习惯、外因性进食、挑食、情绪性进食、过饱响应和食物响应6个维度得分在不同体重组间差异具有统计学意义(P<0.01),食物喜好和主动进食维度得分在不同体重组间差异无统计学意义(P>0.05)。阶层回归分析显示,当排除性别、年龄、母亲文化程度影响后,量表6个维度得分与儿童BMI具有相关性(P<0.01)。反映食物趋向的各维度得分与BMI呈正相关(β:0.09~0.21),反映食物逃避各维度得分与BMI呈负相关(β:-0.47~-0.36)。 结论 学龄前儿童饮食行为与超重/肥胖密切相关,通过干预儿童饮食行为可降低学龄前儿童超重/肥胖的风险。     

An initial evaluation of a commercial weight loss program: short-term effects on weight, eating behavior, and mood

OBJECTIVE: This paper describes an initial, 4-week evaluation of a commercial weight loss program. RESEARCH METHODS AND PROCEDURES: Respondents (n = 985) to newspaper advertisements in two metropolitan areas were assigned to 4 weeks of either the Weight Watchers program or to a Self-Help condition. Weight loss, psychological vitality, and eating behavior were evaluated before and after the 4-week intervention. RESULTS: Weight Watchers participants showed greater improvements than Self-Help participants on all measures; weight losses averaged 1.87 and 0.77 kg, respectively. The superior outcomes shown by Weight Watchers participants on measures of vitality and eating behavior were still evident when extent of weight loss was controlled. Weight losses across different sites, incomes, and levels of obesity were similar. DISCUSSION: Although the present study's intervention and outcome assessments were short-term, the promising results obtained suggest that longer term studies should be undertaken.     

The emotional eating and negative food relationship experiences of obese and overweight adults

Overweight and obesity pose serious public health problems, affecting 68.8% of Americans. Previous research indicated that psychological factors played important roles in an individual’s motivation to consume food. In particular, emotional eating, defined as overeating in response to negative affect, has received particular attention as a risk factor for obesity. This study explored and addressed the emotional factors involved in the development of emotional eating. A total of 10 Midwestern American male and female adults, previously diagnosed as medically overweight and obese, were recruited via online and print advertisement using maximum variation and snowball sampling methods. Using a semi-structured, face-to-face interview format, participants shared their perspectives about the development and persistence of emotional eating. The interviews were transcribed and Atlas.ti software was used to assist in thematic analysis of emotional eating. Study results yielded themes, such as emotional triggers, food cravings, comfort from foods, mindless eating, and childhood experiences. Findings indicated that participants generally lacked emotional self-care, but desired to decrease their emotional eating behaviors. Implications are discussed to construct creative, evidence-based treatments for the overweight and obese emotional eaters.