Mindfulness (2019) 10:670–678

https://doi.org/10.1007/s12671-018-1002-4

ORIGINAL PAPER

Depressive Symptoms and Emotional Eating: Mediated by Mindfulness?

Marthe M. Höppener 1 & Junilla K. Larsen 1 & Tatjana van Strien 1 & Machteld A. Ouwens 2 & Laura H. H. Winkens 3 &
Rob Eisinga 4

Published online: 15 August 2018

# The Author(s) 2018

Abstract
The association between depressive symptoms and emotional eating has been well established. The aim of the current study was
to examine whether the association between depressive symptoms and emotional eating was mediated by mindfulness, a
construct that has successfully been implemented in the treatment of eating disorders and depression. Mindfulness, particularly,
the component Bacting with awareness^ was theorized to decrease impulsive eating. Data from 417 Dutch adult participants were
analyzed. Mediation analyses were conducted using structural equation modeling in Mplus. Of the five mindfulness subcom-
ponents, only acting with awareness mediated the association between depressive symptoms and emotional eating. Results
showed complete mediation in that the effect of depression on emotional eating was entirely carried indirectly through the
mediator acting with awareness. None of the other mindfulness components mediated the depressive symptoms-emotional eating
link. This indicates the potential importance of the Bacting with awareness^ construct, explaining why depressive symptoms
would be associated with emotional eating. Future prospective research should examine whether, why and for whom acting with
awareness may mediate the prospective link from depressive symptoms to emotional eating.

Keywords Emotional eating . Mindfulness . Acting with awareness . Depressive symptoms . Mediation

Introduction 2011). There is robust cross-sectional evidence that depressive

symptoms are positively linked to emotional eating
Emotional eating is highly prevalent among adult populations (Konttinen et al. 2010a, b; Ouwens et al. 2009; Pidgeon et
and has been related to eating disorders (Heatherton and al. 2013; Stice 2002; Van Strien et al. 2016a, b), and recent
Baumeister 1991; Macht 2008; Stice et al. 2002) and weight longitudinal research suggests that depressive symptoms pre-
gain over time (Hübner et al. 2016; Koenders and Van Strien dict future emotional eating (Kidwell et al. 2017).
Mindfulness may be a prominent mechanism explaining the
Electronic supplementary material The online version of this article link between depressive symptoms and emotional eating.
(https://doi.org/10.1007/s12671-018-1002-4) contains supplementary Mindfulness has often been described as the non-
material, which is available to authorized users.
judgemental awareness of current experience and acceptance
toward moments of experience (Bishop et al. 2004).
* Junilla K. Larsen
[email protected] Mindfulness as defined by Baer et al. consists of five subcom-
ponents: Bacting with awareness,^ Bnon-reactivity,^ Bnon-
1
judgment,^ Bdescribing,^ and Bobserving^ (Baer et al. 2006),
Behavioural Science Institute, Radboud University, PO Box 9140,
6500 HE Nijmegen, The Netherlands
and is theorized to decrease impulsive eating, rumination, and
2
increase healthy, internal coping mechanisms (Alberts et al.
GGZ Breburg, Persona Cura, Department of Personality and
Behavioral Disorders in the Elderly, PO Box 770, 5000
2012; Kristeller and Wolever 2011; O'Reilly et al. 2014; Tak
AT Tilburg, The Netherlands et al. 2015; Teasdale et al. 1995). It is therefore considered a
3
Department of Health Sciences, Faculty Science, Amsterdam Public
promising innovative emotion regulation tool to decrease emo-
Health Research Institute, Vrije Universiteit Amsterdam, De tional eating (Daubenmier et al. 2011; Leahey et al. 2008;
Boelelaan 1085, 1081 HV Amsterdam, The Netherlands Kristeller and Wolever 2011; Mantzios and Wilson 2015;
4
Radboud Social Cultural Science, Radboud University, PO Box Ouwens et al. 2015). Surprisingly, less is known about the
9140, 6500 HE Nijmegen, The Netherlands general association between mindfulness and emotional eating.
Mindfulness (2019) 10:670–678 671

To date, one survey study in an obese population found that (277 females, 134 males, and 6 unknown). The ages of
more mindfulness was associated with less emotional eating the participants ranged from 18 to 85, with a mean age
(Ouwens et al. 2015). Another survey study in a non-clinical of 38.99 (SD = 17.59). The body mass index (BMI) of
sample found that mindfulness moderated the association be- the participants ranged from 17.5 to 41.7 with a mean
tween depressive symptoms and emotional eating, with more BMI of 24.0 (SD = 3.8). According to the WHO Expert
mindfulness linked to less emotional eating only among indi- Consultation (2004) cut-off points, 21.8% of the partici-
viduals with low depressive symptoms (Pidgeon et al. 2013). pants were pre-obese (BMI 25 to < 30) and 8.8% were
However, this study used a unidimensional opeationalization of obese (BMI > 30). Of the participants, 95% were
mindfulness (i.e., Battentional focus^). High attentional focus Caucasian and more than half (61.9%) were not reli-
might be ineffective among individuals with high depressive gious. The highest completed educational attainment of
symptoms. Two recent survey studies found evidence for the the participants ranged from primary education (1) to
idea that Bacting with awareness^ was the most important university (8). 2.4% of participants only completed pri-
mindfulness component being associated with emotional eating mary education, 34.8% completed secondary education,
(Tak et al. 2015; Levin et al. 2014). Tak et al. (2015) found that and 62.8% completed tertiary education, including voca-
acting with awareness was most strongly associated with emo- tional training (7.5%), higher vocational training
tional eating in people with diabetes. The same was found by (13.5%), and higher professional training (25.6%) or
Levin et al. (2014) among individuals who had undergone bar- the university (16.2%). Of the participants, 22.9% were
iatric surgery for morbid obesity. Acting with awareness con- students, 74.1% of participants noted a vocation, 2.4%
stitutes an awareness of emotions and present events, which were retired, and 0.6% reported unemployment.
may be a key factor in counteracting food-intake, particularly
in response to depressive symptoms. Procedure
Notably, in most studies examining the association be-
tween depressive symptoms and mindfulness, a lack of Students and research assistants (12 bachelor and 3 master
mindfulness is considered as the antecedent of later de- students) recruited adult participants in their own social
pressive symptoms (Raphiphatthana et al. 2016). network. Participants were asked to fill out a survey on
However, some recent findings on the temporal order of health and emotions. In some cases, these participants
this association suggest that depressive symptoms also distributed the survey among their friends, creating a
precede the development of mindfulness (Gotink et al. snowball sample. As participant recruitment deliberately
2016; Raphiphatthana et al. 2016). According to well- focused on a diverse age-range, the snowball sample has
supported cognitive models of depression, depressive helped in reaching a more diverse sample of participants.
symptoms may induce all sorts of negative cognitive It was emphatically stated that participation was volun-
biases (Beck 1976), which increase the chance of negative tary. Given the nature of the snowball sample, it is un-
interpretations and less mindful thoughts or actions (i.e., known how many participants were approached but de-
acting without awareness). These decreasing mindful clined to participate. The data was collected anonymous-
thoughts or actions may particularly be harmful in our ly; after agreeing to participate in the study, the question-
current obesogenic environment, explaining the link from naire was sent to the participants in an envelope and par-
depressive symptoms to emotional eating through de- ticipants were instructed to seal the envelope after com-
creasing acts of mindfulness. pleting the questionnaire and to hand it to the research
The main aim of the current study is to examine wheth- assistant. Filling out the questionnaire took approximately
er specific mindfulness components mediate the associa- 30 min. Participant recruitment and data collection took
tion between depressive symptoms and emotional eating. place from February to April of 2014. Sealing the enve-
We hypothesize that depressive symptoms are positively lope ensured anonymity and a different research assistant
related to emotional eating and that this association is than the recruiter entered the data in SPSS. The Ethics
mediated by the mindfulness subcomponents, particularly Committee of the Faculty of Social Sciences of the
by acting with awareness. Radboud University Nijmegen approved the study (code-
number: ECSW2015-1210-337).

Method Measures

Participants To measure mindfulness, a Dutch translation of the Five

Facet Mindfulness Questionnaire (FFMQ) was used (Baer
In total, 417 Dutch adults participated in the current et al. 2006). The FFMQ is a self-report questionnaire that
study, of which approximately two thirds were female results in a total mindfulness score and measures five
672 Mindfulness (2019) 10:670–678

subcomponents of mindfulness: observing (the awareness standardized path coefficients. Statistical significance
and attention to internal and external stimuli, α in this was inferred by a p value less than .05. First, an unre-
sample is .78), non-judging (acceptance of thoughts and stricted mediation model was applied to the data, esti-
emotions, α = .87), describing (the capacity to describe mating the direct and indirect effects of depressive symp-
observations, α = .87), non-reactivity (letting thoughts toms and the control variables BMI, education, age, and
and feelings come and go without getting lost in them, gender on emotional eating via the mindfulness compo-
α = .71), and acting with awareness (awareness for the nents mediators. Unstandardized coefficients are reported
present moment and activity, α = .83). The complete ver- and results are significant when the 95% confidence in-
sion of 39 items was used, with a 5-point scale ranging terval does not reach zero. The subsequently applied re-
from 1 (never or almost never) to 5 (often or always). stricted model fixed insignificant effects to zero.
Cronbach’s alpha for the FFMQ in this sample was .84.
Depressive symptoms were assessed by the Center for
Epidemiologic Studies Depression Scale (CES-D; Radloff
1977), translated to Dutch. The IOWA short form with 11 Results
items was used (Carpenter et al. 1998). The CES-D has a
4-point scale. The CES-D has shown good internal con- Descriptive Statistics and Correlations
sistency and test-retest reliability among (Dutch) adoles-
cent and adult populations (Cuijpers et al. 2008; Morin et The descriptive statistics and the correlations between
al. 2011; Roberts et al. 1990). Cronbach’s alpha for the emotional eating, depressive symptoms, mindfulness sub-
CES-D in this sample was .82. components, and covariates are displayed in Table 1. The
Emotional eating was measured using the Dutch Eating self-reported emotional eating scores ranged from 1 to 5,
Behavior Questionnaire (DEBQ; Van Strien et al. 1986). with a mean value of 2.38. If, for descriptive purposes, a
Answers were rated on a 5-point scale. The questionnaire split value of 3 is used with scores exceeding 3 classified
measures different eating styles, among which emotional eat- as high, then 22.8% of our sample scored high on emo-
ing, which consists of 13 items. Cronbach’s alpha of the sub- tional eating. The mean values of the overall mindfulness
scale emotional eating in the current study was .92. scale and the mindfulness subcomponents also ranged
Scores on the above multi-item measures were tallied from 1 to 5 and all exceeded the value of 3 (i.e., mean
by taking the mean of the individual item scores. For value of 3.33 for the overall mindfulness scale). The
depressive symptoms, the potential range of the scale most popular mindfulness component was taking a non-
scores is from 1 to 4, with a high score indicating depres- judgemental stance, the least popular one was observing.
sion, and for mindfulness (both overall scale and individ- The depressive symptom scores had a potential range
ual components) and emotional eating, the overall scores from 1 (no symptoms) to 4 (severe symptoms). The ma-
range from 1 to 5, with high scores indicating greater jority of the participants reported no or very little depres-
mindfulness and a greater tendency to engage in emotion- sive symptoms. When using a cut-off value of > 2, then
al eating, respectively. 12.5% of the participants rated themselves as having at
least mildly depressive symptoms. The descriptives for
Data Analyses age, BMI, and gender replicate the sample characteris-
tics, that is the mean age, mean BMI, and the proportion
Data were analyzed using SPSS 23 (George and Mallery females in the sample.
2016) and Mplus 8 (Muthén and Muthén 2017). Prior to As to the associations, a small positive correlation was
the mediation analysis, the data were screened with SPSS observed between depressive symptoms and emotional eating
to verify the assumptions associated with the statistical (Cohen 1998). Cohen gives the following guidelines for the
analyses (normality, homoscedasticity, and linearity), and social sciences: small effect size, r = 0.1–0.23; medium, r =
to calculate means, standard deviations, and bivariate 0.24–0.36; large, r = 0.37 or larger (Cohen 1992). A negative,
correlations. Mplus was used to examine the extent to medium-sized correlation was found between acting with
which the mindfulness components function as mediators awareness and emotional eating and small negative associa-
in the relationship between depressive symptoms and tions were found between both the total mindfulness score and
emotional eating. The multiple mediators model was es- non-judgment and emotional eating. Observing was weakly
timated using both maximum likelihood estimation (ML) positively correlated with emotional eating. Of the mindful-
and bootstrapping with 1000 samples to examine the ac- ness components acting with awareness, non-reactivity and
curacy of the ML standard errors of the estimates. The non-judgment were negatively correlated with depressive
results are reported as unstandardized path coefficients symptoms, and observing and describing positively. The latter
followed by standard error in parentheses, and as correlations were all small to medium (Cohen 1998).
Mindfulness (2019) 10:670–678 673

Table 1 Means, standard deviations, and bivariate correlations of emotional eating, depressive symptoms, mindfulness (total score), the five mindfulness components, gender, body mass index,

38.99 (17.59)
Mindfulness Components as Mediators

12 The results of the estimation of the unrestricted multiple me-

–
diators model are given in Table 2, in the form of unstandard-

4.97 (1.56)
ized path coefficients and their standard errors (in parenthe-

− .30***
ses). The top panel displays the direct effects of depressive
symptoms and the independent control variables on the mind-
11

–
fulness subcomponents and on emotional eating. It also shows

24.02 (3.81)
the direct effects of the five mindfulness components on emo-

. 40***
− .19***
tional eating. The bottom panel presents the indirect effects of
depression and the control variables on emotional eating via
10

–
the mindfulness subcomponents.

.67 (.47)
As can be seen from the top panel of Table 2, depres-
sive symptoms had a significant effect on all mindfulness

−.10
− .08
− .02 subcomponents. The effects were positive for the observe
–
9

mindfulness and negative for the other components. The

3.04 (.70) direct effect of depressive symptoms on emotion eating,
.10*
.02
.07
.05

shown in the right-most column, was not significant

–
8

however. Also note that acting with awareness was the

3.36 (.72)

only mindfulness subcomponent that had a direct, signif-

.23***
.20***

icant negative effect on emotional eating. The estimates

− .12*
.05
− .08

of the other components failed to reach significance.

–
7

These results together suggest complete mediation in that

3.66 (.75)
− .27***

the effect of depression on emotional eating is entirely

.13**

− .04

.01
.00

.07

carried indirectly through the mindfulness mediator act-

–
6

ing with awareness.

The indirect effects displayed in the bottom part of
3.15 (.58)
.25***

.22***
.28***

− .14**

Table 2 support this conclusion. Depression had a signif-

− .04
.08

− .08

icant, positive effect on emotional eating via acting with

–
5

awareness (b = .08). This positive effect is the result of

3.43 (.67)

depression having a negative effect on acting with aware-

.44***

− .17***

.22***
.17***
.10*

ness (b = −.32), which in turn has a negative effect on

− .02

.02
.07

emotional eating (b = −.25).

–
4
education, and age in a non-clinical sample of 414 adult Dutch participants

In addition to the unrestricted model, a restricted model

3.33 (.37)
.19***
.58***
.54***

.36***
.66***
.57***

that fixed insignificant effects to zero was applied to the

.02

.06
− .04

data. Chi-square goodness-of-fit test statistics and

–
3

additional fit indices suggest that a simple mediation

1.47 (.40)

model with acting with awareness as the sole mediator

− .44***

.17***
− .17***
− .35***
− .32***
− .15**

provided a good fit to the data (χ2 = 21.584, p = .424;

− .13*
.00
.09

− .07

CFI = .998, TLI = .998, RMSEA = .008). The unstandard-

–
2

ized parameter estimates are reported in Table S1 in the

2.38 (.83)
.32***

− .22***
− .19***
− .19***
− .30***
.19***

Supplementary Material to this paper. The standardized

.13**
.11*
− .05

.05
− .06

path coefficients are displayed in Fig. 1. As can be seen,

–
1

among the mindfulness subcomponents, acting with

***p < 0.001, **p < 0.01, *p < 0.05
9. Gender (0 = male, 1 = female)

awareness was the only component affecting, in a nega-

tive way, emotional eating. Also, similar to the unrestrict-
3. Mindfulness, total score
4. Acting with awareness

ed model, the positive total effect of depression on emo-

2. Depressive symptoms

10. Body mass index

tional eating (b = .06) was simply the indirect effect

1. Emotional eating

through acting with awareness. Hence, the association be-

6. Non-judgment
5. Non-reactivity

11. Education
7. Describing

tween depressive symptoms and emotional eating is

8. Observing

completely mediated by the sole mindfulness mediator

12. Age
M (SD)

of acting with awareness. The bootstrap confidence inter-

vals support the claim, with 95% confidence, that
674 Mindfulness (2019) 10:670–678

Table 2 Unrestricted mindfulness mediator model estimating the effect of depressive symptoms on emotional eating (unstandardized path coefficients,
standard errors in parentheses, n = 391)

Mindfulness mediators Emotional eating

Act aware Non-judge Describe Observe Non-react

Direct effects
Depressive symptoms − .32 (.07)*** − .51 (.07)*** − .23 (.07)** .23 (.07)*** − .13 (.06)* .04 (.08)
BMI .01 (.01) .01 (.01) .00 (.01) .00 (.01) − .02 (.01)* .07 (.01)***
Education .03 (.02) − .01 (.03) .09 (.03)*** .05 (.03) .06 (.02)** .05 (.03)
Age ÷ 10 .09 (.02)*** .02 (.03) − .01 (.03) .05 (.02)* − .02 (.02) − .13 (.03)***
Gender (0 = male) .02 (.08) − .06 (.08) .10 (.08) .18 (.08)* − .01 (.07) .61 (.09)***
Act aware − .25 (.06)***
Non-judge − .05 (.06)
Describe − .03 (.06)
Observe .05 (.06)
Non react − .07 (.07)
Indirect effects on emotional eating via mindfulness mediators
Depressive symptoms .08 (.03)*** .02 (.03) .01 (.01) .01 (.01) .01 (.01)
BMI − .01 (.01) − .00 (.00) .00 (.00) .00 (.00) .01 (.01)
Education − .01 (.01) .00 (.00) − .01 (.01) .00 (.01) − .01 (.01)
Age ÷ 10 − .02 (.01)** − .00 (.00) .00 (.00) .00 (.00) .00 (.00)
R2 .103 .115 .073 .046 .070 .260

Bootstrap standard errors (1000 samples) are nearly identical to the standard errors displayed. Age was divided by 10 for presentation purpose
*p < .05, **p < .01, ***p < .001

depression affects emotional eating indirectly through act- females scored higher on emotional eating than males.
ing with awareness (95% CI: .03, .09). Finally, as can be The positive effects of BMI and gender were found to
seen in Fig. 1, emotional eating was also positively asso- be entirely direct. Age, however, was negatively associat-
ciated with BMI and with gender, the latter implying that ed with emotional eating. The negative effect of age on

Fig. 1 Restricted mindfulness

Act aware
mediator model: standardized
path coefficients (n = 391). The −.24
coefficients represent the change
in the dependent variable in Depressive −.33
symptoms Non judge
standard deviation units for a one −.16
standard deviation change in the
predictor variable −.11 .14
Describe
.17
Education

Observe
.14

.18
Non react
.12
Age
−.24

−.14 −.26

BMI Emotional eating

.28
.31
Gender
Mindfulness (2019) 10:670–678 675

emotional eating was both direct and indirect via the act- 1976; Williams 2008). Notably, a meta-analysis of mindful-
ing with awareness facet of mindfulness. ness intervention studies suggests that people may be trained
in being more mindful (and act with more awareness) and that
this might decrease depression induced ruminative thoughts
Discussion (Gu et al. 2015). Moreover, particularly acting with aware-
ness, through reduced automaticity, is related to less impulsiv-
The main aim of the current study was to examine whether ity (Brown and Ryan 2003; Levesque and Brown 2007), in-
the association between depressive symptoms and emo- cluding impulsivity in maladaptive eating behaviors (Tak et al.
tional eating would be mediated by any of the mindfulness 2015; Kristeller and Wolever 2011). Future work may exam-
subcomponents. Previous studies have already shown neg- ine whether and why a decrease in ruminative thoughts might
ative associations between mindfulness and particularly facilitate more acting (i.e., eating) with awareness and, thus,
the subcomponent Bacting with awareness^ and emotional decreased automaticity in eating and emotional eating.
eating in specific subpopulations, including obese people Finally, the mediating role of acting with awareness in the
and people with diabetes (Tak et al. 2015; Ouwens et al. depressive symptoms-emotional eating link may also be ex-
2015; Levin et al. 2014). Our study adds to these studies in plained through difficulty identifying feelings, a subcompo-
that the negative association between acting with aware- nent of alexithymia (Ciarrochi et al. 2011). Difficulty identi-
ness and emotional eating was replicated in a general adult fying feelings has been negatively linked to acting with aware-
population, suggesting that this association does not only ness (Baer et al. 2006; Ciarrochi et al. 2011; Dekeyser et al.
exist among specific subpopulations but also among more 2008) and positively linked to emotional eating (Carano et al.
general adult populations. Moreover, we found that of the 2006; Hund and Espelage 2006; Larsen et al. 2006; Mazzeo
five mindfulness subcomponents, only the subcomponent and Espelage 2002; Moon and Berenbaum 2009; Pinaquy et
Bacting with awareness^ mediated the association between al. 2003) and depressive symptoms (Ouwens et al. 2009).
depressive symptoms and emotional eating. This indicates Similar to acting with awareness, difficulty identifying feel-
the potential importance of this construct, explaining why ings has also been suggested to be a mediator of the associa-
depressive symptoms would be associated with emotional tion between depressive symptoms and emotional eating
eating. Consistent with previous studies, we found that (Ouwens et al. 2009). Future longitudinal research should in-
females and participants with higher BMIs showed higher corporate both mindfulness and alexithymia (e.g., difficulty
emotional eating (Geliebter and Aversa 2003; Larsen et al. identifying feelings) components to see which ones are most
2006). Older participants were less likely to report emo- important in explaining the link between depressive symp-
tional eating, a finding that has been reported before toms and emotional eating.
(Kessler et al. 2013). Older participants were also more Our findings for Bacting without awareness^ being the
likely to act with awareness, which in turn was related to sole mindfulness component mediating the link between
less emotional eating. Further examining possible media- depressive symptoms and emotional eating is in line with
tion of acting with awareness explaining the inverse rela- previous intervention research. To date, a systematic re-
tion between age and emotional eating was beyond the view has shown that mindfulness-based interventions fo-
scope of this manuscript, but might be an interesting ave- cusing on eating behaviors (i.e., eating with awareness)
nue for future research. Future prospective research should are more effective at achieving weight loss than general
examine whether, why, and for whom acting with aware- mindfulness interventions (Katterman et al. 2014).
ness may mediate the prospective link from depressive Another review underwrites this: programs that include or
symptoms to emotional eating. focus on eating-specific tasks are more effective in reduc-
The mediating role of acting with awareness may be ex- ing emotional eating than interventions that do not include
plained through the escape theory, which states that emotional these practices (Kristeller and Wolever 2011). It is possible
eating occurs as a means to escape ones negative thoughts and that these effective eating-specific tasks are similar to the
feelings by narrowing ones focus to concrete acts and not to subcomponent acting with awareness, in the sense that par-
higher-abstract thought (Haedt-Matt and Keel 2011; ticipants learn to Beat with awareness.^ Future research
Heatherton and Baumeister 1991). One previous study should examine mechanisms explaining this association
showed that avoidance of internal events mediated the rela- between acting with awareness and emotional eating, yield-
tionship between negative emotions and emotional eating ing further guidance for intervention research on whether
(Litwin et al. 2016). This same avoidance phenomenon may and how acting with awareness can best be stimulated. We
also explain our mediating findings for acting with awareness. would also like to note the positive correlation between
However, it is also possible that people act (i.e., eat) with observing and both emotional eating and depression, which
less awareness because they are absorbed by depression in- is in line with previous results in non-meditating partici-
duced cognitive biases and related ruminative thoughts (Beck pants (Baer et al. 2006; Levin et al. 2014).
676 Mindfulness (2019) 10:670–678

Limitations and Future Research Acknowledgments The authors would like to thank all students and par-
ticularly Aniek Wols for their help in the data collection.

A limitation of the current study includes the cross- Contributors Marthe Höppener analyzed the data and drafted the paper.
sectional design, especially considering that mediation Junilla Larsen composed the questionnaire, oversaw data collection, and
analyses in cross-sectional designs are less robust, as they reviewed the paper. Rob Eisinga conducted the Mplus analyses and
reviewed the paper. Tatjana van Strien, Machteld A. Ouwens, and
lack the temporal order of events. However, the findings
Laura Winkens read and reviewed the paper.
in the current study seem plausible, as longitudinal studies
have already showed links between mindfulness and de-
Compliance with Ethical Standards
pression and emotional eating (Barnes and Lynn 2010;
Mantzios and Wilson 2015; Raphiphatthana et al. 2016; Conflict of Interest Tatjana van Strien has a copyright and royalty inter-
Williams et al. 2010). Furthermore, as this is a survey est in the Dutch Eating Behavior Questionnaire (DEBQ) and manual.
study, all data are self-reported. The proportion of pre-
obese and obese participants is lower than the Dutch av- Informed Consent Informed consent was obtained from all individual
participants included in the study.
erage (De Groot and Bruggink 2012): this may be due in
part to a bias in self-reports (Sherry et al. 2007), but may Open Access This article is distributed under the terms of the Creative
also be due to a selection bias in recruiting participants. Commons Attribution 4.0 International License (http://
The participants are relatively high educated, as 16.1% of creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
distribution, and reproduction in any medium, provided you give
the participants have a university degree and 25.4% have appropriate credit to the original author(s) and the source, provide a link
a higher professional training degree, while the national to the Creative Commons license, and indicate if changes were made.
average of 2016 is 10.2% for a university degree and
17.8% for a higher professional training degree
(Statistics Netherlands 2017). This may have influenced References
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