1. Introduction

Emotional eating, the act of consuming food in response to emotional cues rather than hunger, has gained significant attention in the context of mental health, particularly its relationship to depression [1]. Depression, one of the most common psychological disorders worldwide, not only has a serious impact on an individual's mood and cognition, but is also closely associated with a range of physiological problems, such as weight gain and metabolic disorders. Emotional eating, as a way to cope with negative emotions, often exacerbates the worsening of depressive symptoms, creating a vicious cycle. Thus, the paper delves into the intricate link between emotional eating and depression, which aims to reveal the psychological mechanisms that drive individuals to seek solace in food amid negative emotional states, such as anxiety and depression. Also, it examines the relationship between emotional eating and depressive symptoms, identifying a potential vicious cycle whereby emotional distress and unhealthy eating behaviors contribute to the exacerbation of depressive symptoms. In short, the research may provide the basis for evidence-based intervention strategies to break the cycle and present a proactive approach to mental health care. A deeper comprehension of the underlying factors contributing to emotional eating may pave the way for the creation of more efficacious treatments for depression and enhanced overall well-being.

2. Psychological Mechanisms of Emotional Eating

The underlying mechanisms of emotional eating, a complex psychological behavior, are influenced by a multitude of biological and psychological processes [2]. Based on emotion regulation theory, individuals try to regulate or adjust their emotional states through behavioral means [3]. However, emotional eating is often regarded as an indication of a deficiency in self-regulation, particularly in the context of stress or negative emotions, where individuals are more inclined to turn to food as a means of alleviating discomfort rather than pursuing healthier coping strategies [4]. And there is a significant correlation between emotional eating and depression. Depressed individuals often exhibit symptoms such as low mood and loss of interest, which further diminishes their ability to regulate their emotions and makes them more likely to seek emotional comfort through eating [5]. On a neurochemical level, depressed patients have a weakened dopamine system, prompting them to seek out high-calorie or high-sugar foods to briefly elevate their dopamine levels for a short-lived sense of pleasure [6]. Hypofunction of dopamine, a key neurotransmitter that is involved in reward mechanisms and motivational regulation, may make it difficult for patients to obtain satisfaction in other ways, which explains the biological motivation for emotional eating.

In addition, emotional eating is closely associated with elevated cortisol levels under stress. Stress stimulates the activity of the hypothalamic-pituitary-adrenal axis (HPA axis), leading to an increase in the production of cortisol, which has been linked to an increased appetite, especially a preference for foods high in sugar and fat. Chronic high cortisol levels not only lead to health problems such as obesity, but may also exacerbate depressive symptoms, creating a vicious cycle. Emotional eating has also been linked to a decreased sense of self-efficacy, which manifests itself as a lack of confidence in an individual’s ability to regulate his or her emotions and behavior [7]. This low sense of efficacy further undermines the individual’s willingness to choose healthy coping styles and reinforces unhealthy eating behaviors. Thus, enhancing individuals’ self-efficacy and emotional regulation, especially through psychological interventions and positive thinking exercises, may be key to preventing and reducing emotional eating.

3. Emotional Eating and the Diagnosis of Depression

3.1. Emotional Eating and Weight Gain

Emotional eating, characterized by the consumption of food as a response to emotional distress, can have a significant impact on the physical health of individuals with depression [8]. This behavior often results in the consumption of high-calorie, high-fat foods, which, while providing temporary comfort, can lead to weight gain [9]. The weight gain due to emotional eating can adversely affect an individual’s self-image and self-esteem, thus creating a vicious cycle that exacerbates depression. It should be recognized that this pattern of eating is both a physical and psychological problem, as it reflects a coping mechanism that may be maladaptive in the long term.

3.2. Emotional Eating and the Exacerbation of Depressive Symptoms

A complex bidirectional relationship exists between emotional eating and depressive symptoms [10]. Though eating can provide temporary relief from negative emotions, over-reliance on food to regulate mood can disrupt the body’s natural stress response mechanisms [1]. This disruption not only weakens an individual’s ability to cope with stress, but may also lead to worsened mood management, further exacerbating depressive symptoms. Once established, this vicious cycle of emotional eating and depressive symptoms is often challenging to break on its own, and healthy mood regulation mechanisms must be restored and eating behaviors improved through targeted interventions. Research at the neurochemical level suggests that abnormalities in the functioning of the dopamine system may play a key role in this vicious cycle, as depressed individuals tend to seek pleasure through foods that briefly elevate dopamine levels, which may further solidify unhealthy eating habits.

3.3. Emotional Eating and the Decrease in Quality of Life

The consequences of emotional eating are not limited to physical health and mood management; it also has a wide-ranging impact on the overall quality of life of depressed individuals [11]. The weight gain and the accompanying emotional distress may create additional barriers in various aspects of socialization, occupational performance, and interpersonal relationships. For example, patients’ anxiety about weight and appearance may result in social withdrawal and decreased participation in social activities, while mood instability triggered by depressive symptoms may affect work performance and even undermine the maintenance of personal relationships [12]. This implies that emotional eating not only affects the mental health of depressed individuals, but negatively impacts their life satisfaction and well-being. Thus, addressing emotional eating not only helps to improve mental health, but contributes to the overall quality of life and social functioning of patients.

4. Emotional Eating and the Diagnosis of Depression

4.1. Diagnostic Criteria for Depression

The link between emotional eating and depression is critical for accurate diagnosis and treatment [13]. Based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), diagnostic criteria for depression include a persistent sad mood, significant loss of interest or pleasure, and significant changes in sleep, appetite, concentration, and energy. In addition, depression may be accompanied by feelings of worthlessness, guilt, diminished thinking skills, as well as recurrent thoughts of death or suicidal ideation, and the persistence and exacerbation of these symptoms may lead to an increased reliance on emotional eating as a coping mechanism when dealing with negative emotions.

4.2. Assessment Methods for Emotional Eating

The complexity of assesing emotional eating stems from its involvement of individuals’ dietary responses to emotions [14]. The commonly used assessment tools include the Emotional Eating Scale, which assesses an individual’s tendency to eat in different emotional states through a series of questions. For example, the Three Factor Eating Questionnaire (TFEQ-R18), which specifically assesses eating behaviors during times of anxiety, loneliness, and depressed mood, helps therapists understand patients’ eating patterns in the context of emotional distress, thus providing a comprehensive diagnosis and intervention.. During the diagnostic process, healthcare professionals or mental health specialists consider the patient’s self-report, psychological test results, and possible physiological factors. Additionally, they incorporate structured interviews and self-report questionnaires, observe the patient’s eating habits, and continuously monitor mood states. Through a comprehensive assessment, professionals are able to accurately identify patterns of depressive symptoms and emotional eating behaviors in order to develop an effective treatment plan. Interventions such as CBT and DBT are widely used to improve mood regulation and reduce unhealthy eating behaviors. To effectively address emotional eating and depression, a comprehensive treatment plan is essential. In addition, the integration of diagnostic assessments and evidence-based treatment interventions can facilitate improvements in mental health, eating behaviors, and overall quality of life for patients.

5. Intervention Strategies for Emotional Eating and Depression

Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), and Mindfulness based Intervention offer comprehensive intervention strategies for emotional eating and depression. Each of these approaches is unique and can help patients improve their emotional regulation and eating behaviors from different perspectives. The combined application of these three approaches provides patients with comprehensive support aimed at improving their overall quality of life, as described below [15].

5.1. Cognitive Behavioral Therapy (CBT)

CBT is a structured, goal-directed treatment approach that focuses on identifying and changing negative thought patterns and behaviors [16]. And its core theoretical foundation is the cognitive model, which states that an individual's mood and behavior are influenced by his or her thinking patterns. CBT helps depressed patients cope with emotional eating through the identification of automatic thoughts, cognitive restructuring, behavioral activation, skills training, and homework as well as relapse prevention. First, the approach helps patients identify and record automatically occurring negative thoughts, which are often unfiltered, negative, and negatively affect mood. Through this process, patients can recognize the presence of these thoughts and begin to question their accuracy. The patient then questions the negative automatic thoughts through evidence and logical reasoning and gradually replaces these negative thoughts with more positive, realistic thought patterns. This cognitive restructuring helps to change the patient's responses to emotions and eating, thereby reducing the behavior of relying on food to regulate emotions. In addition, it encourages patients to engage in activities that bring about positive emotions and a sense of accomplishment. And an increase in positive activities enables patients to enhance their mood and self-confidence, thereby reducing the frequency of emotional eating. Treatment also includes teaching patients new coping skills, such as communication skills, problem solving skills, and stress management skills, which help patients cope more effectively with daily challenges. Finally, homework assignments in CBT allow patients to practice and reinforce the skills learned in treatment in their daily lives. The relapse prevention component teaches patients to recognize early warning signs and develop strategies to prevent relapse, thereby maintaining treatment outcomes.

5.2. Dialectical Behavior Therapy (DBT)

DBT combines the strategies of CBT with positive thinking and emotion regulation techniques for emotional eating interventions [17]. The core theoretical premise of DBT is the dialectical mindset, stating that acceptance and change are mutually reinforcing processes. The approach helps patients deal effectively with emotional eating through a series of strategies. First, DBT provides skills training covering emotional regulation, pain tolerance, interpersonal effectiveness, and self-worth enhancement. Through these skills, patients are able to find healthy coping alternatives to food in the face of strong emotions. Second, DBT provides immediate support through telephone counseling to help patients get the help they need in times of crisis. This real-time support helps patients cope effectively when facing emotional distress, rather than turning to emotional eating. Additionally, DBT uses chain analysis techniques to dissect the sequence of events that trigger emotional distress, allowing patients to gain insight into the root causes of emotional reactions. This understanding helps patients develop strategies to break unhelpful emotional cycles. Finally, DBT emphasizes accepting the parts of life that cannot be controlled while working to change behaviors and thought patterns that can be improved. Through this balance, patients can learn to cope with emotional and life challenges in healthier ways.

5.3. Mindfulness-Based Intervention

Mindfulness-based interventions, such as Mindfulness-Based Stress Reduction (MBSR) as well as Mindfulness-Based Cognitive Therapy (MBCT), have demonstrated considerable efficacy in managing emotional eating behaviors [18], which emphasize present-moment awareness and non-judgmental observation, which are pivotal in addressing emotional eating. First, mindfulness practice helps patients distinguish between physiological hunger and emotional eating signals by promoting awareness of their current physical and emotional states, allowing them to recognize when they are truly hungry and when they are eating because of emotional fluctuations (such as anxiety, stress, or depression). Studies have shown that mindfulness practice can enhance sensitivity to the body's internal signals, allowing individuals to more clearly understand their hunger and fullness states, thereby reducing excessive eating caused by emotional problems [19]. Second, mindfulness-based interventions can also help patients better control emotional fluctuations and reduce the tendency to use food as a tool for emotional regulation. Mindfulness practice emphasizes non-judgmental observation of emotions, that is, not judging or reacting to negative emotions, but facing these emotions with an open and accepting attitude. This approach helps reduce the behavior of seeking food due to emotional distress. Studies have shown that by cultivating acceptance of emotional states, patients can reduce their emotional dependence on food and thus improve their eating behavior. Third, mindfulness interventions also have the potential to support long-term behavioral changes. Improving awareness of eating and emotions can help patients gradually establish healthier eating habits and continue these habits in their daily lives. This long-term self-regulation ability helps maintain a healthy weight and eating pattern, thereby reducing the risk of emotional eating. It has been found that mindfulness practice can effectively reduce emotional problems such as anxiety, depression, and stress, thereby further promoting overall health.

6. Conclusion

The study demonstrates that there is a complex interplay between emotional eating and depression. Emotional eating may not only exacerbate depressive symptoms but also affect patients’ quality of life. Emotional eating may cause depressed patients to consume large amounts of high-sugar and high-fat foods, leading to weight gain and worsening symptoms. Conversely, depression may also prompt patients to engage in emotional eating behaviors, further impairing physical and mental health. Intervention strategies such as Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), and Mindfulness Based Intervention have been shown to improve emotional eating and enhance quality of life. Specifically, CBT works by modifying negative thought patterns and behaviors, DBT combines emotion regulation with mindfulness based techniques, and Mindfulness Based Intervention improves awareness of emotional and hunger signals. Future research should investigate the links between emotional eating and other chronic diseases, and examine its effects in various emotional states to deepen understanding and refine comprehensive intervention strategies for emotional eating and depression.