# Prevalence of negative emotional eating in middle-aged adults: a systematic review and meta-analysis

## TL;DR

About one in six middle-aged adults overeat due to stress or negative emotions, with higher rates in women and high-income countries, increasing obesity and health risks.

## Contribution

First comprehensive meta-analysis quantifying negative emotional eating in middle-aged adults globally.

## Key findings

- Pooled prevalence of negative emotional eating in middle-aged adults is 16%.
- Higher prevalence observed in younger middle-aged women and in high-income countries.
- Emotional eating in this age group is linked to increased obesity and non-communicable disease risks.

## Abstract

Negative emotional eating (EE) is overeating in response to emotions such as stress. Negative EE is a risk factor for obesity, which is, in turn, a risk factor for many non-communicable diseases (NCDs). While previous research has predominantly focused on younger or student populations, the prevalence and determinants of negative EE in middle-aged adults remain underexplored.

A systematic search was conducted in Medline, Embase, PsycINFO, Web of Science Core Collection, and Google Scholar for English language studies published from 2000 onwards reporting on the prevalence of negative EE in adults aged 35–64 years. Pooled prevalence estimates and corresponding 95% confidence intervals (CIs) were calculated using random-effects models. Heterogeneity was assessed with the I² statistic. Subgroup analyses were performed by age, sex, country income classification, and assessment instrument.

Of 1,390 identified records, 38 studies including 13,662 participants met the inclusion criteria. The pooled prevalence of negative EE among middle-aged adults was 16% (95% CI: 14%-19%). Prevalence was notably higher among younger middle-aged females compared to males and older individuals. Additionally, negative EE was more common in middle-aged adults residing in high-income countries compared to those in middle-income countries.

The global prevalence of negative EE among middle-aged adults highlights the need for targeted health promotion and behavioral interventions in this age group. Early identification and modification of unhealthy eating behaviors could help mitigate the risk of obesity and NCDs, particularly in high-income countries facing a growing burden of obesity-related health issues.

This study examined the proportion of middle-aged adults who engaged in negative emotional eating, eating more food than usual in response to negative emotions like stress, sadness, or anxiety. By gathering information from 38 studies with over 13,000 people from around the world, this study found that about one in six middle-aged adults struggle with this kind of eating. Negative emotional eating was most common in women, especially those in their late 30s, and among residents of higher income countries. These results demonstrates that eating in response to negative emotions is not limited to young people, but also affects a sizable proportion of adults in midlife. Overeating in response to negative emotions can increase the risk of becoming overweight and thereby developing health problems like diabetes and heart disease. The results suggest that it is important for health services to help middle-aged adults recognize and manage emotional eating. Early support and simple strategies could help people develop healthier ways to cope with difficult feelings, which may improve both their physical and mental health.