Emotional Eating Beyond Obesity: A Transdiagnostic Conceptual Analysis of Phenotyping, Measurement, and Priorities for Clinical Validation
- 1Discipline of Psychiatry II, Neurosciences Department, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
- 2Clinical Department of Psychiatry, Central Military Emergency University Hospital “Dr. Carol Davila”, 010825 Bucharest, Romania
- 3Department of Internal Medicine, Mallow General Hospital, P51 N288 Mallow, Cork, Ireland
Abstract
Background: The concept of emotional eating (EE) originates in the early psychosomatic accounts of overeating, but its nosological status remains contested more than four decades after it was first scientifically explored. Although neither the DSM-5-TR nor the ICD-11 recognizes EE as a discrete entity, clinically significant presentations of EE are described in the literature and can currently be captured under residual diagnostic categories in the absence of specific criteria. Objective: To examine whether EE is best conceptualized as an independent disorder or a dimensional, transdiagnostic, nutritional-behavioral phenotype, and to identify requirements for its clinical validation. Methods: A conceptual analysis supported by a critical synthesis of the literature focused on phenotypic heterogeneity, nutritional correlates, measurement approaches, diagnostic boundaries, and clinical implications of EE. Results: Negative-affect EE (N-EE) has been linked to changes in food choice, diet quality, processing degree, eating patterns, and potential abdominal adiposity, but these associations do not resolve the contentious question of whether EE is a distinct clinical entity. Eating in response to emotional states has also been linked to depression, emotion dysregulation, dietary restraint, binge eating, body-image concerns, sleep disturbance, and obesity-related outcomes. However, these associations are heterogeneous and do not define a unique disorder. One important asymmetry further complicates classification: N-EE is more consistently associated with psychopathology, while positive EE (P-EE) often occurs in normative social contexts. The proposed framework positions EE as a dimensional, transdiagnostic phenotype and identifies convergent multimethod validity, clinically meaningful thresholds, and discriminant, longitudinal, nutritional, prognostic, and treatment validity beyond established eating and mood disorders as requirements for potential categorical recognition. Conclusions: The literature considered suggests that EE may be usefully approached as a dimensional, transdiagnostic nutritional-behavioral phenotype. This remains a provisional conceptual position rather than an empirically validated classification. Further multimethod and longitudinal research is needed to clarify clinical significance, diagnostic boundaries, and utility before considering independent diagnostic recognition.
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BibTeX
@article{vasiliu2026emotional,
title = {{Emotional Eating Beyond Obesity: A Transdiagnostic Conceptual Analysis of Phenotyping, Measurement, and Priorities for Clinical Validation}},
author = {Octavian Vasiliu and Andrei G. Mangalagiu and Diana Gabriela Vasiliu and Bogdan M. Petrescu},
journal = {Nutrients},
year = {2026},
month = oct,
doi = {10.3390/nu18203399},
url = {https://www.mdpi.com/2072-6643/18/20/3399},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Emotional Eating Beyond Obesity: A Transdiagnostic Conceptual Analysis of Phenotyping, Measurement, and Priorities for Clinical Validation
AU - Octavian Vasiliu
AU - Andrei G. Mangalagiu
AU - Diana Gabriela Vasiliu
AU - Bogdan M. Petrescu
PY - 2026
DA - 2026/10/01
JO - Nutrients
DO - 10.3390/nu18203399
UR - https://www.mdpi.com/2072-6643/18/20/3399
AB - Background: The concept of emotional eating (EE) originates in the early psychosomatic accounts of overeating, but its nosological status remains contested more than four decades after it was first scientifically explored. Although neither the DSM-5-TR nor the ICD-11 recognizes EE as a discrete entity, clinically significant presentations of EE are described in the literature and can currently be captured under residual diagnostic categories in the absence of specific criteria. Objective: To examine whether EE is best conceptualized as an independent disorder or a dimensional, transdiagnostic, nutritional-behavioral phenotype, and to identify requirements for its clinical validation. Methods: A conceptual analysis supported by a critical synthesis of the literature focused on phenotypic heterogeneity, nutritional correlates, measurement approaches, diagnostic boundaries, and clinical implications of EE. Results: Negative-affect EE (N-EE) has been linked to changes in food choice, diet quality, processing degree, eating patterns, and potential abdominal adiposity, but these associations do not resolve the contentious question of whether EE is a distinct clinical entity. Eating in response to emotional states has also been linked to depression, emotion dysregulation, dietary restraint, binge eating, body-image concerns, sleep disturbance, and obesity-related outcomes. However, these associations are heterogeneous and do not define a unique disorder. One important asymmetry further complicates classification: N-EE is more consistently associated with psychopathology, while positive EE (P-EE) often occurs in normative social contexts. The proposed framework positions EE as a dimensional, transdiagnostic phenotype and identifies convergent multimethod validity, clinically meaningful thresholds, and discriminant, longitudinal, nutritional, prognostic, and treatment validity beyond established eating and mood disorders as requirements for potential categorical recognition. Conclusions: The literature considered suggests that EE may be usefully approached as a dimensional, transdiagnostic nutritional-behavioral phenotype. This remains a provisional conceptual position rather than an empirically validated classification. Further multimethod and longitudinal research is needed to clarify clinical significance, diagnostic boundaries, and utility before considering independent diagnostic recognition.
SN - 2072-6643
ER -