Objective
Women have been reported to use more emotion-regulation strategies than do men and to have more abilities to regulate their emotions in a different way. The aim of the present study was to examine gender differences in the relationships of alexithymia, negative mood, and the combination of alexithymia and negative mood with emotional eating in obese persons.
Methods
Four hundred thirteen obese individuals [343 females and 70 males, aged 18–60 years, mean=43.6 years, body mass index (BMI)=38.4±6.6 kg/m2] completed self-report questionnaires, including the Symptom Checklist-90 (SCL-90) questionnaire, the Dutch Eating Behavior Questionnaire (DEBQ), and the Toronto Alexithymia Scale (TAS).
Results
Hierarchical regression analysis showed a significant interaction between gender and alexithymia. More difficulty in identifying or describing feelings was specifically associated with more emotional eating in men.
Conclusion
These findings suggest that alexithymia is more strongly involved in emotional eating of obese men than women. This offers indications for designing gender-specific treatments for emotional eating among obese persons.
The normal response to emotional arousal is loss of appetite, followed by a decrease of food intake, as emotional arousal inhibits gastric hunger contractions [1] and leads to the liberation of sugar from the liver into the bloodstream [2]. Some individuals, however, respond to emotional arousal by enlarging their food intake. This so-called emotional eating is, according to psychosomatic theory, more frequent in obese individuals and is the result of learning experiences early in life in which food was used as a way of coping with psychological problems [3]. Due to these early learning experiences, some individuals may have developed a poor interoceptive awareness: difficulties in recognizing and accurately identifying emotions and visceral sensations related to hunger and satiety [4]. Interoceptive awareness is highly associated with alexithymia, which is a multifaceted construct encompassing difficulty identifying subjective emotional feelings and distinguishing between feelings and the bodily sensations of emotional arousal, difficulty describing feelings to other people, an impoverished fantasy life, and a stimulus-bound, externally oriented, cognitive style, as originally defined by Nemiah et al. [5].
While interview and questionnaire studies have consistently found support for the concept of emotional eating in obese individuals [6] and [7], no support for this concept was obtained in early experimental studies [8], [9] and [10], possibly as a result of the emotional manipulation with labelled, controllable emotional states [11]. Experimental studies in which the source of the elicited negative emotions was diffuse and uncontrollable have found that the obese overeat in comparison with the nonobese [12] and [13]. This overeating after diffuse and uncontrollable emotions suggests a role for alexithymia in emotional eating.
A previous study has found a relationship between interoceptive awareness and emotional eating among females [14]. In addition, difficulty in identifying feelings has shown to be associated with emotional eating among obese females with binge eating disorder, but not among those without binge eating disorder [15]. So far, no studies have examined the relationship between alexithymia and emotional eating in men.
Gender differences in emotional adjustment and emotional eating have consistently been reported, with women showing more depressive symptoms [16], being more emotionally expressive [17], [18] and [19], using more emotion-regulation strategies [20], and showing more emotional eating [21] than men do. Whereas an incidental study has observed no association between alexithymia and gender [22], most large-scale studies in general population samples have found that men show more alexithymia than women do [23] and [24]. In addition, the relationships between alexithymia and psychological or medical problems may well be gender specific. Women have been reported to use more emotion-regulation strategies than men do and to have more abilities to regulate their emotions in a different way [20]. We hypothesize that the associations between alexithymic characteristics and emotional eating problems are stronger for men than for women. A previous study found that alexithymia was associated with the frequent use of health care among men, but not among women [25].
The aim of the present study was to examine gender differences in the relationships of alexithymia, negative mood, and the combination of alexithymia and negative mood with emotional eating in obese individuals. Support for a gender-specific emotional eating model would be clinically useful, because it offers indications for designing gender-specific treatments for emotional eating.
