Eating Behaviors Assessed by the Three-Factor Eating Questionnaire (TFEQ) and Mental Health in Adults: A Systematic Review.

Introduction: Eating behaviors have been studied since 1985 using the Three Factor Eating Questionnaire (TFEQ) by Stunkard & Messik, building scientific evidence on their associations with body weight regulation, eating disorders and mental health. The present systematic review aimed to provide a narrative synthesis of the literature about the relationship between cognitive restraint, uncontrolled eating and emotional eating and mental health in adults.

Methods: Following the PRISMA statement, five databases were searched for research published until 18th March 2023. Eligible articles investigated eating behaviors measured by the revised versions of TFEQ and mental health, measured by psychometric instruments.

Results: A narrative synthesis of forty cross-sectional articles suggests that anxiety, stress, food cravings, food addiction and body dissatisfaction are highly associated with uncontrolled and emotional eating. Depression, negative affect, emotion dysregulation and avoidance of emotions were more frequently associated with emotional eating. Mindful and intuitive eating had negative associations with uncontrolled and, mainly, emotional eating. Cognitive restraint showed an inverse association with depression but a positive association with disordered eating attitudes and body dissatisfaction.

Conclusion: This review supports the importance of the development of emotion regulation skills in interventions for maladaptive eating behaviors.