Mediation of emotional and external eating between dieting and food intake or BMI gain in women

Tatjana van Strien*, Hanna M. Konttinen, Machteld A. Ouwens, Floris A. van de Laar, Laura H.H. Winkens

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review


Objective: Dieting to control body weight is often associated with weight gain, particularly so in women; however, the underlying mechanisms are unclear. In a series of studies on women, we examined whether the relationship between dieting and weight gain can be explained by (serial) mediation of emotional eating (EE) and/or subsequent external eating (EX). Methods: In a pilot study (116 women), we first assessed this (serial) mediation between dieting or dietary restraint and actual food consumption in the laboratory. In Study 1, a four-year follow up on patients with newly diagnosed type 2 diabetes (51 women), we assessed this (serial) mediation between dietary restraint and change in BMI and intake of energy (Kcal; Food Frequency Questionnaire). In Study 2, a three-year follow up study in a representative Dutch sample (287 women), we assessed this (serial) mediation between dieting and change in BMI. Results: There was consistent support for (serial) mediation: In the pilot study, frequency of dieting and dietary restraint were both indirectly associated with grams of crackers eaten through EE and EX. In study 1, dietary restraint had a significant (95% CI) indirect association with subsequent change in measured BMI and a marginally (90% CI) significant indirect association with intake of energy through EE and EX. In study 2, EE marginally (90% CI) acted as a mediator between frequency of dieting and subsequent self-reported change in BMI. In the subsample of overweight women (n = 146) frequency of dieting was indirectly associated with subsequent self-reported change in BMI through EE and EX. Conclusion: The possibility that female dieters may gain weight through EE and/or subsequent EX should be taken into account when treating women with overweight or obesity.

Original languageEnglish
Article number104493
Pages (from-to)1-12
Number of pages12
Early online date15 Oct 2019
Publication statusPublished - 1 Feb 2020


Funding for Tatjana van Strien was provided by the European Union FP7 MooDFOOD Project ‘Multi-country cOllaborative project on the rOle of Diet, FOod-related behavior, and Obesity in the prevention of Depression’ (grant agreement no. 613598 ). Funding for Hanna Konttinen was provided by the Academy of Finland (grants 314135 and 309157 ).

FundersFunder number
European Union FP7613598
European Union FP7 MooDFOOD Project
Academy of Finland309157, 314135


    • (Serial) mediation
    • Dieting
    • Emotional eating
    • External eating
    • Weight gain
    • Women


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