Abstract
BackgroundAround 13% of the world’s population suffers from obesity. More than 40% of people with obesity display emotional eating behaviour (eating in response to negative emotions or distress). It is an alternate to more effective coping strategies for negative emotions. Our study explored the opportunities for helping adults with emotional overeating using a virtual coach, aiming to identify preferences for tailored coaching strategies applicable in a personal virtual coach environment. Three different coaching strategies were tested: a validating, a focus-on-change, and a dialectical one – the latter being a synthesis of the first two strategies.MethodsA qualitative study used vignettes reflecting the two most relevant situations for people with emotional eating: 1. experiencing negative emotions, with ensuing food cravings; and 2. after losing control to emotional eating, with ensuing feelings of low self-esteem. Applied design: 2 situations × 3 coaching strategies. Participants: 71 adult women (Mage 44.4/years, range 19–70, SD = 12.86) with high scores on the DEBQ-emotional eating scale (Memo 3.65, range 1.69–4.92, SD = .69) with mean BMI 30.1 (range 18–46, SD = 6.53). They were recruited via dieticians’ practices, were randomly assigned to the conditions and asked how they would face and react to the presented coaching strategies. Data were transcribed and a thematic analysis was conducted.ResultsQualitative results showed that participants valued both the validating coaching strategy and the focus-on-change strategy, but indicated that a combination of validation and focus-on-change provides both mental support and practical advice. Data showed that participants differed in their level of awareness of the role that emotions play in their overeating and the need for emotion-regulation skills.ConclusionThe design of the virtual coach should be based on dialectical coaching strategies as preferred by participants with emotional eating behaviour. It should be tailored to the different stages of awareness of their emotions and individual emotion-regulation skills.
Highlights
IntroductionMore than 40% of people with obesity display emotional eating behaviour (eating in response to negative emotions or distress)
Around 13% of the world’s population suffers from obesity
Plain English summary Emotional eating is eating in response to negative emotions, and is problematic because it may lead to overweight, depression, and low self-image
Summary
More than 40% of people with obesity display emotional eating behaviour (eating in response to negative emotions or distress). Emotional eating Between 40 and 60% of individuals with obesity have a high degree of emotional eating, defined here as a tendency to eat in response to distress or other negative emotions [5,6,7]. If parental responses to these needs are continuously inappropriate – be it neglectful, indiscriminately permissive, or over-controlling – the child may develop poor satiety awareness (deficient sentience of physiological symptoms associated with hunger and satiety), poor emotional awareness (resulting in difficulty identifying and describing emotions, referred to as alexithymia) [20], and difficulty with regulating emotions [21, 22]. A longitudinal study evidenced a significant serial mediation between parenting quality in infancy and emotional eating at 12 years and at 16 years through the two mediators, suppression of emotions and alexithymia [26]
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