Emotional eating in relation to gastrointestinal symptoms and burnout among young women during the pandemic

Main Article Content

Emre Keles
Nur Pinar Ayaz


The emergence of the coronavirus disease (COVID-19), created unique constraints in everyday life. Emotional eating is a known phenomenon in disasters and is markedly associated with gastrointestinal symptoms. In this study, the aim was to assess the relationship of gastrointestinal symptom severity and COVID-19 burnout with emotional eating among young women during the pandemic disaster.

A cross-sectional study approach was used to allow 462 young women participants in this study. The design of the questionnaires was based on demographics, health behaviors, Gastrointestinal Symptom Severity Scale, Emotional Eating Scale and COVID-19 Burnout Scale. Data were analyzed using percentages, mean values, independent t-test, chi-squared test. The hierarchical multiple regression analysis was performed for predicting risk factors of emotional eating. Significance levels were set at the 5% level.

Of the women, 73.8% were emotional eaters. The level of COVID-19 burnout was moderate with mean score of 29.4±11.1 and emotional eating total score was 21.0±8.1. Increased number of meals, increased weight gain and shorter sleep time were significantly associated with emotional eating (p<0.05). Participants with more than three meals per day were more likely to be emotional eaters (Beta=4.26). The regression model showed that indigestion and COVID-19 burnout were strong risk factors of emotinal eating (p<0.05).

This study demonstrated that indigestion and COVID-19 burnout were strong risk factors of emotinal eating. Emotional eating could pose an additional health burden to young women in the form of poor food choices.

Article Details

How to Cite
YILMAZEL, G., Keles, E., & Ayaz, N. P. (2023). Emotional eating in relation to gastrointestinal symptoms and burnout among young women during the pandemic. Universa Medicina, 42(1), 21–28. https://doi.org/10.18051/UnivMed.2023.v42.21-28
Original Articles


Nolan LJ, Geliebter A. Night eating is associated with emotional and external eating in college students. Eat Behav 2012;13:202–6. doi: 10.1016/j.eatbeh.2012.02.002.

van Strien T, Konttinen H, Homberg JR, Engels RC, Winkens LH. Emotional eating as a mediator between depression and weight gain. Appetite 2016;100:216–24. doi: 10.1016/j.appet.2016.02.034.

Barnhart WR, Braden AL, Jordan AK. Negative and positive emotional eating uniquely interact with ease of activation, intensity, and duration of emotional reactivity to predict increased binge eating. Appetite 2020;151:104688. doi: 10.1016/j.appet.2020.104688.

Sultson H, Kukk K, Akkermann K. Positive and negative emotional eating have different associations with overeating and binge eating: construction and validation of the positive-negative emotional eating scale. Appetite 2017;116:423–30. doi: 10.1016/j.appet.2017.05.035.

Kuijer RG, Boyce JA. Emotional eating and its effect on eating behaviour after a natural disaster. Appetite 2012;58:936–9. doi: 10.1016/j.appet.2012. 02.046.

World Health Organization. WHO Director General’s opening remarks at the media briefing on COVID 19. Geneva: World Health Organization; 2020.

Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet 2020;395:912–20. doi: 10.1016/S0140-6736(20)30460-8.

Lima CKT, Carvalho PMM, Lima IAAS, et al. The emotional impact of Coronavirus 2019-nCoV (new Coronavirus disease). Psychiatr Res 2020; 287:112915. doi: 10.1016/j.psychres.2020.112915.

Abbas AM, Kamel MM. Dietary habits in adults during quarantine in the context of COVID-19 pandemic. Obes Med 2020;19:100254. doi: 10.1016/j.obmed.2020.

Di Renzo L, Gualtieri P, Pivari F, et al. Eating habits and lifestyle changes during COVID-19 lockdown: An Italian survey. J Transl Med 2020;18:229. doi: 10.1186/s12967-020-02399-5.

Sidor A, Rzymski P. Dietary choices and habits during COVID-19 lockdown: experience from Poland. Nutrients 2020;12:1657. doi: 10.3390/nu12061657.

Ammar A, Brach M, Trabelsi K, et al. Effects of COVID-19 home confinement on eating behaviour and physical activity: results of the ECLB-COVID19 International online survey. Nutrients 2020; 12:1583. doi: 10.3390/nu12061583.

Camilleri GM, Méjean C, Kesse-Guyot E, et al. The associations between emotional eating and consumption of energy-dense snack foods are modified by sex and depressive symptomatology. J Nutr 2014;144:1264-73. doi: 10.3945/jn.114.193177.

Liu H, Yang Q, Luo J, et al. Association between emotional eating, depressive symptoms and laryngopharyngeal reflux symptoms in college students: A cross-sectional study in Hunan. Nutrients 2020;12:1595. doi: 10.3390/nu12061595.

Tait C, Sayuk GS. The brain-gut-microbiotal axis: a framework for understanding functional GI illness and their therapeutic interventions. Eur J Intern Med 2021;84:1-9. doi: 10.1016/j.ejim.2020. 12.02.

Fung C, Vanden Berghe P. Functional circuits and signal processing in the enteric nervous system. Cell Mol Life Sci 2020;77:4505-22. doi: 10.1007/s00018-020-03543-6.

Arslan G, Yyldyrym M, Tanhan A, Buluþ M, Allen KA. Coronavirus stress, optimism-pessimism, psychological inflexibility, and psychological health: psychometric properties of the Coronavirus Stress Measure. Int J Ment Health Addict 2021;19:2423-39. doi: 10.1007/s11469-020-00337-6.

Talaee N, Varahram M, Jamaati H, et al. Stress and burnout in health care workers during COVID-19 pandemic: validation of a questionnaire. J Public Health (Heidelberg) 2022;30:531-6. doi: 10.1007/s10389-020-01313-z.

Huerta-Franco MR, Vargas-Luna M, Montes-Frausto JB, Morales-Mata I, Ramirez-Padilla L. Effect of psychological stress on gastric motility assessed by electrical bio-impedance. World J Gastroenterol 2012;18:5027-33. doi: 10.3748/wjg.v18.i36.5027.

Abenavoli L, Cinaglia P, Lombardo G, et al. Anxiety and gastrointestinal symptoms related to COVID-19 during Italian lockdown. J Clin Med 2021;10:1221. doi:10.3390/jcm10061221.

Nilsson D, Ohlsson B. Gastrointestinal symptoms and ýrritable bowel syndrome are associated with female sex and smoking in the general population and with unemployment in men. Front Med (Lausanne) 2021;8:646658. doi: 10.3389/fmed.2021.646658.

Lazarevich I, Irigoyen Camacho ME, Velázquez-Alva MDC, Zepeda ZM. Relationship among obesity, depression, and emotional eating in young adults. Appetite 2016;107:639-44. doi: 10.1016/j.appet.2016.09.011.

Bemanian M, Mæland S, Blomhoff R, et al. Emotional eating in relation to worries and psychological distress amid the COVID-19 pandemic: a population-based survey on adults in Norway. Int J Environ Res Public Health 2020;18:130. doi: 10.3390/ijerph18010130.

Al-Musharaf S. Prevalence and predictors of emotional eating among healthy young Saudi women during the COVID-19 Pandemic. Nutrients 2020;12:2923. doi: 10.3390/nu12102923.

Canadian Centre for Occupational Health and Safety (CCOHS). Coronavirus (COVID-19) – tips: COVID-19 burnout. Canadian Centre for Occupational Health and Safety (CCOHS);2021.

Di Renzo L, Gualtieri P, Cinelli G, et al. Psychological aspects and eating habits during COVID-19 home confinement: results of EHLC-COVID-19 Italian online survey. Nutrients 2020;12:2152. doi: 10.3390/nu12072152.

Zhang J, Zhang Y, Huo S, et al. Emotional eating in pregnant women during the COVID-19 pandemic and ýts association with dietary intake and gestational weight gain. Nutrients 2020;12: 2250. doi:10.3390/nu12082250.

Micali N, Martini MG, Thomas JJ, et al. Lifetime and 12-month prevalence of eating disorders amongst women in mid-life: a population-based study of diagnoses and risk factors. BMC Med 2017;15:12. https://doi.org/10.1186/s12916-016-0766-4.

T.C. Saðlýk Bakanlýðý. Türkiye Beslenme ve Saðlýk Araþtýrmasý (TBSA),2019. [Ministry of Health, Republic of Turkey. Turkey Nutrition and Health Survey 2019]. Turkish.

American Academy of Sleep Medicine. CDC publishes new estimates of U.S. adult sleep duration. Datien,IL : American Academy of Sleep Medicine;2014.

Turan N, Aþti TA, Kaya N. Reliability and validity of the Turkish version of the gastrointestinal symptom rating scale. Gastroenterol Nurs 2017;40:47-55. doi: 10.1097/SGA.0000000000000177.

Garaulet M, Canteras M, Morales E, López-Guimera G, Sánchez-Carracedo D, Corbalán-Tutau MD. Validation of a questionnaire on emotional eating for use in cases of obesity: the Emotional Eater Questionnaire (EEQ). Nutr Hosp 2012;27:645–51.doi:10.1590/S0212-16112012000200043.

Arslantas H, Dereboy F, Yüksel R, Inalkaç S. Validity and reliability of the Turkish version of the Emotional Eater Questionnaire (EEQ-TR). Turkish Psychiatr J 2020;31:122-30.

Yýldýrým M, Solmaz F. COVID-19 burnout, COVID-19 stress and resilience: initial psychometric properties of COVID-19 burnout scale. Death Stud 2020;11;1-9. doi: 10.1080/07481187.2020.1818885.

Lovell RM, Ford A. Global prevalence of and risk factors for irritable bowel syndrome: a meta-analysis. Clin Gastroenterol Hepatol 2012;10:712-721.e4. doi: 10.1016/j.cgh.2012.02.029.

Leo CG, Sabina S, Tumolo MR, et al. Burnout among healthcare workers in the COVID 19 era: a review of the existing literature. Front Public Health 2021;9:750529. doi:10.3389/fpubh.2021.750529.

Gualano MR, Sinigaglia T, Lo Moro G, et al. The burden of burnout among healthcare professionals of ýntensive care units and emergency departments during the COVID-19 pandemic: a systematic review. Int J Environ Res Public Health 2021;18:8172. doi:10.3390/ijerph18158172.

Reichenberger J, Schnepper R, Arend AK, Blechert J. Emotional eating in healthy individuals and patients with an eating disorder: evidence from psychometric, experimental and naturalistic studies. Proc Nutr Soc 2020;79:290-9. doi:10.1017/S0029665120007004.

Scarmozzino F, Visioli F. Covid-19 and the subsequent lockdown modified dietary habits of almost half the population in an Italian sample. Foods 2020; 9:1–8. doi: 10.3390/foods9050675

Liboredo JC, Anastácio LR, Ferreira LG, Oliveira LA, Della Lucia CM. Quarantine during COVID-19 outbreak: eating behavior, perceived stress, and their independently associated factors in a Brazilian sample. Front Nutr 2021;8:704619. doi: 10.3389/fnut.2021.704619.

Freedman DS, Kompaniyets L, Daymont C, Zhao L, Blanck HM. Weight gain among US adults during the COVID-19 pandemic through May 2021. Obesity (Silver Spring, Md.) 2022; 30: 2064–70. https://doi.org/10.1002/oby.23511.

Beccuti G, Pannain S. Sleep and obesity. Curr Opin Clin Nutr Metab Care 2011;14:402-12. doi:10.1097/MCO.0b013e3283479109.

Dweck JS, Jenkins SM, Nolan LJ. The role of emotional eating and stress in the influence of short sleep on food consumption. Appetite 2014;72:106–13. doi:10.1016/j.appet.2013.10.001.

Reichenberger J, Schnepper R, Arend AK, et al. Emotional eating across different eating disorders and the role of body mass, restriction, and binge eating. Int J Eat Disord 2021;54:773–84. doi:10.1002/eat.23477.

Oliver KL, Davies GJ, Dettmar PW. Diet and lifestyle triggers for gastro-oesophageal reflux disease: symptom identification. Proc Nutr Soc 2010;69:E108. doi: 10.1017/S0029665109992965.

Mizuta A, Adachi K, Furuta K, et al. Different sex-related influences of eating habits on the prevalence of reflux esophagitis in Japanese. J Gastroen Hepatol 2011;26:1060–4. doi: 10.1111/j.1440.

Chui H, Bryant E, Sarabia C, Maskeen S, Stewart-Knox B. Burnout, eating behaviour traits and dietary patterns. British Food J 2020;122:404-13. doi: 10.1108/BFJ-04-2019-0300.

Nevanperä NJ, Hopsu L, Kuosma E, Ukkola O, Uitti J, Laitinen JH. Occupational burnout, eating behavior, and weight among working women. Am J Clin Nutr 2012;95:934-43. doi: 10.3945/ajcn.111.014191.