Eating-related behaviours among adolescents are significantly associated with body composition, with variations depending on the specific domain and sex, suggests a study.
“Positive associations were found for subscales like emotional eating, weight concerns, dietary restraint, healthy nutrition, weight gain fear, and figure dissatisfaction, while negative associations were observed for food cue responsiveness, well-being nutrition, and parental pressure,” the researchers said.
“Associations were stronger in males, and notable sex differences in responses may reflect contextual and perceptual factors, highlighting the need to critically evaluate how such measures are designed and interpreted,” they added.
The research team recruited adolescents aged 12.5‒17.5 years from 10 European cities, with valid data on age, sex, sociodemographic status, body composition, and physical activity and who had completed the specific eating behaviour questionnaire “Eating Behaviour and Weight Problems Inventory for Children.” They used adjusted linear regression models for relevant confounders and ANCOVA models.
Eating behaviours related to weight concerns, dietary restraint, emotion eating, fear of weight gain, healthy nutrition, and figure dissatisfaction strongly correlated with higher BMI, fat mass index (FMI), and waist circumference (WC), particularly in males (beta ranges were 0.174‒0.974 for BMI, 0.172‒0.930 for FMI, and 0.128‒0.889 for WC). [Eur J Clin Nutr 2026;80:414-426]
Notably, the strongest association was observed in weight concerns subscale for both males and females.
“These findings are critical for identifying specific behavioural patterns that contribute to obesity and related health issues, providing new insights for more targeted prevention strategies during this crucial stage of development,” the researchers said.
Body image
The results are also consistent with earlier studies showing the significant association of BMI with restrictive eating, body dissatisfaction, and worry about gaining weight. Adolescents who are concerned about weight or body image tend to eat less. [Nutr Hospitalaria 2018;35:1115-1123; J Health Popul Nutr 2021;40:54; Eat Weight Disord EWD 2020;25:1197-1203; Pediatric Obes 2025;20:e70044]
“Although some literature distinguishes between flexible and rigid cognitive control of eating behaviour—each potentially associated with either positive or detrimental effects—it remains uncertain whether these distinctions apply directly to dietary restraint or have consistent implications for body composition,” the researchers said. [Health Psychol Rep 2017;5:314-322]
Causality
The relationship of eating-related psychological and attitudinal constructs with body composition is either bidirectional or unidirectional, which blurs the direction of causality. Moreover, other factors that have not been considered in the current study may influence this association. [Int J Environ Res Public Health 2024;21:1187]
“In some subscales, apparent inconsistences may arise, such as higher fear of weight gain correlating with greater body fat,” the researchers said. “This could reflect either a fear of gaining additional weight or that such fear has contributed to a problematic relationship with food, leading to excess weight.” [Children 2024;11:925]
A previous study also found that individuals with higher body fat are more likely to develop eating disorders, which could potentially explain the above results. [Pediatr Obes 2014;9:1-9]
“Finally, individuals with overweight or obesity may feel uncomfortable endorsing attitudes perceived as pro-eating when responding to questionnaires, which could also influence the results,” the researchers said.