Mood symptoms and disordered eating behaviors are common in adolescents with overweight and obesity. This study aimed to investigate the relationships between mood symptoms, difficulties in emotion regulation, and emotional eating behaviors in adolescents with overweight and obesity.

In this cross-sectional study, adolescents with normal weight (N = 45), overweight (N = 45), or obesity (N = 55) were assessed using semi-structured clinical interviews and self-report scales. Path analysis was used to examine factors contributing to emotional eating behaviors, considering psychiatric comorbidities, mood symptoms, emotional/binge/restrictive eating behaviors, difficulties in emotion regulation, and self-esteem.

Adolescents with overweight and obesity exhibited more depressive, anxiety, and anger symptoms; restrictive, emotional, and external eating behaviors; and psychopathologies such as mood disorders, anxiety disorders, and attention-deficit/hyperactivity disorder (ADHD) compared with normal-weight adolescents. ADHD diagnosis, difficulties in emotion regulation, hypomanic/manic symptoms, and anger symptoms directly predicted emotional eating behavior, while self-esteem was an indirect predictor.

Adolescents with overweight and obesity tend to exhibit similar psychological characteristics, including increased mood symptoms and maladaptive eating behaviors associated with higher rates of anxiety and mood disorders, compared with their normal-weight peers. The most significant predictors of emotional eating behaviors were ADHD and difficulties in emotion regulation. Given the frequency of psychological comorbidities in obesity, their detection and management should be encouraged.