Higher depressive symptoms are associated with lower eating competence among patients with moderate to severe...

Depression is associated with disrupted eating behavior and low diet quality, whereas high eating competence is associated with good health-related and psychological outcomes. Previous research has not examined eating competence in patients with depressive disorder, and most research on eating behavior concerns general populations.

This study aimed to examine whether eating behavior, eating competence, diet quality, and body mass index are associated with the severity of depressive symptoms among patients with depressive disorder. Subjects (n = 93) were adults who participated in the Food for Mind nutrition intervention study, whose baseline data were used. We assessed the outcomes with the Center for Epidemiological Studies Depression Scale (CES-D), Satter Eating Competence Model (ecSI 2.0™), Three-Factor Eating Behavior Questionnaire - 18 (TFEQ-18), and Index of Diet Quality (IDQ).

The scores of eating competence (20.8, p < 0.001) and three subscales - Eating Attitude (8.9, p = 0.012), Contextual Skills (5.2, p < 0.001), and Internal Regulation (2.9, p = 0.009) - werethe lowest among those in the highest depressive symptoms tertile. No tertile differences were reported for food acceptance, diet quality, body mass index, emotional eating, uncontrolled eating, or cognitive restraint. Emotional eating and uncontrolled eating were higher among patients with overweight than normal weight.

Eating competence is a novel indicator to consider in patients with depression and eating difficulties. Our findings on emotional eating, uncontrolled eating, and cognitive restraint differ from previous studies. More research is needed to explore the complex associations between depression, diet, and eating behavior.