Uncontrolled Eating Through the Lens of Mentalization and Emotional Eating: The Moderating Role of Food Addiction

Background. The literature suggests that deficits in mentalization, operationalized as reflective functioning, are associated with emotional and behavioral dysregulation, including emotional eating and uncontrolled eating. These eating behaviors may be intensified by food addiction, yet its moderating role within this framework has not been thoroughly investigated. This study examined whether the relationship between deficits in reflective functioning and uncontrolled eating is mediated by emotional eating, and whether food addiction diagnosis moderates this pathway. Methods. A cross-sectional survey was administered to 559 adults from the general population. Participants completed self-report measures assessing reflective functioning (RFQ-8), emotional and uncontrolled eating (TFEQ-R-18), and food addiction (YFAS 2.0). A moderated mediation model was tested using conditional process analysis with 10,000 bootstrap resamples. Results. Deficits in reflective functioning were positively associated with emotional eating (β = 0.155, p < 0.001), which in turn were associated with uncontrolled eating (β = 1.314, p < 0.001). Food addiction diagnosis significantly moderated the relationship between emotional eating and uncontrolled eating (β = 0.744, p < 0.001). Specifically, individuals with food addiction exhibited a stronger association between emotional eating and uncontrolled eating compared to those without food addiction. The indirect effect from reflective functioning to uncontrolled eating via emotional eating was significantly stronger among individuals with food addiction than those without. The overall model explained 57.3% of the variance in uncontrolled eating. Conclusions. Food addiction diagnosis amplifies the pathway from emotional eating to uncontrolled eating, originating from deficits in reflective functioning. These findings highlight the clinical importance of targeting mentalization processes and emotional eating in interventions for disordered eating behaviors, particularly among individuals with food addiction.