Abstract

Background/Objectives: Emotional eating (EE) is an emerging public health concern among university students, a population exposed to heightened academic demands, psychosocial stressors, and lifestyle changes that may promote maladaptive coping behaviors. EE has been linked to psychological distress, particularly depressive and anxiety symptoms, as well as sociodemographic, lifestyle, and anthropometric factors; however, findings remain heterogeneous and insufficiently integrated within comprehensive analytical frameworks. This study aimed to examine the association between EE and depressive and anxiety symptoms in university students, while assessing the independent contributions of sociodemographic, academic, lifestyle, and anthropometric determinants. Methods: A cross-sectional survey was performed among 1279 university students from 10 regions in Greece. Sociodemographic, academic, lifestyle, and anthropometric data were collected using validated instruments and standardized procedures. Depressive and anxiety symptoms were assessed by the use of the Beck Depression Inventory-II (BDI-II) and the six-item State-Trait Anxiety Inventory (STAI-6), respectively. EE was evaluated utilizing the EE subscale of the Three-Factor Eating Questionnaire–Revised 18 (TFEQ-R18). Multivariable ordinal logistic regression models were applied to examine independent associations. Results: In fully adjusted models, depressive and anxiety symptoms were the strongest correlates of higher EE levels, each associated with more than twofold increased odds. Female sex, Greek nationality, rural residence, enrollment in biomedical sciences, later academic years, and regular smoking were also positively associated with EE. Higher physical activity was inversely associated with EE levels. Overweight, obesity, and increased waist circumference and waist-to-hip ratio were consistently linked to higher EE, with several associations exceeding twofold increased odds. Conclusions: EE in university students is strongly associated with psychological distress and clusters with adverse lifestyle and anthropometric characteristics. These findings support the need for integrated interventions targeting mental health, lifestyle behaviors, and obesity-related risk factors. Longitudinal studies are warranted to clarify causal pathways and underlying mechanisms.

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