Obesity is more strongly associated with inappropriate eating behaviors than with mental health in older adults receiving congregate meals.

This study explored the relationships of inappropriate eating behaviors and mental health with obesity in congregate meal participants in Georgia (N = 120, mean age = 75 years, 75% female, 43% African American). Inappropriate eating behaviors were evaluated with the Three-Factor Eating Questionnaire (18 questions); mental health was assessed with the Depression Anxiety Stress Scale (21 questions); history of depression was assessed with the Behavioral Risk Factor Surveillance Survey; and height and weight were measured to calculate body mass index (BMI) and obesity (52% ≥ 30 kg/m(2)). In bivariate analyses, obesity was associated with cognitive restraint (rho = 0.49, p < 0.0001), uncontrolled eating (rho = 0.22; p < 0.01), emotional eating (rho = 0.32, p < 0.001), and stress (rho = 0.18, p < 0.05), but not with depression or anxiety. In multivariate regression analyses including all six eating behavior and mental health indices, only cognitive restraint and emotional eating were consistently associated with obesity (p < 0.05) when controlled for potential confounders (demographics, food insecurity, and chronic health conditions). Thus, mental health symptoms and inappropriate eating behaviors, particularly cognitive restraint and emotional eating, may be important targets for future research and intervention. Additional research is needed to better understand how cognitive restraint and emotional eating contribute to obesity in this population so that interdisciplinary research and health care teams can appropriately prevent and manage obesity in congregate meal participants.