Emotional Eating Interventions for Adults Living With Overweight and Obesity: A Systematic Review and Meta‐Analysis of Behaviour Change Techniques

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Abstract
Background: Emotional eating (EE) is a barrier to the long‐term success of weight loss interventions. Psychological interventions targeting EE have been shown to reduce EE scores and weight (kg), though the mechanisms remain unclear. This review and meta‐analysis aimed to identify the specific behaviour change techniques (BCTs) associated with improved outcomes.Methods: This is a review update and extension, with new studies extracted from searches of CINAHL, PsycINFO, MEDLINE and EMBASE 1 January 2022 to 31 April 2023. EE interventions for adults with BMI > 25 kg/m2 were considered for inclusion. Paper screening, extraction, BCT‐coding and risk of bias were completed using the Template for Intervention Description and Replication (TIDieR) checklist, Behaviour Change Taxonomy v1 (BCTTv1) and Risk of Bias2 (RoB2)/Risk of Bias In Non‐randomised Studies (ROBINS‐I) tool. Narrative syntheses and random effects multi‐level meta‐analyses were conducted.Results: In total, 6729 participants were included across 47 studies (13 identified in the update). Forty‐two studies contributed to the pooled estimate for the impact of interventions on EE (SMD = −0.99 [95% CI: −0.73 to −1.25], p < 0.001). Thirty‐two studies contributed to the pooled estimate for the impact of interventions on weight (−4.09 kg [95% CI: −2.76 to −5.43 kg], p < 0.001). Five BCTs related to identity, values and self‐regulation were associated with notable improvements to both weight and EE (‘incompatible beliefs’, ‘goal setting outcome’. ‘review outcome goals’, ‘feedback on behaviour’ and ‘pros/cons’).Conclusion: Implementation and evaluation of the highlighted BCTs are required. Weight management services should consider screening patients for EE to tailor interventions to individual needs.

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