Patterns of overeating in middle-aged Chinese from Hong Kong

Abstract Background Obesity is one of the most important risk factors for non-communicable diseases worldwide. Overweightness may be attributable to a wide spectrum of overeating behaviours. However, the various types of overeating behaviors are under-studied in Asia, particularly in non-adolescent age groups. This study aims to estimate the prevalence and factors associated with various overeating patterns among middle-aged Chinese adults. Methods A random telephone survey was conducted in 2023 on Hong Kong Chinese adults between 35 and 59 years or age (n = 785). An instrument composed of modified Positive-Negative Emotional Eating (EE) Scale, Night Eating Questionnaire-Chinese (NEQ), Binge Eating Disorder Screener (BED-7), Depression Anxiety and Stress Scales (DASS-21), demographic factors, BMI and number of reported gastrointestinal (GI) conditions was used. Multiple regression analyses were conducted to test the association of demographic factors, BMI, GI conditions as well as dysphoric mood with overeating behaviors. Results Hong Kong Chinese middle-aged adults reported the following past-month prevalence of overeating behaviors: positive EE (26.1%), general overeating (12.4%), negative EE (9.2%), binge eating (6.0%) and night eating behavior (1.8%). Nightshift work, mental stress, being single and younger age were common risk factors for the various overeating patterns among middle-aged men. Anxiety, high/low educational levels and younger age were common risk factors among middle-aged women. Obesity was associated with binge eating and positive EE in men (OR: 1.7-4.0) and associated with negative EE and general overeating (OR:2.3-2.7) in women. Conclusions This study noted that binge eating, night eating, positive/negative EE, and GOB were distinct eating patterns requiring different clinical approaches. The significant association between various overeating behaviors with BMI, indicates that these individuals should be prioritized to receive healthy eating interventions. Key messages • Adult overeating is not a singular behavior but represents an array of different eating patterns with different risk factors. •  Like their Western counterparts, overeating behaviors in Chinese adults are often linked to dysphoric mood, therefore treatment of obesity may require psychological counseling.