Men and women with obesity and nonalcoholic fatty liver disease (NAFLD) have significantly higher scores on restrained and emotional eating scales compared with control individuals, according to a study in Human Nutrition & Metabolism.

The findings are based on an evaluation of the features and tendencies of eating behaviors in patients with NAFLD compared with patients without NAFLD.

Researchers conducted a cross-sectional study in 103 patients with NAFLD, who were enrolled from a hospital in Japan from May 2015 to July 2016. Patients were then categorized into an obese NAFLD group (body mass index [BMI] ≥25.0 kg/m2; n=68; 35 women) and a nonobese NAFLD group (BMI <25.0 kg/m2; n=35; 18 women).

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The control individuals had voluntarily received an annual clinical examination in June 2015 and from March to April 2017 (n=74; 51 women).

The study participants were asked to complete an eating behavior questionnaire (EBQ), which included a restrained eating scale, an emotional eating scale, and an external eating scale.

Because significant differences were found in women regarding age, the researchers selected participants aged 50 years and older in each group who showed no statistically significant difference for age.

For men in the NAFLD group, the obese NAFLD group, the nonobese NAFLD group, and the control group, the emotional and external eating scales had significant positive correlations (r=0.515, P <.001; r=0.463, P =.008; r=0.598, P =.014; and r=0.593, P =.004, respectively). For the control group, the restrained eating scale and BMI had a significantly positive correlation (r=0.619, P =.002).

Among women, the emotional and external eating scales had significant positive correlations in the NAFLD group (r=0.535, P <.001), obese NAFLD group (r = 0.518 and P = .004), and control group (r=0.512, P =.004). A significantly positive correlation was observed between the emotional eating scale and BMI in the NAFLD group (r=0.480, P =.001).

Study limitations included use of the self-administered EBQ questionnaire, with the potential for recall bias and response errors. Also, all study participants were Japanese, and the results in women were limited to those aged 50 years and older.

“Overall, these findings suggest that eating behavior in patients with NAFLD might vary based on sex and obesity status; therefore, a suitable treatment approach may involve individualized support for effective diet therapy,” the researchers concluded.

Disclosure: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Sugiyama H, Kobayashi Y, Wada S, et al. An examination of eating behavior in patients with non-alcoholic fatty liver disease: a cross-sectional study in a Japanese population. Human Nutr Metab. Published online April 21, 2022. doi:10.1016/j.hnm.2022.200150

This article originally appeared on Gastroenterology Advisor