Application of three different coaching strategies for people with emotional eating 77 4 Plain English summary Emotional eating is eating in response to negative emotions, and is problematic because it may lead to overweight, depression, and low self-image. People with emotional eating have difficulty regulating these emotions and are in need of mental healthcare but may feel too ashamed to seek help. Moreover, healthcare is not always available at the exact moment of the greatest coaching needs. Our goal in this research project is to develop a virtual coach application that is available 24/7. This study examined what kind of automated coaching adults with emotional eating would prefer, and what they would consider as helpful to avoid emotional eating behaviour. Participants were asked questions to reveal their opinion about real-life situations, commented on by a virtual coach. They valued validation of their emotions, but believed a focus on behavioural change to be just as important. Participants displayed differences in emotional awareness of the association between overeating and regulation of emotions. These findings are of importance toward developing an adaptive personalized virtual coach that helps users in their struggle against emotional eating. Background The fast growth of obesity is a threat to public health and around 13% of the entire world population suffers from obesity [1]. People with obesity often have physical, metabolic, and psychological comorbidities such as cardiovascular conditions, type-II diabetes, joint disorders, sleep apnea, and depression [2], and experience a lower quality of life [3-4]. Emotional eating Between 40 and 60% of individuals with obesity have a high degree of emotional eating, defined here as a tendency to eat in response to distress or other negative emotions [5-7]. Emotional eating is associated with cravings for and intake of energy-dense food, and thus additional calories [8–11], binge eating [12], weight gain and, ultimately, obesity [13-14]. Emotional eating is an atypical response to distress because the typical and adaptive response to negative mood such as feelings of depression is loss of appetite. Distress is normally associated with physiological responses that mimic the internal sensations associated with feeding-induced satiety, e.g. inhibition of gastric motility and release of sugar into the bloodstream [15]. It has been postulated that the atypical response of emotional eating develops early in life [16], as a possible outcome of parenting practices that inadequately met the child’s needs [17-19]. If parental responses to these needs are continuously inappropriate – be it neglectful, indiscriminately permissive, or overcontrolling – the child may develop poor satiety awareness (deficient sentience
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