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Emotional eating and metabolic dysfunction-associated steatotic liver disease (MASLD): a pre-registered study in a clinical population

Marisol Vazquez, Laura Wilkinson Orcid Logo, Tom Pembroke

Physiology & Behavior, Volume: 305, Start page: 115186

Swansea University Author: Laura Wilkinson Orcid Logo

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DOI (Published version): 10.1016/j.physbeh.2025.115186

Abstract

Metabolic dysfunction-associated steatotic liver disease (MASLD) affects 38 % of adults globally and has been identified as a significant and increasing contributor to global health and economic burdens. Obesity is significantly associated with MASLD. Eating behaviours may represent an underexplored...

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Published in: Physiology & Behavior
ISSN: 0031-9384 1873-507X
Published: Elsevier BV 2026
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URI: https://cronfa.swan.ac.uk/Record/cronfa70989
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spelling 2025-12-19T13:26:02.9287867 v2 70989 2025-11-26 Emotional eating and metabolic dysfunction-associated steatotic liver disease (MASLD): a pre-registered study in a clinical population 07aeb47532af5a8421686d4f22f4a226 0000-0002-8093-0843 Laura Wilkinson Laura Wilkinson true false 2025-11-26 PSYS Metabolic dysfunction-associated steatotic liver disease (MASLD) affects 38 % of adults globally and has been identified as a significant and increasing contributor to global health and economic burdens. Obesity is significantly associated with MASLD. Eating behaviours may represent an underexplored shared risk factor for these adverse physiological outcomes. Here, we tested a novel mediation model and hypothesised that emotional and uncontrolled eating would be positively associated with liver fibrosis (kilopascals; kPa) and steatosis (controlled attenuation parameter; CAP) via body mass index (BMI). 129 UK clinical patients undergoing a fibroscan, completed validated questionnaires on eating behaviours, snack and alcohol consumption. We confirmed an indirect relationship between emotional eating and steatosis mediated by BMI (P = 0.002), but not for liver fibrosis (P = 0.1). A direct relationship between unhealthy snack consumption and steatosis (P = 0.04) was also shown. We failed to show any direct or indirect relationships between uncontrolled eating and either fibrosis or steatosis. In an exploratory analysis, we also used separate logistic regressions to examine whether emotional eating and BMI were predictive of MASLD, alcohol related liver disease (ArLD) and other causes of deranged liver function tests (binary status). MASLD status was significantly positively predicted by both emotional eating (P = 0.003) and BMI (P = 0.024). By contrast, lower emotional eating scores predicted a higher likelihood that someone would have ArLD (P = 0.035) and emotional eating scores were not a significant predictor of other causes of deranged liver function (‘other group’, P = 0.398). Our findings indicate that psychological therapy focusing on emotional eating may represent a fruitful intervention target for MASLD. Journal Article Physiology & Behavior 305 115186 Elsevier BV 0031-9384 1873-507X MASLD; Liver fibrosis; Liver steatosis; Emotional eating; obesity 1 3 2026 2026-03-01 10.1016/j.physbeh.2025.115186 COLLEGE NANME Psychology School COLLEGE CODE PSYS Swansea University SU Library paid the OA fee (TA Institutional Deal) Swansea University 2025-12-19T13:26:02.9287867 2025-11-26T07:49:35.0421131 Faculty of Medicine, Health and Life Sciences School of Psychology Marisol Vazquez 1 Laura Wilkinson 0000-0002-8093-0843 2 Tom Pembroke 3 70989__35872__fd89d0125c3f463b9e15d34a757300eb.pdf 70989.VOR.pdf 2025-12-19T13:23:17.5363836 Output 603498 application/pdf Version of Record true © 2025 The Authors. This is an open access article distributed under the terms of the Creative Commons CC-BY license. true eng http://creativecommons.org/licenses/by/4.0/
title Emotional eating and metabolic dysfunction-associated steatotic liver disease (MASLD): a pre-registered study in a clinical population
spellingShingle Emotional eating and metabolic dysfunction-associated steatotic liver disease (MASLD): a pre-registered study in a clinical population
Laura Wilkinson
title_short Emotional eating and metabolic dysfunction-associated steatotic liver disease (MASLD): a pre-registered study in a clinical population
title_full Emotional eating and metabolic dysfunction-associated steatotic liver disease (MASLD): a pre-registered study in a clinical population
title_fullStr Emotional eating and metabolic dysfunction-associated steatotic liver disease (MASLD): a pre-registered study in a clinical population
title_full_unstemmed Emotional eating and metabolic dysfunction-associated steatotic liver disease (MASLD): a pre-registered study in a clinical population
title_sort Emotional eating and metabolic dysfunction-associated steatotic liver disease (MASLD): a pre-registered study in a clinical population
author_id_str_mv 07aeb47532af5a8421686d4f22f4a226
author_id_fullname_str_mv 07aeb47532af5a8421686d4f22f4a226_***_Laura Wilkinson
author Laura Wilkinson
author2 Marisol Vazquez
Laura Wilkinson
Tom Pembroke
format Journal article
container_title Physiology & Behavior
container_volume 305
container_start_page 115186
publishDate 2026
institution Swansea University
issn 0031-9384
1873-507X
doi_str_mv 10.1016/j.physbeh.2025.115186
publisher Elsevier BV
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Psychology{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Psychology
document_store_str 1
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description Metabolic dysfunction-associated steatotic liver disease (MASLD) affects 38 % of adults globally and has been identified as a significant and increasing contributor to global health and economic burdens. Obesity is significantly associated with MASLD. Eating behaviours may represent an underexplored shared risk factor for these adverse physiological outcomes. Here, we tested a novel mediation model and hypothesised that emotional and uncontrolled eating would be positively associated with liver fibrosis (kilopascals; kPa) and steatosis (controlled attenuation parameter; CAP) via body mass index (BMI). 129 UK clinical patients undergoing a fibroscan, completed validated questionnaires on eating behaviours, snack and alcohol consumption. We confirmed an indirect relationship between emotional eating and steatosis mediated by BMI (P = 0.002), but not for liver fibrosis (P = 0.1). A direct relationship between unhealthy snack consumption and steatosis (P = 0.04) was also shown. We failed to show any direct or indirect relationships between uncontrolled eating and either fibrosis or steatosis. In an exploratory analysis, we also used separate logistic regressions to examine whether emotional eating and BMI were predictive of MASLD, alcohol related liver disease (ArLD) and other causes of deranged liver function tests (binary status). MASLD status was significantly positively predicted by both emotional eating (P = 0.003) and BMI (P = 0.024). By contrast, lower emotional eating scores predicted a higher likelihood that someone would have ArLD (P = 0.035) and emotional eating scores were not a significant predictor of other causes of deranged liver function (‘other group’, P = 0.398). Our findings indicate that psychological therapy focusing on emotional eating may represent a fruitful intervention target for MASLD.
published_date 2026-03-01T05:34:17Z
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