Hrev_master Healthcare in Low-resource Settings 2025; volume 13(s2):13121 Determinant factors that influence emotional eating behavior in Generation Z Omi Haryati, Laelatun Nurul Hidayah, Nurhalimah Nurhalimah, Yuli Mulyanti, Indriana Rakhmawati Health Polytechnic Ministry of Health Jakarta III, Indonesia Abstract Generation Z faces increasing mental health challenges, often leading to maladaptive coping strategies, such as emotional eating and using food to manage negative emotions. This behavior con- tributes to poor dietary patterns and a higher risk of noncommuni- cable diseases. Despite rising concerns, the psychological deter- minants of emotional eating among Indonesian youth remain underexplored. This study aimed to examine psychological factors associated with emotional eating in Generation Z. A cross-section- al quantitative study was conducted among 110 Generation Z indi- viduals aged 12–27 years who exhibited a tendency toward emo- tional eating. The participants were selected using purposive sam- pling. Three instruments were used for data collection: a demo- graphic questionnaire, psychological factors questionnaire, and Emotional Eater Questionnaire. Data was analyzed using chi- square tests for bivariate associations and binary logistic regres- sion for multivariate analysis, to identify the most influential psy- chological predictors of emotional eating. Anger, boredom, anxi- ety, stress, and depression were significantly associated with emo- tional eating (p<0.05). Stress and boredom are the most influential predictors. Stress and boredom are the key psychological drivers of emotional eating in Generation Z. This maladaptive behavior increases the risk of disordered eating and non-communicable dis- eases. Interventions that enhance emotional regulation and stress management are crucial to mitigate these risks. Introduction Emotional eating has emerged as a growing behavioral con- cern among Generation Z – individuals born during a time of rapid technological advancement – who are often described as intelli- gent, creative, or explorative.1 This behavior, defined as consum- ing food in response to negative emotions, such as sadness, anxi- ety, or stress, serves as a coping mechanism to relieve psycholog- ical discomfort.2 Physiologically, stress triggers the release of Corticotropin-Releasing Hormone (CRH), which can suppress appetite. However, under prolonged stress, the body produces cor- tisol, a hormone that increases appetite and cravings for high-calo- rie foods.3 This biological response often leads to emotional eating and changes in eating behavior, as individuals seek comfort through food. Emotional eating in adolescents is closely tied to broader mental health challenges and serves as a coping mecha- nism for emotional distress such as anxiety, depression, boredom, and despair.4 According to the National Adolescent Mental Health Survey (2022), one in three Indonesian adolescents (34.9%), or about 15.5 million, reported experiencing mental health issues in the past year, while one in 20 (5.5%), or approximately 2.45 mil- lion, was diagnosed with a mental disorder, with anxiety being the most prevalent.5 As a form of psychological self-defense, many adolescents turn to food to manage their emotions, a behavior that may provide temporary relief but has detrimental long-term con- sequences, including disrupted eating patterns, weight gain, and a deepening cycle of emotional and psychological strain.6-9 Emotional eating is strongly linked to increased risks of binge eat- ing, eating without hunger, and higher BMI, which increases the likelihood of obesity over time.10-12 It is also associated with poor dietary habits, such as a high intake of added sugars and fats, con- tributing to physical health issues such as high cholesterol, hyper- tension, cardiovascular disease, diabetes, and eating disorders such as bulimia nervosa and binge-eating disorder.13 Moreover, Correspondence: Omi Haryati, Health Polytechnic Ministry of Health Jakarta III, Indonesia E-mail: omiharyati2@gmail.com Key word: emotional eating, Generation Z, psychological factors. Contributions: OH Conceptualization, data curation, formal analysis, methodology, validation, writing original draft, review and editing, resources; LNH Conceptualization, methodology, validation and writing original draft, references, review and editing; NH Conceptualization, for- mal analysis, review and editing; IR formal analysis, validation, method- ology, validation, writing original draft, references, review and editing. Conflict of interest: the authors declare no conflicts of interest. Ethical approval and consent to participate: the study received ethical approval from the Ministry of Health Polytechnics Jakarta III (registered number L. B. 02.02/F. XIX.21/4818/2024). During the research, the researcher pays attention to the ethical principles of information to con- sent, respect for human rights, beneficence and non-maleficence. Patient consent for publication: written informed consent was obtained from anonymized patients for publication in this article. Funding: this study did not receive external funding. Availability of data and materials: all data generated or analyzed in this study are included in this published article. Acknowledgements: the author gratefully acknowledges the support and permission provided by the local authorities in one of the administrative areas in Bekasi City, which enabled this research. Appreciation was also extended to all participants who contributed valuable insights to this study. Received: 20 September 2024. Accepted: 29 April 2025. Early view: 22 August 2025. This work is licensed under a Creative Commons Attribution 4.0 License (by-nc 4.0). ©Copyright: the Author(s), 2025 Licensee PAGEPress, Italy Healthcare in Low-resource Settings 2025; 12(s2):13121 doi:10.4081/hls.2025.13121 Publisher's note: all claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organi- zations, or those of the publisher, the editors and the reviewers. Any prod- uct that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher. [page 80] [Healthcare in Low-resource Settings 2025;13(s2):13121] depression is a significant contributor to emotional eating, as sup- ported by studies by Rezatiara and Fayasari, which demonstrate a strong correlation between depressive symptoms and emotional eating behavior.14 Persistent emotional eating not only increases the risk of chronic diseases but may also evolve into severely dis- ordered eating behaviors, including bulimia and anorexia nervosa, potentially leading to malnutrition if left unmanaged.15 The Indonesian government and researchers have recognized the growing challenges of unhealthy eating behaviors among the youth. Efforts have been made to promote nutritional education and healthy eating campaigns, particularly in schools, and public health initiatives. However, research indicates that these interven- tions often focus on general healthy eating and nutrition, with less emphasis on the psychological determinants of eating behavior, such as emotional eating.16,17 Studies have identified key factors influencing unhealthy eating in Gen Z individuals, including socioeconomic status, cultural influences, peer pressure, taste pref- erences, food accessibility, and a lack of nutritional awareness or education.16,17 Some research has also examined menu anxiety and its impact on food choices and nutritional status among Gen Z in urban areas.18 Most existing studies have focused on broader unhealthy eating behaviors or attitudes toward local cuisine, with- out directly addressing the psychological and emotional triggers unique to this demographic and region. In addition, amid the ongo- ing mental health crisis affecting Generation Z, which may indi- rectly influence their behaviors and coping mechanisms, individu- als in this cohort often experience transitional challenges including difficulties in adaptation, disordered eating, and emotional eating. Therefore, this study aimed to explore the psychological factors that may influence emotional eating behavior among Generation Z. Materials and Methods Research design This quantitative study employed a cross-sectional design to examine the influence of psychological factors, including anger, boredom, despair, anxiety, stress, and depression, on emotional eating behavior among Generation Z people in Bekasi City. Study participants This study employed a non-probability sampling technique using purposive sampling as specific inclusion criteria were applied, making not all individuals eligible to become research participants. In total, 110 respondents were included in this study. The sample size was calculated using the Lemeshow formula, which is appropriate for large, relatively unstable populations. The inclusion criteria were individuals belonging to Generation Z (aged 12–27 years) who exhibited signs of emotional eating. These signs include a sudden onset of hunger, eating in response to psy- chological discomfort or pressure, using food as a coping mecha- nism for emotional distress, and frequent eating without experienc- ing genuine physical hunger. Data collection and instrument Data was collected using a structured questionnaire completed directly by the respondents, either through in-person distribution or Google Forms. The research instrument underwent prior testing for validity and reliability, and was confirmed to be both valid and reliable. Three standardized questionnaires were used as measure- ment tools to assess the research variables. Demographic Data Questionnaire This questionnaire collected basic demographic information, including age, gender, and place of residence Psychological Factors Questionnaire This instrument was designed to assess six psychological fac- tors associated with emotional eating behavior: anger, boredom, despair, anxiety, stress, and depression. Each factor was measured using seven items, totaling 42 randomly distributed items. Responses were rated on a 4-point Likert scale ranging from 0 to 3, with the following interpretation: 0 = never, 1 = sometimes (1– 2 times per week), 2 = often (3–4 times per week), and 3 = always (>4 times per week). Emotional Eating Questionnaire This instrument was adapted from the Emotional Eater Questionnaire, developed by Garaulet et al. (2012). The question- naire was modified to suit the local language and context, includ- ing revisions to eliminate ambiguous wording. It consists of 10 items assessing reduced control of overeating behavior, the types of food consumed, and feelings of guilt associated with emotional eating. Responses were measured on a 4-point Likert scale ranging from 0 (never) to 3 (always), following the same frequency inter- vals as the psychological factor questionnaire. Data analysis Univariate analysis was conducted using descriptive statistics to summarize the characteristics of each variable. Bivariate analy- sis was performed to examine the relationships between respon- dent characteristics (age, gender, and place of residence) and the dependent variable emotional eating. Additionally, the relation- ships between independent psychological factors—anger, bore- dom, despair, anxiety, stress, depression, and emotional eating– were assessed. The Chi-square test was employed for bivariate analysis as the data were not normally distributed, necessitating the use of non-parametric methods. Multivariate analysis was con- ducted to explore the findings of the bivariate analysis at greater depths and to identify the psychological factors that most signifi- cantly influenced emotional eating behavior. Given that both inde- pendent and dependent variables were categorical, binary logistic regression was used as the appropriate multivariate method. All statistical analyses were performed using IBM SPSS Statistics ver- sion 29. A p-value of <0.05 was considered statistically significant Research ethics Ethical approval for this study was obtained from the Ethics Committee of the Ministry of Health Polytechnic Jakarta III (reg- istration number: L. B. 02.02/F.). XIX.21/4818/2024). Throughout the research process, the principles of research ethics were strictly followed, including informed consent, respect for human rights, beneficence, and non-maleficence. Results Distribution frequency demography data As shown in Table 1, the majority of respondents were adults, accounting for 95 individuals (86.4%), while 15 respondents (13.6%) were adolescents. In terms of gender, 85 respondents (77.3%) were female, and 25 respondents (22.7%) were male. Regarding living arrangements, 59 respondents (53.6%) reported living with their families, whereas 51 (46.4%) did not. These find- Pathways of Change, Part II [Healthcare in Low-resource Settings 2025;13(s2):13121] [page 81] ings indicate that the majority of Generation Z individuals in one of the areas of Bekasi City who exhibit a tendency toward emotional eating behavior are adults, predominantly female, and most com- monly live with their families. Table 2 presents the relationship between respondent characteristics and emotional eating behavior. The analysis showed no statistically significant associations between age, gender, residence, and levels of emotional eating. Seven participants reported low emotional eating and eight reported high emotional eating, whereas among mature respondents, 48 had low emotional eating and 47 had high emotional eating (p=0.571). Regarding gender, 16 men reported low emotional eating and 9 reported high emotional eating, compared to 39 women with low emotional eating and 46 with high emotional eating (p=0.063), sug- gesting a possible trend toward significance. Regarding residence, among those living with family, 28 reported low and 31 reported high emotional eating, while among those not living with family, 27 reported low and 24 reported high emotional eating (p=0.585). As shown in Table 3, all six psychological factors—anger, boredom, despair, anxiety, stress, and depression—were found to have a sta- tistically significant association with emotional eating behavior among Generation Z, as indicated by p-values < 0.05. The anger factor had a p-value of 0.000 with an odds ratio (OR) of 7.284, indi- cating that individuals who frequently experienced anger were 7.284 times more likely to engage in emotional eating than those who did not. The boredom factor also showed a significant relation- ship (p=0.000; OR=19.906), suggesting a nearly 19.906-fold increased risk of emotional eating among individuals who experi- enced boredom. Similarly, despair was significantly associated with emotional eating (p=0.000; OR=13.132), anxiety (p=0.000; OR =6.750), stress (p=0.000; OR=21.778), and depression (p=0.000; OR=6.641). Among these, stress exhibited the strongest associa- tion, indicating that individuals experiencing stress were over 21.778 times more likely to engage in emotional eating behaviors. These findings demonstrate that all assessed psychological factors are significant predictors of emotional eating tendencies in Generation Z. Based on the results presented in Table 4, multivari- ate analysis using binary logistic regression revealed that among the six psychological factors examined, stress emerged as the most influential factor associated with emotional eating behavior. The stress variable demonstrated a statistically significant association (p=0.000, p<0.05) with an Odds Ratio (OR) of 8.751. This indicates that individuals experiencing stress are approximately 8.75 times more likely to engage in emotional eating than those who do not experience stress. Therefore, it can be concluded that stress was the most dominant psychological factor influencing emotional eating behavior among Generation Z in this study. Discussion This study found a significant relationship between six psycho- logical factors (anger, boredom, despair, anxiety, stress, and depression) and emotional eating behavior among Generation Z. Anger factor The findings indicated a positive relationship between anger and emotional eating, with results showing that individuals who frequently experience anger are approximately seven times more likely to engage in emotional eating behavior. This finding sug- gests that anger functions as a potent emotional trigger, often in response to perceived threats or stressors. These results align with prior research, which has shown that individuals who engage in Pathways of Change, Part II [page 82] [Healthcare in Low-resource Settings 2025;13(s2):13121] Table 1. Frequency distribution of demographic data (n=110). Characteristic Kategorisasi Frequency (n) Percentage (%) Age Teenager 15 13.6 Mature 95 86.4 Total 110 100 Gender Man 25 22.7 Women 85 77.3 Total 110 100 Residence Living with family 59 53.6 Not with Family 51 46.4 Total 110 100 Source: Primary Data Analysis, 2024. Table 2. Relationship between respondent characteristics and emotional eating behavior. Characteristics Emotional eating p Low High n n Age Teenager 7 8 0.571 Mature 48 47 Gender Man 16 9 0.063 Women 39 46 Residence With family 28 31 0.585 Not with family 27 24 emotional eating during episodes of anger perceive food consump- tion as a temporary coping strategy to distract themselves from or soothe negative emotions.19 Moreover, emotional eating may serve as a form of emotional suppression, reducing the likelihood of reactive or impulsive behaviors that could arise from an unman- aged anger.15 These findings underscore the importance of foster- ing emotional regulation skills among Generation Z. Developing effective anger management strategies may help reduce reliance on emotional eating as a maladaptive coping mechanism, thereby lowering the risk of obesity and related health complications. Furthermore, this evidence highlights the need for targeted health promotion interventions that focus on emotional regulation, partic- ularly in adolescents and young adults, as part of comprehensive efforts to promote mental well-being and healthy eating behaviors. Boredom factor The findings indicate that boredom is significantly associated with emotional eating behavior, with individuals who frequently experience boredom having approximately 19 times the risk of engaging in emotional eating. Individuals who are bored often struggle to find meaningful activities, leading them to use food as a distraction or a coping mechanism. This is consistent with previ- ous studies showing that boredom is one of the most potent emo- tional triggers for eating more so than other negative emotions.20,21 Emotional eating driven by boredom often stems from feelings of emptiness, where eating is used to relieve monotony or to fill a per- ceived psychological void.22 Supporting this, other studies have identified boredom as a primary driver of emotional eating, with boredom scoring higher than other emotions as a motivating factor.23 These findings suggest the importance of encouraging Generation Z to engage in enjoyable and stimulating activities to mitigate boredom. Furthermore, this study underscores the need for targeted interventions that specifically address boredom, not only to enhance psychological well-being but also to promote healthier dietary behaviors. Despair factor The findings indicate a positive relationship between despair and emotional eating. Specifically, the results showed that individ- uals experiencing despair were 13.1 times more likely to engage in emotional eating. Despair is commonly defined as a sense of failure and loss of hope that often triggers various negative emotional states. These emotions may contribute to emotional eating behaviors.15 This aligns with previous studies indicating that emotional eating can be driven by negative affect, including despair, especially in response to overwhelming demands.3 Furthermore, individuals with poor emotion regulation skills are more susceptible to emotional eating, particularly when facing body image dissatisfaction or psycholog- ical stress.10 These findings suggest that members of Generation Z may benefit from structured group discussions as a strategy to address and manage emotional challenges. Pathways of Change, Part II [Healthcare in Low-resource Settings 2025;13(s2):13121] [page 83] Table 3. The relationship between psychological factors and emotional eating. Psychological factors Emotional Eating p Low High OR n n Anger Not angry 34 10 0.000 Angry 21 45 OR =7.286 Boredom Not bored 39 6 0.000 Bored 16 49 OR = 19.906 Despair Not Desperate 38 8 0.000 Hopeless 17 47 OR = 13.132 Worry Not Anxious 33 10 0.000 Worried 22 45 0R = 6.750 Stress No stress 40 6 0.000 Stress 15 49 OR = 21.778 Depression Not depressed 37 13 0.000 Depression 18 42 OR = 6.641 Table 4. Multivariate test results of psychological factors that most influence emotional eating behavior. Variable p OR 1 2 3 4 5 Anger 0.209 0.196 0.245 0.375 - - Boredom 0.002 0.000 0.001 0.001 0.001 7.399 Despair 0.401 - - - - - Too anxious 0.210 0.168 0.340 - - - Stress 0.003 0.001 0.002 0.000 0.000 8.751 Depression 0.167 0.220 - - - - Age 0.735 - - - - - Gender 0.106 0.111 0.115 - - - Residence 0.542 0.534 - - - - Anxiety and stress factor The findings highlight a significant positive association between anxiety and emotional eating, with an odds ratio of 6.7, indicating that individuals experiencing anxiety are approximately six times more likely to engage in emotional eating. Additionally, stress exhibited the strongest association, with individuals experi- encing stress 21.7 times more likely to demonstrate emotional eat- ing behavior. This suggests that, among psychological factors, stress has the most substantial influence on emotional eating behavior in Generation Z. These results align with those of previ- ous studies, which have identified emotional eating as a response to stress or as a consequence of inadequate and ineffective coping mechanisms, often manifested by eating more than physiological needs.24-26 Stress activates the cortisol response system, which has been linked to unhealthy eating behaviors,27 contributing to the increasing trend of obesity.11 Furthermore, anxiety has been shown to influence eating patterns,28,29 indicating a bidirectional relation- ship in which anxiety can lead to, and be exacerbated by, emotional eating. This study suggests that Generation Z must develop effec- tive stress management and coping strategies to mitigate anxiety and prevent maladaptive eating behaviors. Moreover, it under- scores the responsibility of health providers to deliver targeted education on healthy dietary habits tailored to the needs and behaviors of Generation Z Depression factor These findings indicate that depression has a statistically sig- nificant relationship with emotional eating. Specifically, Generation Z individuals experiencing depression were 6.6 times more likely to engage in emotional eating behaviors. This suggests that depressive symptoms amplify the vulnerability to unhealthy eating patterns and emotional dysregulation. These results align with those of previous studies showing that depressive symptoms are significantly associated with emotional eating and a higher fre- quency of consuming energy-dense, nutrient-poor foods.30 Consequently, emotional eaters are at a greater risk of obesity,31 and recent studies have highlighted emotional eating as a mediator linking depression with early cardiovascular disease risk.32 This underscores the urgency of integrating mental health screening and emotion regulation strategies into dietary interventions targeted at adolescents and young adults. Addressing emotional eating not only supports psychological well-being but also mitigates long- term physical health consequences Conclusions This study concluded that six psychological factors–anger, boredom, despair, anxiety, stress, and depression— were signifi- cantly associated with emotional eating behavior in Generation Z, with stress and boredom demonstrating the strongest effects. 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