Emotion Regulation May Link Mentalization Deficits to Dysfunctional Eating Behaviors

Dysfunctional eating behaviors, ranging from extreme dietary restriction to binge eating and compensatory purging, are often accompanied by an intense, personally distressing overconcern with body weight and shape. A new open access study published in Eating and Weight Disorders – Studies on Anorexia, Bulimia and Obesity examines the psychological machinery behind these patterns, asking whether the capacity to understand mental states, known as mentalization, influences dysfunctional eating indirectly through the ability to regulate emotions. The research, led by Alessandro Frolli and colleagues, was published on 27 August 2026 and is currently available as an early, peer-reviewed accepted version carrying a permanent DOI.

The study rests on two well-established psychological constructs. Mentalization refers to the ability to represent and interpret one’s own and others’ mental states flexibly. Individuals exhibiting dysfunctional eating behaviors frequently show impairments in this capacity, with mental states represented in rigid and less flexible ways. Emotion regulation, meanwhile, describes the processes by which people manage affective states, and difficulties in this domain have repeatedly been implicated in disordered eating. Emotional eating, in particular, has been conceptualized as a maladaptive strategy aimed at modulating negative affective states, meaning that food may be used to dampen or redirect unpleasant feelings rather than to satisfy physiological hunger.

To test whether emotion regulation mediates the relationship between mentalization and dysfunctional eating, the researchers recruited a sample of 231 adults. Participants completed a battery of self-report measures covering all three constructs of interest. Dysfunctional eating was assessed with the Eating Attitudes Test-26, a widely used screening instrument for attitudes and behaviors characteristic of eating disorders. Mentalization capacity was measured with the Reflective Functioning Questionnaire-8, a brief scale capturing how individuals typically interpret mental states. Emotion regulation difficulties were evaluated with the Difficulties in Emotion Regulation Scale-36, which quantifies problems across multiple facets of affect regulation.

The analytical strategy proceeded in stages. Correlation analyses first examined the bivariate associations among mentalization, emotion regulation and dysfunctional eating behaviors. According to the abstract, lower levels of mentalization were significantly associated with greater difficulties in emotion regulation, and those difficulties were in turn significantly associated with higher levels of dysfunctional eating behaviors, with both correlations reported as statistically significant at p < .05. The published early-view version of the article leaves the exact correlation coefficients, standard errors and confidence intervals as placeholder values, so the direction and significance of the associations are reported while the precise magnitudes are not yet available in this version of record.

Building on those correlations, the team conducted a mediation analysis to estimate whether the effect of mentalization on dysfunctional eating behaviors travels through emotion regulation. The abstract reports a significant indirect effect of mentalization on dysfunctional eating behaviors through emotion regulation, described as supporting the hypothesized mediational model. As with the correlations, the specific beta coefficient, standard error and 95 percent confidence interval for this indirect effect appear as placeholders in the early-release text. A significant indirect effect in such a model indicates that the pathway from weaker mentalization through emotion regulation difficulties to more dysfunctional eating is statistically distinguishable from zero, consistent with the idea that emotion regulation is a plausible transmission mechanism.

The authors interpret these findings as suggesting that deficits in the ability to understand and interpret one’s own and others’ mental states may contribute to dysfunctional eating behaviors, particularly when coupled with impaired emotion regulation capacities. In practical terms, the model proposes a chain: when mentalization is rigid or impaired, emotional states become harder to identify, tolerate and modulate, and that dysregulation may then find an outlet in maladaptive eating patterns such as restriction, binge eating or purging. The study’s stated level of evidence is Level I, described as evidence obtained from experimental studies, although the reported design relies on self-report measures and mediation analysis in a single adult sample.

Several limitations deserve emphasis when weighing these results. All data come from self-report questionnaires, which are subject to response biases and may not capture behavior as it unfolds in daily life. The mediation model is statistical rather than experimental, so the significant indirect effect supports a hypothesized structure of associations but cannot by itself prove that emotion regulation causally transmits the influence of mentalization onto eating behavior. The sample consists of 231 adults, and the abstract does not report clinical diagnostic status, so the findings concern dysfunctional eating behaviors in this sample rather than diagnosed eating disorders. The early-view status of the article also means the version is subject to further edits and will be replaced automatically by the final Version of Record.

Despite these caveats, the study points toward a coherent psychological account of why mentalization difficulties and disordered eating so often co-occur. Rather than treating rigid representations of mental states and problematic eating as parallel symptoms, the mediational model positions emotion regulation as the connective tissue between them. If that structure holds up under replication with reported effect sizes and, ideally, longitudinal or experimental designs, it would sharpen the theoretical map linking social-cognitive capacities to eating pathology.

The authors suggest that interventions targeting both mentalization and emotion regulation processes may represent a promising avenue for the prevention and treatment of eating-related difficulties. Such approaches would aim to build more flexible thinking about mental states while simultaneously strengthening the skills needed to manage negative affect, addressing the two links in the proposed chain at once. For now, the study offers a testable framework and preliminary statistical support for it, with the full quantitative details expected in the final published version.

Subject of Research: The mediating role of emotion regulation in the relationship between mentalization and dysfunctional eating behaviors in adults

Article Title: Mentalization and dysfunctional eating behaviors: the mediating role of emotional regulation

Article References: Frolli, A., Cecere, G., Rocchetti, E., La Penna, I., & Rega, A. (2026). Mentalization and dysfunctional eating behaviors: the mediating role of emotional regulation. Eating and Weight Disorders – Studies on Anorexia, Bulimia and Obesity. https://doi.org/10.1007/s40519-026-01870-4

Image Credits: AI Generated

DOI: 10.1007/s40519-026-01870-4

Keywords: mentalization, emotion regulation, dysfunctional eating behaviors, emotional eating, EAT-26, RFQ-8, DERS-36, mediation analysis, reflective functioning, eating disorders, self-report measures, adults