Genetic and environmental relationships between eating behavior and symptoms of anxiety and depression

  • Yun-Mi Song
  • Kayoung LeeEmail author
  • Joohon Sung
Original Article



To assess gender-specific genetic and environmental correlations between depressive and anxiety symptoms, and concurrent and follow-up eating behavior in Korean twins and their family members.


Center for Epidemiological Studies Depression Scale and State-Trait Anxiety Inventory were used to measure depressive and anxiety symptoms in subjects. To assess concurrent and follow-up relationships of the symptoms with eating behavior domains (restrained, emotional, and external eating), the Dutch Eating Behavior Questionnaire was administered to 2359 subjects at baseline (men, 48.5%; 42.0 ± 12.7 years; monozygotic twins, 33.7%) and to 1169 subjects at follow-up (men, 45.9%; 44.9 ± 11.6 years; monozygotic twins, 41.0%). A mixed linear model and bivariate analysis were applied.


After adjusting for age, twin and family effects, income, education, smoking status, alcohol use, exercise, and body mass index, depressive and anxiety symptoms were positively associated with concurrent and follow-up emotional and external eating, but not with restrained eating. The effect size of association with emotional eating increased in men in men over time, but decreased in women. Common genetic and environmental correlations showed a difference between genders, and their strength changed with time. Nevertheless, common genetic correlations were found between depressive and anxiety symptoms, and concurrent emotional eating, in both genders. There were common environmental correlations between anxiety symptoms, and concurrent restrained and emotional as well as follow-up emotional eating, in both genders.


There are similarities and differences in genetic and environmental relationships between depressive and anxiety symptoms and eating behaviors, based on gender and time of assessment.

Level of evidence

Level III, cohort study.


Eating behavior Depressive symptoms Anxiety symptoms Genetic correlation Environmental correlation 



This work was supported by 2017 Inje University Busan Paik Hospital Research Grant.

Compliance with ethical standards

Conflict of interest

This work was supported by the 2016 Inje University Research Grant.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Cardi V, Leppanen J, Treasure J (2015) The effects of negative and positive mood induction on eating behaviour: A meta-analysis of laboratory studies in the healthy population and eating and weight disorders. Neuro Sci Bio Behav Rev. doi: 10.1016/j.neubiorev.2015.08.011 CrossRefGoogle Scholar
  2. 2.
    Godart NT, Flament MF, Lecrubier Y, Jeammet P (2000) Anxiety disorders in anorexia nervosa and bulimia nervosa: co-morbidity and chronology of appearance. Eur Psychiatry 1:38–45CrossRefGoogle Scholar
  3. 3.
    Godart NT, Perdereau F, Rein Z, Berthoz S, Wallier J, Jeammet P, Flament MF (2007) Comorbidity studies of eating disorders and mood disorders. Critical review of the literature. J Affect Disord 1–3:37–49CrossRefGoogle Scholar
  4. 4.
    Turton R, Chami R, Treasure J (2017) Emotional eating, binge eating and animal models of binge-type eating disorders. Curr Obes Rep 2:217–228. doi: 10.1007/s13679-017-0265-8 CrossRefGoogle Scholar
  5. 5.
    Sung J, Lee K, Song YM, Lee MK, Lee DH (2010) Heritability of eating behavior assessed using the DEBQ (Dutch Eating Behavior Questionnaire) and weight-related traits: the Healthy Twin Study. Obesity (Silver Spring) 5:1000–1005. doi: 10.1038/oby.2009.389 CrossRefGoogle Scholar
  6. 6.
    Tholin S, Rasmussen F, Tynelius P, Karlsson J (2005) Genetic and environmental influences on eating behavior: the Swedish young male twins study. Am J Clin Nutr 3:564–569CrossRefGoogle Scholar
  7. 7.
    Sung J, Lee K, Song YM, Kim JH (2011) Relationships between state and trait anxiety inventory and alcohol use disorder identification test scores among Korean twins and families: the healthy twin study. Twin Res Hum Genet 1:73–78. doi: 10.1375/twin.14.1.73 CrossRefGoogle Scholar
  8. 8.
    Jansson M, Gatz M, Berg S, Johansson B, Malmberg B, McClearn GE, Schalling M, Pedersen NL (2004) Gender differences in heritability of depressive symptoms in the elderly. Psychol Med 3:471–479CrossRefGoogle Scholar
  9. 9.
    Slane JD, Burt SA, Klump KL (2011) Genetic and environmental influences on disordered eating and depressive symptoms. Int J Eat Disord 7:605–611. doi: 10.1002/eat.20867 CrossRefGoogle Scholar
  10. 10.
    Munn-Chernoff MA, Grant JD, Agrawal A, Koren R, Glowinski AL, Bucholz KK, Madden PA, Heath AC, Duncan AE (2015) Are there common familial influences for major depressive disorder and an overeating-binge eating dimension in both European American and African American female twins? Int J Eat Disord 4:375–382. doi: 10.1002/eat.22280 CrossRefGoogle Scholar
  11. 11.
    Wade TD, Bulik CM, Neale M, Kendler KS (2000) Anorexia nervosa and major depression: shared genetic and environmental risk factors. Am J Psychiatry 3:469–471. doi: 10.1176/appi.ajp.157.3.469 CrossRefGoogle Scholar
  12. 12.
    Walters EE, Neale MC, Eaves LJ, Heath AC, Kessler RC, Kendler KS (1992) Bulimia nervosa and major depression: a study of common genetic and environmental factors. Psychol Med 3:617–622CrossRefGoogle Scholar
  13. 13.
    Silberg JL, Bulik CM (2005) The developmental association between eating disorders symptoms and symptoms of depression and anxiety in juvenile twin girls. J Child Psychol Psychiatry 12:1317–1326CrossRefGoogle Scholar
  14. 14.
    Kendler KS, Walters EE, Neale MC, Kessler RC, Heath AC, Eaves LJ (1995) The structure of the genetic and environmental risk factors for six major psychiatric disorders in women. Phobia, generalized anxiety disorder, panic disorder, bulimia, major depression, and alcoholism. Arch Gen Psychiatry 5:374–383CrossRefGoogle Scholar
  15. 15.
    Dellava JE, Kendler KS, Neale MC (2011) Generalized anxiety disorder and anorexia nervosa: evidence of shared genetic variation. Depress Anxiety 8:728–733. doi: 10.1002/da.20834 CrossRefGoogle Scholar
  16. 16.
    Eaton NR, Keyes KM, Krueger RF, Balsis S, Skodol AE, Markon KE, Grant BF, Hasin DS (2012) An invariant dimensional liability model of gender differences in mental disorder prevalence: evidence from a national sample. J Abnorm Psychol 1:282–288. doi: 10.1037/a0024780 CrossRefGoogle Scholar
  17. 17.
    Hoertel N, McMahon K, Olfson M, Wall MM, Rodriguez-Fernandez JM, Lemogne C, Limosin F, Blanco C (2015) A dimensional liability model of age differences in mental disorder prevalence: evidence from a national sample. J Psychiatr Res. doi: 10.1016/j.jpsychires.2015.03.017 CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Sung J, Cho SI, Lee K, Ha M, Choi EY, Choi JS, Kim H, Kim J, Hong KS, Kim Y, Yoo KY, Park C, Song YM (2006) Healthy twin: a twin-family study of Korea—protocols and current status. Twin Res Hum Genet 6:844–848. doi: 10.1375/183242706779462822 CrossRefGoogle Scholar
  19. 19.
    Gombojav B, Song YM, Lee K, Yang S, Kho M, Hwang YC, Ko G, Sung J (2013) The healthy twin study, Korea updates: resources for omics and genome epidemiology studies. Twin Res Hum Genet 1:241–245. doi: 10.1017/thg.2012.130 CrossRefGoogle Scholar
  20. 20.
    Kim H, Lee I, Kim J (1996) A study of the reliability and validity of the Korean version of the Eating Behavior Questionnaire.. Korean J Clin Psychol:141–150Google Scholar
  21. 21.
    Song YM, Lee K, Sung J, Yang Y (2013) Changes in eating behaviors and body weight in Koreans: the healthy twin study. Nutrition 1:66–70. doi: 10.1016/j.nut.2012.03.014 CrossRefGoogle Scholar
  22. 22.
    Radloff L (1977) The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 385–401Google Scholar
  23. 23.
    Anonymous Spielberger CD, Gorsuch RL, Lushene RE (1970) Manual for the state-trait anxiety inventory. Consulting Psychologists Press, Palo AltoGoogle Scholar
  24. 24.
    Chon K, Choi S, Yang B (2001) Integrated adaptation of CES—D in Korea. Korean J Health Psychol 59–76Google Scholar
  25. 25.
    Kim JT (1978) The relationship between trait anxiety and sociality. Thesis for the degree of master. Seoul: Korea University Graduate schoolGoogle Scholar
  26. 26.
    Hatemi PK, Hibbing JR, Medland SE, Keller MC, Alford JR, Smith KB, Martin NG, Eaves LJ (2010) Not by twins alone: using the extended Family design to investigate genetic influence on political beliefs. Am J Polit Sci 3:798–814CrossRefGoogle Scholar
  27. 27.
    Ulfvebrand S, Birgegard A, Norring C, Hogdahl L, von Hausswolff-Juhlin Y (2015) Psychiatric comorbidity in women and men with eating disorders results from a large clinical database. Psychiatry Res 2:294–299. doi: 10.1016/j.psychres.2015.09.008 CrossRefGoogle Scholar
  28. 28.
    Grilo CM, White MA, Masheb RM (2009) DSM-IV psychiatric disorder comorbidity and its correlates in binge eating disorder. Int J Eat Disord 3:228–234. doi: 10.1002/eat.20599 CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of Family Medicine, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of Korea
  2. 2.Department of Family Medicine, Busan Paik HospitalInje University College of MedicineBusanRepublic of Korea
  3. 3.Department of Epidemiology, School of Public Health and Institute of Health and EnvironmentSeoul National UniversitySeoulRepublic of Korea

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