The association of perceived stress on disordered eating among female college students: the mediating role of negative emotions and the moderating role of physical exercise

Abstract

Background Disordered eating is prevalent among female college students and is associated with adverse physical and mental health outcomes. This study examined the mediating role of negative emotions in the relationship between perceived stress and three types of disordered eating (emotional eating, restrained eating, and external eating), as well as the moderating role of physical exercise among female college students. Methods A cross-sectional survey was conducted among 604 female college students from four universities in China. Participants completed validated measures assessing perceived stress, negative emotions, physical exercise, and disordered eating. Mediation and moderation analyses were performed using the PROCESS macro (Model 4 and Model 59) with 5,000 bootstrap resamples. Results Perceived stress was positively associated with all three types of disordered eating. Negative emotions partially mediated the relationship between perceived stress and emotional eating, and fully mediated the relationship with restrained eating, but did not mediate the relationship with external eating. Physical exercise negatively moderated the associations between negative emotions and both emotional eating and restrained eating. However, physical exercise positively moderated the relationship between perceived stress and negative emotions, though with very small effect sizes. Conclusion Negative emotions serve as a key mechanism linking perceived stress to emotionally driven eating patterns, with differential mediating roles across eating behavior types. Physical exercise may serve as a downstream buffer that disrupts the translation of negative affect into maladaptive eating behaviors. These findings highlight the need for targeted interventions that address distinct pathways for different types of disordered eating among female college students.