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Background  Obesity defined solely by the Body Mass Index (BMI) may not reflect the true heterogeneity of the obese population. This study aimed to classify the dietary behaviours of overweight and obese individuals and to explore the relationship between patterns of dietary behaviour and cardiometabolic risk factors.    Methods  A total of 259 patients who visited an outpatient weight management clinic at a tertiary hospital and underwent a dietary behaviour assessment between January 2014 and February 2019 were enrolled in the study. Dietary behaviours were assessed in three domains with nine categories, including choice of food (frequently eating out and consumption of instant/fast/takeaway food), eating behaviour (irregular meals; frequent snacking, including eating at night; emotional eating; and overeating/binge eating), and nutrient intake (high-fat/high-calorie foods, salty food, and poorly balanced diet). Latent class analysis (LCA) was used to classify the subjects according to these categories. Associations between latent class and metabolic syndrome were assessed by logistic regression.    Results  The subjects were classified into three LCA-driven classes, including a referent class of healthy but unbalanced eaters ( n  = 118), a class of emotional eaters ( n  = 53), and a class of irregular unhealthy eaters ( n  = 88). Compared with the referent class, emotional eaters had a significantly higher BMI (beta = 3.40,  P  < 0.001) accompanied by metabolic syndrome (odds ratio 2.88, 95% confidence interval 1.16–7.13).    Conclusions  Our three LCA-driven obesity phenotypes could be useful for assessment and management of obesity and metabolic syndrome. The association between emotional eaters and higher BMI and metabolic syndrome was stronger than that with other eaters. Thus, emotional regulation strategies might have benefit for emotional eater’s diet.

A latent class analysis of dietary behaviours associated with metabolic syndrome: a retrospective observational cross-sectional study