The latent profile structure of alexithymia in the elderly and its relationship to eating behaviors: the mediating role of physical activity.

Objective: This study aimed to elucidate the psychological mechanisms underlying the relationship between alexithymia and problematic eating behaviors (EB) among older adults. Specifically, we examined whether physical activity (PA) mediated this association, and we further explored the heterogeneity of alexithymia using Latent Profile Analysis (LPA). Methods: A cross-sectional survey was conducted among 1,773 community-dwelling older adults in China. Participants completed validated questionnaires assessing alexithymia, PA, and EB. Mediation analysis tested the indirect effect of PA on the alexithymia-EB relationship, while LPA identified subgroups of individuals with distinct alexithymia profiles. Results: Mediation analysis revealed that PA significantly mediated the relationship between alexithymia and maladaptive EB, accounting for 18% of the total effect. LPA supported a three-profile solution: pervasive alexithymia (21.15%), adaptive (72.81%), and affective-cognitive dissociation (6.04%). Profile membership was differentially associated with health behaviors, with the pervasive group showing the most unfavorable outcomes (high EB, low PA), and the adaptive group demonstrating the most favorable pattern. Conclusion: These findings highlight PA as a key behavioral pathway through which alexithymia contributes to maladaptive eating in older adults. Moreover, alexithymia is not uniform but heterogeneous, with distinct profiles that confer varied health behavior risks. Interventions to improve eating habits in elderly populations may benefit from tailoring strategies to alexithymia subtypes and systematically promoting PA as an adaptive regulatory mechanism.