Psychological Distress Is Associated with Emotional Overeating in Multiple Sclerosis: The Role of Perceived Disease Impact and Illness Acceptance—A Cross-Sectional Study

Background/Objectives: Emotional overeating may be relevant to nutritional self-management in people with multiple sclerosis (MS), but its links with disease-related appraisals and psychological adjustment remain unclear. This study examined associations between perceived physical impact of MS and emotional overeating, considering illness acceptance and psychological distress. Methods: This secondary cross-sectional study included 382 adults with MS recruited from specialist clinical centres in Poland. Emotional overeating, perceived physical impact, illness acceptance, and psychological distress were assessed using the My Eating Habits Questionnaire, Multiple Sclerosis Impact Scale-29 physical subscale, Acceptance of Illness Scale, and 12-item General Health Questionnaire. Hierarchical regression and serial indirect-association models were adjusted for disease duration and Expanded Disability Status Scale score. Indirect associations were evaluated using 5000 bootstrap resamples. Results: Greater perceived physical impact was associated with emotional overeating at the bivariate level. In the adjusted regression model, greater psychological distress was associated with higher emotional overeating (B = 0.169, β = 0.312, p < 0.001); the model explained 20.1% of outcome variance. The total association between physical impact and emotional overeating was statistically significant (B = 0.038, p < 0.001), whereas the direct association was not (B = 0.010, p = 0.216). Indirect associations were supported through psychological distress alone (estimate = 0.016, 95% CI 0.009–0.025) and sequentially through lower illness acceptance and greater psychological distress (estimate = 0.006, 95% CI 0.003–0.009). Conclusions: Emotional overeating was more closely associated with psychological distress and illness adjustment than with perceived physical disease impact alone. Nutritional care may benefit from attention to emotional triggers for eating and psychological distress; longitudinal studies are needed to establish temporal relationships.