Bulldog Obesity Addressing the Emotional Triggers of Overeating
Overeating, Emotional Eating, and Binge Eating
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Overeating, emotional eating, and binge eating are all terms used to describe behaviours associated with consuming larger quantities of food. However, they arent the same thingand frankly, they arent all problematic. Understanding the nuances between the three can ultimately help to understand what they are and determine whether or not to do anything about them.
Overeating
Of the three terms, overeating is by far the most general. Its an umbrella term that encompasses a wide variety of behaviours and doesnt have a standardized definition as to what it actually is. Suffice to say, overeating is incredibly subjective.
One could define overeating by the quantity of food consumed; however, depending on an individuals nutritional needs and hunger at any given moment, what constitutes overeating for one individual in a particular situation, may not, in fact, be reflective of overeating for another individual in a completely different situation. Thus, it may be more helpful to look at overeating on a person-to-person level, examining the frequency of this behaviour, and assessing if it causes distress.
Emotional Eating
Colloquially, emotional eating is a commonly used term to describe the act of eating in response to ones emotions. You can probably draw to mind at least one of the many tropes that exist around cracking open a bag of chips after a stressful day of work or digging into a pint of ice cream to help lift ones spirits.
Researchers have tried to get a little more specific in defining this term, such that it can be assessed and studied in a variety of in-lab and real-world settings. Several questionnaires exist to assess emotional eating, including the Dutch Eating Behavior Questionnaire (DEBQ; van Strien et al., 1986) and the Emotional Eating Scale (EES; Arnow, Kenardy, & Agras, 1995); however, there is an ongoing debate in the field about how to define emotional eating and what behaviours fall under said umbrella.
For example, while many scales only focus on eating in response to negative emotions, it remains unclear whether positive emotional eating should also be assessed. Research is ongoing to try and figure out whether or not these two behaviours are related or distinct (i.e., if eating to soothe negative emotions is the same process as eating to amplify positive ones).
There are also some researchers who take the stance that emotional eating is not a behaviour at all, but rather a misattribution after the fact: in this theory, people ascribe their eating to the emotional state they were in when it happened, when in reality, it may have occurred due to other factors (Bongers & Jansen, 2016). All of that to say, theres a lot more to it than we may think when we hear someone say, Im an emotional eater, and the jury is still out as to all the nuances of this eating behaviour.
Binge Eating
Binge eating is the only term of the three that ties back to a diagnostic category in the DSM, the manual used to classify mental health disorders. In the DSM, binge eating has two primary characteristics that distinguish it from other forms of overeating.
First off, one must consume what is deemed an unusually large amount of food within a 2-hour period. Second, during this eating episode, the individual must experience a perceived loss of control over their eatingin other words, feeling like they cannot stop, even if they wanted to.
In addition to these two criteria, there must be the presence of three or more of the following:
- eating more quickly than normal
- eating until reaching a point of uncomfortable fullness
- eating large amounts of food when not physically hungry
- eating alone due to embarrassment or shame about ones eating behaviour
- feeling a sense of disgust or guilt with oneself after a binge eating episode
Importantly, and as with all mental health disorders, binge eating goes from being a behaviour to being a disorder if the person is distressed by what they are doing. It also must occur at least once a week for three months. In Canada, diagnoses can usually only be given by psychologists, psychiatrists, and family doctors, upon formal clinical assessment.
Implications for Assessment and Treatment
As mentioned, the key to any diagnosis and subsequent treatment is the caveat that the individual experiencing the behaviour must experience distress because of it. The reality is that overeating, and even emotional eating, are relatively normative and most people will engage in some level of these behaviours over the course of their life without issue. In fact, shaming people for behaviours that arent actually problematic can feed into a problem that wasnt actually there in the first place.
However, in many cases, overeating, emotional eating, and binge eating are behaviours that people engage in when experiencing disordered eating or having difficulties with emotion regulation. In these cases, it's important to get to the bottom of what the function of the behaviour is such that it can be addressed and managed.
What's Behind Emotional Overeating?
Last month, Michelle Obama made a special guest appearance on the long-running hit TV show, The Biggest Loser. Id heard about the shows premise: contestants who struggle with obesity and often face serious health risks relocate to a fitness ranch, where together they learn about nutrition, diet, and exercise, while competing to lose weight. But I had never watched it until I saw the episode featuring the First Lady. The contestants were invited to the White House where Mrs. Obama, in her typically down-to-earth and enthusiastic manner, joined in on the shows intense workout in an effort to spotlight the importance of diet and exercise. While the issue of obesity and poor nutrition are of tremendous significance, as our country struggles to get fit, we should also be shedding light on the emotional side of eating.
Whatever one may think of The Biggest Losers reality-TV editing or competitive format, one thing I personally appreciate is that the show acknowledges that the factors contributing to obesity, food addiction, and weight gain go deeper than the surface. Contestants are encouraged to uncover and understand the psychological and emotional roots and implications of their struggle with their weight. When it comes to our relationship with food, there is much more going on than we would often assume. Like any addictive substance, food is often used to cover over or subdue emotional pain. It is used to numb us or soothe us, yet it is also used to torment us or cause us anxiety.
Struggles with eating and weight gain usually start early, when our relationship with food is first established. One contestant on The Biggest Loser described how the physical abuse he experienced throughout his childhood left him with a desire to somehow shield himself both physically and emotionally. Growing up with a violent and erratic stepfather and a fearful mother who failed to protect him, he used food to feel bigger, safer, and comforted. Its easy to see how such an extreme example of physical abuse could lead a child to start to use food as consolation and weight as armor. However, it is far more difficult to identify how more subtle forms of mistreatment, mis-attunement, and abuse can lead to issues with eating.
As children, we all experience varying degrees of emotional pain. The love, care, and nurturance we get from our caregivers lead us to form a positive sense of self and helps us to create our identity. Yet, no parent or person is perfect. Even the best parents are only attuned to their childs needs about 30 percent of the time. This means that, as children, each of us was inevitably left lacking certain things we needed. We may have felt rejected, isolated, unseen, or unheard. Conversely, we may have felt intruded on, overly controlled, or intimidated by our parents. All of these factors could have impacted our relationship with food. We literally and figuratively learned how to feed ourselves from how we were nurtured by our parents and influential caretakers.
Many of us eat for reasons other than to nourish our bodies or even to enjoy one of lifes pleasures. To understand why we overeat, its valuable to identify what the emotions are that lead us to mindlessly snack, overindulge, or binge. Are these feelings familiar? Do they bring up any memories or remind us of ways we felt in our past? Do our patterns of eating remind us of ways we saw our parents use food or other substances? Or conversely, might our actions seem like a reaction to ways we saw our parents use food or other substances?
A woman I know tells a story of her 30-year struggle with her weight. One of her earliest memories is of being barely over a year old and crying through the night for her bottle, while neither her mother nor her father woke to feed her. Night after night, hungry and alone, she would wait, but no one came. Finally, one morning when her mother brought her bottle, the child took the bottle and, even though she was starving, she refused it and threw it on the floor. She recalls that something shut down in her, and she never wanted food from her mother again. As she grew up, her relationship with food was further complicated by her mothers own struggle with weight and consistent focus on her young daughters figure. As a result, the woman grew up suffering from binge eating, over-feeding herself with a desperation that indicated a disconnectedness from her body. She had trouble distinguishing her real feelings of hunger from a desire to fill herself up.
People with eating disorders, both overeaters and anorexics, disregard their own values and personal goals in relation to their health, looks, and lifestyle. They use food to feel bad about themselves, to punish themselves, or to gain a sense of control. Instead of using it to fuel their bodies, they use food to fuel a cycle of self-hatred and self-protection. All of us have an inner coach, or critical inner voice, that lures us into destructive behavior then pounces on us the minute we mess up. The critical inner voice is a driving force behind an eating disorder, and to challenge an unhealthy relationship with food, a person must deal with this internal enemy.
We live in a society that supports being slim, sometimes to the extreme. This unrealistic ideal can be used in the service of our inner critic to put ourselves down, to feel inadequate , or to isolate us from the world around us. Failing to identify our critical voices as they come up, leaves us more at risk for falling off the wagon. However, we can challenge our voices by not engaging in the behaviors they are supporting. And even though they may initially become louder, enticing us and telling us we will fail, the more we ignore them, the more they lose their hold on us, and the stronger we become.
To have a healthy body, it is necessary for us to take action of a physical level with diet and exercise, but to have a healthy relationship with food, it is necessary for us to understand ourselves on a deeper emotional level or to uncover why we eat the way we eat. If we challenge the behaviors alone through diet and exercise, the emotions we were using eating to cover up wont just go away. Once we identify the feelings and inner voices that perpetuate the cycle of self-hatred and the insensitivity to our body, we can gain control of self-destructive eating habits and not react adversely to pressure and triggers that lead us to abuse food. By taking action on a physical level and taking interest on an emotional level, we can re-establish our relationship with food, with our bodies, with our past, and with ourselves as a whole. We can uncover who we really are, our real wants, desires, and goals, and we can stop engaging in the patterns that get in our way.
Read more from Lisa Firestone at PsychAlive.org
