“If I’m exhausted and anxious or bored, I run to food like it’s a drug that’s going to numb the uncomfortable feelings I’m experiencing. It gives me the opportunity to dissociate and escape, but in the aftermath it never feels good.” This is how one of my clients, a strong survivor of emotional and binge eating, describes the addictive, seductive comfort and subsequent tension that accompanies her relationship with food. For her and many others, food is more than a source of fuel and nutrition; it’s a way of receiving immediate emotional comfort and finding temporary escape.
Emotional eating doesn’t only affect chronic binge eaters or those with disordered eating patterns. Most clients (and even dietitians like ourselves) partake in episodes of emotional eating every once in a while. As humans, when faced with a difficult situation we don’t like to deal with the actual issue at hand; food is an easily accessible and affordable surrogate to facing the problem. We all have a food that we gravitate to—some reach for the chocolate Kisses while others delve into a bag of Doritos. Though there’s nothing wrong with eating these foods in moderation, a cycle of emotional eating may result in losing touch with one’s internal cues. This can ultimately lead to a spiral of binge eating, negative body image, weight gain, urges to restrict food intake, hypertension, diabetes, and, most prominently, an unhealthful relationship with food, one’s body, and oneself. As dietitians, being able to relate to the urge or habit of emotional eating is especially important in providing insight and assistance to our clients.
Emotional eating is distinct from real hunger. When clients are in the vicious cycle of emotional eating, there comes a point when they can’t decipher true physiological hunger from that of emotional hunger.
Physiological hunger, according to Merriam-Webster, is defined as “an uneasy sensation occasioned by the lack of food.” Real hunger is brought on by a physical need for food and typically develops gradually. Clients will say that this hunger usually isn’t accompanied with a specific craving. Often characteristics of physiological hunger include stomach growling, low blood glucose, shakiness, irritability, weakness, and lethargy if prolonged. Once food is consumed, these feelings diminish; the tank is filled, so to speak.
Emotional eating, sometimes described as “stress eating” or “boredom eating,” occurs when one consumes food for psychological purposes. Clients are eating food to deal with an emotional issue rather than to satisfy feelings of physical hunger. Food is used as an escape, distraction, comfort source, or even transition from different modes of the day (going from work to home or from taking care of kids to being alone). Many times, food is viewed as a reward or punishment, eg, eating a brownie because of a good grade or due to a recent breakup. This type of hunger occurs suddenly with specific cravings for food high in fat, sugar, or salt. Food usually doesn’t decrease these feelings but rather results in feelings of anxiety, guilt, or shame.
Reasons for emotional eating include the following:
- work-related stress;
- life/family stress;
- boredom or loneliness;
- lack of mindfulness when eating due to not taking time to eat regular meals;
- restrictive eating tendencies during the day;
- societal cues, such as celebration or mourning; and
- a sense of well-being. A 2015 review article by Alonso-Alonso and colleagues in Nutrition Reviews showed that food substances (mainly sugar, fat, and salt) have similar addictive and instantaneous euphoric effects as that of cocaine and other addictive drugs due to elevation of dopamine levels.
Emotional eating is something we as dietitians will see again and again. It’s vital we treat this type of habitual eating with care, patience, and empathy. Simply telling clients not to eat those foods or to eat lettuce instead isn’t going to do the trick. Remind clients that it’s OK to sometimes indulge in a treat, even when they aren’t hungry. The issue arises when clients consistently use food to treat deeply rooted emotions without insight of the genuine problem, resulting in negative mental and physical health consequences.
Here are some useful techniques to review with clients battling emotional eating:
- Have clients write in a food diary to assess where or what foods they eat due to stress or boredom.
- Suggest clients use a hunger scale of 1 to 10 before eating, 1 being “starving” and 10 being “overly full.” If clients indicate a score of 6 or higher when eating, they’re likely eating for emotional reasons.
- Develop a plan with clients for when they experience an emotional urge to eat. Recommend clients try to hold back on the urge rather than act on it. Over time, resisting the initial impulse often will lead to a diminished desire to partake in emotional eating.
- Recommend clients learn how to “honor feelings without using food,” as is nicely discussed in the book Intuitive Eating: A Revolutionary Program That Works by Evelyn Tribole, MS, RD, and Elyse Resch, MS, RD, FADA, CEDRD. Clients should meet with a therapist or use journaling to recognize and approach the underlying emotional issue at hand.
- If the cycle seems almost unbreakable, advise clients to remove comfort/binge foods from the house until they feel more in control.
- Remind clients not to be hard on themselves. We’re all human, and our emotions play a significant role in our behaviors. Being mindful of these behaviors is key to success.
Nevertheless, we all need a snack sometimes. Here are some balanced (and tasty) snacks to swap with common comfort snacks high in sodium, fat, and sugar:
- one slice of whole wheat bread, 1 T nut butter, and a handful of carrots;
- one sliced apple, string cheese, and a small handful of almonds;
- one package of old fashioned oats mixed with 1/2 of a sliced banana and 1 cup of skim or 2% milk. Add 1 T of slivered almonds for some extra good fats; and
- half of an avocado filled with 1/2 cup cottage cheese with five whole grain crackers.
— Hilary Raciti, RDN, CDN, is a passionate dietitian who hopes to help improve people’s relationship and understanding of food. She firmly believes food should be a source of fuel, laughter, and love. With experience working in long term care facilities as well as outpatient partial hospitalization programs and intensive outpatient eating disorder treatment centers, Hilary molds her nutrition therapy to best suit each individual client’s needs or concerns. She’s currently pursuing private practice in Wayne, New Jersey. Please visit her at trucenutritionllc.com.