February 13, 2011 / Praxis
An interview between TOJ Editor-in-Chief Chris Keller and the author of GENERATION EX-CHRISTIAN, Drew Dyck.
Picture a fashion model in a magazine. Fashion industry research indicates a high probability that she has an eating disorder—either anorexia or bulimia. This should come as no surprise, since industry standards select and continue to employ models who are significantly underweight.
Now think of a neighbor or coworker. Although it may not be obvious, he or she may also have problems with eating and body image. The main difference between your neighbor and the fashion model is that your neighbor is more likely to overeat than under-eat. But both eating problems can be dangerous. And what about yourself? Chances are four in ten that you have an eating-related problem, and, if you are female, chances are 9 in 10 that you don’t like your body.
America has a growing obesity epidemic. No ethnic or racial group is immune to this epidemic, nor is it a problem mainly for adults, as children are becoming clinically obese at younger and younger ages. According to the American Dietetic Association, this increase in Americans’ weight cannot be accounted for by a biologic change, but rather by a change in lifestyle and environment. Overeating to manage uncomfortable emotions, such as sadness, loneliness, worthlessness, hopelessness, and even guilt, contributes to the growing problem of obesity in the United States.
People of all faiths use food as a means of distraction from negative emotions and difficult life challenges. Whether the use of food as a distraction is considered socially acceptable depends largely on the perceptions of one’s spiritual community. For many, obesity and overeating carry a similar social stigma to smoking, drugs, and alcohol, because each activity contributes to our ability to avoid the reality of negative emotions and can cause physical ailments.
Emotional eating is a very distressing and common problem in America. It affects far more Americans than the more extensively researched eating disorders of anorexia and bulimia. Because of the social stigma Americans attach to being overweight and the highly-prized super- thin body, many are ashamed of their emotional eating behaviors and keep them secret. Others have engaged in such behaviors for so long that it begins to feel normal. Fortunately, there are a number of effective and well-developed options to address emotional eating.
What is “emotional eating”?
Emotional eating refers to a range of behaviors in which people eat for reasons other than true hunger or participation in cultural events. An example is the common practice of eating beyond one’s fullness signals to feeling literally “stuffed.” Other forms of emotional eating also exist, including: frequent overeating when stressed, eating a large amount of high-calorie foods, being secretive about what is eaten, eating alone, feeling out of control when eating, eating when not hungry, eating foods perceived as “forbidden”, grazing or snacking throughout the day, eating to soothe or forget feelings, and other emotional uses of food. It is important to note that not everyone who eats for emotional reasons is overweight, but many are.
If emotional eating behaviors are severe enough, the person could be diagnosed with an eating disorder. What separates a diagnosable eating disorder from less severe emotional eating is often the frequency and severity of the behaviors, the degree of distress the behavior causes, and the degree of body hatred that ensues. Among emotional eaters, people who are overweight, normative, or underweight can all be significantly uncomfortable existing in their body. When the level of physical or emotional distress is too great, assistance should be sought from a qualified medical professional, counselor, or registered dietician. Sadly, however, while these emotional eating behaviors often start in a person’s teens or early twenties, many individuals fail to seek or receive appropriate intervention until their thirties or forties. That is a long time to suffer. And some never ask for help, but remain in the darkness of shame and secrecy, never even telling their closest friends, family, or spouse.
What causes emotional eating?
A major risk factor for emotional eating is living in a culture that values thinness. This said, all Americans are at risk. Cultures that value thinness create categories of “forbidden” foods, leading to a choice to either deprive oneself of food to fit into the image or give in and eat the “bad food.” These experiences place us in a contradiction: we’re told to fight our biological drive to eat and minimize food intake in order to be thin, but we are at the same time saturated with a vast array of appealing foods in excessive portion sizes quickly eaten in distracting environments. In all things, we are continually pushed to multi-task. Within these circumstances, eating becomes a very emotionally charged event intermixed with a variety of feelings and needs. This situation is made worse by our sedentary lifestyle, which is promoted by cities built around travel by car rather than walking.
These cultural circumstances are a long way from a spiritually healthy environment. In a Christian environment, there would instead be recognition that each person is created unique by a loving God—unique in mind, soul, and body. Beauty comes in many forms, shapes, and sizes, and is both internal and external. All foods are good, gifts of a loving God. The natural hunger urges we experience are built into us by God’s design, and should not be negated or overruled. In the Bible, eating and feasting are frequently associated with joy and celebration—social experiences set aside from the workday or other distractions. In a spiritually healthy environment, it is likely that emotional eating would occur less often, because many of its root causes would be lacking.
Those most vulnerable to emotional eating are the same individuals most vulnerable to the other eating disorders. Such individuals are more likely to have been abused physically, sexually, or emotionally. They are often depressed, anxious, have low self-esteem and may abuse substances (legal or illegal). They may have a history of repeated dieting and regaining of weight or continued weight increases over a long period of time. Additionally, difficulties in any type of relationship tend to drive emotional eating behaviors. They may come from overweight families or families with other psychiatric disorders. Their families may be rigid and less supportive, being less open and direct with their feelings. There is often less structure, rules, and consistency or predictability in these families. These families can be isolated and sedentary. Independence is not stressed. All of these factors may contribute to a sense of having no control over one’s life and provide an inclination to use food as a source of comfort and control. The biggest influence on a child’s relationship with food comes from his or her parents.
People who are overweight are often viewed in our society as being weak-willed, ugly, awkward, gluttonous, lazy, bad, weak, stupid, worthless, and lacking in self-control. Considering the amount of ridicule many overweight individuals endure, it is no wonder that many internalize these toxic beliefs. Even healthcare professionals, supposedly trained to understand the risk factors and intervene appropriately, often evidence bias against the overweight. Overweight individuals may be less likely to visit health professionals for preventive healthcare to avoid lectures about weight or being embarrassed by inappropriately sized equipment. Beyond social relationships, overweight individuals may suffer discrimination in employment, salary, promotion, and education.
Our society demonstrates the incorrect attitude that “if they only knew they were overweight, they would do something about it.” Realistically, the vast majority of overweight adults and children in fact know they are overweight and from that may develop a poor body image and a continued unhealthy relationship with food. A common myth is that overweight children and adolescents are unconcerned about their weight or make little effort to control their weight. But American children are dieting at an alarmingly young age. Hearing that “God loves you just the way you are” or similar platitudes is not usually helpful to the emotional eater because of the din of societal messages that contradict this spiritual truth. A person’s underlying thoughts, emotions, and behaviors must be acknowledged and confronted by the individual.
How does eating emotionally distract from emotions?
Emotional eating is an effort at managing emotions through food. It works in several ways:
· Eating produces a sense of fullness and increases blood sugar levels. Both reduce the physical agitation that comes with feelings of anger, distress, and anxiety and produces an experience of numbness in which all emotions, including depression and loneliness, are minimized.
· Eating to the point of physical discomfort distracts from emotional pain.
· Continuous eating also distracts from disturbing thoughts.
· Consuming foods that are enjoyable or that are associated with positive experiences brings pleasure, which can temporarily relieve depression.
· Certain foods raise endorphin levels (the “feel-good” brain chemical), mimicking drug use and improving mood.
· High carbohydrate food facilitates the release of serotonin. Serotonin is the calming brain chemical. When the brain is using it, feelings of stress and tension are erased. This is why foods eaten out of emotion rather than hunger are frequently high carbohydrate, since such foods increase serotonin.
These many effects on emotions readily reinforce and encourage emotional eating behaviors. The emotional relief from food is short-lived and is repeatedly followed by an extreme sense of guilt and self-reproach. The more emotions build, the more likely the individual is to engage in the very same behavior that resulted in feelings of guilt. Thus begins a vicious and difficult-to-break cycle.
How to end emotional eating
Treatment of emotional eating has three main objectives:
· Reducing or stopping the emotional eating behaviors.
· Improving attitudes about weight, shape, eating behaviors, and physical activity.
· Possible weight loss or prevention of further weight gain, when medically appropriate.
There are many effective psychotherapy methods that achieve these goals, such as Cognitive Behavioral Therapy, Interpersonal Therapy, Dialectical Behavioral Therapy, Marital/Family Therapy, and participation in Support Groups. Self-help and professionally led support groups can be quite effective, since people with emotional eating problems often try to soothe their emotional distress through isolated eating rather than by reaching out to a support network. Groups can help individuals reduce shame and isolation, learn to identify and express emotions directly, receive affirmation and counsel, choose supportive relationships, and trust that others may be willing and able to help when distress arises. Groups are particularly important from a spiritual perspective, because they reconnect us to the human community, allow us to experience God’s love, forgiveness, and acceptance in a palpable way, and help us to feel less alone with our emotional burdens.
It is important to remember that emotional eaters are often very aware of their weight loss “failures.” Guilt, shame, and feelings of failure increase emotional eating. When not immediately successful, emotional eaters will need to recognize this as part of the slow process of change and then identify new and alternative responses. Eventually the emotional eater will redefine success from weight loss to healthy lifestyle and improved quality of life. Through this education process, the emotional eater will learn to focus on what success truly means for them.
Nutrition education is key
American’s waistlines are growing in spite of the vast number of diet products, weight loss products and medical weight-loss procedures that seem to be multiplying exponentially. Think of how many “magic bullet” weight-loss methods are readily available – such as diet pills, green tea, smoking, fasting, restricting to “good or healthy” foods, commercial programs focused on weight loss or meal replacement, negative calorie/vegetarian/low-fat/no-fat/no carb diets, and fluid restriction and dehydration techniques. This doesn’t even touch on the number of gyms and personal trainers that claim they can make you into the best you can be. The list goes on and on and the pictorials that go with the ads are quite convincing. We are led to believe that if a product is natural, then it must be safe. According to the American Academy of Family Physicians, there are more than 50 individual dietary weight-loss supplements and more than 125 commercial combination products available for weight loss. Yet none of these products met the criteria for recommended use for their efficacy, safety, or quality. Medical interventions can be lifesaving, but often do not address the underlying issues that created the obesity in the first place. This often treats the symptom and not the problem.
Sadly, dieting is very ineffective. In almost all cases, the weight is quickly regained once normal eating is resumed. Dieting by its nature avoids recognizing internal cues. It takes pure willpower to avoid eating. Furthermore, dieting can be outright harmful. It can lead to feelings of depression, anxiety, anger, and irritability while decreasing body image and self-esteem. It can create food and weight preoccupation, social isolation, decrease metabolism, deplete the pocketbook through costly regimes, and reinforce good/bad food choices while increasing shame for giving into temptation.
Therefore, weight loss is not the focus of treating emotional eating. Instead, a healthy relationship with food and one’s body are the main goals. Such changes may ultimately lead to appropriate, gradual, and sustainable weight loss, with its positive physiological effects. The American Dietetic Association has seen that a decrease of a mere 6-7% of body weight paired with a 30-minute per day increase in physical activity can decrease the conversion of impaired glucose tolerance to diabetes by more than half. Furthermore, weight reduction of just 5-10% decreases the risk or status of cardiovascular diseases, arteriosclerosis, and Type II diabetes. Total cholesterol decreases, low-density lipoproteins (LDLs or “unhealthy cholesterol”) decreases and the high-density lipoproteins (HDLs or “healthy cholesterol”) increases. Sleep apnea improves. But even if weight does not decrease, the healthier emotional and physical lifestyle is a major benefit. The Health At Every Size movement is growing by leaps and bounds among healthcare professionals who recognize that being overweight does not necessarily mean that one is unhealthy.
The positive focus on a healthy relationship with food and one’s body is a breath of fresh air for Americans who are burdened by the incessant blare of thinness messages and images. Such a change of focus opens the door for individuals to function in greater harmony with their bodies, listening to internal cues regarding hunger and satiety. This changed focus therefore allows people to appreciate their bodies and the life-giving mechanisms that God built into them. To be at war with the body God gave us inherently disconnects us from God. To appreciate and understand our body deepens our experience of God’s love for us and his presence in our everyday life.
Emotional eating is a common problem in the United States, but one that has received insufficient attention. Many people are experiencing significant distress from emotional eating—distress that can be relieved. Emotional eating causes problems both internally and externally. Unless the emotional, cognitive, relational, and spiritual aspects of emotional eating are addressed, disordered eating and weight may be difficult to reduce. Public and professional awareness of the signs and dangers of emotional eating are essential so that individuals can seek and treatment professionals can provide appropriate assistance. If you feel you may be an emotional eater, please begin your healing journey by seeking a more detailed assessment with an appropriate medical provider, counselor, or registered dietician.
The American Dietetic Association www.eatright.org
National Institute of Health www.nih.gov
American Academy of Family Physicians www.aafp.org
Health at Every Size www.healthyweight.net
Academy for Eating Disorders www.aedweb.org
Intuitive Eating: A revolutionary program that works by Tribole & Resch
Breaking Free from Emotional Eating by Roth
Moving Away From Diets by King, Kratina, & Hayes
The Body Image Workbook by Cash
Brain Lock: Free Yourself from Obsessive-Compulsive Behavior by Schwartz
Darcy Tucker, MA, LAMFT, is the Assistant Program Director for the Remuda Life Program, the residential facility of the Remuda Ranch Programs. Remuda Ranch Programs for Anorexia & Bulimia, Inc., the nation’s largest inpatient facility dedicated to the treatment of women and girls suffering from eating disorders. Remuda offers a specialized 30-day residential program for women and adolescents struggling with emotional eating. Ms. Tucker has spoken on the topic of the mental health professional’s role in understanding and treating emotional eating. She can be reached at (800) 445-1900; email email@example.com. Additional information is available through the Remuda website: www.remudaranch.com.