Over eating used to be thought of as one single phenomena. It has become clear after 35+ years specializing in this field, that there are at least 5 types, of which any one person may have all of, some of, or just one aspect.
The treatment for each type varies, which makes the field confounding at present time, with one treatment, such as Intuitive Eating seeming at odds with the newly emerging neurochemistry of addiction or metabolic syndrome treatment. I do believe there is a way through, as there are many stages of recovery that can twist and turn and accommodate many modalities of nutrition therapy.
Overeating, which is driven by the perception that a food is to be limited, or by actual unavailability of foods. In our culture, deprivation driven eating often follows weight loss diets, or restrictive eating disorders, where certain foods are considered fattening or unhealthy. Willpower erodes, and individuals are often surprised by a spring-loaded loss of control with food. Often, this is preceded by intrusive thoughts about food, excessive counting or planning re; eating, a growing obsession with eating, and eventual breakdown of former willpower.
The over eating can take the form of “to and fro” trips to the kitchen for ‘just one more’ slice of cake, or develop into full-blown binge eating.
The treatment is to reconnect to one’s own body, to spend time discovering one’s own hunger and satiety processes and to legalize all forbidden foods. In other words, all past diets, excessive health rules, and other imposed nutrition standards are relinquished, using a variety of techniques and approaches, including the Intuitive Eating method described by Tribole and Resch in their book, Intuitive Eating. This paradoxical method must be adapted to the individual needs of the client, regarding their requirement for structure versus freedom through the process. In the long run, the individual makes choices about what to eat from a more wholistic sense of self, listening to the body, learning to trust oneself, allowing one’s diet to evolve toward true satisfaction and freedom. More on this process in later sections!
Emotional overeating can include a very wide range of over eating patterns, and reasons for it. Most emotional overeating is done in an effort to cope with unwanted emotions, much like one might use alcohol or an addiction, as a comfort, protection or defense system through the difficult situations in life. The deeper issues underlying emotional eating vary greatly with individuals, and recovery depends on discovering and trusting the underlying meaning within the system. Symptoms can be viewed as messengers pointing towards potential transformation.
Treatment, as outlined later in this article, occurs in stages, where insight work is geared toward discovering what aspect of any given days’ eating is emotionally driven (versus normal eating), and to become aware of what the eating provides despite the distress that it may be causing weight gain.
Learning to understand what the overeating is soothing often leads one to re-evaluate unquestioned belief systems about ones true Self, about relationship patterns, safety, empowerment, self-care, sexuality.
As one makes the actual life changes beckoned by the emotional eating, the need for the food can become extinguished, albeit in stages and levels throughout the years. At advanced phases of healing, some individuals opt to set boundaries with certain types of eating, be it a time of day, a manner of eating (standing or eating out of the bag), or a type of food (for some fast food is an example). Rather than feel deprived, people describe being set free but use the urges to over eat as a signal that their attunement to themselves is an important alert.
The weight gain that can occur from emotional overeating cannot be the driver for recovery. Due to the high level of prejudice against weight gain or ‘fatness’, by our culture, most individuals come into treatment seeking weight loss versus freedom from overeating. Thanks to Health at Every Size (HAES), there is a building social transformation through awareness and support that beauty and health come in all sizes and shapes. The section on re-alignment of motivation to recover addresses this is more detail.
Addiction hijacks the brains’ neuro-circuitry and has expanded from a list of substances, such as mood altering drugs and alcohol, to behavioral addictions as well. Behavioral addictions such as gambling, stealing, and now disordered eating, are potentially addictive because of their powerful effects on the brain’s reward system, the circuitry underlying craving. The question as to whether a particular food substance like sugar or white flour is addictive continues to be debated, but through the new understanding of reward centers and impulsivity temperament differences, the behavioral addiction of overeating, including bulimia rituals involving overeating and purging, are emerging as significant.
It appears that some individuals have more of a reward stimulus to eating certain foods than others, just as others are hardwired to over indulge on alcohol or tobacco, and this reward circuitry can become an added driver in over eating disorders.
Addictive overeating overlaps with emotional overeating, likely in an additive manner. As one resolves the emotional issues, the addictive drive may still exist.
Treatment is still young, since abstinence from a given type of food looks like dieting, and dieting drives deprivation driven eating. Nonetheless, as people become aware of the annoying aspects of a food addiction, if present—the obsessive thinking, the arousal phase when thinking about overeating, the inability to enjoy a hearty portion without doubling or tripling that portion, the physical after-effects—it is possible to explore the pluses and minuses of avoiding certain rituals, places, or eating situations in an effort to re-route one’s own circuitry and find more freedom, not less.
Metabolic Hormone Driven Eating
We are 70 years into the industrialization of the production, processing, and mass marketing of food. As a result of this industrialized food production system, we are discovering a phenomenal rise in metabolic hormone changes, which drive the biochemistry behind energy production, food cravings, and body weight balance. Insulin overproduction is the major culprit of overeating and rises from eating a disproportionately high quantity of refined flour and sugary foods. The tendency to overproduce insulin in some individuals and some ethnic groups appears to have an epigenetic source, which can be exacerbated by weight gain and by food habits regarding highly processed foods.
High fasting insulin levels and a tendency to overproduce insulin, in general, have serious effects on our sense of well being, on energy production, brain alertness, fatigue, and food cravings. High insulin levels tend to squelch glucagon production. Glucagon is the hormone responsible for temporary appetite suppression between meals and throughout the night and morning. Glucagon mobilizes our natural fat stores, so that the body maintains a weight balance, providing energy from foods recently eaten or that have been stored as fat. This key health hormone is high between meals – balancing insulin when insulin levels are normal.
Metabolic syndrome is a physical disorder where insulin levels are too high, causing food to be stored as fat versus burned off between meals. This syndrome results in a new discovery—that a calorie is not a calorie anymore. Protein calories, fat calories and refined grain/sugar calories have different effects on weight and energy production.
Weight gain from metabolic syndrome is NOT necessarily driven by emotion, deprivation, or addictive eating, rather, is primarily due to an acquired dysregulation of normal energy production and metabolic physiology.
With too much insulin and too little glucagon, many of our food and weight regulation systems (leptin and ghrelin levels) are thrown off.
Although significant calories are taken in, cravings for more food can occur as blood sugar levels shift, and fatigue is common due to lack of ability to access the energy that exists in foods. In other words, mitochondria don’t get access to burning off the full amount of foods eaten, since high insulin levels tend toward storage of calories.
Individuals to have a history of any other type of over eating disorder, and who end up gaining fat stores, can become susceptible to pre-metabolic syndrome, since in some individuals the weight itself can trigger insulin/glucagon imbalance. This is a complex physiological dynamic, which is highly treatable. With attention to sufficient access to food and resources, diets that include significant protein, one that is rich in plants, including a variety of plant fats can help. Using a modification of intuitive eating, toward plants, proteins and delicious fats, (and including favorite desserts/snacks according to the intuitive eating model), the body’s metabolic hormones can return to normal. More on treatment is outlined later in this article.
HABIT—AS AN ASPECT OF OVEREATING
Habits form throughout our life. They may originate from cultural, familial, or social routines, and for whatever reason, become personal. With regard to eating, some individuals get into the habit of eating by the clock instead of their bodies, and inadvertently over eat. Cleaning our plate was an admonition in our food-coupon cutting home, as was having dessert after both lunch and dinner.
When assessing someone’s over eating profile, there are dozens of day to day habits that unfold about food shopping, eating out, portioning food, snacking, caring for oneself around food, fluid consumption, and activity, never mind the heavy hitters–food preparation and cooking.
Some habits may result in over eating. What differentiates emotional eating from a habit, or addictive eating from a habit?They exist in a spectrum and certainly can overlap. To keep it simple, I think of a habit as something one can change through analyzing motivation and making appropriate behavior modification interventions IF someone WANTS to make a change. Such behavior modification efforts can work if the eating isn’t driven by deeply rooted issues.
Over eating disorders can be devastating and leave a trail of habits amidst that form as one learns to cope with, let’s say, years of emotional eating, dieting, then deprivation driven eating added on. Shopping, cooking and mindful eating can morph into unhelpful habits over time, alongside body checking habits and exercise devolution. Addressing the habit problems has to be timed well… better to form a good attachment and get a clear assessment of what kind of eating is what. I often leave the habits for last, as the other treatment seems more important. In the end, I will say though…After someone has spent years and years of time and money through the very personal journey of recovery, it ends up being surprising how much habit there is to change. I have found that the process of, say, learning to cook, or self- care around food is best done with a lot of fun, camaraderie and humor. Persistence can be fueled by a sense of community, creative ideas and some technology apps!