This post was written as a sort of summary of the field in terms of separating out the key treatment approaches: non diet/intuitive eating, simpler behavioral approaches for those without significant disorder, those with emotional overeating outside of diet driven overeating, and the additional physiologic factors newly associated with metabolic syndrome like problems.
There are so many versions of what is considered overeating.
People may think they are overeating if they’re eating something off their “healthy” food lists, or their weight loss plan, never mind if one is too hungry or hasn’t let themselves have a beloved food for too long. With all the advice flying around about when, where, why and how to eat, one may assume that overeating is defined by any number of random parameters, such as an eating episode that is too late at night, unless visiting France, Greece or other parts of the world that start a meal at 9pm and end past midnight.
Overeating is subjective, so to get our bearings, I will define the kind of overeating we are talking about here, the problematic, obsessive, psychologically significant over eating patterns, which can become a hostage -taking of oneself. Here are some loosely defined parameters:
- Eating outside of the bounds of physical hunger on a regular basis such that more food is consumed than the body needs (assuming hunger and satiety mechanisms are all working ‘normally’).
- Eating past the point of satiety/fullness on a regular basis such that more food is regularly consumed at these times than the body physiologically needs. There is can be a psychological sense of comfort at being very full, or in some people satiety signals can be weak for a variety of reasons including genetic hardwiring, meaning that it takes more food to get to the same level of satisfaction than ‘normal’ eaters need.
- Experiencing a loss of control with eating such that more food is consumed than is physiologically needed on a regular basis due to a compelling inner drive that can seem to take on a life of its own.
- Binge Eating Disorder as described in the DSM V is one type of overeating disorder.
- Experiencing ongoing physical cravings and hunger driven by physiological conditions such as over-insulin production, including metabolic syndrome, or reaction to some medications.
Over eating behavior can vary from grazing (snacking all day long) to regularly overeating at meals, to full-blown binges that feel out of control.
Excess weight gain occurs due to eating outside of normal physiological signals, unless a compensatory behavior is used, to get ‘rid’ of the food, whereupon an eating disorder in the bulimia range develops.Motivation to get treatment for overeating problems is often driven by the weight gain, since our culture has a deeply condoned prejudice against ‘fatness’. The shame associated with being overweight drives individuals to try to lose weight, which does not target the core over eating behaviors, nor the underlying issues. As we will see, weight loss driven diets drive deprivation- driven over eating, creating a vicious cycle of over and under eating, with increasing self loathing, confusion, shame and precious time lost.
There are generally 3 types of psychological overeating, and a fourth that includes a metabolic component:
1. Simple habit
Where overeating occurs as a behavioral problem which may be resolved with education or behavior modification. For example, some might eat by the clock, or finish over sized portions of food for reasons that don’t qualify as necessarily emotion driven or disordered. Insight, motivation and a targeted behavior plan may resolve this overeating. An example might be that someone would work with a hunger/satiety scale and aim to stop eating when satisfied, removing the plate of leftover food, hence reducing the amount of food consumed with the result of feeling physically better without being overly full.
2. Deprivation-Driven Overeating
Due to evolutionary human survival mechanisms, we have a deeply programmed response to real or perceived limits with food. When a type of food, or secure amounts of food are reduced for any reason, a litany of deeply rooted, psychological processes may ensue, including covetous, and obsessive thoughts toward food, fantasies and dreams of eating, and eventually a strong impulse to get and eat foods despite the boundaries that are in place. This may mean stealing food, breaking a diet despite perceived high risk of weight gain, or having to deal with the health risks of lets say diabetes or heart problems when a diet is broken.
Deprivation driven food obsession may result in behaviors and attitudes toward food demonstrated by a drastic increase in watching food shows, reading recipes, talking about food, cooking for others and serving larger portions of food to oneself or others. If food is scarce due to limited availability, or self -imposed restrictions for health or a weight loss agenda, normal evolutionary psychology points toward an inevitable loss of control with foods.
The source of deprivation driven eating includes inadequate available food due to famine, drought, and the like, weight loss or “health-driven” diets which eliminate calories and especially which eliminate the balance of macronutrients, which create satiety. The ratio and types of carbohydrates, fats and proteins that is key to the neuro-chemistry of satiety and natural termination of eating are specific and when not provided, drive surprising, impulsive eating behaviors.
Deprivation driven eating may show up for example, as a seemingly benign drive to slice off another sliver of brownies from the tray in the kitchen, having sworn them off repeatedly. Despite the resolve not to touch them, much less have another and another slice, the ritual of paring off the edge of the batch of them continues.
Hence, the nature of the psychology of this category of eating is an inner tug of war within oneself, resolving to stay strong about the lack of food, then, breaking down as another part of our selves demands eating, despite the consequences. (I myself was so hungry at a retreat center, which closed its kitchen at night that I found myself clamoring over a barricade to the refrigerator there despite the rules forbidding it!)
An example of “normal” deprivation driven overeating includes Thanksgiving, or anywhere where a certain type of food is only available once/year or in a certain geographical location (think croissant in France), or a family member’s special dish.Deprivation driven eating becomes a major driver toward binge eating, when the deprivation of calories or macronutrients or special very desirable foods continues to be limited. (I once had a 4 year-old survivor of a drug addicted mother, who did not feed her enough food for years. Her drive to binge was exhibited by getting up in the night, going to the refrigerator of her foster home and pulling food out in her sleep. Glass broke, food spilled, and she would be found eating amidst it all, hungrily despite having eating full meals during the day.)
3. Emotional Overeating:
Over eating provides a strong neurochemical and associative comfort response to any given segment of individuals within a culture. To paraphrase a quote by Michael Strober, former head of the Eating Disorder Program at UCLA.., ‘There are two kinds of people… those who eat under stress and those who do not.’
Emotional overeating creates a means of emotional regulation, be it reward or even self- harm, with many different types of physical and psychological mechanisms at play. Like other substance abuse or addiction/dependence issues, this type of overeating is a source of emotional regulation, with roots in genetics, psychological history and current psychological state, body image stress, changes in cultural acclimation to foods, and responses to processed foods. Association to certain foods plays another key role in emotional overeating, be it positive or negative.
Over eating can provide a sense of physical and psychological homeostasis, and can be a response or defense to both positive and negative emotions. In some individuals the weight that is gained from overeating may provide a protective function, such a boundary within the world against some types of expectation or intrusion. Often the weight gain entrenches a pattern of deep self loathing, driving a split within aspects of self that need to be integrated in order to heal.
The reasons for emotional eating may be known or completely baffling, yet the drive to do so can break through all logic and resolve about its negative consequences. Treatment is multifaceted, with an emphasis on deep self- inquiry and insight, to get to the source of what inner intelligence or messenger is communicating to any given individual. The self judgment, must be replaced with an integrated sense of self understanding and respect since emotional overeating can seem disconnected from one’s sense of control, and normal willpower. Food approaches need to allow for exploration, insight and development of a deep understanding of one’s own body, and how to feed it. This requires masterful care from dietitians trained in the psychology of nutrition, health and exercise.
Excellent treatment exists, full recovery is possible.
4. Metabolic Syndrome – and Other High Insulin Physical Conditions
Metabolic syndrome is the result of a growing and highly prevalent physiological condition, related to and maybe even caused by high reliance on processed foods, especially those with disproportionate levels of refined sugar, refined or processed flour, and chemical factors that produce high shelf life for the purposes of mega profits within the big business of food manufacturers.
Metabolic system is discussed by a leading pediatric endocrinologist, Dr.Robert Lustig, as a socio-political driven disorder where the big businesses of food processing, agriculture, and advertising lure vulnerable populations toward eating habits that are physically devastating.
One of the key markers of metabolic syndrome and related disorders is a higher than normal fasting insulin level, and/or high insulin to fasting glucose levels. High insulin may occur outside of frank metabolic syndrome, yet is a serious marker for problems with increased hunger, cravings, and fatigue that drive overeating and limit access to the kind of vitality and energy that drives our sense of well being. Never mind exercise… with too high levels of insulin, the lead-in to type II diabetes, finding the energy to exercise drops along with motivation and overall physical energy in general.
Attention and brain- power suffer in children, adolescents and adults, as the physical and psychological problems associated with metabolic syndrome drive devastating changes in the body’s ability to make energy out of food.
Metabolic syndrome and insulin problems appear to have a genetic or epigenetic driver—some ethnic groups are predisposed to reacting strongly to a diet that has a significant amount of highly refined carbohydrates, especially sugars such as the high fructose corn syrup, and highly processed flours used in packaged, long shelf life snack foods, and fast foods. The condition results in being unusually fatigued, with a tendency to less satiable hunger (meaning more food is needed to satisfy hunger than the body actually requires calorically).
Factors to Consider When Treating Overeating Disorders
- Exercise Resistance Syndrome- A common and extremely important syndrome to recognize and treat…see free podcast episode 69 on Women in Depth Podcast Series or sign up for free condensed version of ebook with “opt-in” sign up on website www.franciewhite.com
- Separation and clarification each type of overeating: behavioral versus deprivation- driven versus emotional overeating and the identification of metabolic shifts or other physiological drivers to overeating.
- Each type of eating has a completely different treatment, and since most people have elements of each, treatment is layered in phases to address each aspect of the total picture.
- The longer the history of dieting, the more important to capture the attitudes and affects of dieting, fitness efforts, body image and life events, throughout the segments of life the a life map summary.
- Cultural, social, familial and gender related body image issues.
- Consider how overeating may be ideal defense, a primitive source of self-care, a protective defense system, or a key signal from the deeper self that beckoning profound changes in physical, psychological or spiritual aspects of life.
- Review of physiological sources of hunger/satiety problems.
- Assess and treat the commonly high degree of self-critic, where negative self -judgment becomes the problem in and of itself often justified by the individual if excess weight gain creates a shame/self-distrust cycle.
- Evaluate the inner aspects of self involved in decisions and rituals of overeating – the Inner Eater, the Rebel, the Critic/Cynic, the Body, the CareTaker, etc. A shift in the active internal characters is key toward an integrated wholeness that aligns eating with one’s whole being.
- Radical Self-Care is mandatory, but getting there is a winding road through many levels of exploration and determination to make both inner and outer life changes.
- The nutritionist process (an RD specializing in the psychology of eating)… involves 5-7 modules transitioning from intuitive eating or the non diet approach through models that evaluate unique individual requirements for satiation, energy production, an understanding of possible addictive elements with eating, and the need for personalized structured programs. Evaluation of pantries, shopping, recipes, involving eating “lab” (Lets Eat!) sessions which can occur in the home or off site kitchens must be fun, fulfilling and practical for today’s busy schedule.