What is emotional eating: causes and risks
There are several expressions, such as "cravings", "emotional eating" or even "food addiction", that can be related to the construct of emotional management. All of them refer to situations of loss of control with the intake of food (or drink), usually in response to emotions such as sadness, anger, anxiety or even boredom.
Difficulty controlling food can lead to situations or behaviors that can alert us to emotional eating, such as:
- Having a feeling of urgency to eat (you may even end up eating food that is unfinished, half-raw, or in poor condition).
- Eating secretly.
- Reacting with a confrontation, even with aggression, when food consumption is limited.
- Eating until you feel uncomfortably full, not from satiety but from loss of control.
- Feeling guilty or ashamed afterwards.
These symptoms are often referred to as "food anxiety," but they are not actually symptoms of anxiety, although anxiety can trigger them.
Relationship between emotional eating and binge eating disorder
Emotional eating is not a recognized diagnosis in the classification manuals of diseases and disorders, which is why there is so much diversity in nomenclature. When this lack of control over food is more intense and, among other characteristics, the presence of binge eating is detected at least once a week for a minimum of three months, it becomes a binge eating disorder (as long as this loss of control is not accompanied by compensatory behaviors, such as inducing vomiting). Binge eating disorder is a diagnostic entity recognized by clinical professionals, and included in the diagnostic manuals ICD-11 and DSM-5-TR (WHO, 2021; APA, 2022).
Binge eating disorder in adults
Although not strictly part of the diagnostic criteria, binge eating disorder is often associated with body image distress and negative beliefs about one's own body. However, in emotional eating, this may not be present.
The relationship between emotional eating and binge eating disorder is not entirely clear, but it is accepted that emotional eating is a risk factor for the development of binge eating disorder . Among the few data we have, one study —with several important limitations—indicates that three out of ten people with emotional eating will progress to binge eating disorder after eight years (Estice, 2013). One consideration to keep in mind is that binge eating disorder is defined from an adult perspective , which means that some of the criteria are more difficult to meet in children and adolescents, especially when we consider that they generally do not have free access to food.
Emotional eating is a risk factor for the development of binge eating disorder. In both cases, people also have difficulty regulating their emotions.
Emotional eating usually involves an attempt to regulate an unpleasant emotion by seeking immediate pleasure, although it may also be eating purely for pleasure. In both emotional eating and binge eating disorder, however, people are considered to have general difficulties regulating emotions.
What are the risks of emotional eating?
The most important risk of these behaviors is the presence of overweight and obesity and all the associated consequences, such as, for example, type 2 diabetes. It should be remembered that the presence of obesity in childhood and adolescence is significantly associated with obesity in adulthood, with all that this may imply in terms of loss of functionality and quality of life and the appearance of chronic diseases . (Simmonds, 2016). But it can also be related to the appearance of symptoms of mental health disorders, especially depressive or anxious clinical (Gariepy, 2010; Luppino, 2010).
At the same time, and as we have already mentioned, some people with emotional eating will end up developing an eating disorder such as binge eating disorder. And others could also end up developing another eating disorder, especially bulimia nervosa, although there is little data on this. (Jacobi, 2011)
It should be emphasized that one of the risks of the presence of emotional eating is that, since it is not a recognized diagnosis, it can go unnoticed or be minimized and, at the same time, minimize or not detect related mental health problems or disorders. Often there is discomfort in the person or in the family environment derived from these difficulties. The person may feel shame, guilt and low self-esteem.
Emotional self-regulation in eating disorders
What favors the appearance of emotional eating?
There are several factors that have been associated with emotional eating, although their impact is generally not well understood. Some of them are:
Difficulties in regulating emotions
Being impulsive or having difficulty dealing with emotional distress and conflict, for example. A misunderstanding with friends at school, for example, can end with emotional eating. In this case, people eat as a response to discomfort and as a way to compensate for this discomfort. Managing boredom is a key factor, since emotional eating is very common in these situations. If, in addition, we have had some conflict at school, the risk increases!
Ultra-processed foods are designed to be highly rewarding and, therefore, encourage uncontrolled intake in the form of emotional eating.
One aspect related to the identification and regulation of emotions has to do with the awareness of knowing when we are hungry and when we are full . We don't know if it is the chicken or the egg, but people with emotional eating may have difficulty identifying it correctly.
It is important to note that people who have difficulty regulating their emotions due to another disorder, such as attention deficit hyperactivity disorder (ADHD) or autism spectrum disorder (ASD), are more vulnerable to experiencing episodes of emotional eating (this does not mean that all people with these disorders will experience them). For example, people with ADHD are more likely to eat more quickly, snack more, and have difficulty planning meals. People with ASD, on the other hand, may selectively eat unhealthy foods or eat in response to the stress of certain social situations.
Consumption of ultra-processed foods
Another factor associated with emotional eating is the consumption of ultra-processed foods and beverages , which are industrial formulations made from substances extracted from foods, derived ingredients and additives, with little or no presence of "whole" foods, usually very palatable, ready-to-eat and with a long shelf life. These products are designed to be highly rewarding and, therefore, encourage uncontrolled intakes in the form of emotional eating. There was an advertisement for potato chips that said: "Do you think you can eat just one?" Well, probably not, since they have been designed to make you want more. Currently, there is a growing interest in this area, both in terms of research and social advocacy.
On the one hand, research in this area, although still young, indicates that the consumption of these foods could have a direct effect on brain circuits that regulate emotions . On the other hand, the advertising of many of these unhealthy and somehow "addictive" products is aimed at children and adolescents, a fact that needs to be reviewed in depth from a social and political perspective. Unfortunately, these foods tend to be cheaper than many fresh products, and, therefore, socioeconomic level is a factor related to obesity and very possibly also to emotional intake.
The relationship with food in the family
Another relevant factor is the relationship you have with food at home. In this case, a factor that can prevent the appearance of emotional eating is having a healthy diet and lifestyle habits , including:
- Not having higher-risk foods available at home (especially ultra-processed foods, which should be consumed sporadically).
- Follow a varied diet.
- Have regular meal times.
- Make meals as a family.
Guidelines for promoting healthy eating at home
What can we do to address emotional eating at home?
The first step in being able to act in a situation of emotional eating is to identify the problem. Some questions that can help us detect if our son or daughter may have emotional eating are:
- Do you have a problem with food?
- Does he say he's hungry after eating a normal meal?
- How often does it happen to you and in what situations?
- Do we follow healthy eating habits at home or is there room for improvement?
The guidelines will need to be individualized in each case, but some general recommendations are :
- Improve family habits. If we don't have healthy habits in the family, fix them. Ensure meal times, plan shopping, eat together at the table.
- Manage the environment. Do not have foods at home that are used sporadically (especially ultra-processed foods, which are only bought for special occasions). If we do not have them at home, we make it more difficult for the person to lose control in the event of an "emergency" to eat. For example, it is not necessary to have cookies at home or bagged potatoes, but we buy them when there is a party.
- Exercise and take care of your sleep. Healthy habits include exercising and sleeping the recommended hours for your age.
- Do not reinforce with food. Review if we reward good behavior with food. We will need to think about other rewards, for example, good grades can be rewarded by spending a day in that place we like so much. Or if we use food for "fear of getting angry" and look for other strategies as the case may be.
- Distinguish between hunger and cravings. Help identify when a child or adolescent is hungry or wants to eat. If they have just finished eating, they are unlikely to be hungry. Another clue will be the bodily sensations of hunger or the absence of these. If after a few minutes and they are distracted, they no longer remember that they wanted to eat, it may not have been hunger. If they are only hungry for certain foods, but not for others, this may not be hunger either.
- Plan moments of risk (boredom) . When emotional intake occurs in relation to managing boredom, we can help the child or adolescent organize themselves during times of greatest risk. We can start by planning an activity of interest in an environment where eating is not possible (for example, playing sports). The ultimate goal will be for the person to be able to manage boredom autonomously and without the need to eat.
- Work on emotional regulation and conflict resolution . In the event that uncontrolled eating occurs due to difficulties in emotional regulation or conflict resolution, it will be necessary to help the person identify emotions and regulate them in a different way, and to seek possible solutions to conflicts. In some cases, it will be necessary to have the help of a professional in the field of psychology.
- Seek professional help when there is another disorder such as ADHD or ASD . This problem needs to be addressed in an integrated and global way with the help of clinical professionals.
The Hospital Sant Joan de Déu Barcelona is carrying out a study to better understand binge eating disorder and related behaviors and to find predictors of this condition. For this reason, we need the participation of adolescents between 12 and 18 years old, who are being monitored for obesity and who binge eat or have emotional eating. If you think your son or daughter could participate and would like more information about the project, you can write an email to hospitalbarcelona.estudiprecbed.salutmental@sjd.
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