Hungry? Or Coping?

Keeping emotional eating in check

Making good food choices is one of the most important things we can do for the health of our hearts. We know we should be eating plenty of fruits, vegetables and whole grains while limiting sodium, salt, saturated fat and avoiding trans fats. Even so, many of us find ourselves looking for comfort from food. After a bad day at work, we drown our stress in ice cream or squash our frustration with pizza, only to remain stressed and even feel a little guilty afterward. Some call it “stress eating” or “emotional eating.” But what is emotional eating, and how can it be managed to avoid harmful heart health consequences?

According to Mark Gorman, a staff psychologist at the Massachusetts General Hospital Weight Center, emotional eating happens “when someone doesn’t like the emotions they’re feeling — they feel really stressed, for example — and in order to cope with that stress, they eat because eating makes them feel better.”

Simply put, emotional eating is a coping mechanism. With emotional eating, people often tell Gorman that there is relief in the moment — whether they feel better or numb — from whatever negative emotion they are experiencing, such as guilt or distress.

Emotional eating is not considered a true eating disorder, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the standard classification of mental disorders used by mental health professionals in the United States. Anorexia (food restriction) and bulimia (binging and purging) are well-known eating disorders; binge eating has also been added to the DSM-5. These eating disorders, however, are behavioral patterns that have distinct criteria, including a level of distress, impairment in functioning and frequency of repeating a behavior. At this time, emotional eating does not have a set criteria or set of symptoms to distinguish it as a diagnosable eating disorder.

To receive a binge eating diagnosis, for example, the American Psychiatric Association website states:

Binge eating disorder involves frequent overeating during a discreet period of time (at least once a week for three months), combined with lack of control and associated with three or more of the following:

  • Eating more rapidly than normal
  • Eating until feeling uncomfortably full
  • Eating large amounts of food when not feeling physically hungry
  • Eating alone because of feeling embarrassed by how much one is eating
  • Feeling disgusted with oneself, depressed or very guilty afterward

Binge Eating Disorder also causes significant distress.

Dr. Mark Gorman

A person who is eating in response to emotions, however, may very well have a sense of control but chooses to use food as a way to numb, cope or pacify a feeling. “An emotional eater might say, ‘Yes, I ate a whole cheese pizza by myself, but that was a choice I made and at no point did I feel like I couldn’t stop myself. I was in control the whole time.’ That’s different than a clinical diagnosis of binge eating,” Gorman said.

Despite some similarities, emotional eating is not necessarily a symptom of an eating disorder. It might more accurately be thought of as a behavioral response to negative emotions, just as a person might scream in response to anger or go on a run in response to frustration.

It may also be a response to a positive stimulus as well, eating too much cake at a wedding or ordering a large steak dinner as a way to celebrate a promotion. Enjoying food is part of how our culture celebrates, grieves and processes things. “If someone comes in to my office and says ‘My mom died and I’ve been eating casseroles for two weeks,’ nobody is going to pathologize that and say that’s a problem,” Gorman said. “But if someone comes in and says their mom died two years ago and they’ve been eating casseroles nonstop ever since, that’s a different situation.”

Given that emotional eating can sometimes sabotage diets and create a lot of guilt, what is a stress eater to do? Gorman weighed in: “I always say ‘the opposite of stress is not eating. The opposite of stress is relaxation.’ So really what we need to do is to teach the coping strategy of relaxation.” Another example, if a person is lonely, eating does not satisfy the emotion of loneliness. However, some kind of interpersonal enjoyment, such as bonding with friends or family, would pacify loneliness and fulfill the emotional need.

So how do we know if we’re eating emotionally and how can we keep it in check? If you are not eating out of physical hunger, but you are feeling an emotion and eating, Gorman suggests you are likely eating emotionally.

Paying attention to what you are eating and why — or eating mindfully — is an important step for keeping emotional eating in check. Gorman suggests that when you have a craving, ask yourself some questions:

  • Why am I reaching for this?
  • Is it because I am physically hungry?
  • When is the last time I ate?
  • Do I have a headache or is my stomach rumbling?

If you just had dinner an hour ago and you are not feeling any physiological need, say to yourself, “This does not seem like hunger, this is more of a head hunger or craving.” At that point, ask yourself:

  • What else is going on?
  • Am I bored?
  • Am I stressed?
  • Am I upset?
  • Am I trying to make something unpleasant more pleasant?

Gorman suggests that when trying to curb emotional eating, look for alternatives to soothe the emotion or take your mind off it. If you are stressed, go for a walk, put on some music you like or change the lighting. If you are lonely, call, visit or email a friend, or reach out on social media. Evaluate all the alternatives.

When a craving or the need to eat emotionally strikes, the feeling may seem to last forever, but cravings really may only last around 30 seconds. To get over the craving hump, some people use tricks such as:

  • brushing teeth right after dinner (if you don’t want to brush again, you’re likely not to eat again)
  • reach out to a friend or talk to a partner or spouse
  • snap a wristband or headband to distract yourself until the moment passes

Gorman also suggests writing down emotions and exploring “Where am I right now? How am I feeling? What are my options?” Looking at the answers on paper can help you be clear that the emotional eating is not worth the potential health consequences such as weight gain, high blood pressure or diabetes that may be associated with consistently making bad food and portion size choices. In other words, weigh the pros and cons and then make a conscious choice. No doubt, sometimes you will still choose to eat emotionally, and that is fine occasionally, particularly if you choose healthy food when you do. “I’d rather someone be proactive in choosing to eat than being reactive in choosing to eat,” Gorman said.

If you deem that emotional eating is a true problem for you, because it is sabotaging your weight or your health, it is reasonable to think about going to see a therapist, such as a counselor, social worker, or psychologist. Having a care team with a dietitian covering the nutritional element and a psychologist covering the behavioral element can be especially helpful in addressing negative eating patterns and making healthier food choices overall.

Even if you are an occasional stress eater and you inhale a few cupcakes after being stuck in traffic, you can still live a healthy life. Gorman recommends the 80-20 rule, meaning you commit to making healthy choices at least 80 percent of the time and loosening the reins no more than 20 percent of the time. “You don’t have to be 100 percent healthy 100 percent of the time. If you make healthy choices 80 percent of the time, that’s pretty darn good and you should feel good about that,” he said.

This information is provided as a resource to our readers. The tips, products or resources listed or linked to have not been reviewed or endorsed by the American Heart Association.

See also: 

Dear Diary, Today I ate . . . -- Using a food journal to support weight management

Does When and How Often I Eat Matter? 

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