Teen Eating Disorders
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Managing Emotional Eating

Lisa is a classic emotional eater. She uses food to escape and soothe negative emotions, and responds to upsetting internal triggers in a repetitive, automatic self-defeating way. If you find yourself eating when you are not really hungry, Lisa’s story of relapse recovery may provide strategies to help you get back in control.

Lisa’s Story

Before her surgery, Lisa’s binges consisted of thousands of calories of junk food, candy and ice cream. After the surgery she followed her doctor’s protocol of eating five small meals a day. She lost 100 pounds in a year, but in the next year she regained 30. Scared and confused, she sought help to stop the relapse.

While she was not bingeing like she used to, her days were spent in mindless grazes, which often followed one of her planned meals. She knew her overeating was not due to physical hunger, and was puzzled why she was unable to follow the recommended regimen. Lisa recalled in childhood her father was absent for long periods, during which her mother became agitated and depressed. When distressed after being teased by her peers, she looked for consolation, and remembered her mother coldly and angrily telling her to “grow up.” That was when she discovered that food comforted and soothed hurt and rejection.

Lisa’s husband is a busy, successful accountant who is often absent due to demands of the office, and when home, likes to have her listen to tales of office politics. She says she doesn’t mind spending time with him this way, but finds herself grazing later on.

Here are the therapeutic lessons that formed the core of Lisa’s recovery:

Primary vs. Secondary

Often our problem with managing emotions is how we feel about how we feel. Lisa brought to her marriage the old childhood conclusion that vulnerability and need for comfort were weaknesses, defects. By not trusting the primary feelings of hurt and disappointment, she generated the painful and unnecessary secondary feeling of shame, which drove her to use food to escape herself. (Paradoxically, the excess eating only produced more shame). Separate the primary from the secondary emotion.

Validate

Lisa’s food use was her way of telling her emotions to “go away, leave me alone.” Grazing covered up the disappointment triggered by her husband’s unavailability. But by repressing the hurt, she avoided telling him what she needed, and helped keep the relationship stuck in an unproductive groove.

Feelings play a vital role in healthy functioning. Anxiety mobilizes us to prepare for a threat; guilt tells us we failed to live up to an internal standard; hurt and anger direct us to address a problem. Recognize the feeling, affirm it is OK to feel it, examine what it may be directing you to know or do.

Examine the Story

Imagine that I made arrangements to meet a friend for dinner and wait 45 minutes for him to show up. The feelings I have will depend on the story I tell myself:

1) He told me he might have to work late (compassion)

2) He must have had an accident (anxiety)

3) He forgot (frustration and anger)

Feelings, beliefs, and behavior are intertwined. Lisa’s grazing decreased when she could see her husband’s behavior as less about her and more about the demands of tax season. Ask if you might feel better by changing your thinking.

Softening

Lisa reduced the intensity of her feelings of rejection when she linked her husband’s unavailability to memories of her father’s absences. Greater consciousness of our emotional history puts current feelings into a broader context, reduces blame, and increases self-integration and a sense of ownership and control. Soften feelings by linking past to present.

Effect Awareness

I encourage clients to explore what effect they seek from the emotional eating – to calm, soothe, comfort, escape, distract, numb? The next step is to brainstorm – can that effect be produced in another way? Deep breathing, visualization, meditation, prayer, stretching, walking, talking, music, reading – these are examples of alternative ways to create similar effects. By committing to doing these things first, clients find they can surf over the crest of the emotional wave, getting to the other side believing, I can handle this. Lisa learned to respond to urges by practicing a muscle tensing and releasing technique for self-soothing. Try this: clench your hands into tight fists and hold for 30 seconds, then slowly release, letting the tension escape from your fists and forearms. The warmth and tingling you may feel is a way of knowing you are able to relax without putting in calories. Call “time out” and use an alternative intervention to produce the effect you seek.

Get In Balance

Overeating occurs inside a lifestyle context and often there are lifestyle imbalances that set up food use:

1) Food is used as a break for those who are too busy;

2) Boredom sets up entertainment eating;

3) Isolation leads to using food for love;

4) Constant caretaking sets up eating to reward ourselves.

Lisa’s food cravings were reduced when she converted rejection into motivation to connect more with old friends. Look for lifestyle imbalances that need attention.

Letting Go

Therapeutic growth is not like white flag waving, or giving up. Rather, it is more like calculated risk taking, similar to deciding to pass the car ahead – determine if there is room to pass, speed up, return safely to a new position. Letting go of emotional eating will be uncomfortable, and leads to doubts about what will take its place. Eventually Lisa took the risk of talking to her husband about what she needed. She used an “I” message (I need more fun time with you) not a “you” message (you are neglecting me) and was surprised and pleased when he agreed to a weekly movie outing. Counter self-defeating behavior by surrendering to positive, healthier levels of coping.

Conclusion

These strategies helped Lisa recover to the 100-pound loss milestone. While there is no miracle cure for emotional eating, there are many constructive ways to understand and manage it. Each strategy is like a life jacket that can keep you floating above the undertow to use food.

Lee Kern, M.S.W., L.C.S.W., is the clinical director for Structure House, a residential weight loss facility in Durham, NC. Kern leads the post-bariatric surgery program. Designed for patients following weight loss surgery, the program offers surgery-focused medical assessments and personalized eating and relapse prevention plans. For information, visit www.structurehouse.com or call 800-553-0052.