When is overeating or emotional eating an eating disorder?

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Most people have some sort of emotional eating trigger. Eating becomes a way to feel better when sad or a way to celebrate when joyful. And emotional eating can be a normal physiological response to distress. But when does this pattern become abnormal and enter the realm of disordered eating or a diagnosable eating disorder?

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Emotional eating disorder

Engaging in emotional eating is a common behavior and can be a normal physiological response to stress, especially among women. But it does not necessarily constitute a diagnosable eating disorder. Yet, this type of coping by eating can progress to an eating disorder and can certainly be considered an abnormal eating pattern. 

Why do people engage in emotional eating?

Emotional eating disorders can occur in response to negative feelings, such as sadness or anger, anxiety, or guilt. (1) Typical events that may lead to emotional eating are financial worries, health issues, illness or death of a loved one, or relationship problems. Emotional eaters often reach for comfort foods that are high in fat, carbs, and sugar – items like desserts, ice cream, and candy. (2) After an emotional eating episode, the negative feelings often come back and are compounded by guilt from the eating. This creates a vicious cycle that repeats as part of the disorder.  

Food is believed to be a way to fill a “void” or “emptiness” inside, triggered by negative feelings. The emotional feedback loop is not well understood. But certain behaviors that surround emotional eating are almost always present:

  • Withdrawing from others in times of emotional need, instead of seeking support
  • Disengaging from stress-relieving activities, like exercise, meditating, journaling, etc. 
  • Confusing physical hunger with emotional hunger
  • Negative self-talk during times of emotional eating – further lowering self-esteem 

Differences between physical and emotional hunger cues

One way people can manage their emotional eating response is to learn the difference between their body’s physical hunger cues and emotional hunger cues. Some differences between physical and emotional hunger cues include: (3)

  • Physical Hunger
  • Emotional Hunger
  • Develops slowly over time
  • Comes on very suddenly
  • Causes you to desire a variety of foods
  • Crave only certain foods
  • You feel the sensations of fullness and satisfaction and follow these cues to stop eating
  • You may binge on food and feel full but not satisfied and continue to eat
  • You have no negative feelings about eating
  • You feel guilt or shame about eating 

Binge eating disorder

Binge eating disorder (BED) is the most common eating disorder in the United States. While emotional eating shares some signs and symptoms of binge eating disorder, binge eating disorder contains specific diagnostic criteria and behaviors that occur more frequently and over a longer period of time. 

An episode of binge eating is characterized by: (4)

  • Eating, in a short period of time, an amount of food that is larger than what most people would eat in a similar period of time
  • Lack of control during the episode – a feeling that one can’t stop eating or control what or how much is being eaten 
  • Feeling distressed by binge eating
  • Binge episodes occurring at least once per week for three months
  • No behaviors that compensate – such as purging, fasting, exercising, etc. 

In addition to the criteria above, binge eating disorder episodes are also associated with at least three of the following characteristics:

  • Eating much faster than normal
  • Eating until uncomfortably full 
  • Eating large amounts of food even though not physically hungry
  • Feeling embarrassed by the amount eaten and eating alone to hide that
  • Feeling depressed, disgusted, or guilty after a BED episode

Binge eating disorder has severe health risks over time and requires highly specialized treatment. 

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The link between binge eating disorder and emotional eating

Both emotional eating and BED come with negative feelings like depression, guilt, and disgust from overeating. These feelings can involve negative self-talk and low self-esteem. Emotional eating can be mild – such as eating ice cream in response to a breakup, then reverting back to normal habits – or more severe. 

The frequency and severity of signs and symptoms is usually what distinguishes emotional eating, or disordered eating, from a full-blown eating disorder. (5)

Severe emotional eating can become a bridge to BED if the frequency, amounts eaten, and behaviors associated with it match up to diagnostic criteria. Weight gain can be a sign, but should not always be construed as originating from emotional eating or BED. There are many reasons individuals gain weight, including restricting food in some way, such as any kind of dieting in general and eliminating certain foods, ingredients, or food groups from their diets. 

When to seek treatment

Addressing emotional eating disorders entails uncovering the emotional needs that aren’t being met. While weight gain can be a sign of emotional eating or binge eating disorder, restricting food intake in any way, such as a diet of any kind, should never be a solution. (6) 

Treatment can include psychotherapy to learn effective emotional regulation skills. (5) A tactic that people often learn in therapy to combat emotional eating is to replace the behavior with an enjoyable energetic or relaxing activity, depending on what you think might meet your emotional needs best. These can include writing in a journal, reading a book, going for a walk, listening to music, meeting a friend, or finding a quiet way to relax. It takes time and a conscious shift in mindset to accomplish, but it is possible to replace lifelong behaviors with better habits. 

One study showed that regular exercise, yoga in this case, acted as a proactive measure to prevent emotional eating. This regular routine increased the subjects’ mindfulness, which in turn helps control emotional behaviors. (7)

Binge eating disorder is a severe condition that warrants professional help from a team familiar with eating disorders. Treatment for BED is highly specialized and differs from treatment for other eating disorders, like anorexia and bulimia, in its approach and modalities. 

If you think you or someone you care about may be engaging in emotional eating or have binge eating disorder, it is important to seek help as soon as possible. Our team at Within Health is here to support you in treatment, and recovery from all eating disorders. Speak to our team now for more information.

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Resources

  1. Chang, R. S., Cerit, H., Hye, T., Durham, E. L., Aizley, H., Boukezzi, S., Haimovici, F., Goldstein, J. M., Dillon, D. G., Pizzagalli, D. A., & Holsen, L. M. (2022). Stress-induced alterations in HPA-axis reactivity and mesolimbic reward activation in individuals with emotional eating. Appetite, 168, 105707. https://doi.org/10.1016/j.appet.2021.105707
  2. van Strien, T., Cebolla, A., Etchemendy, E., Gutiérrez-Maldonado, J., Ferrer-García, M., Botella, C., & Baños, R. (2013). Emotional eating and food intake after sadness and joy. Appetite, 66, 20–25. https://doi.org/10.1016/j.appet.2013.02.016 
  3. Feeding your feelings - mayo clinic health system. (n.d.). Retrieved September 26, 2022, from https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/feeding-your-feelings 
  4. Binge eating disorder. National Eating Disorders Association. (2018, February 22). Retrieved September 26, 2022, from https://www.nationaleatingdisorders.org/learn/by-eating-disorder/bed 
  5. Pennesi J-L, Wade TD. A systematic review of the existing models of disordered eating: Do they inform the development of effective interventions? Clinical Psychology Review. 2016;43. doi:10.1016/j.cpr.2015.12.004
  6. van Strien, T. Causes of Emotional Eating and Matched Treatment of Obesity. Curr Diab Rep 18, 35 (2018). https://doi.org/10.1007/s11892-018-1000-x 
  7. Shelov, D., Suchday, S., & Friedberg, J. (2009). A Pilot Study Measuring the Impact of Yoga on the Trait of Mindfulness. Behavioural and Cognitive Psychotherapy,37(5), 595-598. doi:10.1017/S1352465809990361

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