Emotional/Stress Eating:
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Emotional/Stress Eating:

Facts, Challenges, and Interventions. . Jeremy Clorfene, Ph.D.. Head Psychologist Advocate Weight Management Program (Chicago Area). . 565 Lakeview Parkway, Suite 102. Vernon Hills, IL 60061. o 847-990-5770.

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Emotional/Stress Eating:




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Presentation on theme: "Emotional/Stress Eating:"— Presentation transcript:

Slide1

Emotional/Stress Eating:

Facts, Challenges, and Interventions

Jeremy Clorfene, Ph.D.

Head Psychologist Advocate Weight Management Program (Chicago Area)

565 Lakeview Parkway, Suite 102

Vernon Hills, IL 60061

o 847-990-5770

c 847-877-1331

www.jeremyclorfenephd.com

Slide2

Why do we eat?

1.

Hunger/Fuel

2. Every other reason

Slide3

What is Emotional/Stress Eating?

Eating

in response to negative

emotions

Stress

, anxiety, sadness, anger, despair, loneliness, boredom,

hopeless, helpless, shame, pressure

, fatigue,

sleepiness…so

you

can feel

better

(

temporary).

Slide4

Emotional/Stress Eating is mitigating an

unpleasant uncomfortable state by eating

to temporarily feel better or distracted…

“I just have to have it.”

Usually you will never

feel more justified eating when they are feeling these negative

emotions

(

Stinking Thinking

)

Slide5

Slide6

NOTE

:

Emotional

eating

discussed

in terms of negative emotions rather than eating when

“happy”

or

“excited” (positive emotions).

Human emotions and experience is complex, and the link between

negative emotions and

eating is key.

Separate Issue

:

Eating when happy…usually “reward eating.”

Eating for celebration/social/out …“I’m Italian, we eat”

Slide7

What Triggers Emotional Hunger?

Stimulated

by situations, thoughts, feelings,

people, cues

, time of day, and long-standing habits

. Examples: commute, supervisor, paying bills, parenting…

Human

beings are

emotional: it provides

color,

depth

,

quality.

Imagine

a life without emotions?

Dictates how

we live,

interact,

work,

play, meaning

and

purpose

.

Clearly, eating

and emotions can have a strong relationship.

How we related to food is emotional, passionate …. “a love affair with food.”

Slide8

Physical vs. Emotional Hunger

Physical hunger occurs when our body needs food for energy.

Anxiety

, sadness, or anger does not feel like hunger even though a person may want to eat.

Years of emotional/stress eating forgotten what

physical hunger truly feels like –

Over

time, when emotional eating is targeted as a treatment goal

patients

will reconnect with physical hunger cues.

Progress is when eating

in response to physical hunger rather than emotional hunger.

Slide9

What is the Biochemistry / Physiology?

Where do we feel negative emotions?

Negative

emotions and stress

will activate our body in

a fashion designed to protect us against that threat.

Our

body does not know if the threat is real or perceived but it is receiving messages from the brain that

something

is wrong.

Anxiety, fear, anger, betrayal, sad activates

the "fight

or flight" response.

Slide10

“Fight or Flight Response”

During Stress adrenal glands release two hormones: Adrenaline

and

Cortisol

Stimulate

our organs and muscles

to cope with the threat causing our

negative emotions.

Our

body’s response to a bear chasing us in

the

woods is very similar to being scolded by

a supervisor

at work.

Slide11

Cortisol

Cortisol

increases appetite and sugar cravings

We

love sweets, sweets, sweets

Also, Turning off of “full centers” in

the brain

Numbing all other feelings…

Sugar

is the great anesthetic!

Once

obese, got to eat to stay obese

Vicious

cycle

Taubes

, G,

Why We Get Fat

, 2010

.

Slide12

The Cycle

Concomitantly

, obesity can contribute to a negative self-worth which can significantly impact a patient's overall mood (gender differences as

well).

Thus

, a cycle of lowered self-worth fuels negative emotions which in turn increases eating and subsequently obesity. In most situations, emotional eating takes place when a patient is

rarely physically

hungry.

Slide13

Slide14

BTW…we are the most in debt, obese, addicted,

medicated

cohort in

history

woa

!

Slide15

Limbic System - Dopamine

Brain’s “pleasure chemical”

Controls emotions, memories, and smell

We make many decisions based on emotions (dopamine)

With the sight of food, dopamine flushes your brain

Takes approx. 2 seconds to make a decision (uh

ya

fast)

Once levels decrease, question why you did it?

Buyer’s Remorse

Lindstrom M.

Buyology

of Belief. 2008

Slide16

Similarities b/t Food Addiction and Drug Addiction

PET scans show obese patients have lower dopamine levels

Similar to drug addicted subjects

Thus less sensitive to reward stimuli

Takes more food (stimulus) to gain pleasure

Obese patients more vulnerable to food intake as a source of pleasure

Wang GJ.

J Addictive Diseases

. 2004

Slide17

Conscious Mind

Our personal identity, creative mind runs the show about 5% of the time

Aware of the Past, Present, and Future

Holds our wishes, desires, and aspirations

Holds our “positive thoughts”

Our “Free Will”

Lipton BH. Biology of Belief. 2008

Slide18

Subconscious Mind

Stimulus-response cycle…reflex system

Not governed by reason or thinking

Years of stored, learned programs, habits

Runs the show 95% of the time

Lipton BH. Biology of Belief. 2008

Slide19

Subconscious Mind (cont.)

50,000 (

est

) automatic thoughts per day / called sub vocalizations

Every thought, aware or unaware has a chemical signature

95% are automatic!

Aware of only 5% = 2500 ...

80% of those thoughts are Negative / Limiting (approx. 2000)

4 negative to 1 positive

Why so much negativity?

Marshalla

,

Repeatlessness

, 2006

 

Slide20

Perceptions and Feeling

Brain is attracted to negativity:

Researchers looked at how we fall into negative mindsets and then it is difficult to undo

Slide21

How to describe the glass?

Glass is ½ Full = Gain Frame (positive)

Glass is ½ Empty = Loss Frame (negative)

Slide22

New Surgical Procedure

70% Success

30% Failure

30% Failure

70% Success

Group 1

Group 2

Slide23

Governor Rating

40% Jobs Saved

40% Jobs Saved

60% Jobs Lost

60% Jobs Lost

Group 2

Group 1

Slide24

Mind Frame Conversion (600 lives at stake)

Group 1

Group 2

If 100 lives are Saved how many are Lost?

If 100 lives are Lost how many are Saved?

600-100 = ?

GAINES TO LOSS

LOSS TO GAINES

Slide25

How long to figure out the problem?

GAINES TO LOSS

LOSS TO GAINES

7 seconds to figure it out

11 seconds to figure it out

Chaiken

, S., &

Ledgerwood

, A. (2012)

Slide26

What does this mean

?

Once the mind experience, thinks, perceive loss…it resists change

Shifting from positive to negative is easy

Shifting from negative to positive is hard… It takes effort and work!!

Why? Negativity

is

emotionally

protective.

Control/predict pain is better than feeling good and then be disappointed!

Slide27

Positive feedback is short-term, transient.

Negative feedback sticks all too well.

Ex. Performance review…

25 things you do awesome, but that one opportunity

for

growth”

Ask people about “love,” tell you about heart-break

Ask about belonging, tell you about rejection

Ask people about connection, tell you about disconnection

Slide28

Positive Attitude!

Slide29

Also…Anything that is perceived to require “EFFORT” is also considered

negative!

Building success is

about

effort, effort doesn’t feel good, increases risk for emotional eating unless there is a payoff/reward/

reinforcer

.

Building frustration tolerance, victories off-set the discomfort, confidence and positive results ensue!

Slide30

Let’s Get Real…A typical Day

What is the emotional/stress eating pattern?

Most

people do not emotionally eat in the morning

or

early afternoon.

Patients report emotional/stress

eating takes place

mid

to late afternoon and in the evening.

Factors:

Sleep/Energy

,

Hormones

,

Hunger, Behavior…

Slide31

Sleep/Energy

Sleep and Energy: Greatest level of focus, attention, and energy mid-morning

!

Post-prandial

dip…nap time would be great/siesta (good luck)…then, “

4pm,

Tea and Crumpets”

The day progresses fatigue, sleepiness increases, b/c most people totally sleep deprived (caffeine)

Sleep deprivation increases cortisol, and caffeine activates adrenal gland (double whammy).

Slide32

Ghrelin Levels (hunger hormone)

Slide33

Behavior

What are we doing between 6am and 6pm?

Working, busy, distracted…

Then we commute, come home and then …bills, kids, marital issues, single parent, medical issues…

THEN WHAT?

Slide34

BACK UP THE

EMOTIONAL/ STRESS

EATING TRUCK

!

(4pm – Midnight!)…sugar/carb time!

Slide35

H.A.L.T.

(4pm – Midnight)

H = Hungry…

A = Angry…

L = Lonely…

T = Tired…

Slide36

Brief Summary

Once obese (morbid) there are some real challenges:

1. Cortisol

2. Dopamine

3. Fat cells influence the brain to eat

4. Negative thinking

5. Sleep deprivation

6. Ghrelin

7.

Food is the go to numbing agent!

Slide37

Behavioral Therapy

“We’re pretty good at engineering and building roads, cell phones, drinkable water, but good luck trying to change peoples behavior”

Charles

Merbitz

, 1996

Slide38

Treating Emotional/Stress Eating

But what are we treating?

Depression, Fatigue, Hunger, Convenience, Trauma, Irritability,

or

A really good opportunity to eat what we want?

HABITS

and drive-

thrus

!

Slide39

Slide40

Levels of Stress/Emotional: Low, Medium, High

Low Stress (0-3)

tired, hungry, bills, commute, child’s grades, boredom, night time eating, TV eating, eating while cooking…

Medium Stress (4-6)

water in your basement, car accident, chronic back pain, family…

High Stress (7-10)

Death/Disability, betrayal, DUI, divorce, job loss…

Slide41

People need their stress to eat!

Ex. Lori, Michael

Slide42

Treatment/Intervention

Break the problem down for the patient: Where’s their stress “hotspot”?

Get a commitment…have they bought into working on this issue?

Discuss the downside to taking away their “coping” and/or “buddy” (mild discomfort)

Slide43

STRUCTURE

and

PRECISION

Slide44

I. STRUCTURE

Regular visits with health care team (1-4x/mo)

Regular monitoring of weight and biometrics.

Higher the connectivity between team and patient better results.

Emotional support, cheerleading with successes and victories, and interventions for lapses

Accountability, cause “naughty” is done in private

Keep ‘

em

coming…even when not doing well.

Slide45

II. STRUCTURE

Do they have a meal plan?

Meal Replacements – 2 for wt loss and at least1 for sustaining – great tool

Nutrition needs met (and quality) without excess

cals

Simplify decisions

Reduce temptation (eat this first, less likely to eat that)

Control costs

Ditschunett

et al., Obesity Res, 2001

Slide46

I. PRECISION

Elevate awareness: acknowledge and recognize negative emotions

Self-monitoring (food records)

Raising self-awareness is absolutely necessary

Patients underestimate calories by 1/3

Overestimate physical activity by ½

Keeping food records is critical

Hold patients accountable, no records no treatment

Food records are diagnostic and intervention

If you count it, you change it

Foreyt

J.

Medscapre

Diabetes & Endocrinology

. 2004

Slide47

II. PRECISION

PREVENT

Identify and fight biggest risk factors for patient and

Battle Stinking Thinking

Battle the “Emotional/Stress eating habits”

FIX

Get back on meal plan at all costs

Work hard till it is not so hard

Slide48

III. PRECISION

PREVENT

:

Stimulus Control – that is, risk factors/triggers

Home (kitchen, fridge, pantry, hidden drawer) = get it out of the house, they’ll get over it

Eating out/drive thru = planning

Late night eating = stop

Strengthen the “internal muscle” …fight the urges, develop tolerance for the discomfort

Slide49

IV. PRECISION

Dieting cycles produces unhealthy thinking relapse behavioral patterns. “Stinking Thinking” are methods to get off plan and justify eating what you want!

Stinking Thinking: The Big Five

1. I already messed up lunch…so…let’s party!

(stole a little, might as well steal a lot)

2. “I’ll just have one” or “I’m just getting a Diet Coke from McDonalds”

3. “I’m stressed so I need this”

4. “I can’t do this/I can’t handle this”

5. “I’m not in my routine so I can have…”

Slide50

V. PRECISION

FIX

once off their plan…stress ate

GET THEM BACK ON PLAN

This is the key!!!!

This is hard, this is the work, this is the change!

Separates the old pattern and builds the correct new behavioral pattern

This is what is always missing!

But it is NOT what your patient wants to do!

This is where the negativity flourishes!

This is where they Give Up!

Must fight this and help them get back on plan!!

Slide51

Summary

Negative emotions / physiology do increase cravings…but

Emotional/Stress eating is more about habits

Get commitment, self-monitor

Pin-point key pattern and target that behavior

Build eating plan to help routine

Grind it out a bit…fight the discomfort

If got off plan, fight to get back on plan asap!

And maybe a whole-

lotta

-psychotherapy.

Slide52

Questions?