Presentations text content in 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
Why do we eat?
2. Every other reasonSlide3
What is Emotional/Stress Eating?
in response to negative
, anxiety, sadness, anger, despair, loneliness, boredom,
hopeless, helpless, shame, pressure
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
in terms of negative emotions rather than eating when
“excited” (positive emotions).
Human emotions and experience is complex, and the link between
negative emotions and
eating is key.
Eating when happy…usually “reward eating.”
Eating for celebration/social/out …“I’m Italian, we eat”Slide7
What Triggers Emotional Hunger?
by situations, thoughts, feelings,
, time of day, and long-standing habits
. Examples: commute, supervisor, paying bills, parenting…
emotional: it provides
a life without emotions?
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.
, 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 –
time, when emotional eating is targeted as a treatment goal
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?
emotions and stress
will activate our body in
a fashion designed to protect us against that threat.
body does not know if the threat is real or perceived but it is receiving messages from the brain that
Anxiety, fear, anger, betrayal, sad activates
or flight" response.Slide10
“Fight or Flight Response”
During Stress adrenal glands release two hormones: Adrenaline
our organs and muscles
to cope with the threat causing our
body’s response to a bear chasing us in
woods is very similar to being scolded by
increases appetite and sugar cravings
love sweets, sweets, sweets
Also, Turning off of “full centers” in
Numbing all other feelings…
is the great anesthetic!
obese, got to eat to stay obese
Why We Get Fat
, obesity can contribute to a negative self-worth which can significantly impact a patient's overall mood (gender differences as
, 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
BTW…we are the most in debt, obese, addicted,
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
Once levels decrease, question why you did it?
of Belief. 2008Slide16
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
J Addictive Diseases
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. 2008Slide18
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. 2008Slide19
Subconscious Mind (cont.)
) 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?
Perceptions and Feeling
Brain is attracted to negativity:
Researchers looked at how we fall into negative mindsets and then it is difficult to undoSlide21
How to describe the glass?
Glass is ½ Full = Gain Frame (positive)
Glass is ½ Empty = Loss Frame (negative)Slide22
New Surgical Procedure
40% Jobs Saved
40% Jobs Saved
60% Jobs Lost
60% Jobs Lost
Mind Frame Conversion (600 lives at stake)
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 GAINESSlide25
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
, S., &
, 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!!
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
Ask people about “love,” tell you about heart-break
Ask about belonging, tell you about rejection
Ask people about connection, tell you about disconnectionSlide28
Also…Anything that is perceived to require “EFFORT” is also considered
Building success is
effort, effort doesn’t feel good, increases risk for emotional eating unless there is a payoff/reward/
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?
people do not emotionally eat in the morning
Patients report emotional/stress
eating takes place
to late afternoon and in the evening.
Sleep and Energy: Greatest level of focus, attention, and energy mid-morning
dip…nap time would be great/siesta (good luck)…then, “
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)
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…
BACK UP THE
(4pm – Midnight!)…sugar/carb time!Slide35
(4pm – Midnight)
H = Hungry…
A = Angry…
L = Lonely…
T = Tired…Slide36
Once obese (morbid) there are some real challenges:
3. Fat cells influence the brain to eat
4. Negative thinking
5. Sleep deprivation
Food is the go to numbing agent!Slide37
“We’re pretty good at engineering and building roads, cell phones, drinkable water, but good luck trying to change peoples behavior”
Treating Emotional/Stress Eating
But what are we treating?
Depression, Fatigue, Hunger, Convenience, Trauma, Irritability,
A really good opportunity to eat what we want?
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, MichaelSlide42
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
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
coming…even when not doing well.Slide45
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
Reduce temptation (eat this first, less likely to eat that)
et al., Obesity Res, 2001
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
Diabetes & Endocrinology
Identify and fight biggest risk factors for patient and
Battle Stinking Thinking
Battle the “Emotional/Stress eating habits”
Get back on meal plan at all costs
Work hard till it is not so hardSlide48
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
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
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
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-