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Emotional eating: what is it and why does it happen?

Posted Apr 18 2012 12:00am

What do we mean when we refer to emotional eating, and how does it differ, if at all, from compulsive overeating, binge eating disorder, and bulimia?

It may surprise you but there is still, as of this writing, no official diagnosis for binge eating disorder, much less emotional eating. This is in spite of the fact that it is the most common of all eating disorders. It affects almost half of all adult women who have any type of eating disorder, and one-third of all people who diet. For the time being, it’s officially categorized in the diagnostic manual as Eating Disorder Not Otherwise Specified. It may not be necessary to stick a label on every problem, but it is useful to have a widely agreed upon and accepted way to define a common syndrome so we’ll know if a treatment that has been found effective for some people can be expected to help many others with the same symptoms.

There is a behaviorally-based definition for binge eating disorder that has been proposed for inclusion in a future edition of the Diagnostic and Statistical Manual. The central features of this diagnosis include eating an excessive quantity of food “that is definitely larger than most people would eat…under similar circumstances” and consumed within a “discrete time period,” accompanied by feeling a loss of control and followed by marked distress. There are a few other associated behaviors like eating quickly and feeling uncomfortably full that are added, but the basic definition is virtually identical to that of bulimia but without compensatory behavior, such as purging.

This similarity to bulimia, plus the vagueness of the supposedly objective criteria in the definition may be an indication of why there is not yet an official diagnosis for such a common syndrome. That’s because this behavior is not only a mental disorder, but it’s also a very common though maladaptive coping mechanism that virtually everyone has experienced at one point or another. In other words, it includes a very broad gray area that gets darker and darker until everyone would agree that it is no longer grey. The problem that the DSM people seem to be struggling with is agreeing on how to define the point that it turns black.

This reflects a larger problem with defining many disorders that are dimensional or based on frequency and severity. When does daydreaming or restlessness become attention deficit disorder or hyperactivity? At what point does apprehension become anxiety? Where do we draw the line between a burst of creative exuberance and hypomania? These are easy to identify as pathological at the extreme end of symptom frequency and severity, but defining that boundary can be very subjective. It’s different than a diagnosis that’s defined by categorical symptoms, such as many that accompany psychosis, which are either present or they’re not.

Emotional eating is an example of a dimensional behavior. Rather than viewing bulimia, binge eating disorder, and compulsive overeating as unique disorders, they can be seen as a subset of emotional eating. The difference between them is that the behavior may differ in frequency and quantity, and people vary in how they deal with the anxiety caused by it – some try to compensate by trying to undo it while others don’t – but the emotional eating may really be just one very common coping mechanism to ease stress. If that’s the case, how does this coping mechanism help?

To explain that will require a separate post (or several). But it’s helpful to first understand the current thinking about self-control and what causes it to break down. In a nutshell, this theory proposes that self-control, or willpower, is a limited resource like muscle strength that gets weaker each time we use it. That means that the more you have to restrain your behavior, the worse your self-control will be. The theory is well summarized in David McRaney’s blog post and it offers a very compelling explanation that’s based on a slew of studies. Keep an open mind while reading it though, because there are a lot of problems that this theory does not address and there are other ways of interpreting the research.

Meanwhile, ponder this: why would anyone try to cope with distress by doing something that will make them feel worse? Rather than solving the problem it just adds to it! Even if it happens once or twice, don’t we learn from doing something that turns out badly and try to avoid repeating it? Stay tuned.

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