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Anxiety & Overeating – What’s the Overlap?

Contributor: Jennifer Pells, PhD is a licensed clinical psychologist and employee of Structure House, a residentially-based weight management treatment program in Durham, North Carolina.

girl-491623_640Think back to a situation when you felt really anxious – worried, tense, fearful, dreading, etc. Can you recall the feeling of that anxiety in your body, maybe in your stomach or your chest, and the gnawing worried thoughts that you couldn’t stop? Anxiety can be a painful, paralyzing emotion.

Most of us are pretty motivated to avoid feeling it, and we will find ways to avoid anxiety if we can, or somehow reduce the intensity or distract ourselves away from the feeling.

Using Eating to Cope

Enter overeating. Often without realizing it, individuals can fall into a habit of eating when they feel worried, anxious, nervous, or stressed.

On a purely rational level, this may not make sense – what does eating have to do with reducing anxiety? But humans are complex, and there are a number of ways that eating may serve an anxiety-reducing function. First, let’s highlight a few things we know about the overlap between anxiety and overeating.

Binge Eating and Anxiety

Anxiety symptoms and disorders frequently co-occur with overeating, and studies have shown that those with Binge Eating Disorder have a greater likelihood of experiencing significant symptoms of anxiety compared with the general population (1).

Binge Eating Disorder is marked by regular episodes of eating an objectively large amount of food in a relatively short amount of time with a feeling of loss of control during the eating episode, with accompanying distress and impairment in one’s life (i.e., health, social functioning, work performance).

Comfort Eating Is Common Among the Entire Population

hand-556763_640In one study, anxiety was the most frequently cited among a list of emotions that trigger binge eating, followed by sadness, tiredness, anger, and happiness (2). Keep in mind, however, that it is not only those with Binge Eating Disorder who use food to cope with anxiety.

Many individuals who do not engage in binge eating still engage in ‘emotional overeating’ – eating more than their body needs for nutrition in response to emotional triggers, including anxiety.

Prevailing Theories on This Connection

In the following paragraphs, brief descriptions are provided for some of the prevailing theories of the association between negative emotions, including anxiety, and overeating. Each theory is supported by a number of well-conducted, published studies.

Escape from Self-Awareness (3)

Because chronic dieters (those frequently attempting to engage in dietary restraint in order to lose weight) are sometimes more prone to episodes of overeating or binge eating, researchers have sought to understand the mechanisms linking dieting and overeating.

The “escape” theory posits that dieters are especially vulnerable to negative feelings about themselves, resulting in higher levels of anxiety and depression. To ‘escape’ from awareness of these thoughts and feelings, attention and cognition is focused instead on immediate, concrete stimuli, such as food.

Emotion Regulation (4)

hand-339614_640Emotion Regulation refers to the ability to identify and make sense of emotions and utilize effective strategies for balancing one’s emotions, including reducing the intensity of negative emotions or increasing the frequency of positive emotions.

An example of effective emotion regulation could be taking a walk outdoors when feeling irritated with someone (instead of yelling at them, which could make the situation worse and the negative feelings even stronger).

When anxious, individuals who struggle with emotion regulation will look for a fast, available method for decreasing the anxiety as quickly as possible, often choosing the short-term relief at the expense of long-term negative consequences.

Trade-off (5)

This explanation is related to the other theories discussed so far in that overeating is viewed as a way to reduce negative feelings, but does so by reducing the intensity of certain emotions perceived by the individual to be highly aversive and intolerable by accepting a ‘trade-off’.

That is, anxiety could trigger someone to overeat because s/he dislikes the anxiety and has learned that eating seems to soothe the feelings, at least temporarily.

The individual may be aware that s/he may feel guilty, disappointed, or depressed after overeating, but for that person, the trade-off is acceptable – at least s/he no longer has to feel the intense anxiety that was initially present.

This theory has received support because it helps explain why overeating continues despite negative consequences, including some persisting negative feelings.

Experiential Avoidance (6)

One of the most current and well-researched ways of understanding the overlap between anxiety and overeating (and more generally, the ways that humans react to their own emotions) is through a concept known as Experiential Avoidance.

This occurs when we do not want to be aware of or “in contact” with our own internal experiences (thoughts, feelings, or sensations) and take steps to reject, deny, disconnect, or avoid those experiences. If we do this persistently, the behaviors we engage in to control our internal experience lead to negative consequences.

If an individual eats to try to calm anxious feelings and does this repeatedly, it is likely that negative physical and emotional effects will occur.

The Connection Between These Models

hand-93168_640A consistent picture emerges across these models: a perception, belief, and/or experience of internal thoughts, feelings, or sensations as unwanted, aversive, frightening, abnormal, and/or unacceptable coupled with learning various methods for getting rid of or pushing away (avoiding) the unwanted experience.

Applied to anxiety and overeating, a person who feels anxious (e.g., tense, afraid, worried, agitated, panic) and finds these emotions and sensations to be highly distressing or intolerable may overeat to cope with the anxiety.

The hoped-for effect of this coping strategy may be to suppress, numb, distract, soothe, avoid, or mask the original anxiety. Although it takes time and effort to learn new ways of managing anxiety, the likely outcome of doing so is reduction of the need to overeat in response to this emotion.

Coping in More Effective Ways

There are numerous approaches for lessening the intensity of anxiety and/or coping in a more effective way when anxiety is present:

  • Psychotherapy with a licensed mental health provider, especially Cognitive Behavioral, Dialectical Behavior Therapy, or Acceptance and Commitment Therapy
  • Self-help through books (7,8), apps , or online programs (e.g., www.online-therapy.com; www.get.gg/cbtstep1)
  • Courses in mindfulness meditation (search for “MBSR” in your local area)
  • Discuss medication options with your physician or a psychiatrist

Community Discussion – Share your thoughts here!

What do you do to soothe yourself and relieve anxiety? Have you found that taking step towards better self-care has made a difference in the frequency of anxiety occurring?


References:

  1. Telch, C.F. & Stice, E. (1998). Psychiatric comorbidity in women with binge eating disorder: Prevalence rates from a non-treatment-seeking sample. Journal of Consulting and Clinical Psychology, 66, 768-776.
  2. Masheb, R.M. & Grilo, C.M. (2006). Emotional overeating and its associations with eating disorder psychopathology among overweight patients with binge eating disorder. International Journal of Eating Disorders, 39, 141-146.
  3. Heatherton, T.F., & Baumeister, R.F. (1991). Binge eating as escape from self-awareness. Psychological Bulletin, 110, 86-108.
  4. Safer, D.L., Telch, C.F., & Chen, E.Y. (2009). Dialectical Behavior Therapy for Binge Eating and Bulimia. Guilford Press: NY.
  5. Kenardy, J., Arnow, B., & Agras, W.S. (1996). The aversiveness of specific emotional states associated with binge-eating in obese subjects. Australian and New Zealand Journal of Psychiatry, 30, 839-844.
  6. Hayes, S.C., Wilson, K.G., Gifford, E.V., Follette, V.M., & Strosahl, K. (1996). Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64, 1152-1168.
  7. Brantley, J. (2007). Calming your anxious mind: How mindfulness and compassion can free you from anxiety, fear, and panic. New Harbinger.
  8. Wilson, K.G. & DuFrene, T. (2010). Things might go terribly horribly wrong: A guide to life liberated from anxiety. New Harbinger.

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

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