Emotional Eating FAQS for Health Providers

What is emotional eating and how does it differ from binge eating disorder?

Emotional eating is a general term for a type of disordered eating that’s characterized by obsessive thinking about food and unwanted, compulsive eating. The behavior is often a response to psychological stressors, especially those related to dietary control. Binge eating disorder (BED) is one form of emotional eating that’s defined by specific diagnostic criteria.

The criteria for a diagnosis of binge eating disorder include episodes of rapid consumption of large quantities of food in one sitting, at least weekly, for three months or more. Other criteria include intense negative feelings of shame, guilt, depression, and marked distress about the loss of control.

Behavior that meets some, but not all of the diagnostic criteria is still a significant indication of disordered emotional eating that would indicate a need for further evaluation and treatment by an eating disorder specialist.

What signs or symptoms can help me identify an emotional eater?

Binge eating disorder is the most common of all eating disorders, but it can be very difficult to spot in a routine medical evaluation. There are three main reasons for this:

1. There’s no specific body type associated with binge eating.

Most binge eaters are not significantly overweight in spite of their excessive calorie intake. This may be due their tendency to restrict their eating between binge episodes.

2. Binge eaters are ashamed about their eating and may be reluctant to disclose it.

Therefore, they’re less likely to report it as a concern to anyone—even their health care professional—unless asked about it.

3. Many who struggle with the behavior may not recognize it as disordered eating.

They often think they’re like anyone else who’s concerned about their weight and tries to diet. They tend to blame their own failure of self-control making them less likely to report it as a problem.

Three clues that may indicate emotional eating:

1. Focused on dieting: Always thinking about food, dieting, or weight. May ask to skip taking their weight or express anxiety about getting on the scale during routine exam. Weight history may show wide fluctuations from over- to underweight.

2. A tendency to think in all-or-nothing terms: e.g.: “If I’m not perfect on my diet, I’m afraid I’ll become obese!” “If I let myself have one cookie, I’ll end up eating the whole box!”

3. Defensive or self-critical reaction when asked in general about their eating : May exhibit heightened anxiety, shame, or other signs of concern.

What should I recommend to my patient who may be struggling with emotional eating or BED?

If any of the signs listed above are apparent, explore further to determine the likelihood of a problem with emotional eating:

Have they been experiencing problems or distress with eating or weight? Do they have concerns about their control around food? Do they have a tendency to go on and off diets? Do these shifts tend to go to extremes? Do they experience more than a few episodes of losing control of their eating?

Are they restrictive about what they eat? Are they perfectionists about food choices? Do they eat meals at regular intervals, or graze through the day? Do they prefer to eat alone? Do they feel judged or ashamed when they eat with others? Asking these questions is more likely to reveal unwanted, compulsive eating, together with intense shame, if a patient is initially reluctant to discuss it.

The next step would be a referral for a more thorough evaluation by a credentialed mental health professional with proven experience in treating eating disorders.

To learn more, go to www.equipoiseteletherapy.com

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