In the past few weeks, as the world has been struggling to curtail the coronavirus pandemic, social distancing requirements and the fear and anxiety brought on by the disease has changed our relationship with food. Shortly after Governor Cuomo issued a stay-at-home order for New York State, New Yorkers crowded grocery stores to stock up on pantry items like beans and pasta, swapped takeout for home-cooked meals, and went on baking frenzies worthy of their own Netflix show. In addition, stress and anxiety induced changes in our eating habits, leading some people to overeat and others to decrease their food intake. If you have recently found yourself snacking more than usual and gorging on calorie-dense foods, you are not alone.
High-intensity, acute emotional states that promote the fight-or-flight response (e.g. extreme fear) suppress appetite and food intake. This neat evolutional perk ensured the survival of our species. However, in the case of moderate stress, about 40% of people actually respond by increasing their food intake. This behavior, often referred to as “emotional eating,” also causes some of us to reach for energy-dense and highly palatable foods, such as chocolate, sweet and savory pastries, pizza, burgers, French fries, and sausages. Emotional eating is understood to be a coping strategy that provides short-term relief from stress and negative emotions. However, a temporary improvement in mood can be followed by other negative emotions, such as feelings of guilt. In addition, emotional eating can lead to weight gain. If you identify as an emotional eater, there might be several reasons why you respond to stress by increasing the consumption of sugary and fatty foods:
Serial dieting. Our bodies are unable to distinguish between self-imposed food restriction and real food shortages. Therefore, the body responds to dieting the same way it would respond to starvation: by slowing down the metabolic rate and increasing hunger and appetite. This often causes dieters to abandon their restrictions, particularly under stress. Therefore, dieting is considered to be a risk factor for the development of emotional eating.
Poor interoceptive awareness. Some people are prone to confusing stress-related physiological responses with hunger—a phenomenon known as poor interoceptive awareness. This can be the result of inadequate emotion regulation strategies (e.g. suppression of emotions or avoidance of stress by distraction) and can lead to emotional eating. Interestingly, poor interoceptive awareness can develop as a result of damaging parental practices, such as neglectful, overly protective, manipulative, or hostile behaviors.
Inadequate sleep. While not everyone changes their eating behaviors in stressful situations, almost everyone will attest to the fact that stress can interfere with sleep. In turn, poor sleep can lead to emotional eating by interfering with neurobiological, behavioral, and cognitive processes that regulate emotional responses. Moreover, emotional eating can lead to increased weight gain in short sleepers, i.e. people who habitually sleep less six hours a night, compared to long sleepers.
History of trauma. Post-traumatic stress disorder (PTSD) as well as childhood and adult trauma exposure are associated with emotional eating. One possible mechanism underlying emotional eating in individuals with a history of trauma is the hypo-activation of the hypothalamic pituitary adrenal (HPA) axis. Under stressful conditions, the HPA axis coordinates a neuroendocrine response that is thought to promote survival. However, a history of trauma might decrease HPA axis responses to stress and as a result, erase the typical post-stress reduction in hunger.
Genetic susceptibility. The prevalence of emotional eating among children is very low, as emotional eating most commonly emerges in the transition between adolescence and adulthood. Additionally, both genetic and environmental factors play an important role in the development of emotional eating. For example, one study reported that a mutation in the dopamine D2 receptor (DRD2) gene predicted emotional eating in adolescents, but only if they also experienced inadequate parenting, such as high psychological control (e.g. “My father (mother) makes me feel guilty when I fail at school.”). In addition, a mutation in the serotonin transporter (5-HTT) gene can lead to emotional eating in adolescents, but only if the mutation co-occurs with depressive feelings. Both studies highlight the importance of genetics in the regulation of eating behaviors under stress, but indicate that it’s both nature and nurture that lead some people to turn to food in an attempt to self-medicate.
Depression. Depression is typically characterized by a loss of appetite and weight loss. However, a significant 15-29% of depressed patients suffer from so-called “atypical depression,” which causes increased appetite and subsequent weight gain. These symptoms of atypical depression have a stronger association with emotional eating than other individual depression symptoms, linking depression to obesity.
If you are worried about the long-term consequences of emotional eating, consider talking to a healthcare professional who can recommend strategies to minimize it. Studies show that such strategies might involve any of the following:
- Incorporating moderate intensity unstructured exercise (e.g. long walks) and/or high-intensity structured exercise (e.g. running or interval training)
- Finding social support
- Implementing cognitive behavioral therapy (CBT)
- Establishing healthy, balanced dietary choices early on in the day
- Using mindful eating habits (e.g. paying attention to hunger and satiety cues while eating)
- Avoiding trigger foods (e.g. not buying foods you are likely to consume in response to stress)