How to Break the Vicious Cycle of Emotional Eating After WLS

October 28, 2019

Weight loss surgery (WLS) or bariatric surgery is one of the most promising interventions for morbid obesity. However, changing eating habits after the surgery can prove challenging to individuals who emotionally eat. Furthermore, according to research, the general tendency to eat in response to negative emotions is related to poor postoperative weight loss. Therefore, it is important to understand what emotional eating is and how to break the vicious cycle of emotional eating so you can experience a successful outcome after weight loss surgery.

The Definition of Emotional Eating

Before we talk about how to break the emotional eating cycle, we will talk about what emotional eating is. Emotional eating can be defined as eating in response to emotional distress (Chesler, 2012). It is also defined as the act of consuming food in response to certain emotional states like boredom, loneliness, or anxiety (Timmerman & Acton, 2001). Recent research suggests that emotional eating can even occur when you are feeling happy (Cardi, Leppanen, & Treasure, 2015).

The Cycle of Emotional Eating

When we feel negative emotions, we want to interrupt that process. Some people turn to overeating in response to their negative emotions, and the effect is that their emotional intensity decreases. When we overeat, dopamine works to reward us by releasing feelings of pleasure and euphoria. Because we feel better, we learn (through positive reinforcement) that overeating helps us feel better. It is no wonder that we may turn to food when we are experiencing overwhelming emotions because overeating seems to help. For depression, many people emotionally eat. However, overeating only helps in the short term.

After we overeat, we may feel temporary relief. However, that relief is fleeting. After that temporary relief we feel, we often feel guilt and shame because we ate too much.

Since we learn that overeating helps us, we continue to engage in the behavior. When that temporary relief wears off, we start to feel guilt and shame because we overeat. Feeling this guilt and shame can cause us to engage in overeating again because we want to feel relief from these negative emotions.

How to Start Breaking the Cycle

Here are some strategies to learn how to break the vicious cycle of overeating.

Recognizing physiological symptoms of hunger
There are various reasons why individuals emotionally eat. One reason is that it may be difficult to realize when you are eating in response to an emotional state rather than eating because you are feeling physical symptoms of hunger.

Research suggests that stress and other negative emotions can make it seem like we need to consume food, even when we may not need to. Therefore, it is important to know the physical symptoms of hunger. We name the feeling of our need to eat as “hunger.” Here are some common physiological symptoms of hunger:

• Headache
• Lack of Energy
• Nausea
• Feeling of emptiness in stomach
• Gurgling, rumbling or growling in stomach
• Dizziness, faintness or light-headedness
• Shakiness
• Weakness

Even knowing the symptoms of physical hunger, we may sometimes turn to food in response to emotional distress despite the fact that we are not feeling the physical symptoms of hunger. One helpful way to break the pattern of emotional eating is to become more in tune with how you physically feel.

You can try to rate your “fullness” on a scale from 1-10 before you reach for some food (1 being the rating you would give if you’re experiencing many physical hunger cues and 10 being the rating you would give if you were completely full). Being more mindful of your hunger cues can help you only eat when you need to.

Cognitive-Behavioral Strategies
Chesler (2012) examined case studies where Cognitive Behavioral Therapy (CBT) was used to treat emotional eating and found that it was helpful. Cognitive Behavioral Therapy is a therapeutic treatment modality used by psychotherapists. It is based on the idea that our thoughts, feelings, and behaviors are all connected, and that by changing our thoughts we can change our feelings or behaviors. CBT also proposes that we can change our feelings and thoughts by changing our behaviors. You can find a CBT therapist.

If Cognitive Behavioral Therapy is not what you prefer, you can try some of these CBT strategies to break the cycle of emotional eating:

• Journaling: When you keep track of your food intake as well as your emotional state it can help you to see your patterns and provide accountability. You can use an online tool, or keep a regular journal. This can help you identify the emotional states that lead you to emotionally eat. It is recommended you track what you eat, how many calories you consume, and your emotional state before you started eating.
• Stimulus Control: This means identifying the foods you turn to when you emotionally eat (i.e., chocolate or chips), and removing them from your household or not buying them when it comes time to go grocery shopping.
• Premack Principle: This strategy can be used to plan activities for when you participate in emotional eating. For instance, if you really feel the desire to eat something arising from emotional distress, tell yourself you have to do an activity to earn it. It is recommended that you engage in some sort of exercise like taking a walk or riding a recumbent bike for a certain amount of time before you allow yourself to eat. You may even find that by the time you are done with your activity, your urge to engage in emotional eating may diminish.
• Activity Scheduling/Planning: If you are more likely to emotionally eat after dinner, tell yourself you have to wait one hour after dinner before you snack. Identify the times of the day you are most likely to emotionally eat and make a rule that if you feel the urge to engage in emotional eating, you have to wait one hour to indulge. You may find that by waiting for one hour it will diminish your urge to eat. Sometimes boredom may lead to emotional eating. Planning activities throughout the day (like brief bursts of exercise) can help you prevent boredom.
• Metacognitive Strategies: “Metacognitive” means “thinking about the way you think.” Using metacognitive strategies helps you become more aware of how and what you think about. If you find yourself thinking about engaging in emotional eating, track the thoughts that lead you there. You may find that the thought behind the urge can be challenged (see cognitive restructuring below).
• Cognitive Restructuring: This is the ability to recognize your maladaptive thoughts and change them. For example, if you have the thought, “I can’t control my eating,” cognitive restructuring can turn this thought into a more rational thought such as “I am in control of what I eat. I have the desire to eat right now, but it does not mean I cannot control what I do.”

Mindful Eating Practices

Using mindful eating practices can help curb the impulse to emotionally eat. Mindfulness is the definition of being fully present in the moment without judgment.

This means that you make an effort to be aware of what is going on inside of yourself (your thoughts, emotions, and urges) and outside of yourself (your environment) without criticizing. Often times, we consume food while we watch television, or while we browse on our cell phones. The mindful eating practice is when you focus on yourself consuming the food, without any interruptions. Some ways to incorporate mindful eating practices are:

• Taking three deep breaths before your meal
• Doing a body scan before and after your meal (You can learn how to do a body scan here: https://www.fresno.va.gov/docs/Transcript_Body_Scan_Brief_.pdf)
• Writing down everything you eat in a notebook
• Taking time to really describe to yourself how the food tastes as you consume it
• Limiting your distractions while you eat (try not to eat in front of your computer or television)
• Placing your eating utensil down on the table after every bite

If you engage in overeating, it is important not to shame yourself. Instead of saying mean things to yourself, try thinking in a more balanced perspective like, “I ate too much. It makes me feel good temporarily, but now I don't feel so good about it. I will use this opportunity to learn from my mistakes and will try again next time I feel like overeating.”

You want to be successful after your weight loss surgery (WLS), and emotional eating can sabotage that success. Trying these strategies may help you stop the vicious cycle of emotional eating.

References

• Canetti, L., Berry, E. M., & Elizur, Y. (2009). Psychosocial predictors of weight loss and psychological adjustment following bariatric surgery and a weight‐loss program: The mediating role of emotional eating. International Journal of Eating Disorders, 42(2), 109-117.
• Cardi, V., Leppanen, J., & Treasure, J. (2015). The effects of negative and positive mood induction on eating behavior: A meta-analysis of laboratory studies in the healthy population and eating and weight disorders. Neuroscience & Biobehavioral Reviews, 57, 299-309.
• Chesler, B. E. (2012). Emotional eating: a virtually untreated risk factor for outcome following bariatric surgery. The Scientific World Journal, 2012.
• Mathus-Vliegen, E. M. H. (2007). Long-term health and psychosocial outcomes from surgically induced weight loss: results obtained in patients not attending protocolled follow-up visits. International Journal of Obesity, 31(2), 299.
• Tan, C. C., & Chow, C. M. (2014). Stress and emotional eating: The mediating role of eating dysregulation. Personality and Individual Differences, 66, 1-4.
• Timmerman, G. M., & Acton, G. J. (2001). The relationship between basic need satisfaction and emotional eating. Issues in Mental Health Nursing, 22(7), 691-701.

ABOUT THE AUTHOR Dr. Joanna R. Benavidez is a licensed clinical psychologist. She has a Ph.D. in clinical psychology, and she is a member of the American Psychological Association (APA). Dr. Benavidez is the owner of a private practice located in San Diego, California that specializes in providing presurgical psychological evaluations. Read more articles by Dr. Benavidez!

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