Running from Emotions
by Georgie Fear & K. Aleisha Fetters
Many women would raise their hands and identify emotional eating as a predicament that’s blocking their weight-loss progress. It’s a stumbling block we trip over again, and again, and again. However, other than “stop,” what we should do about this situation is scarcely addressed. As for why we become emotional eaters, most women don’t know because no one has explained it! In fact, many of us fear that being an emotional eater can’t be changed and it’s just the way we are. Thankfully, that frightening thought is simply untrue.
While individual differences in mental health and mood inclination can be linked with genetics, all of our emotional experiences (including using food to modify how we feel) are the result of conscious or unconscious processes we conduct in our brains. That means we aren’t stuck with our emotional processing in the same way we’re genetically programmed for a given hair and eye color (hair dye and contact lenses aside). You don’t have to go back in time and be born as someone else because you are not the problem.
Coping with emotions in healthy, productive ways is a set of skills; they’re learnable and changeable. We can change the way we process feelings and end emotional eating. We can learn how to lift ourselves when we’re down, stay calm when our emotions are intensifying, and take action despite feeling anxious or fearful.
It’s not your fault if no one taught you these skills as a youngster, modeled them throughout your formative years, or reminds you as an adult to tap into them when life feels brutally hard. We’re going to teach you how in this book, and we promise it’s never too late to learn.
What Emotion Regulation Skills?
Emotional regulation skills are the behaviors and strategies we use to manage, inhibit, or enhance emotional experiences.[i] We perform them consciously or unconsciously. They come in two varieties: adaptive (helping us adjust to the world and thrive) and maladaptive (more harmful than helpful). For optimal well-being, we want to have a wide variety of adaptive emotional regulation skills and regularly use them instead of the less-effective, more harmful ones.
When young, we form many of our emotional regulation skills as we interact with our parents or caregivers. If all goes well, we observe adults managing their emotions in healthy ways, such as talking about their feelings or heading outside for a walk to improve a low mood, and we learn to use these adaptive emotional regulation skills for ourselves. Sometimes we fine-tune these adaptive skills later in life, as a result of working with a mental health professional or even through books.
However, not all of us learn healthy emotional regulation skills as children, or even well into adulthood. Our parents might not have been able to spend enough time with us to imprint their emotional regulation skills on us, or they might have not possessed these adaptive skills themselves. The type of bond we have with our main caregivers can also impact how we learn to manage our emotions.[ii]
If no one teaches us adaptive emotional skills, our normal day-to-day feelings become painful, confusing obstacles. In the face of this suffering, it’s natural and understandable that we’ll do just about anything to cope. This can lead to developing maladaptive emotion regulation behaviors, such as avoiding experiences or emotions, abusing drugs or alcohol, or turning to food. We can also develop maladaptive behaviors because we observe them (like watching Mom hide with food in the bedroom), or because we needed them to survive (such as placating a parent with substance abuse issues to avoid outbursts or violence). These maladaptive behaviors aren’t good for us or for the people we love. But good people develop them as a natural way to solve the problem of emotional pain and survive.
Given the option, none of us would choose to have maladaptive behaviors. We’re all doing the best we can do get by with what we have.
How Deficits in Emotional Regulation Ding Our Health
Limitations in adaptive emotional regulation are linked to mental health problems including anxiety, depression, disordered eating, and substance abuse.[iii], [iv] This may be because emotional regulation ability affects how well we recover from what happens to us. For example, after negative experiences such as maltreatment or a traumatizing event, a person with better-developed emotional regulation skills may be able to heal and cope to a greater extent, whereas a person with fewer resources may experience more long-term psychological effects.
Emotional regulation abilities not only impact mental health, but also influence physical wellness. The combination of stress and ineffective emotion regulation produces abnormal cortisol levels, and are linked to unhealthy lifestyle behaviors including emotional eating, a sedentary lifestyle, reduction of physical activity, lower fruit and vegetable intake, and sleep problems.[v], [vi] When our mental wellness is suffering, our bodies are impacted by the hormonal signature of uncontrolled stress—and on top of that, our other healthy lifestyle behaviors typically take a hit.
You may have experienced some of these effects yourself. Recurring worries can banish a good night’s sleep, elevate blood pressure, and worsen digestive ailments. Feeling overwhelmed by stress, suffocated with anxiety, or deflated by hopelessness can make it all but impossible to go to the gym. After a devastatingly rough day, few of us are up to getting groceries and cooking dinner. And, practically everyone has had a friendship or romantic relationship strained when someone shuts down in the face of conflict or isn’t able to communicate how they feel or what they want.
All of these effects negatively impact our long-term health.
The Ties between Emotion Regulation and Eating Behaviors
Not everyone with deficits in emotion dysregulation goes on to develop an eating disorder, and not everyone with an eating disorder has difficulty regulating emotions. Still, a 2019 meta-analysis of 96 studies found that there’s a consistent link between deficits in emotion regulation abilities and eating problems, including eating disorders.[vii] In fact, a 2016 study found that patients undergoing treatment for eating disorders showed greater problems with emotional regulation than patients undergoing treatment for other psychiatric illnesses:
“Patients with EDs [eating disorders] demonstrated significantly more difficulty in terms of their overall ability to regulate emotions, their ability to accept emotional responses, their ability to accomplish goals in the midst of emotional states, their ability to attend to and acknowledge the significance of emotions, and their ability to influence emotional states.”[viii]
There’s ample evidence that emotional dysregulation plays a pivotal role in binge eating, in which people eat large amounts of food and feel unable to stop. Binge eating is tightly linked with obesity, and is the most common eating disorder, making it a research topic of prime importance.
Escape theory asserts that binge eating is primarily a way to flee self-awareness. Self-awareness occurs when we turn our attention to ourselves and notice our characteristics. Automatically, we compare our current selves to our ideals, or what we want ourselves to be. As you can imagine, there can be a painful gap between what reality and what we want.
What do we do with this discomfort? There are three potential responses: We might change our ideal, so that the current version of ourselves isn’t so far off. We might work on changing ourselves to move closer to our desired state. Lastly, we might flee from the painful self-awareness altogether, turning away or blocking those thoughts. Escape theory proposes that binge eating is a manifestation of the third option; rapidly eating large amounts of food serves to block out thinking about ourselves, and for a short while, escape the pain.[xiv]
An explanation known as the affect regulation model explains things slightly differently, positing that people binge eat to change their mood (affect is another word for mood).[xv] The affect regulation model is broader, so it can explain binge eating which results from sadness, loss, frustration, anger, overwhelm, loneliness, anxiety, or other uncomfortable feelings that are not specifically self-awareness. This model doesn’t contradict escape theory, so both coexist among experts as tools used to explain human eating behavior. As far as either theory is concerned, overeating or binge eating serves as a maladaptive emotion regulation strategy.
Even if a woman doesn’t lose control when eating or think her food habits fit the definition of a binge, difficulty dealing with emotions is a major contributing factor to weight gain and obesity through a more common behavior: emotional eating.[xvi] Emotional eating is defined as using food to cope with negative emotions, which is a perfect fit for that affect regulation model we just mentioned. Emotional eating is closely related to binge eating, and the same factors fuel both habits.
Emotional eating is also incredibly prevalent. Think about it: Consuming more food than usual or eating unhealthy foods when we feel sad, mad, or disappointed is so commonplace that the modern woman perceives it as normal.
While occasionally using food to impact our emotions is harmless, high levels of emotional eating lead to uncontrollable weight gain. Patients seeking weight-loss surgery report high levels of emotional eating, and even after undergoing a major life-changing procedure to facilitate weight loss, they don’t just stop emotional eating. They typically cut back for the first 12 months following surgery, but then slowly, but surely, resume their normal habits to eat their emotions.[xvii] Emotional eating isn’t something people can’t just stop through pure desire, dedication, or willpower.
Fittingly, mounting evidence shows that emotional skill development is a crucial part in successfully treating and preventing both binge eating and emotional eating.[xviii] Treatment methods and programs such as behavioral weight-loss counseling, diet programs, cognitive therapy, and medication that don’t include emotional skill development are ineffective for many women. Some women feel better for a short time and relapse when life gets hard again.[xix], [xx] Sadly, few weight-management programs and “experts” address emotional regulation skills in their treatment approaches, opting instead to focus on food, food, and more food. If your personal history includes being given food directions, recipes, diet programs, and eating advice ad nauseam—and no direction on how to skillfully deal with your feelings—
Using food to manage emotions also creates problems that reach beyond excessive caloric intake. Relying on eating as a standalone coping mechanism or comfort displaces us from using our emotional skills to feel better or seeking comfort in alternate forms. Once we begin rehearsing this pattern, we’re likely to choose to forego socializing or exercising when we’re feeling blue, and choose instead to stay home with a pint of ice cream. It’s easier, it’s faster, and we don’t have to get sweaty.
This creates a cycle of being unhappy, seeking comfort in food, feeling stuffed—again and again. Each time it is easier and more automatic, because it feels reliable, it becomes a habit, and we haven’t practiced other options. Due to disuse, we lose what adaptive emotional regulation skills we originally had. Our friendships can fade and become distant, instead of becoming stronger like when we share our tough times with pals. Perhaps scariest of all, our children and other people we love are watching us, and we cannot avoid the impact of our role-modeling on their behaviors. Imagine a preteen daughter feeling sad after being excluded by nasty girls at school. She thinks, When mom’s sad, she gets a tub of ice cream. Might as well give it a shot.
Sadly, eating isn’t even very effective as a coping mechanism. Almost universally, binge eating and emotional eating tend to follow episodes of intensely negative mood. Eating causes an immediate reduction in negative mood, but as soon as the eating ends, there’s a steep drop back to the low mood.[xxi] A 2011 meta-analysis of 36 studies found that after a binge, people actually feel considerably worse than they do immediately before they start binging.[xxii]
Binge eating consistently makes women feel worse, but they keep on doing it in a bit to feel better… how does that work? This seeming contradiction comes down to recall bias, a fancy term for the human tendency to remember things inaccurately or to omit details of past experiences.
For example, in interviews, women say that binge eating gives them relief from negative feelings and thoughts. However, when researchers capture data on people’s moods two minutes before, during, and after binges, it tells a different story: Any emotional relief from eating is slight, brief, and immediately replaced by an even lower emotional state as guilt and shame arise and awareness returns.[xxiii] Women tend to forget the worst parts of the experience, leading them to believe that food was more effective than it really was, and look to it again the next time they’re eager to feel better.
[i] Vohs, K. D., & Baumeister, R. F. (Eds.). (2016). Handbook of self-regulation: Research, theory, and applications. Guilford Publications.
[ii] Cutrona, C. E., & Russell, D. W. (2017). Autonomy promotion, responsiveness, and emotion regulation promote effective social support in times of stress. Current opinion in psychology, 13, 126-130.
[iii] Sloan, E., Hall, K., Moulding, R., Bryce, S., Mildred, H., & Staiger, P. K. (2017). Emotion regulation as a transdiagnostic treatment construct across anxiety, depression, substance, eating and borderline personality disorders: A systematic review. Clinical psychology review, 57, 141-163.
[iv] Fasciano, L. C., Dale, L. P., Shaikh, S. K., Little Hodge, A. L., Gracia, B., Majdick, J. M., … & Ford, J. D. (2020). Relationship of childhood maltreatment, exercise, and emotion regulation to self-esteem, PTSD, and depression symptoms among college students. Journal of American College Health, 1-7.
[v] Aparicio, E., Canals, J., Arija, V., De Henauw, S., & Michels, N. (2016). The role of emotion regulation in childhood obesity: implications for prevention and treatment. Nutrition research reviews, 29(1), 17-29.
[vi] Isasi, C. R., Ostrovsky, N. W., & Wills, T. A. (2013). The association of emotion regulation with lifestyle behaviors in inner-city adolescents. Eating behaviors, 14(4), 518-521.
[vii] Prefit, A. B., Cândea, D. M., & Szentagotai-Tătar, A. (2019). Emotion regulation across eating pathology: A meta-analysis. Appetite, 104438.
[viii] Ruscitti, C., Rufino, K., Goodwin, N., & Wagner, R. (2016). Difficulties in emotion regulation in patients with eating disorders. Borderline personality disorder and emotion dysregulation, 3(1), 3.
[ix] Dingemans, A., Danner, U., & Parks, M. (2017). Emotion regulation in binge eating disorder: A review. Nutrients, 9(11), 1274.
[x] Whiteside, U., Chen, E., Neighbors, C., Hunter, D., Lo, T., & Larimer, M. (2007). Difficulties regulating emotions: Do binge eaters have fewer strategies to modulate and tolerate negative affect? Eating behaviors, 8(2), 162-169.
[xi] Westerberg, D. P., & Waitz, M. (2013). Binge-eating disorder. Osteopathic Family Physician, 5(6), 230-233.
[xii] Hudson, J. I., Hiripi, E., Pope Jr, H. G., & Kessler, R. C. (2007). The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological psychiatry, 61(3), 348-358.
[xiii] Heatherton, T. F., & Baumeister, R. F. (1991). Binge eating as escape from self-awareness. Psychological bulletin, 110(1), 86.
[xiv] Morin, A. (2003). Self-awareness review part 2: Changing or escaping the self. Science & Consciousness Review, 1.
[xv] Leehr, E. J., Krohmer, K., Schag, K., Dresler, T., Zipfel, S., & Giel, K. E. (2015). Emotion regulation model in binge eating disorder and obesity-a systematic review. Neuroscience & Biobehavioral Reviews, 49, 125-134.
[xvi] Van Strien, T. (2018). Causes of emotional eating and matched treatment of obesity. Current diabetes reports, 18(6), 35.
[xvii] Nasirzadeh, Y., Kantarovich, K., Wnuk, S., okayrainec, A., Cassin, S. E., Hawa, R., & Sockalingam, S. (2018). Binge eating, loss of control over eating, emotional eating, and night eating after bariatric surgery: results from the Toronto Bari-PSYCH Cohort Study. Obesity surgery, 28(7), 2032-2039.
[xviii] Goldschmidt, A. B., Lavender, J. M., Hipwell, A. E., Stepp, S. D., & Keenan, K. (2017). Emotion regulation and loss of control eating in community-based adolescents. Journal of abnormal child psychology, 45(1), 183-191.
[xix] Telch, C. F. (1997). Skills training treatment for adaptive affect regulation in a woman with binge‐eating disorder. International Journal of Eating Disorders, 22(1), 77-81.
[xx] Robinson, A. (2013). Integrative response therapy for binge eating disorder. Cognitive and behavioral practice, 20(1), 93-105.
[xxi] Deaver, C. M., Miltenberger, R. G., Smyth, J., Meidinger, A. M. Y., & Crosby, R. (2003). An evaluation of affect and binge eating. Behavior Modification, 27(4), 578-599.
[xxii] Haedt-Matt, A. A., & Keel, P. K. (2011). Revisiting the affect regulation model of binge eating: a meta-analysis of studies using ecological momentary assessment. Psychological bulletin, 137(4), 660.
[xxiii] Deaver, C. M., Miltenberger, R. G., Smyth, J., Meidinger, A. M. Y., & Crosby, R. (2003). An evaluation of affect and binge eating. Behavior Modification, 27(4), 578-599.
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