Obesity has reached epidemic proportions with 3.8 million people weighing over 300 pounds and approximately 65 percent of Americans being overweight. Childhood obesity has more than tripled in two decades. The causes of obesity are many, some complex and others simple, such as living sedentary lifestyles.

Jessica struggled with her weight for more than two decades. She describes her struggle: “I gained weight as an adolescent. I was very unhappy as a teen. I felt unattractive, unloved and unwanted. Food was a way of making me feel better. I didn’t worry about eating because I figured I could lose the weight when I wanted and I was very successful at it. As a teenager, I could lose 10 pounds in a week but the ease of losing weight gave me permission to eat whatever I wanted. The day came that I couldn’t lose it so quickly. My weight went up and down for a long time and then the general trend was that my weight increased over time. I had phases when I lost weight, but it was a struggle not to put the weight back on. I would re-gain the weight I lost plus add a few pounds. As I experienced the increased weight after a successful round of dieting I became even more restrictive and crazy about my weight loss schemes. I would spend a day or two not eating at all and then decide I would eat only cabbage soup for a few days. This is an example of the wild schemes I would concoct to control my weight. Now I am totally out of control. I am about 86 pounds overweight and I feel completely helpless to do anything about it. The more I try to control, the more I want to eat. The more problems I face and the more stressed I feel, the more I eat.”

Jessica is typical in that her desire to lose weight is often accompanied by an extreme diet. Sometimes the unusual eating patterns include taking diuretics, laxatives, an assortment of over-the-counter diet pills, but almost always includes an odd concoction of foods or an extreme restriction.

Mark was in the same position as Jessica. He felt out of control with his weight and was seeking to have bariatric surgery to lose weight. He reports that he has multiple health problems that include hypertension, diabetes and knee joint pain. His work as an accountant is highly stressful but also very sedentary.

“I eat at my desk on most days,” he said. “I have several favorite snack foods, such as chips, cookies and chocolate. I like to munch while I work. As a consequence, I never take time out for a meal because I’m not hungry. I seldom sit down to a full meal unless my wife forces one on me. I think I am not eating that much, but I keep gaining weight. I weigh 295. It’s the highest weight that I have been in my life. I want to diet and exercise, but I don’t see how I can. I don’t have enough time to have a normal meal. I don’t have time to exercise except some time on the weekends, but when I try to exercise my knees bother me, so I give up. I feel the only way I can do anything about this problem is if I have surgery.”

Jessica has behavioral and emotional issues that have played a part in her disrupted eating patterns. She has lost touch with the real purpose of eating, which is to nourish her body with the proper nutrients. She has become weight obsessed. Mark, overworked and overstressed, has used food as a means of managing his stress. Yet, the stress is increasing exponentially as he gains more weight and changes his physiology, which makes him even more inclined to store fat.

Why We Eat

Food can be used as reward or punishment. It can generate guilty pleasure or be used to comfort us. Food is used to connect us socially and is a primary connection to the first person that loves us – our mother. A complex behavior, eating is triggered by a number of biochemical reactions, psychological motivators and behavioral patterns.

Current scientific thinking indicates the complexity of the chemistry of eating by identifying the numerous neuropeptides, neurotransmitters and peripheral neurological system via the gastrointestinal tract and pancreatic hormones that control our desire to eat. Our metabolism and our fat cells also influence our desire to eat. Even the temperature in the room will cause you to eat more. Most restaurants are cool because cooler temperatures are an inducement to an increased appetite. In addition, we have environmental stimuli to compel our eating. We are bombarded with advertisements and social enticements to eat constantly.

Eating behavior can go awry for many reasons. The first cause is genetic. If you are born to obese parents, you have an 80 percent chance of being obese. If one parent is obese or carries the OB gene, then you have a 40 percent chance. The genetic predisposition, if present, is not a direct cause of obesity; you have to have acquired the behavior of overeating along with the environmental influence to indulge. Obese people can and do overcome genetics. If you have a thin parent, it may be that he or she is carrying the OB gene.

If you think you have the OB gene, you have environmental influences to overcome as well.  Over time the portion sizes in American have increased as much as two to four times. For example, the average burger has gone from 330 calories to 900 calories. The average soda has been up-sized from a 6-ounce serving to a 16-ounce serving. At a restaurant the average meal with the oversized portions usually represents a full day’s allotment of calories. While caloric intake has increased, our lifestyles have become more sedentary.

As our portions have super-sized so have we. The average rates of overweight and obesity have increased to more than 50 percent of the population. The astounding increase cannot be explained by genetics alone. Apparently our culture has influenced our thinking and behavior around food intake. Eating behavior can range from mildly disordered (eating too much junk food) to moderate or severe disorders that include binge eating disorders, bulimia and anorexia. Abnormal or unhealthy eating patterns can be present in the very thin, normal weight or overweight individual.

Severe disorders require professional treatment. Binge eating is different than overeating. Binge eating is often done in secret while overeating can be shared with others and include overindulging in sweets and snacks for pleasure or comfort. Binge eating, like bulimia and anorexia, are often accompanied by lack of control and can be associated with mood disorders, such as depression and anxiety.           Unusual eating behavior is almost always characterized by craving and not by appetite. Many people with eating problems often can’t tell when they are hungry. They eat for a variety of reasons and rarely experience real hunger because cravings are indulged. Obese individuals are considering surgery as a technique to lose weight. Surgery is almost always successful in controlling caloric intake because of mechanical or physiological barriers, but once individuals adapt to the changes, they start to re-gain the weight. The reason is that the eating behavior is motivated by craving and not by hunger. Craving is a psychological experience, while hunger is a physiological one. Creating a physical barrier to prevent eating will not overcome the psychological motivation to eat.

Solutions

The most effective cure for obesity is never to let your weight go beyond normal limits. The second best cure following weight gain is exercise. Exercise is the magic pill. When your body’s physiology changes because of obesity, it essentially becomes a fat-making factory. No one pill is going to change all the chemistry in your body to make you not want to eat or to burn fat. Wanting to indulge in comfort foods has little to do with body chemistry, but hunger does have everything to do with body chemistry. Indulging cravings is a behavioral and cognitive problem.

Eleven Actions to Combat Emotional Eating

  1. Identify the triggers to your desire to indulge. Make notes on your desire to eat, when, what was happening and what triggered the desire.
  2. Plan alternative behavioral responses other than eating. If stress causes you to snack then choose an alternative response, such as meditation, deep breathing or taking a walk.
  3. Eliminate the negative thoughts that cause you to feel convinced you can’t do anything about the problem.
  4. Live the life you desire. Real substantive change occurs when you are in touch with your frustration.
  5. Learn to identify your feelings and express yourself. Develop and use your network of social support.
  6. Decrease your indulgence in intensely flavorful processed foods.
  7. Journal your feelings and use your journal to develop a positive relationship with yourself.
  8. Eat whole, fresh foods. Stay away from processed foods, especially those high in fat, sugar and salt.
  9. Use healthy eaters for support and as role models.
  10. Hire a coach to help you to identify the specific changes you need to make to be successful at overcoming your unhealthy eating patterns.
  11. Exercise. It will reverse much of the problems associated with overeating. Exercise increases good cholesterol and you will reap additional benefits: increased metabolic rate, decreased appetite, less stress, improved mood, better glucose regulation, higher energy levels, increased confidence and more.

How They Changed

Jessica wanted to overcome her eating and weight problem. She was very motivated and changed her focus away from the scale and onto her behavior and thinking.

“I learned to identify what I was thinking and feeling,” she explains. “Every time I had a craving I kept a journal in my purse or in my pocket and wrote down what I was doing and what was going through my mind. I reviewed my notes with my coach, who gave me helpful ideas on what to change in my behavior. She coached me through my negative thinking – I had no idea how often I was indulging in negative thinking. I learned that if I felt the least bit out of control or feared I might not be in control, I wanted to eat. I put all of my focus on my relationship with my mother but she wasn’t influencing me anymore. I was living my own life but I was still acting as if I had to have my secret stash of food to make me feel better. I learned to eat out in the open. Once I did that, I was really aware of how much I was eating and I wasn’t going to eat a bag of cookies in front of other people. It was interesting in that as I gave up my food habit I realized there were important aspects about myself that had to change. I learned to take control of me and accepted the fact that nothing else is really in our control. I learned to take life a step at a time and to welcome the surprises and challenges.”

Mark was able to lose 50 pounds, and although not exactly back to normal weight, he is on his way.

“I didn’t realize how miserable I was,” he says. “I was using chocolate to make my life more bearable. I hated my job and I dragged myself to work every day. Once I stopped overindulging my cravings, I felt miserable. I understood how powerful my cravings were because it was like going cold turkey. I relied on sweets to get myself through the day. When I finally gave up the sweets and worked through my depression and fear of facing change, I got up the nerve to change my career direction. I got a new job that I love and more important than losing weight, I learned that I had to face my disappointments head on and do something about them.”

By Dr. Vanessa Gourdine

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