Compulsive Overeating

For many patients, bariatric surgery has a “magical” quality. Following surgery, patients eat less, feel satisfied, and lose weight. At long last there is freedom from the struggle to control their eating and their weight. It’s so easy it does feel like magic.

Sadly, some bariatric patients are disappointed to find that their struggle continues. Yes, they may eat less, feel more satisfied, and lose some weight. But they continue to feel stressed by an internal urge to eat. Responding to this urge sabotages, or at least plateaus, their weight loss.

Typically, patients who are stressed by an internal urge to eat are compulsive overeaters. Compulsive overeaters are people who eat to satisfy emotional hunger. They are relying on something outside of themselves (food) to try to make them feel better on the inside. Often, compulsive overeaters are unaware of the emotional hunger they are trying to satisfy. They just know that, for a little while after eating, they feel better. The sense of feeling better, however, is short-lived. Feelings of embarrassment and guilt soon follow and often lead to more compulsive eating.

In her book, The 5 Reasons Why We Overeat, Cynthia G. Last, Ph.D. writes about the most common psychological patterns of overeating and outlines a specific plan to overcome each one. Her common patterns of overeating include the following:

Impulsive Overeating. Impulsive overeaters experience sudden spontaneous urges to eat and respond to them without thinking about what, when, or why they are eating. Hedonistic Overeating. Hedonistic overeaters eat because they enjoy the sight, smell, taste and experience of eating. It is difficult for them to resist food. Stress Overeating. Stress overeaters eat to induce a feeling of physical and/or mental relaxation.

Avoidance Overeating. Avoidance overeaters eat to escape their problems. Energizer Overeating. Energizer overeaters eat to get a physical and/or emotional pick-up. Almost every patient engages in at least one overeating pattern. Following are some of Dr. Last’s self-help treatment guidelines for each pattern. If you engage in more than one pattern, choose the one that gives you the least difficulty and use Dr. Last’s treatment plan to learn to manage it. Working from the least problematic to the most problematic will give you the greatest success.

In addition to the reason described above, professionals from the Minirth-Meir Clinics have identified relationship issues that often lead to compulsive overeating. These issues include the following:

Overeating for protection. People who have experienced various kinds of abuse, disappointment in intimate relationships, or who are uncomfortable with their sexuality, often use weight to protect them from intimate relationships that might be hurtful and/or to soothe their pain when they have been/are being hurt.

Overeating for punishment. Keeping themselves overweight is a way some people express anger toward themselves or others.

Overeating to feed a hungry heart. People who come from dysfunctional families where they did not receive the nurturing and love they needed often eat to fill the emotional vacuum left by the lack of nurturing and love. Even people who come from functional families often encounter enormous setback and hurt that leave them with an emotional deficit. Feeding the stomach becomes a way to try to take care of that deficit.

Professionals at the Minerth-Meir Clinics have produced a book explaining these (and other) reasons for compulsive overeating and a self-help workbook to help overcome them. The book is entitled, Love Hunger, Recovery from Food Addiction, by Minirth, Meir, Hemfelt and Sneed. The workbook has the same title but adds the word “workbook”.

Many people have been able to significantly reduce or end their compulsive overeating with self-help materials like those described above. Others find their compulsive overeating difficult to overcome on their own. When self-help materials are not sufficient, working with a psychotherapist trained in treating eating disorders can prove beneficial. Psychotherapists who use Cognitive Behavioral Therapy have been very successful in treating compulsive overeating behavior.

The Impulsive Overeater

Impulsive overeaters are high-energy, action-oriented people. They are generally fun loving and optimistic. They have many interests and cannot tolerate boredom. Because Impulsive Overeaters are so busy pursuing life, they do not pay attention to when, where, or what they eat. Their inattention to food often causes them to eat too much.

If you identified yourself as an Impulsive Overeater the following four treatment guidelines can help you. Begin with the first treatment method and practice it for one week. Add one treatment guideline each week over the next three weeks.

Change your eating environment. Limit where you eat. If eating in front of the TV has been a problem for you, don’t allow yourself to eat there. Limit your eating to the kitchen or dining room. Engage in an alternative behavior while watching TV such as chewing sugarless gum or working on a project. Limit when you eat. Set a specific time for each meal and/or snack. And do your best to eat only at those times. Most people need to eat every 4 to 5 hours to avoid overeating in response to extreme hunger. Limit what you eat. Plan healthy menus and keep healthy food at hand. Avoid grabbing junk food because it is quick and easy to eat on the run.

Reward yourself to reinforce new behavior. Plan small and large rewards for practicing behaviors to change your eating environment, eating schedule, and food choices. Change your eating style. Always use plate and utensils when you eat. Serve only one portion of food at a time. Don’t eat food out of a container using only your hands. Use aversive imagery. Picture yourself doing things you want to stop doing, i.e. eating while driving or out of a container with your hands. Imagine unpleasant consequences for doing this, i.e. crashing your car because you couldn’t pay attention to where you were going or dropping food on your clothing and having to attend a meeting/function with soiled clothing.

Practice these treatment methods over and over until you find that you are no longer Impulsively Overeating. Use them again whenever you lapse into the behavior. The Hedonistic Overeater

Hedonistic Overeaters are outgoing, adventurous people. They like to have a good time, enjoy life, and take time to smell the roses. Hedonistic Overeaters typically experience great pleasure in eating and pay close attention to the smell, texture, and taste of the food. Hedonistic Overeaters particularly enjoy rich, high calorie foods that case them to consume too many calories. If you are a Hedonistic Overeater the following treatment guidelines can help you modify your behavior. Complete the first treatment guideline for one week. Add one additional guideline each week for the next three weeks.

Reduce your calorie intake. Substitute high-calorie foods with reduced calorie foods, i.e. eat sugar free hard candy instead of eating candy bars, drink diet drinks instead of high-calorie beverages. Control portion sizes. Eat small portions of favorite foods, i.e. eat a Hershey’s Kiss instead of an entire candy bar. Savor each bit of the small portion by eating slowly and making sure that you relish the taste and texture of the food. Increase pleasurable activities. Make a list of activities that you enjoy. Take time to engage in these activities instead of eating. Develop healthy attitudes about food. Identify unhealthy attitudes about food.

Example: Food is love. Replace unhealthy attitudes with healthy attitudes. Example: Food is nutrition. Positive relationships with family and friends provide love.

Practice these guidelines until you are pleasurably eating an appropriate amount of food. Repeat them when you find yourself falling back into Hedonistic Overeating behavior.

The Stress Reducer Overeater

Stress reducers are sensitive and imaginative people who have a lot of energy and drive. When they positively direct their energy, they can be very productive and successful. Unfortunately, pent-up feelings that are not properly directed can create a lot of tension and stress. Stress reducers often get into the bad habit of eating to reduce tension and stress. When use of the habit is chronic, weight gain is inevitable.

If you are identified as someone who overeats in response to stress, use the guidelines listed below to reduce, or eliminate, the behavior. Begin with the first guideline and practice it for a week. Add one additional guideline for the next four weeks.

Engage in deep muscle relaxation. Tighten and then relax the various muscles in your body one areas at a time. Progressively tense and relax all the muscles in your body. Do these exercises once a day.

Engage in abdominal breathing. Place your hands on your abdomen (the part of your stomach below your waist). Inhale slowly and deeply until you feel your stomach push out. Hold your breath for 3 seconds and then exhale slowly. Repeat 10 times. Practice this exercise once each day.

Use coping statements. Identify ways that you add to your stress by using, “What if?” statements or other disaster thinking. Replace stress inducing statements with stress relieving alternatives.

Example: From: “I’ll never be successful at losing weight.” To: “I’ll work with my surgical tool to help me successfully lose weight.” Practice thought-stopping. Identify obsessive concerns, which only cause you to become more and more upset. Place a rubber band around the wrist of your non-dominant hand. Whenever you notice yourself obsessing, snap the rubber band and loudly say the work STOP. If you are in a place where you cannot speak loudly, say the work in your head.

Use exposure to overcome anxiety producing situations. Identify the objects, events, places, people, and/or experiences you avoid because they create anxiety. Rank the things you fear from most feared to least feared. Start with the thing you fear the LEAST. Gradually and repeatedly expose yourself to what you fear. Start with a short exposure and work up to longer exposure. With gradual and repeated exposure, you should decrease your anxiety and increase your ability to comfortably tolerate the exposure.

Progressively work through your list of fears using the exposure method. You may need a family member or friend to support you through the process. For things you fear the most, you may benefit from the support of a psychotherapist.

As you release your tension, your urge to overeat will decrease and you will be more successful in achieving and maintaining a healthier body weight.

The Avoidance Overeater

Avoidance Overeaters are warm, compassionate people who are sensitive to the feelings of others. They often have life-long friends who know they can count on them. Although they are responsive to the needs of others, they have a difficult time dealing with their own wants, needs, and problems. They often turn to food to escape their problems. When they overeat to avoid their problems, they become overweight.

If you identify with the Avoidance Overeater you need a strategy to stop the behavior. The four treatment guidelines described below are designed to help you give yourself the same good care you give others and get control of your eating behavior. Start with the first treatment guideline and practice it for one week. Then add one treatment guideline for the next three weeks.

Learn to identify your emotions. Keep a log of your feelings, especially the negative ones. Common positive feelings are happy, excited, pleased, comfortable, energetic, and relaxed. Common negative feelings are angry, hurt, depressed lonely, worried, jealous, and embarrassed. Include in your log the times you eat, whether you ate at a meal or a snack, if you’re eating was planned or unplanned, and the feelings you had before you ate. Engage in problem solving skills. State the problem and its facts, brainstorm the realistic solutions, evaluate the solutions and choose the one that best fits the facts and implement the solution and evaluate the outcome. Repeat these steps until you achieve the best outcome you can.

Use assertiveness communications skills. Learn to verbally communicate your wants, needs, and feelings in a clear, direct, honest way using “I” statements without sarcasm or blame. Learn to use assertive non-verbal communication skills. Look people in the eye, stand up straight, keep your voice calm and even in tone.

Practice assertive communication skills. Write out a script and rehearse it. Use a mirror to be sure you are using good verbal and non-verbal skills. Practice assertive communication skills with a friend or a support group. Use visualization to mentally rehearse assertive communication. Visualize yourself communicating successfully. Practice the scene over and over to reinforce assertive behavior.

Used repeatedly, the guidelines above can help you become more assertive. The more assertive you become, the less you will turn to food for comfort.

The Energizer Overeater

Energizer Overeaters are bright people who think deeply about things. They tend to be serious and show precision and attention to detail. Because of their depth and perfectionism, they are easily dissatisfied and feel bored, tired, or sad. When they feel bad, they use food as a pick-up. Overeating to energize leads to weight gain.

Eating in response to mood is the most common reason why people overeat. Mood eating may have both biological and environmental causes. To conquer their overeating behavior, mood overeaters must develop skill to improve mood. The following four treatment guidelines can help you eliminate the negative emotions that trigger this behavior. Practice one treatment guideline at a time and move on when you have become comfortable with the current one.

Challenge beliefs. Identify unhelpful beliefs. Unhelpful beliefs often include words like, always, never, all, completely, and should. They are rigid and exclusionary. They make you feel bad. Replace unhelpful beliefs with helpful beliefs. Helpful beliefs are flexible and allow room for exceptions or special circumstances. They include multiple shades of gray. They make you feel good.

Engage in positive self appraisals. Identify negative self-statements that put you down. Negative self-statements often include words like I can’t, I’m not, I won’t be able to. Replace negative self-statements with positive self-statements. Positive self-statements include words such as I can, I am, I will.Engage in pleasurable/healthy activities. Socialize with people you enjoy spending time with. Have some meaningful social interaction every day.

Engage in meaningful hobbies, activities or sports. Treat yourself to special indulgences. Take a bubble bath, have a massage, wear clothes that make you feel good, make your environment attractive. Take good care of yourself. Eat a nutritious diet, exercise, get sufficient sleep, and allow time for relaxation.

Develop personal goals. Identify things about yourself or your life that bring you down. Determine to change them for the better. Make a list of changes that would make you happy. State them as goals. Maybe it would benefit you to learn to be more assertive or socially skilled. Maybe you need more education to get the job you want. Maybe your friends engage in abusive behavior and new friends would be more supportive. Maybe your living conditions are drab and would be brightened by some redecorating. Personal goals can range from making small changes to fulfilling major accomplishments. Choose one of your goals and break it down into several small steps. Reward yourself for completing each step. Celebrate when you achieve the goal.

Practicing the treatment methods listed above will improve your mood, raise your self-esteem, and bring you more happiness. Feeling better about yourself and your environment and having interesting things to do will curb your overeating behavior and help you to lose weight and/or maintain your goal weight.