Women attending clinic sessions may sometimes find themselves struggling with adopting new dietary practices. It is not uncommon for individuals to face psychological challenges when attempting to break old eating habits. It is crucial to understand that following sound nutritional guidance requires a level of conscious control over one's eating behaviours. Emotional impulses that prioritize immediate food satisfaction can render logical advice ineffective in such instances.

Emotions can often lead to a desire to eat for various reasons, such as suppressing feelings, seeking gratification, or finding solace. This form of emotional hunger is a unique stimulus that sets it apart from physical hunger, offering temporary satisfaction. Regrettably, no quantity or type of food can effectively address emotional needs in the long term. Consequently, this behavior frequently results in feelings of guilt and a recurring pattern of unhealthy eating, culminating in negative emotions before the cycle restarts.

The emotional eating cycle:

Understanding the cycle

As the cycle persists, the underlying issue intensifies due to a lack of acquiring constructive strategies for managing emotions. Over time, managing weight gain may become more challenging, while a sense of helplessness grows in relation to food and emotional responses. Nevertheless, despite feelings of powerlessness in these areas, it is feasible to instigate a beneficial transformation. By acquiring healthier coping mechanisms for emotions, evading triggers, overcoming cravings, and ultimately halting emotional eating, a positive change can be achieved.

Here’s a guide to outline the differences between emotional and physical hunger.

When examining emotions and eating behavior, distress emerges as the most commonly studied emotion in academic research. Extended periods of stress and depression have been found to be associated with increased food consumption, with individuals tending to eat more during stressful times (1,2). It is believed that individuals experiencing anxiety may turn to emotional eating as a coping mechanism for heightened arousal, while those dealing with depression may find solace in emotional eating as a source of positive emotional experiences (3). These observations are supported by a study conducted in Spain, which revealed that individuals who do not engage in emotional eating often experience positive emotions such as joy, relief, love, enjoyment, happiness, and pleasure. Such individuals may consume energy-dense foods purely for the pleasure they provide. Conversely, individuals who consume energy-dense foods high in fat and sugars in response to negative emotions often experience hedonic pleasure and immediate gratification (4).

Critically, emotional eating appears to influence the types of food eaten. The majority of food selected is characterized by higher sugar or high saturated fat-based foods and less healthy /processed/fast food meals.

Breaking the cycle of emotional eating

During times of urgent emotional hunger, it is advisable to proactively plan ahead. Ensure that your cupboards and refrigerators are stocked with foods and snacks that are high in fiber and protein. Opt for these options when you find it challenging to divert your attention from emotional cravings.

Try to pause before giving into a craving. Emotional eating tends to be automatic and virtually mindless. But if you can take a moment to pause and reflect when you’re hit with a craving, you give yourself the opportunity to make a different decision.

Utilizing an eating diary can be a valuable tool in monitoring and analyzing your cravings along with the associated emotions. It is recommended to document any cravings experienced each day and note the corresponding emotional state. Take a moment to contemplate and review these entries regularly, both daily and weekly. By identifying patterns in your cravings, you can gain insight into the triggers behind them. While comprehending the reasons for your cravings may not immediately eliminate them, over time, it can assist in recognizing and addressing these triggers. This awareness can empower you to proactively prevent unhealthy eating habits by addressing the root causes effectively.

o   Do you eat when you are tired? Would you benefit from HRT or a natural remedy to support adrenal function?

o   Do you eat as a reward? What else could you look forward to as a reward in place of food?

o   Do you feel unwell or have chronic pain? Don’t put off investigating with a GP or Nutritionist to see if you could reduce or prevent symptoms that lessens your need to numb with food.

o   Do you have work or financial pressures? Do you eat to numb anxious thoughts about this?

o   Are you dehydrated? Dehydration can be confused with hunger at times. Check your urine colour, is it dark yellow? Urine should be fairly clear and if it isn’t drinking more fluids throughout each day will help.

o   Are you upset or angry? We know that positive psychological states and hunger influence each other. (5)

Mindfulness

Mindfulness meditation has proven to be significantly helpful prior to attempting weight loss in terms of food cue reactivity, intuitive eating and emotional impulse regulation. (6) If you desire to break the pattern of emotional eating, mindfulness meditation may offer some support.

Intuitive eating

Developing a more peaceful relationship with food is the ideal alternative to ‘dieting’. Acceptance of the changes that life stages can bring as well as aging, may help us deal with satiety and hunger cues. (7)

Self-compassion

Higher levels of self-compassion have been linked to higher diet quality, greater levels of intuitive eating and lower levels of emotional eating (8). Its thought that body esteem mediates this link between self-compassion and intuitive eating and self-compassion may be a useful tool of self-care that can help you rely less on food as a coping mechanism to a negative emotional state. (9,10)) When generalized anxiety disorder (GAD) is present, an improvement in emotional eating through identification of healthier eating behaviour interventions can be experienced when self-compassion is practiced. (3).

The phenomenon of emotional eating is quite complex as a multifaceted compilation of internal and external issues, influencing the decision to eat food and the quantity and kinds of food which will be consumed.

Overall, prevention of food use as a coping strategy is crucial among emotional eaters. Practices such as stress management via mindfulness meditation and self-compassion, breath work or yoga should be considered.

Menopause and emotional eating

As if emotional triggers to crave unhealthy foods weren’t enough, during the menopause transition, our hormone shifts create an even more complex succession of biochemical reactions, making the right food choices even more difficult for some women and crucial for short- and long-term health.

A hormone called ghrelin, often referred to as the hunger hormone as it has a key function in stimulating food intake via the nervous system signalling the gut. At high levels it impacts other hormone release, notably, cortisol (a major stress hormone). There is a complex relationship between ghrelin, oestrogen and cortisol, whereby under chronic stress situations, ghrelin increases reward seeking through food consumption, whereas oestrogen decreases it. (11). This may explain why oestrogen dips during the menopause transition can lead to increased hunger.

A higher frequency and severity of anxiety, depression, sleep concerns, cognitive complaints, pain, and vasomotor symptoms are associated with greater frequency and severity of problematic eating behaviours in both peri and post-menopausal women. (12) Stress eating, and menopause status significantly contribute to depressive symptom-weight association, further adding to the complexity of this cycle for women in midlife. (13)

Eating right for menopause involves some changes to what might have been healthy options in your twenties and thirties. In order to apply this logically to our everyday food choices, women in perimenopause and beyond need to

1 Avoid attacking yourself/blaming or shaming if your feelings/cravings for food have changed in recent years.

2 Acknowledge that hormonal shifts can control us unless we support our body by nourishing it specifically for this life stage.

3 Seek nutrition advice and/or healthcare advice if you need it.

4 Consult with a menopause coach to receive expert guidance during this challenging phase.

When & where to get help

If healthier snacking options and mindfulness or other forms of stress management do not help, it may be beneficial to seek cognitive behavioural therapy (CBT) via local NHS practices.

Menopause coaching and nutrition sessions can assist individuals in breaking the cycle by increasing awareness of emotional eating triggers. These sessions also provide interventions for managing sugar consumption and balancing hormones to enhance motivation in overcoming emotional eating habits.

References

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2 Dakanalis A, Mentzelou M, Papadopoulou SK, Papandreou D, Spanoudaki M, Vasios GK, Pavlidou E, Mantzorou M, Giaginis C. The Association of Emotional Eating with Overweight/Obesity, Depression, Anxiety/Stress, and Dietary Patterns: A Review of the Current Clinical Evidence. Nutrients. 2023 Feb 26;15(5):1173. doi: 10.3390/nu15051173. PMID: 36904172; PMCID: PMC10005347.

3Fonseca NKOD, Costa MA, Gosmann NP, Dalle Molle R, Gonçalves FG, Silva AC, Rodrigues Y, Silveira PP, Manfro GG. Emotional eating in women with generalized anxiety disorder. Trends Psychiatry Psychother. 2023;45:e20210399. doi: 10.47626/2237-6089-2021-0399. Epub 2022 Feb 14. PMID: 35156782; PMCID: PMC10597384.

4Morllo Sarto H., Barcelo-Soler A., Herrera-Mercadal P., et al. Efficacy of a mindful eating programme to reduce emotional eating in patients suffering from overweight or obesity in primary care settings: a cluster-randomised trial protocol. BMJ Open . 2019;9(11) doi: 10.1136/bmjopen-2019-031327.e031327

5de Rivaz R, Swendsen J, Berthoz S, Husky M, Merikangas K, Marques-Vidal P. Associations between Hunger and Psychological Outcomes: A Large-Scale Ecological Momentary Assessment Study. Nutrients. 2022 Dec 5;14(23):5167. doi: 10.3390/nu14235167. PMID: 36501197; PMCID: PMC9736756.

6Lattimore P. Mindfulness-based emotional eating awareness training: taking the emotional out of eating. Eat Weight Disord. 2020 Jun;25(3):649-657. doi: 10.1007/s40519-019-00667-y. Epub 2019 Mar 11. PMID: 30859465; PMCID: PMC7256094.

7 Vorlet J, Carrard I. Barriers and facilitators of intuitive eating in postmenopausal women: A qualitative study. Health Psychol Open. 2023 Feb 18;10(1):20551029231157515. doi: 10.1177/20551029231157515. PMID: 36814441; PMCID: PMC9940212.

8Carbonneau N, Holding A, Lavigne G, Robitaille J. Feel Good, Eat Better: The Role of Self-Compassion and Body Esteem in Mothers' Healthy Eating Behaviours. Nutrients. 2021 Oct 30;13(11):3907. doi: 10.3390/nu13113907. PMID: 34836162; PMCID: PMC8625178.

9Thayer R.E. Calm Energy—How People Regulate Mood with Food and Exercise. Oxford University Press; Oxford, UK: 2001.

10Van Strien T., Frijters J.E., Bergers G.P., Defares P.B. The Dutch Eating Behavior Questionnaire (DEBQ) for assessment of restrained, emotional, and external eating behavior. Int. J. Eat. Disord. 1986;5:295–315. doi: 10.1002/1098-108X(198602)5:2<295::AID-EAT2260050209>3.0.CO;2-T.

11 Smith A, Woodside B, Abizaid A. Ghrelin and the Control of Energy Balance in Females. Front Endocrinol (Lausanne). 2022 Jul 15;13:904754. doi: 10.3389/fendo.2022.904754. PMID: 35909536; PMCID: PMC9334675.

12 Riedy DR, Ghose SM, Sabet SM, Reid MP, Williams CM, MacPherson A, Dautovich ND. A comprehensive investigation of the association between menopause symptoms and problematic eating behavior in peri- and post-menopause cisgender women. Women Health. 2024 Apr;64(4):317-329. doi: 10.1080/03630242.2024.2325559. Epub 2024 Apr 14. PMID: 38616232.

13 Schreiber DR, Dautovich ND. Depressive symptoms and weight in midlife women: the role of stress eating and menopause status. Menopause. 2017 Oct;24(10):1190-1199. doi: 10.1097/GME.0000000000000897. PMID: 28697039; PMCID: PMC5607068.