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Friday, 13 August 2010

Appetite Sensitivity Training For Comfort Eaters

What is comfort eating? If you eat when you are angry or sad or anxious it is obvious. If you go backwards and forwards to the fridge looking for food and nothing satisfied, then probably you are an emotional eater. But if you eat a bar of chocolate because it is there and you want a taste buzz, is it the same?

People usually call themselves comfort eaters if they eat more than they need. They may even call themselves addicts if they carry on eating when they are full, or are especially attached to a particular kind of food. I wouldn’t mind a fiver in my own pocket for every person who has told me “I’m addicted to chocolate.”

Experts also have ways of thinking about emotional eating. There is indeed a school of thought which marks compulsive eating as an addiction. There is also a school of thought which suggests that emotional eating is an attachment to food as a substitute for more authentic forms of self soothing that comes from good, mutually adaptive relationships.

Then there is the trauma account of emotional eating which suggests that food is the way of managing forbidden feelings such as anger or fear. This account of emotional eating allows for the possibility that some people do not want to feel any of their emotions because of deep rooted feelings of shame. And thus they eat so that they won’t have to feel anything at all.

The link between overeating and feelings is quite clear. We only know we have an emotion when we feel it in the body. Sadness gives me a feeling in the pit of my stomach and anger gives me tightness in my chest. If I do not like feeling angry, eating might take away that feeling and give me a nice warm feeling somewhere else.  If I can’t make sense of that feeling in my chest and call it “fear” I might convince myself I am hungry and go to find some soothing food.

Experts have met the problem of emotional eating by doing “feelings sensitivity training”. There are many steps to this kind of training. The first step is permission to have emotions. The second step is teaching good names for the feelings that we experience in our mind and body too. The third step might help us to know why some feelings are more troublesome than others. And the last important step is learning all kinds of skills to manage our feelings better. Managing conflicts and standing our ground with other people is all part of building emotional intelligence. This will help reduce all kinds of disordered eating behaviour, from calorie restriction to chronic overeating.


There is a possibility that Appetite Awareness Training might help even better for emotional eaters.

Experts give the name “interoceptive awareness”  to our understanding of the changing experiences that happen in the body. People with weight problems and eating problems seem bad at interpreting these signals and are more likely to interpret everything, including emotions, as feeling hungry or having cravings.

The old way of dealing with this is to increase our sensitivity to emotions, to be able in other words to recognise when we are angry and when we are feeling useless.

Some new research suggests that it might be even better to learn how to recognise physical hunger and how exactly to distinguish it from a buried feeling.  A group of researchers in the USA have recently conducted an experiment in which a group of people were exposed to 5 weeks of Appetite Sensitivity Training. All they had to do was self monitor hunger, cravings and fullness sensations for each eating event; and also relate the degree to which they felt positively or negatively after each eating episode to help them distinguish between hunger and feelings.

On week 4 they also self monitored to identify specific emotions triggering urges to eat, with the help of a sheet with emoticons J and feeling words. During this week they were given advice on other ways of managing their feelings.

At the end of the period, participants and controls returned to the clinic to complete the post intervention assessments.

The results were clear. People who did the appetite training did not show much improvement on emotional awareness but they had big changes in appetite sensitivity. They reported fewer urges to binge or cut back on food and better eating control.

Emotional eating is a multi dimensional idea. I believe that any single explanation of it and the treatment that follows will not work for everyone. Clearly, emotional eating is behaviour which must take account of our history, our beliefs and our emotional strengths and weaknesses. But this research shows clearly that Appetite Sensitivity Training might be an important part of therapy and get change fast, even for people with “issues”.

1 comment:

  1. Hi Deanne,

    really interesting and useful research. How would you personally set this up with a client if you were to use this idea in therapy?