Snacking at the fridge.
April 15, 2020 | by Kristen Johnson MD

In the midst of our efforts to figure out the medical facts of triaging, testing, and treating COVID-19, there is an insidious, unofficial diagnosis bubbling to the surface: The COVID #19. The hashtag is not a trendy social media reference, but a symbol for pounds and—like the Freshman #15 or the Seahawks-out-of-Superbowl-contention #12—refers to a tendency to eat more, and less healthy foods, in times of uncertainty, disappointment, or even emotional relief. To support wellness and self-care in these unprecedented times, I am sharing the “Why?” behind this seemingly uncontrollable habit, and some specific tools to help all of us cope in ways that are (usually) better for our physical and mental health.

First, the attentive reader may have caught that “usually,” and if you read no further than this paragraph, I want to put my most important point right here:

1. Have compassion for yourself!

What we are going through is REALLY DIFFICULT. We are scared, confused, and anxious. It is totally normal in times like these to turn to habits that help us feel better, even if only momentarily. Your brain is trying desperately to reach for things that bring a sense of calm or happiness, and food can do that for us. So maybe, believe it or not, we can sometimes just accept that. We can acknowledge, “I feel bad and this [cookie, pizza, ice cream] is helping me feel better.” We are giving virtual hugs to everyone we love these days—why not give a virtual hug to your food-indulging self, and just let that be? It’s really, truly okay.

That said, if we are honest with ourselves, the better we feel during consumption of personal comfort food [cookie, pizza, ice cream] is almost always short-lived. From a biochemical standpoint, sugary substances hit our brain hard, bumping up the feel-good hormones of dopamine and endogenous (made in our own body) opioids.

Dopamine is associated with feelings of motivation (“I got this!”), novelty (“Ooh, finally something different!”) and reward (“Good job, self!”), and opioids are associated with pain relief (physical and existential) and happiness. In other words, for a glorious brief moment we feel great! Shockingly, this brain activity is the same as what happens with cocaine or heroin consumption (yikes) and similar to those drugs, once that feel-good moment has spiked, it crashes down ruthlessly, bringing withdrawal symptoms of fatigue, irritability, poor concentration, depression, and anxiety. You may recognize those as the feelings you were trying to get away from to begin with.

Serotonin, another happy hormone, comes down too. This whole process is in addition to the insulin surge that follows our typically high-sugar binging, which also brings down our mood, energy level, and (bonus!) stores that extra sugar as fat. And if we weren’t feeling bad enough already, over time the brain responds with dependence, just like with cocaine and heroin, meaning you gradually need more and more sugar to get the same dopamine/opioid feel-good response, all the while driving our serotonin lower and our waistlines out. So our poor brain, despite it’s good intention to bring us a respite from negative feelings, finds itself way worse off.

It’s extremely difficult (see point #1 above!) to remember all of this when the [cookie, pizza, ice cream] are in our hand, or more likely in our mouths, but that bring us to the next tip:

2. Pause, even for a second, before you pick up any food or drink and ask yourself, “What am I feeding?”

If the answer is, “I’m hungry” or “I’m feeding the fact that today was ridiculously miserable and I am choosing to respond with this,” then go for it. Really. But maybe in that brief pause you’ll hear a voice that says, “I’m scared/lonely/anxious/confused/overwhelmed,” and if you can, pause just a second more and ask:

3. What does that emotion really need?

Again, maybe the answer is, “duh, it needs this [cookie, pizza, ice cream],” in which case okay, go for it. Really. But maybe the answer is that you need a good cry, or a walk, or a nap, or a FaceTime with a friend or someone you’ve been worried about. In that case, listen, listen, listen to the answer and your innate knowledge of what you need to feel better. It can be difficult to listen, and even more difficult to respond to what you hear. These non-food responses require energy, or planning, or feeling uncomfortable feelings, and in our moments of just wanting to feel better RIGHT NOW, the [cookie, pizza, ice cream] are so much easier to access. But with intention, and practice, the alternatives to emotional eating can get easier, and even become a habit in themselves. Which brings us to my next action item:

4. Plan ahead (a.k.a. be a step ahead of your own brain)

Keep an easy-to-find list in your pocket, on your pantry door, or in your phone of things that make you feel better without the metabolic crash. Review this every day so that it comes to mind easier in a rough moment. Talk to a friend or co-worker and agree to call or text each other every time you feel the urge to eat in response to emotions that could be better fed. Decide to not bring your most binge-worthy items into your house, or make them hard to get to. Put a note of self-love or even a smiley face on the packaging of these items. Eat outside in the sun, or on a walk. Anything to encourage the moments of pausing and reflecting can help, and increase the chances that you choose something more aligned with what you really need.

If those strategies cannot compete with your brain’s overwhelming need for dopamine and natural opioids now, then you simply take a deep breath when it’s over and return to compassion. You have never been a healthcare provider (or parent, or child, or friend) in the middle of pandemic before. Your brain does not have any practice processing this, and it is naturally going to run full speed to anything that will help this reality feel less daunting, even if just for a minute. This is normal, and it’s ok—usually. If it’s not ok, you will know it. You will feel depression or anxiety that is more than the momentary internal scolding of, “I really shouldn’t have eaten that.” You may also find out it’s not ok from something external—your clothes don’t feel good, or your doctor notices your blood pressure or blood sugar is trending up. In that case, please remember this final tip:

5. Find help

In the dark moments of emotional eating, it is so easy and normal to feel that you are the only person who can’t get a handle on this. So many moments of overeating happen in private—after the kids are in bed, when your partner is not home, in the car—which brings with it a sense of shame and secrecy. For kicks, Google ‘emotional eating’ or search it on Amazon. Do page after page of websites, articles, books, podcasts, and blogs exist just because you can’t figure this out? You know the answer to that. Following are some resources if you feel this is more than just a pandemic-related blip in your eating habits, or if this blip is impacting your life more than just a passing moment of gustatory regret. For now, please know that emotional eating is not a product of personal weakness or just lack of will power. It is normal response to stress driven by biochemical and hardwired brain processes. We can practice and improve on managing those better, but in the end we each deserve compassion for doing our best, whatever that may look like for each of us.

Recommended Resources include:

Books

  • Savor: Mindful Eating, Mindful Life by Thich Nhat Hanh, Lilian Cheung
  • First Bite, How We Learn to Eat by Bee Wilson
  • Intuitive Eating, A Revolutionary Program that Works, by Evelyn Tribole and Elyse Resch

Podcasts

Food, We Need to Talk - hosted by young woman who has struggled with food and weight, and a Physical Medicine & Rehab professor from Harvard who runs a lifestyle medicine program as well. Great balance of age, background, real world and medical perspectives.

Apps

Insight Timer - free meditation app, search for ‘overeating’ for individual guided meditations. Ten to 30-day overeating courses at reasonable prices.

Sanvello - an app offering self-care, peer support, coaching, and therapy to improve mental health and wellness.

For those interested in behavioral and medical weight management, visit our Lifestyle & Metabolic Medicine webpage for more information. Dr. Johnson will be available for new patient consults after June 1; call her office at 206.860.5499 to schedule an appointment.

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Written By: Kristen Johnson MD