The relationship between emotion and eating is a complex psychobiological process that is often studied to understand the maladaptive behaviors in obesity and eating disorders (Canetti, Bachar & Berry, 2002; Alberts, Thewissen & Raes, 2012). Through examining the literature to try and understand what processes of the mind and body are contributing to problematic eating behaviors it is possible to also extract what processes may be contributing to a positive relationship with food and eating. The nutrition world can benefit from the practice of positive psychology, which teaches that when the focus is on strengthening strengths and on that which makes life worthwhile rather than focusing on pathologies, we flourish (Seligman & Csikszentmihaly, 2014). This paper explores through literature and personal inquiry the same process of focusing on what works in reference to healthy eating behaviors and weight and how it can be applied to developing positive relationships with eating and food. This is important because as a society, we have developed a paradoxical culture that is highly critical and dissatisfied with appearance rather than seeking happiness, and has an obsession with being thin yet struggling with an obesity epidemic (Garner, 1997). That dissatisfaction with body image is so widespread is symptomatic of a population that needs help finding a lifestyle that supports a better relationship with food and eating.
This paper will look at the literature on how eating behaviors are affected by biological and social function. Research on appetite, satiation, and satiety as well as self-esteem offer insight into how a person can optimize for a healthy relationship with eating and food to ultimately maintain a healthy weight and content life.
Research question
What biological and behavioral mechanisms can lead to a positive relationship with eating and food?
Appetite, Satiation, and Satiety
The processes of appetite satiation, and satiety are based on a variety of intertwined biological, mental, and external phenomena. Examining these processes is important to the understanding of eating behaviors and what drives some people to overeat as well as what can contribute to healthy eating behaviors. “Satiation is the process that causes one to stop eating; satiety is the feeling of fullness that persists after eating, suppressing further consumption, and both are important in determining total energy intake” (Benelam, 2009).
One of the ways the brain receives the signal that it is time to stop eating is through the distention of the stomach. As distention continues various hormones including insulin are secreted so that nutrient absorption and other biological mechanisms can occur post-eating (Benlam, 2009). Benlam (2009) also points out that long term satiety is affected by the levels of hormone secretion which depends on food choice. This implies that people who consistently eat a whole foods diet rich in nutrients and high-water content can experience satiety with less calorie intake than people who are eating highly palatable foods (high fat, high sugar, processed foods) (Rolls, 2012). In the presence of highly palatable foods it is easy to override the mind and body’s signals to finish eating and the result is overconsumption of foods that do not provide the body with the nutrition that optimizes for satiety.
To sustain a long-term positive relationship with eating, it is essential to eat foods that reduce the risk of leptin resistance. Leptin resistance is found in obese people which means that the hormone that is center to the satiety process is not able to effectively regulate feelings of satiation which drives the individual to continue to eat past a healthy amount (Rolls, 2012). In addition to reducing exposure and consumption of highly palatable foods, people with healthy eating behaviors are not overloading their system by eating before satiety signals have decreased. Eating just because the clock reads a specific time may contribute to obesity and dysregulation of appetite and satiety (Rolls, 2012).
Personal Inquiry Regarding Satiety
I’ve had many different relationships with food and my body and experienced different patterns of satiety depending on my eating behaviors. As a teenager into my mid 20’s I suffered from anorexia nervosa and sustained an abnormally low body weight. I recall being chronically hungry and tired for 10 years with a huge obsession for sweets which is well explained by the role of ghrelin in long term energy balance. Benlam (2009) writes, “In humans, ghrelin levels are inversely correlated with levels of body fatness; that is they are low in obese subjects, higher in lean subjects and abnormally high in subjects whose energy intake is chronically restricted, such as those suffering from anorexia nervosa. As I have evolved away from restrictive eating patterns and found functional ways of dealing with stress and control, my eating behaviors have evolved in such a way that I experience satiety and satisfaction most of the time, especially when I cook for myself.
As I enter week five of the shelter in place mandate during COVID-19, I am aware that this is the most consecutive amount of time that I have not had any meals prepared by a restaurant or in the office setting. With all meals prepared at home using simple, whole foods, with a balance of vegetables, fruity, protein, and starchy vegetables, and no exposure to baked goods (often found in my office setting), I find myself not needing as many sweet snacks and feeling satiety after each meal. It seems there is a compound effect of consistently cooking my own food that leads to greater levels of satisfaction and in turn drives snacking behavior and dessert consumption to decrease.
Social Impact on Eating Behavior
The food choices we make, how much we choose to eat, and when to eat are for the most part not autonomous decisions and deeply rooted in our social identity and norms (Exline, Zell, Bratslavsky, Hamilton & Swenson, 2012; Cruwys, Bevelander & Hermans, 2015; Spanos, Vartanian, Herman & Polivy, 2015). Delormier, Frohlich & Potvin (2009) state, “Eating does involve isolated choice, but it is a choice conditioned by the context in which it occurs” (p.217). This means that individuals are highly susceptible to the collective eating behaviors of their family, peer group, community, and their own sense of self. The indication is that people who are surrounded by healthy eaters are more likely to make healthy choices themselves and vice-a-versa; those who are surrounded by family and peers who overeat and snack on junk food are likely to participate in the same behavior by virtue of the modeling phenomena. “Modeling persists even when the model is not physically present” (Spanos, Vartanian, Herman & Polivy, 2015). However, individuals are not completely victim to their environments and the people they model. People who are more willing to acknowledge that social influence impacts personal eating behavior may be less susceptible to the social cues to eat and therefore may be able to make healthier choices (Spanos, Vartanian, Herman & Polivy, 2015).
Antidote to Negative Social Eating
Sociotropy, or the need to please others to maintain social harmony, is a predictor to eating in response to social pressure (Exline, Zell, Bratslavsky, Hamilton & Swenson, 2012). Interestingly, Exline et al. (2012), found that people who perceive that their self-control or higher social status is a threat to someone else who is eating will feel distress and in turn perhaps eat more or make less healthy choices to minimize discomfort (p.170). Additionally, people with greater self-control are seen as less fun than those who indulge more. (Exline et al., 2012).
The findings above apply to people who feel compelled to please others and may not be true for people who have higher self-esteem, less vulnerable to social pressures, or less concerned with their own eating behavior threatening others. Cruwys et al., (2015) points out that people with higher self-esteem worry less about rejection so they are less likely to be influenced by the modeling effect. Confidence and self-esteem are not only important to mental health but also physical health as it applies to eating behavior. There is reason to believe that greater self-esteem can lead to more autonomous food choices that ultimately allow the individual to make their own decisions based on their personal needs, rather than their social group.
Adolescents, Self-Esteem, and Eating Behaviors
Adolescents is a time of emotionally complexity attributed to internal hormonal and brain changes as well as external shifts in social relationships and emerging social identity (Guyer, Silk, & Nelson, 2016). Consequently, as teens are forming their identity and undergoing physiological changes, their mental health is highly susceptible to low self-esteem, self-consciousness, self-criticism, and depressive symptoms which are precursors to eating disorders. (Courtney, Gamboz & Johnson, 2008). Courtney, Gamboz & Johnson (2008) conducted a study with 197 adolescent and found that teens with low self-esteem show depressive symptoms and are more likely than those with higher self-esteem to engage in problematic eating at the follow up period. Self-esteem was measured using the The Structured Clinical Interview for DSM-IV Personality Disorders which asks questions about feelings of inadequacy, negative self- talk, and feelings of guilt for actions taken (Courtney, Gamboz & Johnson, 2008, p. 410).
By focusing on ways to develop a strong self-esteem teens and adults may protect themselves against the depressive symptoms that can lead to problematic eating behavior such as emotional eating, external eating, and restrictive eating. One way to do this is it engage in mindfulness practice aimed at eating behaviors that allows the individual to become aware of their negative self-talk about their body and promote self-acceptance (Alberts, Thewissen & Raes, 2012). Alberts, Thewissen & Raes (2013) found in a study using a mindfulness-based intervention, that positive relationships with eating and food can be cultivated when people are more accepting of their bodies, accepting of the moment despite feeling guilt around food, and learn to cope with emotions in other ways besides eating. While the mindfulness intervention used in this study was focused on eating behavior, other mindfulness studies have shown a positive correlation with a range of mindfulness-based interventions and significant increases in self-esteem (Randal, Pratt & Bucci, 2015). Finding ways to improve self-esteem in both teens and adults can contribute to a healthy relationship with eating and food in two ways: (1) limit the need to please others in social eating scenarios so that food choices are autonomous and potentially healthier, and (2) reduce depressive symptoms that can lead to problematic eating behaviors.
Personal Inquiry
Reflecting on my ten years of anorexic, highly restrictive eating behavior, I am able to recognize the social aspects identified in the literature that contributed to a strained relationship with eating and food. The modeling from my mother and feeding structure of the household taught me that restrictive eating and skipping meals is normal. The only meal my mother ate was dinner. While she fed my brothers and me she would diligently measure her food out on a scale to eat later. As Delormier, Frohlich & Potvin describe (2009), “family meal times can reveal….expectations associated with roles of being a mother or family food preparer (p.222). I believe as a female with the innate drive to be a mother one day, too, I was more susceptible to adopt my mother’s relationship with eating than my brothers. However, even when I had a conscious realization that her relationship to food and eating was maladaptive, I struggled to identify and participate in a healthy relationship with eating because I did not know what that looked like. Modeling my mother as well as my peers who had eating disorders, combined with what the literature shows leads to low self-esteem such as critical self-talk, ruminative thinking, and body comparison (Cowdrey & Park, 2012; Alberts & Raes, 2012), I believe an eating disorder was inevitable.
I recall feeling extreme guilt and shame when I would be eating out with friends who shamed me for having lost so much weight. There is one moment that stands out in my memory that demonstrates the phenomena of people pleasing in response to perceived social pressure (Exline et al., 2012). I was in a restaurant in New York City with my friend and her mom and was going to order a salad and they were going to order sandwiches. I could feel the judgement as we all shared what we planned to order so I ordered crab cakes instead. I really didn’t want to eat something fried but could feel that I was a threat as an eating companion if I didn’t order something more substantial. As I recovered from anorexia I felt that in social situations I had to prove to everyone that I was not anorexic and eat even when I didn’t necessarily have the internal cues to eat. As I’ve gone through therapy, coaching, and an internal transformation it is not surprising that I increasingly have more diligence in making the food choices I want rather than trying to please others.
Conclusion
This paper has looked at both biological and social processes that can contribute to adults and teens developing a positive relationship with eating and food. Eating meals and choosing foods that maximize hormonal balance for long-term satiety as well as engaging in processes that lead to positive self-esteem are just two ways that people can perpetuate healthy eating behaviors. In exploring my own experience with anorexia, the crisis is less about food, and more about confidence in oneself. The long-term habit of cooking and ensuring balanced nutrition compounds creating reward and drives continued healthy eating behaviors. Developing a healthy relationship with eating and food first requires developing an acceptance and love for oneself so that the psyche is less vulnerable to external influences that can derail autonomous healthy behaviors. The people who organically developed a healthy level of confidence and balanced eating behaviors through childhood and into adulthood are the best models for the remainder of the population. For those who hope to live with a healthy relationship with eating and food must recognize that it is a complex processes that takes time to evolve.
References
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