28 August 2024 — Primary care physicians are well positioned to treat emotional eating because of their long-standing relationships with patients. noted Jana DeSimone Wozniak, PhD and Hsiang Huang, MD, MPH of Harvard Medical School and Cambridge Health Alliance in Cambridge, Massachusetts. According to their article, which was published in Harvard Review of Psychiatry, Part of the Lippincott portfolio of Wolters-Kluwer, Emotional eating has been linked to a myriad of health problems, including being overweight or obese, increasing difficulty losing and maintaining weight, diabetes, and heart disease.
Traditional approaches to weight control do not adequately take emotional eating into account
“Emotional eating is characterized by increased motivation to consume food in response to stress and/or emotional and mood states,” explain Dr. Wozniak and Dr. Huang. “Individuals who eat due to negative emotional states and stimuli report a tendency to consume so-called ‘palatable foods’ (i.e., foods high in sugar, fat, and calories).”
Some individuals without obesity report eating in response to negative emotions or stress, the authors say, but emotional eating is more commonly associated with higher body fat percentage, waist circumference, and body mass index. In addition, emotional eating is associated with lower success with traditional, behavior-based weight loss treatments (e.g., reducing portion size, calorie and fat intake, and/or the amount of carbohydrates consumed).
Family doctors are well positioned to recognize emotional eating
Emotional eating often overlaps with depression, anxiety, and eating disorders, note Dr. Wozniak and Dr. Huang. They recommend using the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) to screen for disordered eating behaviors related to negative emotional states or psychosocial stressors. For example, if a patient presents with weight-related concerns and reports “Loss of appetite or overeating“ The PHQ-9 allows the provider to further explore the nature of the eating disorder and emotion coping patterns.
Primary care physicians can use screening tools that identify eating disorders and life stressors. Examples for primary care include the Screen for Disordered Eating, the Perceived Stress Scale–10, and the Eating Disorder Examination Questionnaire.
Dr. Wozniak and Dr. Huang point out that people who meet the criteria for binge eating disorder (BED) can also suffer from emotional eating, but that not everyone who suffers from emotional eating meets the diagnostic criteria for BED (episodes of compulsive eating that recur on average once per week for at least three months).
Clinical considerations for primary care physicians in dealing with emotional eating
Psychological interventions, particularly cognitive behavioral therapy and mindfulness-based interventions, are the standard first-line approaches to treating emotional eating, the authors say. However, acceptance and commitment therapy and dialectical behavior therapy also reduce emotional eating in adults who are overweight or obese, and research suggests that improvements are sustainable.
The U.S. Food and Drug Administration has not approved any medications to treat emotional eating. However, underlying mental health conditions may require psychopharmacological treatment, with special attention to comorbid conditions.
Dr. Wozniak and Dr. Huang recognize that psychological interventions specifically designed to treat emotional eating may not be readily available to all patients in primary care. “Encouraging patients to track their moods and eating habits to develop a greater awareness of the causes of emotional eating, engaging them in mindfulness exercises via the Internet or phone-based applications, and helping them identify alternative, adaptive strategies for emotion regulation can all help to increase awareness of internal and external factors that contribute to and maintain emotional eating and promote nonjudgmental, adaptive management of it.“
Read article: Emotional eating in primary care: considerations for assessment and treatment
Wolters Kluwer provides proven clinical technology and evidence-based solutions that engage clinicians, patients, researchers and students in effective decision-making and outcomes across the healthcare landscape. We support clinical effectiveness, learning and research, clinical monitoring and compliance, and data solutions. For more information about our solutions, visit https://www.wolterskluwer.com/en/health.
###
About Wolters Kluwer
Wolters Kluwer (EURONEXT: WKL) is a leading global provider of information, software and services for professionals in healthcare, tax and accounting, financial and corporate compliance, legal and regulatory, and corporate performance and ESG. We help our clients make important decisions every day by Expert solutions that combine in-depth expertise with specialized technology and services.
Wolters Kluwer reported annual sales of EUR 5.6 billion for 2023. The group serves customers in over 180 countries, has offices in over 40 countries and employs around 21,400 people worldwide. The company’s headquarters are in Alphen aan den Rijn, the Netherlands.
For more information, see www.wolterskluwer.comfollow us on LinkedIn, on facebook.And YouTube.
