One theory is that overweight people have elevated insulin levels, and stress-related weight gain is more likely to occur in the presence of high insulin. How much cortisol people produce in response to stress may also factor into the stress—weight gain equation. In , British researchers designed an ingenious study that showed that people who responded to stress with high cortisol levels in an experimental setting were more likely to snack in response to daily hassles in their regular lives than low-cortisol responders.

When stress affects someone's appetite and waistline, the individual can forestall further weight gain by ridding the refrigerator and cupboards of high-fat, sugary foods. Keeping those "comfort foods" handy is just inviting trouble.

Countless studies show that meditation reduces stress, although much of the research has focused on high blood pressure and heart disease. Meditation may also help people become more mindful of food choices.

With practice, a person may be able to pay better attention to the impulse to grab a fat- and sugar-loaded comfort food and inhibit the impulse. While cortisol levels vary depending on the intensity and duration of exercise, overall exercise can blunt some of the negative effects of stress.

Some activities, such as yoga and tai chi, have elements of both exercise and meditation. Social support. Friends, family, and other sources of social support seem to have a buffering effect on the stress that people experience.

For example, research suggests that people working in stressful situations, like hospital emergency departments, have better mental health if they have adequate social support.

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Sign up now and get a FREE copy of the Best Diets for Cognitive Fitness. Impulsivity, reward sensitivity, and the experience of intense craving the intense desire to consume a specific food [ 56 , 57 ] would be the three facets of food addiction in the field of overeating, overweight, and obesity.

Chocolate, carbohydrates, and salty snack are the most commonly craved foods [ 58 , 59 , 60 , 61 , 62 ]. Studies on cue-reactivity research have repeatedly shown similarities between drug and food craving.

In both cases craving is more likely to occur in the presence of substance-related stimuli. Thus, substance cues or food cues tend to increase the craving [ 63 ]. Alternatively, the mediation of emotions might be considered emotional eating. The tendency to eat in response to negative emotions or stress is an atypical stress response, as the typical stress response consists of not eating because the physiological stress reactions mimic the internal sensations associated with feeding-induced satiety [ 27 ] see for empirical support [ 64 ].

However, it has not yet been resolved whether restraint eating is a cause of the consequence of emotional eating [ 65 , 66 ], and this may also differ in various subgroups [ 67 ]. Nevertheless, as it was mentioned above, emotional eating may also occur, independently of food restrictions.

We noted that emotional eating tends to co-occur with external eating i. There exists, however, a subtype of depression that is characterized by the atypical features of increased appetite and subsequent weight gain [ 70 ]. Emotional eating has been considered a marker of this depression subtype [ 71 ] because it shares with this subtype the atypical feature of increased appetite in response to distress such as feelings of depression for support, see [ 72 ].

In various cross-sectional studies, emotional eating was indeed found to act as a mediator between depression and obesity [ 73 , 74 , 75 , 76 ]. Generally speaking, life adverse experiences are defined as all kinds of traumatic experiences occurring in childhood, adolescence, and adulthood, which include emotional abuse, physical abuse, sexual abuse, sexual harassment, rape, bullying by peers, witnessing domestic violence, and serious accidents that threatened the lives of subjects.

As an example of traumatic experiences, abuse-related PTSD symptoms are associated with hyperactivation of HPA axis and with subsequent increases in peripheral cortisol, which in turn have been linked to accumulation of fat in adipose tissues and, consequently, an increase in abdominal obesity [ 77 , 78 ].

In line with these findings, the hyperactivation of HPA axis with an exaggerated cortisol response to stress has been observed in obese patients [ 79 ] and was also put in relation with stress-induced eating [ 80 ], with night eating syndrome NES [ 81 ] and with waist adiposity in binge eating disorder BED patients [ 82 ].

Stress, depression, life adverse experiences, abuse-related PTSD, etc. might be potential risk factors for obesity via emotional eating. Some studies have focused their interest on the relationship between trauma, dissociation, and binge eating disorder. Generally, it is concluded that dissociation may play an important mediating role between the presence of early trauma and the development of eating disorders e.

In this regard, it has been hypothesized that when negative emotional states are activated, a shift toward lower levels of cognition and self-awareness is initiated, which involves cognitive processes similar to dissociation.

This mechanism tends to remove the inhibitions, thereby facilitating the start of binge eating or overeating, both in clinical e.

Several studies seem to support the hypothesis that dissociation may have a mediating role in the abuse and binge eating link [ 86 , 87 ]. Along with dissociation, other authors have proposed some specific psychological variables that function as mediators in the relationship between childhood abuse, obesity, and bingeing, such as depression [ 88 ], trait anger [ 89 ], and perceived stress [ 90 ].

With respect to depression, Moyer et al. Depression has been consistently associated with obesity and central obesity [ 91 ]. Once again, a possible way to interpret the link between childhood abuse, depression, and obesity is emotional eating.

Regarding trait anger, a it seems to be related to the increase of visceral adipose tissue [ 92 ]; and b it is associated with emotional eating [ 93 ]. Considering adverse experiences, the following ideas seem to be relevant: Subjects with adverse childhood experiences have a higher risk of developing maladaptive coping strategies, including stress-induced emotional eating [ 94 ].

Perceived stress may explain the link between child abuse and the development of obesity in adulthood [ 90 ]. Activation of the stress response can lead to emotional dysregulation that has been associated with increased appetite, a preference for foods high in sugar and fat [ 11 , 95 , 96 , 97 ], fat visceral accumulation, and obesity in adults [ 97 , 98 , 99 ] and adolescents [ 98 , 99 ].

Some authors have reported that overweight subjects tend to gain weight when stressed [ 11 ] and that obese individuals increase their food intake after having experienced negative emotions and perceived stress [ , ].

Stress-related adaptation involves the concept of allostasis, which is the ability to achieve the physiological balance through the change of the internal environment [ 96 , , ]. Conditions of repeated or incontrollable chronic stress are followed by higher cortisol response and tend to activate a state of allostatic load, resulting in neural and emotional dysregulation, which contribute to maladaptive behaviors such as repeated consumption of high caloric food [ 96 ], lack of control over eating, and binge eating [ 82 , , ].

Overall these abovementioned results suggest that psychophysiological responses to stress may influence subsequently eating behavior and hence may also mediate between the trauma and eating disorder link.

It is well known that PTSD is usually associated with significantly higher rates of substance use disorders, other comorbid psychiatric disorders, and a variety of self-destructive and impulsive behaviors, including suicide [ , , ]. It has been suggested that the ingestion, and especially over-ingestion, of fatty or sugary energy sources may be just another strategy that traumatized individuals use to numb themselves from their unpleasant feeling states and memories [ ].

Thus, certain foods might act just like other substances that alter brain chemistry and, hence, consciousness.

As we mentioned above, Randolph first described the phenomenon of food addiction and linked it with addictive drinking in [ 2 ]. Since then, the notion that certain foods can act like other addicting substances in the brain despite having other peripheral metabolic effects that substances of abuse do not necessarily have has been accepted.

In fact, food intake and drug use both cause dopamine release in parts of the brain that mediate pleasure and emotion. The degree of subjective reward or experience of pleasure is clearly linked with the amount of dopamine release.

Comparing similarities between action of certain foods and other substances of abuse, it must be noted that a food can stimulate the opiate system and there are similarities in use and withdrawal patterns of sugar and of classic drugs of abuse; b similar patterns of brain activation occur in response to food and drug cues; and c people may gain weight when they stop smoking or drinking.

It has been proposed that certain foods can be addicting to certain people, especially traumatized people. Part of the people exposed to alcohol, nicotine, drugs of abuse, etc. The point is how can we determine if someone will go on to develop an addiction to food or to any substance or behavior?

From a genetic perspective, it has been proven that people with reduced dopamine type 2 receptor availability have a predisposition toward obesity and substance dependence.

Other risk factors are environmental. In this regard, a history of psycho-trauma would be an example and leads to the self-medication hypothesis of PTSD. This way, victims of interpersonal violence may select highly palatable foods containing high concentrations of sugar, fat, salt, or caffeine, sometimes to the point of addiction, in an attempt to dampen arousal and facilitate numbing and avoidance specific symptoms to PTSD [ ].

Hirth et al. The participants of this study may have eaten more fast food to reduce trauma-induced PTSD symptoms, using that food as self-medication.

Both fast food consumption and sugary soda consumption are usually associated with weight gain. PTSD symptoms may initiate a process of overindulging in unhealthy food and beverages in an attempt to compensate for the way trauma-induced memories make trauma victims feel.

The problem would get worse when patients with PTSD symptoms try to reduce the effects of bingeing with unhealthy dieting behaviors and possibly develop eating pathology, consistent with the model of Stice and Shaw [ ]. The results reported by Hirth et al. are consistent with theories that unhealthy dieting behaviors, such as vomiting and laxative abuse, are linked to PTSD [ , ].

Figure 1 tries to summarize the model which links negative emotions with weight gain. Negative emotions, emotional eating, and weight gain. In accordance with our review, we found that in spite of the fact that there are many risk factors involved in the increase in prevalence of obesity all around the world over the past few years, from those related to environmental and personal factors, particularly emotional eating plays a crucial and complex role in it.

In the meantime, emotional eating is as well influenced by several risk factors: from social and physical environment to genetics, psychology, and food preferences. From our exploration we concluded that the epidemic of overweight and obesity is not only a matter of palatable and addictive foods available everywhere but also the individual responses to food.

Undoubtedly, we explored that emotional eating emerges in response to negative emotions, but it was also important to examine how self-regulation, effects of stress, parenting, and parental bonding and coping would have an effect on the act of eating and subsequently on emotional eating and its correlation with the body mass index.

Although it is well known that the typical response of stress on eating behavior is usually loss of appetite, we found that stressful circumstances are associated with greater energy and fat intake. Considering the field of study focused on overeating, it was seen that impulsivity, reward sensitivity, and the experience of intense craving result from self-regulation failures regarding both substance use and overeating.

Nevertheless, some more research is needed in order to prove the causal direction between reward sensitivity and overeating. Another important factor to consider in order to self-regulate successfully among children is the proper parenting styles, which would influence positively on eating behavior.

Authoritative parenting style, less maternal support, the lack of parental bond, and overprotection would disrupt the well-being of children and the ability to cope with challenging situations. Subsequently, these factors would interfere with their attitudes toward the act of eating.

On the other hand, regarding negative emotions and feeling depressed, it is known that they are associated with loss of appetite and, as a result, weight loss. However, research showed that emotional eating would act as a mediator for a specific subtype of depression and it would have just the opposite effect on eating behavior, increasing weight as a result.

In this regard, life adverse experiences, childhood trauma, and abuse-related PTSD, among other traumatic and stressful situations, were associated with dissociation, which plays an important role in the development of eating disorders, emotional eating, and obesity.

In the field of over-ingestion of specific kinds of foods, such as sugary and fatty sources, these foods were proposed to be addicting to traumatized people. The genetic hypothesis proved the link between reduced dopamine type 2 receptor availability and the predisposition toward obesity and substance dependence.

On the other hand, the PTSD hypothesis showed the over-ingestion of palatable foods in traumatized people derives from an attempt to lessen arousal and to avoid specific symptoms derived from PTSD, that is, emotional eating as self-medication.

In conclusion, in order to face the obesity problem, the addictive behavior should be the focus of research and treatment and not the addictive substance as traditionally has been considered.

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Impact of this chapter. Abstract The first time that terms such as food addiction and addictive eating were mentioned was in , in an article by T. Keywords food addiction eating addiction emotional eating stress negative emotions posttraumatic stress disorder overweight obesity.

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I regularly eat even when I am not hungry. I eat very quickly and am not aware how much I have eaten.

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Download references. Faculté des sciences, département des sciences de la nature et de la vie, Université Alger 1, Alger, Algérie. University of Sciences and Technology Houari Boumediene, Algiers, Algeria.

You can also search for this author in PubMed Google Scholar. Conceptualization: HB and EAK; Methodology: HB, HS, AB, and EAK; Formal analysis and investigation: HB, HS, AB and EAK; Writing original draft preparation: HB; Writing-review and editing: HB and EAK; Supervision: HS and AB.

All authors have read and approved the final content of the article. Correspondence to Hassiba Benbaibeche.

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Reprints and permissions. Benbaibeche, H. et al. Emotional and external eating styles associated with obesity. J Eat Disord 11 , 67 Download citation. Received : 26 September Accepted : 24 April Published : 02 May Anyone you share the following link with will be able to read this content:.

Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Download ePub. Abstract Background Obesity is related to eating habits.

Objectives The current study assesses the eating styles of Algerian adults. Methods The sample consisted of volunteers aged from 31 to 62 years old, with obesity and 90 having normal BMI. Conclusion These results could be used to provide clinical information at the initial screening for obesity criteria, obesity prevention and treatment.

Plain English summary Emotional, external and rigid restrained eating are three eating habits related to obesity.

Background The prevalence of obesity has increased worldwide and has reached pandemic proportions in the present century [ 1 ]. Methods Participants Two hundred Algerian volunteers women and 93 men were recruited to participate in this anonymous study of eating styles.

Measures Anthropometry We measured height, body weight, and waist circumference WC of the participants using a standardised protocol. Results Participant characteristics are summarised in Table 1 according to their BMI category and also in the total sample.

Table 1 Characteristics of participants according to BMI Full size table. Table 2 Simple linear regression model to predict associations between eating styles and BMI Full size table.

Discussion Overeating is an uncontrolled eating behaviour which is closely associated to obesity. Conclusion Obviously, eating styles of participants with obesity has largely different from normal BMI individuals. Availability of data materials The datasets generated and analysed during the current study are not publicly available, as individual privacy could be compromised.

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They offer helplines, resources, and educational materials on eating disorders and body image concerns. The Body Positive is a non-profit organization that empowers individuals to cultivate self-love and a positive body image. They offer workshops, educational programs, and online resources to promote body acceptance and resilience.

Their approach emphasizes self-care, self-compassion, and body neutrality. Be Nourished is a body trust organization that offers workshops, trainings, and resources centered around body acceptance and healing from disordered eating.

They emphasize the importance of body autonomy, intuitive eating, and challenging diet culture. The Center for Mindful Eating is a non-profit organization that promotes mindful eating practices to support a healthy relationship with food and body.

They offer resources, webinars, and professional training to promote a compassionate and non-judgmental approach to eating. The information contained on or provided through this service is intended for general consumer understanding and education and not as a substitute for medical or psychological advice, diagnosis, or treatment.

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Eating Disorder Helplines The Alliance for Eating Disorders Awareness Helpline The Alliance for Eating Disorders Awareness Helpline offers support and resources for individuals dealing with eating disorders.

Crisis Text Line Crisis Text Line is a confidential support service that provides help and resources to individuals in crisis.