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Weight change & associated health problems

Emotions, emotional eating and self esteem issues

For many of the people we spoke to “eating is an emotional thing” (Meeka). Changes in weight can have both emotional causes and emotional impacts, with the two sometimes becoming intertwined in a vicious circle.
 

While there are many reasons why people put on weight, June thinks that “at the root of it all is emotions”.

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Age at interview: 70
Sex: Female
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Yeah, because I think something I learnt from Slimming World is that, in my opinion, you can group people into why they’re there and it could be a sweet tooth, it could be comfort eating. It could be alcohol, it could be a very busy social life but at the root of it all is emotions because why can one person have exactly that same life and remain slim and another person puts weight on. There’s, there is, I think, very deeply psychological reasons underlying it.

For some, overeating was linked to a specific stressful or traumatic event in their life. The end of Kate’s marriage was the trigger to binge eating “in earnest”. Ria told us that the sudden loss of her son in a motorcycle accident saw her put on three stone in six months. Others found that stress led to repeated episodes of binge eating. Others, like Carole and Shirley, described how the progression of their illness or life events and financial worries had led them to eat in unhealthy ways.
 

Ellie says that her diet goes ‘out the window’ every time her son has problems and that when he is fine things are fine with her too.

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Age at interview: 69
Sex: Female
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You’ve got to be in the right frame of mind, you can’t do it if there’s something wrong in your life, you can’t.

What do you mean?

My son is a real problem and every time he kicks off, that’s when the diet goes out the window and that’s when we start smoking again [sighs]. But when things are fine with him, they’re fine with me and I can do it. But you can’t do it if you’ve got some kind of emotional background and och, I can’t even, couldn’t even start to begin to tell you what he’s like, drugs and stuff. Suicidal, that kind of thing. It’s very, very difficult and that’s what knocks me, and it is not a comfort because all the time you’re eating, you’re think, ‘I shouldn’t be doing this.’ But you think you need something to, to cheer you up and that’s when you do it. But he’s okay just now, so…

Okay.

….hopefully I can get back to scratch again.
 

 

After losing her son in a motorbike accident, Ria put three stone on by binge eating.

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Age at interview: 73
Sex: Female
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So, there I am in 2010, I've decided to go on a diet because my daughter's getting married and, you know, this is all getting a bit too much. And on the June the thirtieth 2010, my son was killed in a motorbike accident.

Oh, sorry

Completely out of the blue – there one minute, not the next, yeah. In the six months after that I put three stone on by a sort of binge eating. And when I say binge eating – ludicrous things – you know, family sized tubs of ice cream in one evening. I used to eat Horlicks out of the jar with a spoon, and I could eat half a jar of Horlicks at one go, and it kind of made you feel sick, but I was never actually sick, so I didn’t have bulimia. I just had this binge eating thing.

 

After his heart attack Colin was scared to go out but he didn’t talk to anyone about his fears in case they laughed at him. Staying at home and being inactive led him to put on more weight. He now realises it would have been better to talk to someone.

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Age at interview: 72
Sex: Male
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And then I go and have a blinkin’ heart attack and I get frightened of going out.

Have you talked to somebody about that?

No.

About our…

No.

….your being scared of….

No. To be honest with you, I’ve been frightened of talking to people about stuff like that in case they laughed at me and now I realise, I’m beginning to realise after that speaking to that nurse about the worries that I had, that wasn’t one of the ones I raised with her, but it was the worry about the five a day that she picked up on mainly and I found out she didn’t laugh at me about it so it, it would have been worth talking about these things to people.

Stress was one of several emotions which led people to over eat (also known as ‘emotional eating’). Maxine Mary put the emotional aspect of her overeating down to the neglect and abuse she suffered as a child. For many, eating was an attempt to change the feelings they were experiencing, such as loneliness, sadness or feeling unloved; Kate, Maxine Mary and others  referred to this as ‘comfort eating’
 

Maxine Mary describes the emotional dimension of her overeating: “I get off the phone from my mother and I’ve got my head in the fridge”.

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Age at interview: 63
Sex: Female
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And I have to be really careful on portion size and how much food I eat in a day.
 
How easy? How difficult is that?
 
It’s extremely difficult. It, because it’s like [ah, pause] there’s also an emotional component to this. Echoes of my childhood come back to me and the neglect, abuse that I suffered. And, you know, I’ve found my. I get off the phone from my mother and I’ve got my head in the fridge. And I’m thinking, “What am I doing? Why am I doing this?”
 
So I know that there is an emotional aspect to my overeating. It’s not just physical. It’s, it’s also an emotional thing that I find it quite hard sometimes to recognise although I am getting better at it. But, you know, bad times.

 

Kate, a recovered alcoholic, comfort ate to change her feelings.

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Age at interview: 58
Sex: Female
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Well I will confess here that I’m a recovered alcoholic and that has a relevance in the binge eating because it’s the same feelings. So for example I used to drink to change my head. And I suspect the binge eating is the same. In fact it’s classified in the DSM in the same area that, you know, I used to eat, I comfort eat to change my feelings. I was feeling uncomfortable, feeling sad, feeling something and I used to immediately turn to food, to sweet foods specifically. And, you know, I’ve always done that so if I was making peppermint creams with the children for example I would end up eating them all, you know, but especially the scraps and things I’ve always had this inability to switch off the to, to stop. I’ve had this inability to stop. So I haven’t had a drink for 21 years so it was complete abstinence. But with eating it’s very difficult because it’s a process addiction. And you can’t stop eating but I have discovered you can stop eating sugar. And I don’t crave sugar and it’s now been since February. So I have actually managed to apply, apply the abstinence thing to sugar.

Others said they wouldn’t call it ‘comfort eating’, because they knew they shouldn’t be doing it so it wasn’t a comfort at all.

“I’m an emotional eater so a couple of weeks ago my husband found out he’s probably going to lose his job through things and straight away I turned to my comfort food and that’s what I do just to keep me, and even though it makes me feel worse a couple of days later, at that time if feels that’s what I need.” (Shirley).

Heather said: “I think in some ways it’s a little bit of a viscous circle, that, the sort of comfort eating. If you’re feeling down with yourself because you’re overweight, it is quite easy to eat for comfort which makes it worse.” June said that when her son was a toddler she would reward herself with a treat on a Saturday for managing all week as a single mum. Rewarding herself on a regular basis then became an ingrained habit that lasted for decades.
 

For June, comfort eating soon turned into a habit that has lasted for decades. Her inability to change her behaviour has left her feeling a ‘failure’.

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Age at interview: 70
Sex: Female
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I think it just starts as a small thing really. You know, my thing used to be, my son used to go to his dad’s on a Saturday when he was a toddler and I would go and do a weeks shopping and I would just buy one item that was a little treat to myself for managing all week as a single mum and then I think once you get that idea, I mean, I think they’re called neural pathways, I think your brain makes connections for good or ill so that it just creeps up. You think, ‘Oh that was hard. I did that. I’ll just have a Kit-Kat or, you know, and before you know it you’re rewarding yourself on a regular basis so eating three healthy meals a day, well balanced, five a day, all that and then I just ruin it really by treats. But it’s not just comfort eating. I, I think there’s a difference. I think comfort eating becomes habit, you know. So, your habit is to go in the kitchen and have a little look around and find something to eat perhaps while you watch a television programme or you’re reading or if you’re sat at the computer doing some work and then it just changes from being a comfort thing to, to a habit and becomes ingrained with the decades.
 
What do you think would help you to break that pattern?
 
I think, one of the main, one of the main things I think I have to say is that you feel a failure because, you know, I’m an intelligent person, I know what I should do so you feel a failure so and if you’ve got decades of evidence to prove you’re a failure that does sort of reinforces it really.

Relationships with others were a key cause of emotional eating. These could be parent child relationships, wider family relationships, romantic relationships or social relationships, for example at school or work. Angela described how she had been taunted for being fat both at home and at school, which had led her to feel depressed and suicidal in her teenage years. She turned to food, particularly chocolate: she said that her relationship with food was affected by a desire to be loved, not just as a child, but in her adult relationships too.
 

Angela felt fat and insecure and just wanted to be loved.

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Age at interview: 51
Sex: Female
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I just wanted to be loved to be honest. I wanted, I could see like people around me going off, getting married, having children and I think that’s what I wanted. I wanted to, I wanted to have that and I always felt, in those years, I just remember feeling insecure and I look back now and I think, ‘Why did I feel that. Why did I think I was fat then? Why was I with this person who was just telling me I wasn’t good enough?’ you know, because I think when you’re locked into that kind of relationship, it doesn’t help, you know.

Being overweight affected people’s body image and self-esteem in numerous ways. For example, several people said they didn’t feel as attractive or confident when they were overweight, with many feeling self-conscious and unhappy about what other people might think of them. Myra said, “I thought, ‘People must think I’m awful’, you know, being this size and you tend to think what people, other people will think about you, you know”. Lesley said she didn’t want people thinking she was fat because she was “eating fifteen pies a night” when in fact she was trying to eat healthily. According to Ellie, “It’s just being judged by the rest of the world. As being fat and thick”.
 

Lesley feels she is letting health professionals and her family down by being overweight, as if she was ‘abusing’ the second chance given to her following her cardiac arrest.

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Age at interview: 60
Sex: Female
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Is there an emotional side to being overweight or to put on weight?

Yeah, I think so. I think from my point of view, I feel that being overweight is letting people down a little bit. Either whether it’s the clinical side, they’re saying, you’re letting them down because you haven’t done it. Obviously, my husband and my, the family would like me to lose weight because there’s still the slight fear that something might happen again, so you feel you’re letting them down or you’re not, you’re not trying. You know, you’ve been given another chance of living, which is what has happened to me, I’ve been given a second chance and I’m abusing it and not trying and I find that frustrating because, you know, perhaps I’m not trying as hard as I can do. But then this other bit of me says, well if the rest of my life is just eating salad leaves and water then I’m not interested. Do you know? It, it’s finding that balance and that was what, I think I keep saying, you know, I’m trying, I am eating healthily, I am eating this and I feel I need something else to come in to help me and, again, I go back to medication, I think, I don’t want people thinking, ‘Oh, she’s just blaming that because she’s eating, you know, fifteen pies a night,’ which is not the case.

So, I feel the strongest thing is letting people down about being overweight and again, the way you look. You sort of think, ‘Oh, you know, you see yourself back in the thing and you think, that’s not really what I want to see, you know, you want to see someone a bit slimmer.’
 

 

June avoids social occasions because of being ‘fat’. She explains that being overweight hurts both physically and mentally.

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Age at interview: 70
Sex: Female
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So you go into a very negative mind….?

Oh well, of course, if you picture yourself putting on ten stone and the faces of the people you know. That’s really all we have to do.

They would be utterly shocked and it’s seeing people’s shock because being very, very, very fat is shocking, especially if you weren’t that fat the last time they saw you [laughs]. And it’s, no, it’s very destructive just all around, it’s awful. You avoid seeing people. You avoid social occasions. You avoid all kinds of things. There are opportunities and chances that life might offer you which you don’t take up because you take up too much space. Over and over and over again.

It’s something that I hate, and I fight naturally. But I haven’t been as successful obviously as, as would have been a good idea for my health and the, it hasn’t ruined or obliterated my life, simply because I’ve been in the happy situation of perhaps not having to. But it’s been it’s everything I say, I mean it hurts, it’s painful both physically and mentally.
 

Low self-esteem and concerns about other people’s reactions to them led some of those we spoke to avoid social situations. Maxine Mary said she felt very self-conscious about eating in public; Heidi said she tended not to speak up in public due to lack of confidence. June X said she avoided social occasions, while Ria said the fact that she didn’t feel attractive had impacted on her ‘not wanting to put herself out there’ with internet dating.
 

Ellie is ashamed to ask for a seatbelt extension on flights. She feels judged by other people who may assume that her weight is her fault.

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Age at interview: 69
Sex: Female
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What else? It’s just being judged by the rest of the world. As being fat and thick. I think you’ve got to be thick if you’re fat.

Okay, yeah.

Plane seats. That’s just awful when you’ve got to ask for the extra belt. It’s shaming.

Okay, so shame is something that you associate with the experience of being overweight or, or the experience of obesity?

I don’t particularly think it’s my fault, right, up to a point I do. But I don’t think it’s my fault entirely. It’s something to do with genes and whatever, but everybody looks and things, ‘That’s your fault,’ and I hate that. I hate everybody thinking I did this to myself and I didn’t try to do it to myself, you know what I mean.

Hm-mm, yeah.

Everybody assumes that every fat person sits all day and eats all day. They don’t.

Yeah.

I eat a lot less than most folk.
 

 

Liz dreads the idea of having to wear a flimsy dress at a wedding in a hot country. She says that people need to know how much unhappiness is due to being overweight.

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Age at interview: 54
Sex: Female
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The only thing that mattered with that whole event was the fact that she was slim and I'm fat. I cannot tell you how much... I look... hunted round my wardrobe looking for something that would make me look three stone lighter. You know, there must be something in this wardrobe full of clothes that will make me look three stone... there wasn’t, obviously. The best I could do was put on sort of high heels and black trousers; that was my best effort. But that whole thing... none of the other stuff mattered; just the fact that I was fat and she wasn’t.
 
And, you know, there's going to be a wedding in the not too distant future; next year or two, and I'm guessing that they’ll probably want to go abroad. So, this is like [husband] and her son and to be daughter-in-law, and the thought of that, having to spend several days, probably somewhere hot, which ain’t great when you're fat, or fair; dressed in clothes... because at least this do that I went to I could wear black trousers, high heeled black boots, you know something... a scarf that gives you a bit of length, a nice jacket, tailored look is always more flattering. So, I'm thinking, 'Well, this is just going to be marvellous isn't it. We're going to be somewhere hot where you can't cover up.' I can't wear a smart suit; I'll have to wear a flimsy frock, and just the thought of that is enough to make me feel sick. And again, you know, there’ll be probably a hotel, a pool – how am I going to wear swimsuit? How am I going to be... ah, I can't tell you... I can't tell you how that makes me feel. I'm so ashamed.

Do you want me to stop?

It's OK. It doesn’t matter, does it? People need to know. They need to know that however happy fat people come across as, it's not all that... it eats you up inside, and that’s how bad it makes you feel – ashamed, sad, worthless.

Some emotions, such as shame, were associated not only with having a bigger body size, but with the act of eating itself, particularly binge eating. Sometimes people described binge eating as being like an addiction. Kate, a recovered alcoholic, compared it to alcohol addiction, saying she had the same thought patterns: “So I would binge. I would sort of, my eyes would glaze over and then I’d go to bed feeling ashamed. And then in the morning I would wake up full of remorse and distress vowing I would never do it again day after day after day. Exactly the same pattern as alcohol”. Those who experienced eating as an addiction described the desperation they felt around food, feeling panicky, being unable to stop, feeling out of control and not having an ‘off button’.
 

Carole gets panicky if she doesn’t have bread in the house because “it’s like a drug”.

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Age at interview: 59
Sex: Female
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It’s weird. It’s just [sighs] it really, it’s complete craving and you get so panicky, like if you haven’t got bread in the house, I panic because I know I’m going to need it and it’s like a drug, it feels like, and it’s [sighs] it’s so, it’s bizarre. It’s really weird how it’s so physical and like now, I can say, well, just don’t get that bread. Don’t buy it. Don’t or get crackers or something or have something you don’t like but it’s so overwhelming and I have to go out and get some and or I’m sort of like oh, I don’t know, it’s like you feel like you’d steal it, if you needed it, it’s so, such an overpowering feeling.

Depression was commonly mentioned as both a cause and a result of overeating, with some saying they were caught in a vicious circle of depression and weight gain. Carole described how losing weight and then putting it on again was “a sort of spiral that you go down because the depression then gets worse and you feel bad about yourself and you haven’t got the… it’s all too overwhelming, so you can’t do what you know you should do”. The emotional aspect of eating made it hard for some to lose weight, even when they knew what they should be doing. Ria said, “I know exactly what I should be doing, and I know exactly what would solve it, and I find it almost impossible to do it”. For Christine, the emotional aspect of eating seems to depend on whether she is on or off medication.
 

Christine feels that she is caught in a vicious circle: when on antidepressants she puts on weight and off medication she loses weight but feels miserable.

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Age at interview: 53
Sex: Female
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Can you pinpoint the times in which you have gained weight?

When I’m stressed and anxious.

Okay.

It’s been in relation to depression.

And tell me about these sort of evening kind of trips to the freezer.

Yeah, well, all it is I get too tired. So, say anytime at night, sometimes I go to bed early, like I nine o’clock and I just watch TV in bed and I’d fall asleep quite happily. But sometimes if I stay up I’ll think, ‘Oh, I’ll just have some ice cream and I’ll just watch tele,’ and I’m comfortable and I’m happy and I’m relaxed but I’m just eating for the sake of it and I cannot physically stop myself doing it.

But the problem is with depression, it’s a vicious circle with your eating because if you’re depressed you lose weight, I lose weight because I’m not on any antidepressants. As soon as you go on them, you’re a lot happier mentally but then you pile the weight on, so you can’t win. You’re either depressed to the point of suicide or you’re on antidepressants and pile the weight on. You know, this is why we’re trying to cut the dose of it down to the minimal. It’s only a very small dose anyway. It’s the tiniest dose you can have, but if I can cut it down it might trigger something that, that makes you able to motivate and able to focus and, and lose weight.
 

See also ‘The vicious circles of chronic health conditions and being overweight’.
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