Emotional hunger leads to obesity

Associate Professor Dr. Taha Can Tuman, stating that just as psychological factors lead to obesity, obesity also leads to psychological problems, said, ‘Individuals with obesity are five times more likely to experience a major depressive episode in the past year compared to normal-weight individuals. The relationship between obesity and depression appears to be stronger in women. A study has shown that obesity is associated with a 37% increase in depression in women.’
Associate Professor Dr. Taha Can Tuman from Medipol Mega University Hospital Department of Mental Health and Diseases drew attention to the psychological reasons underlying obesity. Dr. Tuman stated that obesity is one of the fastest-growing health problems in our country, emphasizing, ‘There has been a significant increase in obesity rates in recent years. Obesity not only leads to physical illnesses such as hypertension, type 2 diabetes, increased risk of stroke, sleep apnea, gallbladder diseases, and high cholesterol, but also affects mental health by causing depression and anxiety disorders, especially social anxiety disorder. Obesity is a serious public health issue due to both additional physical illnesses and psychiatric problems. A body mass index between 25-30 is considered overweight, and above 30 is considered obese. The development of obesity is influenced by genetic, hormonal, sociocultural, psychological, and environmental factors.’
Stimulating the reward center like drug substances, Associate Professor Dr. Tuman listed the psychological factors that cause obesity, stating, ‘We observe factors such as binge eating, loss of control over eating, stress, sadness, internal distress, anxiety, worry, unhappiness leading to excessive eating and night eating during emotional distress periods. In addition, impulsivity, difficulty in delaying pleasure and satiety, attention deficit and hyperactivity disorder, atypical depression, anxiety disorders, and bipolar disorder are associated with obesity development. Inability to cope with negative emotions, using excessive eating as a coping strategy to deal with negative emotions such as stress, discomfort, anxiety, and unhappiness, and feeling better after eating are factors leading to obesity development. Stressful life events, high perceived stress levels, and difficulties in emotion regulation make eating a relief mechanism and a reward, especially for those who have difficulty coping with negative emotions. Eating, like addictive substances, stimulates the reward center in the brain by increasing dopamine and endogenous opioids, providing pleasure to the individual. The pleasure derived from eating acts as a positive reinforcer, while escaping from negative emotions such as stress, discomfort, anxiety, and unhappiness by eating acts as a negative reinforcer, leading to an increase in excessive eating behavior.’
Drawing attention to binge eating and night eating disorders, Associate Professor Dr. Taha Can Tuman pointed out that binge eating is the most common eating disorder in obese patients and provided the following information, ‘Binge eating disorder involves consuming more food than most people could eat in less than 2 hours and losing control over eating during this time. Symptoms include eating much faster during binge eating episodes, eating until uncomfortably full, eating large amounts of food when not physically hungry, eating alone due to embarrassment, feeling disgust or guilt after eating. In addition, another eating disorder common in obese individuals is night eating syndrome. Just as psychological factors lead to obesity, obesity also leads to psychological problems. Obesity causes dissatisfaction with body image, feeling more unhappy, decrease in self-confidence and self-esteem, and decrease in quality of life. Therefore, depression often accompanies obesity. Individuals with second-degree obesity are five times more likely to experience a major depressive episode in the past year compared to normal-weight individuals. The relationship between obesity and depression appears to be stronger in women. This is because the appearance affects self-esteem more in women compared to men. A study has shown that obesity is associated with a 37% increase in depression in women. Due to affecting the appearance and causing dissatisfaction with the body, social anxiety disorder is also common in these individuals.’
‘Obesity surgery may not be sufficient alone’ Associate Professor Dr. Tuman, emphasizing that surgery is not sufficient alone in psychologically induced obesity, said, ‘In patients with problematic behaviors such as binge eating, impulsive eating, loss of control over eating, night eating, emotional eating, it is observed that the individual gains weight again or returns to their previous weight after obesity surgery. Surgical interventions are not an effective solution alone in psychologically induced obesity. Cognitive-behavioral therapy is effective in obesity treatment. The goal of therapy is to change unhealthy eating habits. Lifestyle changes such as reducing meal frequency and portion size, adopting healthy eating habits, and exercise are targeted. In addition, in obesity, cognitive methods such as informing about the causes of obesity and the physical and psychiatric diseases it causes, stimulus control, goal setting, self-monitoring, and behavioral methods such as rewarding the performed behavior are used. Cognitive restructuring of dysfunctional thoughts that hinder weight loss, increasing individuals’ emotion regulation, stress management, and problem-solving skills to reduce emotional eating are used.’