Chapter 1 12 Common ways to control lifestyle-related obesity -eat less, exercise more- only help in the short term [16-18]. In fact, after every dieting attempt, the weight comes right back on. Science has shown that dieting is not the answer [19-21]. In fact, dieting does nothing to address why emotional eaters became overweight in the first place, namely emotional eating. Plusminus 40-60% of overweight or obese people are emotional eaters [22-23]. Emotional eaters are more likely to be overweight or obese, than individuals without emotional eating behaviour [24-25]. Emotional eating behaviour is possibly caused by, among other things, genetic vulnerability [25-26] a “biologically based sensitivity that interacted with the environment in which one was raised and specific life events one faced – the ‘social’ part of biosocial” [27, p. 28]. An invalidating environment can have caused chronic stress during childhood, such as neglect, being abandoned by parents, patronizing, and abuse [28]. Beijers and Van Strien postulate that the quality of the parent-child relationship in early childhood, in the capacity of care and attachment, may be a predictor for the development of emotional eating behaviours in the adolescent years [29]. Emotional eaters suffer from reduced interoceptive awareness, a poor vision of what is happening in one's own body [30], and a high degree of alexithymia (the inability to identify and describe emotions experienced by oneself [31-32]. Emotional eaters eat more when experiencing negative emotions, such as stress or anxiety, in a quest for well-being. This is atypical behaviour, because normally when people have stress or anxiety, they have no desire to eat at all [2, 33]. Most people go straight into the so called fight-or-flight mode [34]. In threatening situations that cause a lot of stress, the human body's natural survival mechanism is triggered by a chain reaction of hormonal processes [2]. These processes cause the stomach contractions to stop, and to suppress feelings of hunger. Blood is sent to the muscles so the body can prepare for action [6, 35-36]. Treating emotional eating behaviour Successful ways to treat emotional eating behaviour include mindfulness, Cognitive Behaviour Therapy [5, 37], and Dialectical Behaviour Therapy [27-28, 38]. Mindfulness can be effective in treating emotional eating behaviour. Studies reported decrease of emotional eating, due to decrease in perceiving stress [39-42]. Cognitive Behaviour Therapy seems effective in terms of weight loss and reducing emotional eating [5, 37], but high scores on emotional eating were predictors of treatment resistance [43]. A combination of CBT with mindfulness resulted in greater reductions perceived stress and stress-eating [44].
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