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Eating Chocolate When Anxious: A Binge or Comfort Eating?

The consideration of a tried-and-true constant is a reward to build on.

A friend whom I have not seen in months because of COVID-19 warned me that she is considerably heavier than she was in February. “It is my daily chocolate binge,” she told me. “It started when a nephew came down with the virus, then his wife, and next, one of his children. They recovered, but the eating did not stop because then two colleagues got sick and died about a month ago. I think I am suffering from some kind of eating disorder because I cannot control my eating of sweets.”

Her anxiety is not unique. A recent report by Express Scripts analyzing the prescriptions filled for its more than 31.5 million users found that from January 19 to March 15, prescriptions for anti-anxiety drugs increased by 34.1 %. March was when COVID-19 was declared a pandemic. And as the number of cases grow, it is likely that more prescriptions for these drugs will also grow, as might the incidence of binge eating.

The link between emotional distress and binge eating is well defined. Binge eating, according to the American Psychiatric Association (APA), is defined as recurring episodes of eating significantly more food in a short period of time than most people would eat under similar circumstances. Anxiety has been identified as a trigger initiating these episodes of excessive eating. In a study of female students between 14 and 25 years of age, women who met the criteria for binge eaters reported that tension, sadness, and anxiety often preceded their overeating.

A review of the risk factors associated with eating disorders by Rosenbaum and White also found anxiety significantly associated with binge eating disorder although, as the authors point out, understanding how eating to the point of physical discomfort helps anxiety is not well understood.

The majority of people surveyed in these research studies had a history of anxiety, and many had been diagnosed with an anxiety disorder. However, the anxiety and overeating described by my friend arose specifically in response to the pandemic. For those who are at increased risk from COVID-19, who have experienced the sickness and perhaps death of family and friends, and/or who may live in a neighborhood where too few are taking precautions against getting and spreading the virus, anxiety such as experienced by my friend seems almost inevitable. Some are choosing to endure this unpleasant, and to some extent, debilitating emotional state by using anti-anxiety medications such as benzodiazepines. These medications do reduce anxiety and help people sleep, but their use come at a cost: They can be highly addictive.

My friend found a “natural” way to handle her anxiety, a solution that is non-addictive and does not require a prescription. She turned to carbohydrates, specifically the sugar found in chocolate. Sugar and starchy carbohydrates, if eaten in the correct amount, will increase the synthesis and activity of serotonin, thus producing calmness and a decrease in anxiety. The effect may be felt within 30 minutes and, if the right type of carbohydrate is consumed in the correct amount, the most common side effect, weight gain, can be avoided. Moreover, unlike benzodiazepines, side effects of drowsiness and dizziness are unlikely. And although the lessening of anxiety may last only a few hours, it is possible to have repeated doses and experience the same calming effect again throughout the day.

But my friend, like most who almost unconsciously turn to carbohydrates such as chocolate to help their anxiety are, alas, rarely given instructions on “dosing,” and thus may overeat. There is no information on a package label of chocolate or Cheerios on how much to eat to bring about the calming effect without weight gain.

Chocolate is a rather bad food choice, because its high-fat content makes it calorically expensive and slows down the rate of digestion, thus slowing the onset of calmness. Very low-fat breakfast cereals, snacks such as pretzels, and meal foods like potatoes, pasta, and bread are better choices. And foods containing fat like butter, cheese, and peanut butter are to be avoided, in order to decrease excessive calorie intake.

To promote serotonin synthesis in the brain, only 30 grams or less of the carbohydrate food need to be eaten. Bingeing, i.e., continuous eating until the eater is too full to eat anymore, will not promote calmness (only guilt). A parallel example is that no one would binge on a bottle of Tylenol or aspirin in order to lessen a headache or back pain. The correct dose of pain relief would be taken, and then the user would wait, knowing that it might take some time for the pain to subside. The same dosing and waiting must be followed when eating carbohydrates to dampen anxiety. This is often hard to do, so it helps to find a distraction such as a Zoom or FaceTime call or a puzzle to work on while waiting.

Just avoid turning on the news.

More from Judith J. Wurtman Ph.D.
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