Helping Patients Who Eat for Emotional Reasons

People may choose to eat for a variety of reasons other than hunger. Celebrations, social events, nostalgia, access and health conditions are just some of the factors that influence what, how much and why we eat. Emotional reasons also may influence relationships with food.

Eating may be used as an outlet to express a variety of emotions, including sadness, loneliness, stress or anxiety. It may be influenced by food cues in the environment and cravings or pleasure obtained from food. Food also may be used as a tool to provide emotional comfort.

For individuals who use food to help manage their emotions, it can be helpful to identify and encourage other coping methods that do not center around food, such as mindful physical activity, meditation, connecting with a friend and taking time for self-care activities. Self-monitoring may be an effective tool for individuals who rely on food for comfort. Taking time to journal thoughts around food and feelings may be helpful to identify patterns and make behavior changes.

For many individuals with eating disorders, food is used to help manage emotions, making it important for the RDN to evaluate whether eating disorder symptoms and behaviors exist during the nutrition assessment. Eating disorders affect individuals of all backgrounds, regardless of age, sex, sexual orientation, race and socioeconomic status. However, RDNs play an important role in helping patients and clients to improve their relationship around food.

Questions to gain further insight to this relationship might include:

• Do you ever eat in secret?
• Do you ever enjoy eating but then feel guilty afterward?
• Do you ever feel out of control around food and eat more than you intended to?

While it is not the RDN's role to diagnose an eating disorder, being aware of disordered eating behaviors can help with the treatment plan. This includes knowing when to make a referral to a mental health professional, which is essential to the recovery process. It also plays a fundamental role in forming nutrition treatment plans. Stress management, self-awareness and self-care activities all can have a role in treatment, whether or not the patient is working through an eating disorder.

References:

• Setnick, J. Chapter 1: Eating Disorders and the Dietitian In: Academy of Nutrition and Dietetics Pocket Guide to Eating Disorders, 3rd Ed.. Chicago, IL: Academy of Nutrition and Dietetics; 2025: 1-13.
• Hackert AN, Kniskern MA, Beasley TM. Academy of Nutrition and Dietetics: Revised 2020 Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Eating Disorders. J Acad Nutr Diet. 2020;120(11):1902-1919.e54.