It probably would not surprise you that stress is a primary predisposing factor to an eating disorder (ED), but did you realize an eating disorder itself is a source of stress and poor nutrition causes stress?
The person with the eating disorder gets trapped in a vicious cycle of stress that is difficult to break. Stress causes the eating disorder and the stress of the eating disorder and nutrient deficiencies perpetuate the stress as well as the illness.
Scientific studies have shown that psychological stress may worsen the symptoms of almost every known medical condition. This certainly is applicable to eating disorders. Furthermore, studies have shown that learned and practiced stress management skills and good nutrition can impact and dramatically improve people’s health and well-being.
If stress causes eating disorders and eating disorders cause stress, then any treatment plan or prevention education program must focus on helping people reduce their stress through effective coping skills. This page will explain the connection between EDs and stress, explain why prolonged stress is unhealthy, and offer tips for reducing stress.
- Poor nutrition adds to your stress
Good nutrition, moderate exercise, adequate sleep, practicing stress reduction techniques and activities, and perhaps medication treatment will allow you to think clearly, feel more in control, be more energetic, feel more relaxed, and to have the focus required to work towards your recovery.
Perhaps stress more than any other factor, ultimately leads to an eating disorder. If there was no stress or conflict, the individual would not need to use eating disorder behaviors as a coping mechanism.
There are limitless possibilities and combinations of stressors that can predispose someone to an eating disorder, including work, school, finances, family and relationship problems, and media and cultural pressures. All of these issues become sources of stress that the individual desperately wants relief from. Unfortunately, people turn to unhealthy addictive behaviors, such as eating disorders to cope with stress.
People turn to eating disorders subconsciously as a way to soothe themselves and gain a sense of control (albeit a false sense of control). The anorexic has a false sense of emotional relief by restricting food, the bulimic feels a false sense of emotional relief and release through purging, and the binge eater finds a false sense of solace physically and emotionally during binge episodes. Although these behaviors may in the short-term seem effective in making one feel better, over time these unhealthy behaviors take on a life of their own and end up causing more stress than the original stressors.
Eating disorders are the source of stress for various reasons. First, nutrient deficiencies, lack of adequate calories, and dehydration cause physical stress to the body.
People with eating disorders often have nutrient deficiencies:
Second, the self-imposed rules and rituals of people with eating disorders cause them a great deal of stress.
Third, individuals with eating disorders try to keep their eating disorder behaviors a secret, because they consider their behaviors shameful and embarrassing.
Fourth, those with eating disorders often withdraw socially, develop relationship problems, have difficulty expressing themselves, are self-conscious about their weight and appearance, place too high expectations on themselves, and are high achievers and perfectionists. All of these things add to their stress.
When people are stressed, their bodies are wonderfully and automatically “activated” to prepare the body for the perceived threat. Their bodies go into a “fight or flight” response to deal with the danger. To prepare the body to deal with the stressor, the body releases the hormones Adrenaline and Cortisol into the bloodstream.
While the stress response is a natural and beneficial process meant for short-term activation, prolonged stress requiring continuous activation of the stress response can be unhealthy for the body.
Prolonged stress can result in such symptoms as headache; upset stomach; lack of or increased appetite; indigestion; acid reflux; muscle tension in the neck, face, or shoulders; heart racing; elevated blood pressure; anxiety; depression; and fatigue. Besides these symptoms, prolonged stress can lead to other diseases, such as cardio-vascular disease and type 2 diabetes.
Prolonged stress puts the stress response into “overdrive” causing too much Cortisol to be released into the body. Too much Cortisol can lead to cravings of food high in sugar, sodium, and fats, which can lead to the over consumption of these foods and ultimately weight gain.
Elevated levels of Cortisol produce a rise in sugars in the bloodstream. Additionally, too much Cortisol, a fat-storing hormone, and elevated sugar levels signal the body to store fat especially in the abdomen. Therefore, if you need to lose weight for health reasons, prolonged stress is definitely not helping matters.
Stress depletes the body of essential vitamins and minerals, so it is especially important to eat well-balanced meals and snacks after being stressed. This is what happens:
- A person experiences stress
- This triggers the body to release stress hormones
- Stress hormones excrete nutrients such as the essential minerals of calcium, magnesium, iron, and zinc from the body
- This process in turn helps the body more effectively deal with stress by reducing stress-related symptoms and mood swings and helping muscles to relax
- The body needs to replenish nutrients used
Poor nutrition elevates stress levels, while good nutrition makes it easier for the body to deal with stress. A wholesome nutrition plan involves consuming adequate calories, vitamins, and minerals and eating proteins, vegetables, fruits, whole grains, dairy, and oils (unsaturated fats). Drinking water is essential to keeping the body hydrated. Generally, it is recommended that people drink 8 – 8 ounce cups of water daily. More water is needed if physically active and with exposure to hot temperatures.
Poor nutrition and consuming too few calories can lead to health problems, lower your immune system’s resistance, break down body organs and tissue, impair your ability to think clearly and function, and can cause depression, anxiety, irritability, mood swings, and fatigue.
When you experience fatigue, a lack of concentration, and feel irritable, it is more difficult to handle stress and situations that might not otherwise be stressful and anxiety provoking become stressors. On the other hand, good nutrition gives you more energy, improves your concentration, and helps you stabilize your mood. With this in mind, you can understand why breakfast is considered the most important meal of the day.
Many people drink caffeinated and/or sugary beverages or eat sweets to boost their energy. This energy boost from refined sugar is only short-lived. Eating protein and carbohydrates low in refined sugar provides a longer lasting, more sustainable energy level. There is nothing wrong with or bad about eating sweets and drinking sweetened and caffeinated beverages in moderation, but consider your goal when making food choices – do you need a quick fix or longer-lasting endurance?
The emotional eater eats in response to his or her feelings, not in response to physical hunger. The emotional eater may eat in response to feelings of stress, sadness, happiness, anger, anxiety, and feeling overwhelmed and depressed. Considering most of the time we are experiencing either negative or positive emotions, this can lead to a lot of munching and overeating.
Most of the time emotional eaters and bingers eat carbohydrates high in fat and sugar due to the soothing affect these foods bring them physically and emotionally. Eating in response to one’s emotions, not physical hunger, can result in the consumption of too many calories from foods high in sodium, sugar and fats.
Learning to eat in response to physical hunger, not emotions, is important. Eat when physically hungry and stop when comfortably full. When the temptation to eat in response to emotions occurs when you are physically satisfied, try distracting yourself with something else, such as calling a friend, doing a craft, exercising, or practicing a relaxation technique.
People with eating disorders need to learn how to be a “mindful” eater. To become a mindful eater one must have a healthy relationship with food and their body. Eating should be both physically and emotionally satisfying.
Qualities of the mindful (or intuitive) eater include:
- Trusts self to make appropriate, nutritionally sound food choices and be in control over eating
- Eats when physically hungry; stops eating when physically satisfied
- Eats a variety of foods from each of the food groups
- Chooses and consumes foods that are appealing
- Is flexible about food choices
- Adapts to eating whatever is available or served
- Enjoys food but is not preoccupied by thoughts of food
- Experiences freedom from food rituals and rules
- Is non-judgmental about food. For example, does not label food as “safe/good” and “unsafe/bad”
- Is okay with eating foods high in sugar, fat, and sodium in moderation
- Does not experience feelings of guilt after eating
Sometimes eats for reasons other than physical hunger, such as emotional eating, availability of food in social situations, or just because it tastes good – and is okay with it
Any stress management plan must begin with good nutrition. Good nutrition gives the body the needed nutrients it needs to function at an optimum level.
Next, a stress management plan requires an understanding on what causes you stress. Once you understand what causes you stress, you can develop a plan for how you will deal with that stressor in the future. Obviously, you cannot predict every stressful situation, but you can look for connections on what has caused you stress in the past to predict your future stress triggers. This information will give you insight into what stress relief method to use and when to use it to help you relax.
To prepare yourself for dealing with stress, start practicing some stress reduction techniques to find out which one’s you feel comfortable with. Then, train yourself to automatically switch into your stress reduction mode when you feel stressed or anxious.
Nutrition tips for reducing stress:
Consider these tips for reducing stress in your life:
- Good nutrition
- Adequate sleep
- Moderate exercise
- Practice time management skills, including prioritizing
- Setting time aside for relaxation, recreation, and vacations
- Go to therapy and/or a support/therapy group
- Do not be afraid to say “no” to opportunities to take on more responsibilities
Consider what types of recreation you enjoy and do these regularly. Here is a list of activities for you to consider using to reduce your stress:
- Watching movies
- Renovating and decorating home
- Going for walks
- Being in nature, such as through hiking or camping
- Singing; being in a choir
- Painting or drawing
- Going to the beach
- Planning and going on a vacation or weekend-get-away
Start practicing some of the stress management techniques listed below to discover what methods work best for you and you enjoy.
DEEP BREATHING - Take several deep diaphragmatic breaths by inhaling through your noise (counting to 5 to yourself) and then exhaling through your mouth (counting to 8 to yourself).
VISUALIZATION or GUIDED IMAGERY - Imagine a tranquil scene and use all of your senses to experience it, such as a sunset on a beach or a stream and waterfalls in a forest. You may use a CD or tape to lead you through a guided imagery.
MEDITATION – One form of meditation you can practice for 5-20 minutes is to focus on a word, phrase, a sound or nothing at all in order to distract yourself from other thoughts, center yourself, and relax. Some may use this as a spiritual exercise by focusing on a scripture passage or word of spiritual significance.
MUSCLE RELAXATION – Tense and relax all of the muscle groups in your body. For example, tense and relax all the muscles in your face, holding a tight grimace 10 seconds, then completely relaxing for 10 seconds. Repeat procedure for other muscles in your body.
RHYTHMIC EXERCISES - While any exercising can help reduce stress, non-strenuous, focused, rhythmic exercise done for the purpose of reducing stress and centering self can help you achieve a more tranquil state. As you exercise, focus on your rhythmic movement, your breathing, how your body feels, and experience your senses taking in the surroundings. Rhythmic exercises include jogging, walking, rowing, cycling, and swimming. For example, if you are riding a bike, concentrate on the movement of your legs pedaling, your inhaling and exhaling, the feeling of the warmth of the sun and the wind against your face, etc.
MINDFULNESS - "Mindfulness is the here-and-now approach to living that makes daily life richer and more meaningful," says Claire Michaels Wheeler, MD, PhD, author of 10 Simple Solutions to Stress. Mindfulness involves having the wonder and curiosity of a child, it is without judgment, it is detail-oriented, and requires focusing only on the activity of the moment. Use all of your senses to take in the environment, whether you are outside in nature or inside interacting with family or friends. Stop and smell the roses!
MUSIC – The right music can lower your blood pressure, relax your body, and calm your mind. Unlike other stress relief techniques that require focused quiet time, music can be listened to as you go about your daily activities. Soothing music can help make your daily tasks more enjoyable, help relieve your stress, can inspire you, and give you emotional strength for the day. Listen to music you enjoy that relaxes you at a modest volume.
MASSAGE – Massage offers many health benefits in addition to providing relief from various aches and pains, muscle tension, and stress. The soothing effects of massage create a sense of well being. You can either have a massage by a masseur or do a self-massage. For details on how to give yourself a self-massage, do a search on the topic on the internet.
SQUEEZE A STRESS BALL – When feeling stressed try squeezing a stress ball to relieve tension. Squeezing a stress ball is also good for exercising your hand muscles, such as after typing. A gel or foam-filled stress ball is squeezed in the palm of your hand and can be manipulated by the fingers. Consider buying a stress ball at a store on the internet.
TAKE A BREAK – Taking a break or time out allows you time to refresh yourself, whether it be a break from work or a time out from the intensity of a conversation or other activity. Ideally, you will return from the break more alert, clear-minded, and energetic.
WRITE ABOUT IT - Sometimes it is helpful to put your feelings and thoughts in writing. This helps you to express and organize your feelings in a safe, private way and gives you time to consider the best way to deal with your emotions and situation. Venting your emotions through writing will help you compose yourself in preparation for later verbalizing your issues should you need to take such action.
COMPOSE YOURSELF - Rather than blurting out a response, take a moment to compose yourself before responding to someone who has upset you by taking a deep breath to inhale and exhale or counting 1-10 to yourself.
EXPRESS YOUR FEELINGS – Express your feelings! Don’t bottle your emotions up inside as this only produces resentments, grudges, and misunderstandings. If someone or something is bothering you, express this. If someone has hurt your feelings, communicate this using “I statements”, such as “I feel … when you …” instead of using “you statements”. “You statements” such as “You make me feel …” usually makes the other person feel blamed and results in him or her being defensive.
SOCIALIZE – Socializing is essential to your mental health. Talking and doing activities together provides a distraction from stress and lessens its intensity. Talking allows you to air your thoughts and feelings. The feedback from others can give you a fresh perspective. Be open to receiving their support, encouragement, and help. Be a good listener and be ready to help and support others, too. If you are feeling stressed, call or visit a friend. If you are feeling seriously stressed and/or depressed, consult a therapist.
Don’t wait until you are stressed to practice stress reduction techniques.
Use stress management techniques as an ongoing way to prevent and reduce stress.
It is easy, especially when depressed, to read this but not act upon it. Make a commitment to reducing your stress in some specific ways. Start today!
Men are less likely than women to admit to being stressed and are less likely to reach out for help when stressed. Generally, men think that asking for help is a sign of weakness. On the contrary, taking action to deal with stress or any problem requires great strength and courage. Striving after personal growth and improvement is an admirable quality in any person.
A discussion about EDs and stress without mentioning the stress experienced by caregivers over their affected loved one’s eating disorder would seem remiss. Parents, partners, and entire families often are profoundly affected and stressed by a loved one’s eating disorder.
Living with a person with an eating disorder can be extremely difficult with all of their rules and rituals, secretive behaviors, mood swings, depression, irritability, social withdrawal, and their controlling nature.
Unlike other life-threatening illnesses, those with eating disorders are often in denial of their disease and unwilling to seek treatment. This causes a sense of helplessness and hopelessness about how to reach out and help a loved one – and this causes them a great deal of stress.
In other situations, a loved one will seek treatment, but his or her progress may seem slow. This requires patience on the part of family and friends. Caregivers worry that the person with the eating disorder may never completely recover and they may feel at a loss of how best to offer support. Again, this produces stress.
It is helpful to view the person with the eating disorder and their illness separately. In other words, you love the person himself, but despise the illness in him that is destroying him.
For more information, see the "Parents" page on this website.
For support, visit the N.A.M.E.D. online support group for Concerned Others or write to Chris@NAMEDinc.org or call the Helpline at 1-877-780-0080.
Here are some stress management tips for caregivers:
- Practice stress management techniques, skills, activities, and a stress reduction lifestyle
- Model and practice good nutrition and moderate exercise
- Communicate your feelings to your loved one, but do not pester
- Do not be an enabler by conforming to the unreasonable demands and control of the person with the eating disorder
- Do not share the shame of the child’s eating disorder by avoiding discussions about it to him and those whom you can confide in for help and support
- Give equal attention, care, and love to all family members despite your worries over your child with the eating disorder
- Learn about eating disorders, so you better understand the disease
- Be willing to participate in a loved one’s therapy sessions, if asked
- Join a support group, such as N.A.M.E.D.’s Online Support Group for Concerned Others
- Consider counseling for yourself to get support for dealing with your situation