Iran Journal of Nursing

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Ebrahimi E, Mohammadi Shirmahaleh F, Habibi M, Mardani Hamooleh M. Harmful Experiences Associated with Emotional Eating of Iranian Obese Women: A Phenomenological Study. IJN 2021; 34 (132) :47-62
URL: http://ijn.iums.ac.ir/article-1-3491-en.html

Background & Aims: Emotional eating is defined as the tendency to eat in response to stress or negative emotions in order to overcome negative emotions. According to research evidence, emotional eating is harmful to health. For example, emotional eating is associated with weight gain, increased risk of type 2 diabetes, metabolic syndrome, high blood pressure, and hyperlipidemia. Therefore, it is important to identify the factors that cause emotional eating to be harmful, as it helps us to get a deeper insight into emotional eating and its harms and plan more effective educational and psychological interventions to manage emotional eating. To do this, we need to analyze the experiences of people who have had emotional eating, to explore and explain this behavior from their point of view. As a result, we can identify the various psychological, social, and cultural dimensions of emotional eating. In addition, research evidence shows that emotional eating is more common in obese people than normal weight people, and women are more vulnerable to emotional eating than men. In addition to being universal, emotional eating behavior also has culture-related characteristics. According to these points, the aim of this study was to explain the harmfulness of emotional eating in young Iranian obese women.
Materials & Methods: The present study was conducted using a qualitative method and a hermeneutic phenomenological approach in 2020. Participants in this study were 17 young women aged 25 - 45 years living in Kermanshah or Karaj, with emotional eating experience and a body mass index of 30 or higher. Pregnant women were not included in this study due to their different body mass index. Participants were selected using purposive sampling method with maximum diversity approach. Data were collected through in-depth individual and face-to-face interviews. Sampling and interviews continued until the data saturation stage. The main questions asked of the participants during the interview were as follows: 1) Describe one of your emotional eating experiences and explain the thoughts, ideas, emotions and physical feelings that led you to eat at that time. 2) What other experience in your life is similar to this experience, and what does it mean to you? 3) Under what circumstances do you have the most emotional eating? And what do you think the relationship between these conditions and emotional eating means? 4) What is the difference between the times when you eat emotionally and the times when you eat normally? Also, exploratory questions were asked to analyze the deeper layers of the participants' lived experiences. Some of the exploratory questions asked in the present study were as follows: What did you mean by ....? Could you explain more? Please give an example in this regard? Data analysis began at the same time as data collection process. Dickelman's 7-step method was used to analyze the data.
Results: In data analysis, a major theme emerged called "harmful companions" which showed that while participants experienced emotional eating, some other experiences accompanied their emotional eating, causing emotional eating to be harmful for these people. The main theme of "harmful companions" consists of seven sub-themes named lack of self-control in eating behavior, unconscious eating, body abuse, contradictory experiences, eating addiction, excessive eating of certain foods, and secretive eating. Lack of self-control in eating behavior means that emotional eaters do not have enough control over their eating behavior and their emotional eating is accompanied by fast eating, overeating, eating regardless of food quality, swallowing unchewed food, eating at the wrong time, and etc. The sub- theme of "unconscious eating" includes those experiences accompanying emotional eating that are not within the control of the conscious mind, and includes eating without consciousness, eating without will, eating involuntarily, eating without thinking, eating without purpose, unwanted eating, and eating without the right to choose. The sub- theme of "body abuse" refers to the victimization of the body, especially the gastrointestinal tract, during emotional eating experiences, and includes distracting from negative emotions by engaging the mouth and stomach through eating, replacing pain caused by filling the stomach with psychological pain of anxiety and chewing foods with clenching teeth to vent anger. The sub- theme of "contradictory experiences" includes the functions of positive and negative emotional eating and contradictions in attitude, feelings, and behavior of participants during emotional eating; Like enjoying eating but with a sense of shame for how you eat, eating pleasantly but with a guilty conscience; eating with craving but without pleasure, eating with craving but unwanted and the necessity of eating unnecessary. The sub- theme of "eating addiction" includes quasi-addictive traits found in emotional eaters, such as; mental temptation to eat, eating out of habit, physical urge to eat, psychological dependence on eating, compulsive eating, and searching behavior to find food. The sub- theme of "excessive eating of certain foods" means that although the participants' overeating included a variety of foods; in particular, they ate more sugary foods, high caffeine foods, starchy or fatty foods, and high-fat and salty snacks. The sub- theme of "secretive eating" means that participants ate secretly to avoid negative judgments and blame for their overeating, or that secretive eating was to passively eat their share of the food.
Conclusion: The results of this study showed that emotional eating alone is not harmful, but some other experiences that accompany it, cause it to be harmful in physical, psychological, and social dimensions. An interesting finding of this study is the sub-theme of "body abuse". This sub-theme expresses the need for people to maintain their mental cohesion even at the cost of harming their body. Another important point of this study is that; the "harmful companions" of emotional eating that emerged in the form of seven sub-themes complicate the cognition and management of emotional eating, and it is necessary to pay attention to harmful companions in psychotherapy programs to manage emotional overeating especially in women.