Eating And Your Energy Levels

Description

Disordered patterns of eating play a central role in the maintenance of anorexia nervosa, bulimia nervosa, binge-eating disorder, and other specified feeding and eating disorders (OSFED). For this reason, psychoeducation regarding the content and consequences of ‘normal’ versus ‘abnormal’ patterns of eating are an important aspect of treatment.

The transdiagnostic model of eating disorders identifies several processes which contribute to disordered eating across diagnostic groups (Fairburn et al., 2003). These include:

• Overvalued beliefs about shape, weight, eating, and control. People with eating disorders base much of their self-worth on their ability to control their shape, weight, and eating. Other features of eating disorders are believed to stem from this ‘core psychopathology’, including extreme weight control behaviors (e.g., self-induced vomiting, driven exercise), body-shape checking and avoidance, and preoccupation with weight and appearance (Cooper & Dalle Grave, 2017).
• Dietary restraint. Overvalued beliefs about shape, weight, and eating lead individuals to establish strict dietary rules which are challenging to maintain. In restrictive eating disorders (e.g., anorexia nervosa), restraint can result in significant weight loss and a severely low body mass index (BMI) due chronic food restriction. In eating disorders where there is a binge-eating component (e.g., bulimia nervosa), difficulties adhering to these strict dietary rules can cause people to abandon attempts to restrain their eating, resulting in episodes of binge-eating.
• Broader maintaining factors. These can perpetuate disordered eating for some individuals. They include:
  • Mood intolerance.
  • Interpersonal difficulties.
  • Low self-esteem.
  • Perfectionism.

Failure to meet the body’s energy requirements plays an important role in disordered eating (Waller et al., 2007). When the human body is deprived of energy from food, individuals experience a range of problematic symptoms including intense hunger, preoccupation with food, and impaired cognitive functioning. Research suggests that these symptoms play a role in the development and maintenance of disordered eating (Keys et al., 1950).

Understanding the causes and consequences of low energy provides people with an explanation as to why they are experiencing certain difficulties related to their eating disorder, such as preoccupation with food and the urge to binge-eat. In addition, energy levels explain that people benefit from providing the body with a consistent supply of energy throughout the day (e.g., eating regular meals and snacks).

Before discussing energy graphs, it is helpful for clinicians to hold in mind key some of the key nutritional facts about food intake and energy levels:

• Food is the main source of energy for the human body, which it needs to function normally. The body uses energy when it is awake and when it is asleep. This is because basic bodily functions (such as breathing, thinking, maintaining a regular temperature) operate irrespective of whether the body is active or sedentary.
•  Different types of food affect the body’s energy levels in different ways. While it is important to eat a balanced diet that includes all the main food groups (e.g., protein, dairy, oily foods, fruit, and vegetables), the most important energy source for the human body is carbohydrates. Carbohydrates are as important to the human body as gasoline is to cars: though cars need oil and water, they can’t drive at all without gasoline. Common carbohydrate-based foods include rice, pasta, bread, and breakfast cereals.    
• Carbohydrates are broken down and digested once eaten. Some carbohydrates are also stored in the liver and muscles as glycogen (a type of sugar). The body stores and releases glycogen throughout the day to make sure it’s energy levels don’t get too low between meals. However, the body stores only a small amount of glycogen: it lasts around 24 hours if it isn’t topped up (Waller et al., 2007). For this reason, people are encouraged to eat carbohydrates regularly throughout the day.
• Eating carbohydrates leads to increases in energy (i.e., blood-sugar) levels. Other food groups (e.g., protein, vegetables) lead to comparatively smaller increases in energy. When energy levels drop, a message is sent to the brain to increase hunger. Feeling hungry is the body’s way of telling people that they need to top up their energy levels.
• Restricted eating results in low energy levels and, when left unchecked, the onset of symptoms of ‘semi-starvation’ (Keys et al., 1950). These include problematic physical changes (e.g., urges to binge-eat, tiredness), psychological changes (e.g., preoccupation with food, reduced concentration), emotional changes (e.g., anxiety, irritability), and social changes (e.g., withdrawal, strained relationships).   
• Purging after eating can lead to more dramatic falls in energy levels. This is because the human body releases insulin after eating, which regulates its blood-sugar levels. After purging, the amount of carbohydrates the body absorbs will be lower, but insulin levels will remain high. This leads to even lower blood sugar levels. 

Energy graphs draw attention to the benefits of regular eating. Eating regularly throughout the day (including a regular intake of carbohydrates) supplies the body with the energy it needs for optimal functioning. This in turn helps prevent symptoms of semi-starvation, increase control over food intake, and improve mood and concentration.