Christopher Trennepohl, MPH
I don’t want to speak for everyone, but I had big plans for quarantine. I found that it was more difficult to adjust to such a massive shift than I anticipated. The days slipped by, and many of my good habits fell by the wayside. One way that this manifested was my eating habits. As previously noted (https://uncexchanges.org/2020/06/17/sustained-wellness-during-the-covid-19-pandemic/) the COVID-19 pandemic has dramatically changed many of our routines, including our eating routines. For example, before quarantine I was packing my breakfast and lunch and following a regular eating schedule, but more recently I find myself eating unplanned and unscheduled snacks throughout the day.
This style of eating is consistent with “grazing.” The formal definition of grazing is “the unstructured, repetitive eating of small amounts of food… not in response to hunger,” and often includes a loss of control.1 Although there is nothing inherently wrong with grazing from time to time, for some individuals, grazing behaviors can be associated with other disordered eating behaviors like binge eating.2
Grazing has been featured in several recent studies. Heriseanu et al. (in the Journal of Eating Disorders) compared grazing behaviors in individuals with obesity (defined as a BMI ≥ 30 kg/m2) with and without eating disorder features.3 Specifically, they examined whether grazing was goal-directed or habitual. Goal-directed behavior is a decision made with a particular goal in mind (“I want a snack, so I made a sandwich”), whereas habitual behavior is an action performed often in response to an environmental trigger (such as having a cookie every time I walk by the cookie jar). Goal-directed behavior is also more focused on a specific outcome (“I am hungry, so I will eat”) and flexible (“I don’t need to eat a cookie today”).4, 5
How was this measured? It was quite an unusual study. The authors used a simulation in which participants “shook” a virtual vending machine, and snacks would fall out after a certain number of “shakes.” Participants were instructed to discover when “shaking” the machine in different directions released the most snacks to try to win as many snacks as possible. Participants with eating disorder features were less likely to shift their behavior based on feedback they received during the simulation task. The authors concluded that participants with eating disorder symptoms were less likely to flexibly adapt their behavior and suggested that this means they might rely less on cues such as hunger or satiety when making decisions about eating (i.e., engage in more compulsive or habitual eating).
What does this study actually tell us? We know that rigid habitual eating can be psychologically distressing.6 We also know that habits form after repeating an action many times.7 As healthcare professionals, we should consider addressing inflexible eating patterns in individuals with eating disorder traits, bringing more awareness to unhelpful eating behavior and increasing intention and flexibility in service of improving one’s relationship with food and eating habits. And even those without eating disorder traits may benefit from engaging in intentional and flexible eating patterns rather than falling into mindless eating habits or rigid rules around eating that may lead to long-term disordered eating. This is particularly important as we continue to practice social distancing and working from home, which has led to so many changes in our daily routines. While this is certainly easier said (or written) than done, it is always good practice to increase mindfulness and to reflect on our motivations for doing what we’re doing throughout the day.
1. Heriseanu AI, Hay P, Corbit L, Touyz S. Grazing in adults with obesity and eating disorders: A systematic review of associated clinical features and meta-analysis of prevalence. Clin Psychol Rev. Dec 2017;58:16-32. doi:10.1016/j.cpr.2017.09.004
2. Conceição EM, Mitchell JE, Machado PPP, et al. Repetitive eating questionnaire [Rep(eat)-Q]: Enlightening the concept of grazing and psychometric properties in a Portuguese sample. Appetite. 10 2017;117:351-358. doi:10.1016/j.appet.2017.07.012
3. Heriseanu A, Hay P, Corbit L, Touyz S. Relating goal-directed behaviour to grazing in persons with obesity with and without eating disorder features. J Eat Disord. 2020;8(48)
4. Balleine B, Dickinson A. Instrumental performance following reinforcer devaluation depends upon incentive learning. Comparative and Physiological Psychology. 1991;43(3):279-296.
5. Adams C. Variations in the sensitivity of instrumental responding to reinforcer devaluation. Comparative and Physiological Psychology. 1981;34(2):77-98.
6. Mantzios M, Egan H, Bahia H, Hussain M, Keyte R. How does grazing relate to body mass index, self-compassion, mindfulness and mindful eating in a student population? Health Psychol Open. 2018 Jan-Jun 2018;5(1):2055102918762701. doi:10.1177/2055102918762701
7. Dickinson A. Actions and habits: the development of behavioural autonomy. Philos Trans R Soc Lond B Biol Sci. 1985;308(1135):67-78.