By Dr. Franziska Kohl
Introduction
“Nothing is forever except change” is a well-known Buddha quote capturing the impermanent nature of life. Change provides an infinite combination of challenges for organisms that strive to upkeep homeostasis within their body systems while meeting their daily needs. As a result of this, adjusting to change is a function of life that is deeply rooted in all organisms through the process of evolution. In fact, it is so deeply ingrained that our human body responds to most changes without our conscious awareness [1]: they are regulated by our autonomic nervous system which controls all of our essential functions like heart rate, body temperature, blood pressure, respiration, wake-sleep rhythms, sexual arousal – and digestion.
The autonomic nervous system began its evolution in invertebrates about 500 million years ago [2]. After 400 million years of further evolution, the system reached its current level with the emergence of social mammals about 75 million years ago[3]. The key players of this system are two branches of the peripheral nervous system that create opposing actions. The sympathetic nervous system branch is responsible for activation while the para- sympathetic aspect controls states of recovery and homeostasis [figure 1].
Both branches have terminals at all essential organs of the body. Due to major advances in research over the last 20 years, it became apparent that these two branches act interdependently like dimmer switches that are entuned to each other via nerval feedback loops, constantly exchange information and hence fine tune the regulation of organisms. It is this independent system of the autonomic nervous system that regulates energy balance, glucose, fat homeostasis as well as appetite [4]. By removing the management of baseline functioning from our conscious awareness to our autonomic nervous system, massive brain capacity was freed up so we can deal with the daily aspects of life.
Of all basic human needs, eating plays a special role: our bodies depend on the plain caloric intake but more important might be that all mammals were nursed by their mothers and hence food is intricately connected with nurturance via the presence of the warm body of a mother, a soft voice, a gentle touch and a deep sensation of satiation – all of which translates to safety, wellbeing, and balance [5].
In healthy humans, the autonomic nervous system strives to return to the state of wellbeing for all functions of homeostasis can happen here, and in no other nervous system state. The nervous system state for nurture is present only in social mammals and was coined “ventral vagal” by Dr. Stephen Porges in 1995 [6]. In the East, this state of balance has been known for over 5000 years and is the base requirement for entering the Yogic state of “Sattva”, which expands the concept beyond the physical aspects. Sattva is based on the ventral vagal platform which is understood to be the foundation for happiness, for healthy relationships – also for hunger and feeding mechanisms – with the ultimate goal of maintaining homeostasis in our bodies whenever the challenges of life reduce sufficiently to allow for homeostasis to occur.
Western View on Classification and Pathology
Energy balance is the concept that describes the relationship between energy intake (food) and energy expenditure (metabolism & activity) [7]. The body is programmed to strive towards an equilibrium by regulating our states of hunger and energy levels via our nervous system and emotions. In the instances of overeating, poor mood precedes binge eating directly: 95% are accounted for by anger, anxiety and sadness, with anger being highlighted as especially impactful on the occurrence of binge eating. Additionally, individuals are less capable of tolerating negative moods and are unconsciously defaulting to poor emotional coping strategies [8]. The existing literature suggests that overeating may not stem from the experience of negative emotions per se, but is due to a lack of adaptive strategies to rebalance the emotional state. Two of the maladaptive strategies that are highlighted are suppression and rumination [9]. These strategies are causing sufferers to turn to food to escape from the emotions and/or to down-regulate their emotions in this way [10]. In addition to the poor regulation of emotions, body image disturbance and poor self-esteem are correlating highly to this phenotype [11]. Alongside emotional states, physiological states resulting in increased hunger or sugar cravings can play a key role like the presence of low blood sugar due to adrenal fatigue or undiagnosed diabetes [12].
All overeating concepts point to the stress response of the body being at the core of the issue. The human body’s stress system has two branches: the first -and faster one- being the autonomic nervous system via nerve innervation and second the hypothalamic-pituitary-adrenal axis via hormonal output into the bloodstream. While both systems were previously thought of as inflexible, the research of Dr.Porges has revealed that the autonomic nervous system has flexibility and is hence targeted as a mode for intervention. According to the “Polyvagal Theory” all physiological states are directly linked to autonomic states which determine the way we respond to change, stress and challenges of life [13].
The system of key importance for homeostasis is the “ventral vagal state” which is the only one activating the “social engagement system”. The social engagement system inhibits the sympathetic response of the hypothalamic-pituitary-adrenal axis and upholds – or foster a return to – calm behavioral states [14]. “It is important to note that social behavior, social communication, and visceral homeostasis are incompatible with the neurophysiological states and behaviors promoted by the […] neural circuits that support defense strategies [15].”
Alongside the nervous system impact, a hormone that plays a crucial role in resetting our system to a place of balance, and has been underestimated until recently, is Oxytocin: it promotes the body’s return to homeostasis and has been coined the anti-stress hormone [16] – it is not surprising that it is released as a result of the activation of the social engagement system [figure 2].
Let’s apply these large concepts to the question of how emotional states are regulated in case of overeating: before an event of overeating occurs, the individual experiences strong emotions resulting in a state of stress [17]. In response to this, the body is attempting to bring the system back into balance. By excessively using the muscles of mastication while overeating, the social engagement system is activated via the afferent nervous system fibres of the vagus nerve and could trigger visceral changes that would support a return to the social engagement system and hence create a sense of wellbeing. At the core of the theory is the mechanisms through which social behaviors may serve as regulators of physiological activity and vice versa [18]. This concept ties into the shared social engagement system experience of all mammals of being breastfed and nourished by a care provider in the earliest and most vulnerable stages of our life. These deeply rooted positive social engagement system memories are impacting all decisions we make today [19].
Eastern View on Classification & Pathology
The rise of chronic diseases in the West is creating a collective urgency for more comprehensive, integrative health approaches that prioritizes prevention [20]. While allopathic medicine is evermore capable of reducing acute symptoms of disease and trauma, holistic medicines provide relief to chronic disease patterns like overeating.
The fundamental principle of Ayurveda lives in the dynamic triangle of the medicine provider, the medicine receiver and the medicine itself [21]. This means that the relationship of the Ayurvedic provider to the patient and the medicine is equally important to its knowledge and understanding of the two. To be most effective, there is a close connection between all three aspects of this triangle.
All Ayurvedic treatments have the same end goal: to re-unite an individual with its true nature as spirit, also called Svastha or Perfect Health [22] which is often referred to as “Higher Self” in the West [23]. This tall goal can be used like the North Star by reliably and consistently guiding life in its direction via many smaller, daily steps. As we progress in this direction, our intellect or Buddhi grows allowing us to align ever more precisely with this direction [24]. The base requirement to step on this path towards Higher Self is to practice the cultivation of a Sattvic lifestyle which Dr. Halpern calls the “Ladder of Enlightenment” [25]. Ayurveda suggests daily practices alongside an individualized diet and lifestyle to create a progressive balance in the body, mind and spirit that allows and empowers this journey.
The forgetting of our true nature as spirit is causing us to overfocus on the experiences of our senses, which are the Ego’s primary tools: driven towards pleasure and away from pain, humans end up in an experience of imbalance – and separated from spirit – both of which is causing suffering on different levels. The overindulgence in the sense of taste during overeating is ego driven due to an effort to dull the feelings of discomfort [26]. This dynamic causes disease due to excessive interaction between senses and sense-objects [27].
From the Ayurvedic lens, the act of overeating is reliably causing the Kapha dosha to go out of balance in an attempt to tame the strong emotions caused by either Vata (anxiety, overwhelm) or Pitta (anger, intensity). In the Shushruta Samhita the presence of Vata dosha in the mouth cavity is given primary responsibility: by forcing food down into the stomach, it is causing Vata dosha to go out of balance and cause disease [28]. It is mentioned that the Pitta dosha is affected by perfectionism as well as eating foods that are not in healthy alignment with the organism [29].
It is curious that during overeating the mental discomfort (anxiety and anger) is not engaged with on the mental level, but on the somatic plain via physically overeating: The vitiation of Kapha dosha is causing sluggish digestion and is followed by systemic water retention, paleness and lethargy [30]. While the coolness may counterbalance the intensity and heat of anger, which in the aggravation of Pitta dosha [31], the lethargy will have a calming and slowing effect on the entire body since this effect resides in the blood.
In the big picture, it is Kapha’s ultimate nature to stabilize, which is described with the qualities of heavy, cold, moist, static, smooth and soft, all of which are offering stability and relief to the experience of instability prior to binge eating. If Kapha is in balance its solid nature to contain, hold and nurture is true power. In overeating these characteristics are over-used by over-eating and are causing excessive heavy, cold, static states across body, mind and spirit.
If this doshic mechanism is engaged frequently, it will result in weight gain and obesity[32]. Additionally to the physical impact on the body, is the likely involvement of the mental Kapha. Akin to the function of Kapha on the physical body, the mental Kapha’s role is to stabilize, contain and protect the mind and brain to enable well-being to our consciousness. If aggravated alongside the physical body, symptoms result in mental dullness by dampening the nerve impulses across the entire brain. This mental aspect calms the aggravation of the nervous system induced by heightened emotional states [33]. The Ayurvedic text of Charaka Samhita summarizes plainly that overeating is causing disease with various symptoms in the head [34].
In the big picture of the doshas, overeating is using Kapha as a coping mechanism to protect from the anxiety, worry and stress of Vata and/or the anger, irritation and judgement of Pitta. Additionally, Kapha is intimately connected with fat via its nourishing nature that reflects the organism’s capacity to love and be loved on a subtle level. When people feel unloved by themselves and others, they turn to food to buffer their low self-esteem and low self-love with a layer of fat to protect from this perception [35].
From an Ayurvedic perspective, overeating is causing the aggravation of Kapha dosha. Via the resulting lethargy and heaviness this is generating a calming, stabilizing and soothing effect on the body and mind, which might be the unconscious target of this coping strategy that fails to address the core issue driving it.
Eastern View of Management
For individuals that overeat, the relationship between mind and body is disrupted due to poor body awareness [36], distorted self-perception as well as perfectionism [37] which are often causing the stressful emotional states in the first place. Overeating is the body’s attempt to steady emotions and hence a main focus is to reconnect body and mind by rebalancing the relationship to Self, Self love and Self-nurturing [38]. Rebuilding the relationship to body and emotions in general, and a trust to food, hunger and satiation in specific, will require a humble approach for a steady and nourishing diet is a cornerstone to rebuild the stability and resilience that naturally resides within the body, which Ayurveda calls “ojas”. Ojas will also increase the ability to endure challenging emotional states [39]. The first – and most difficult- step is to become aware, and begin to name, the negativity present from perfectionism as well as cynical internal dialogue, both of which are often connected to deep rooted and unconscious shame [40]. Held in awareness, these can be addressed by supporting the Affected with spiritual concepts like the inherent imperfection of humankind, inborn ability for forgiveness & kindness that will soften the harshness of the life experience and point to the path out of dysfunction.
Caution needs to be exercised around Ayurveda’s strict guidelines towards diet and lifestyle as well as its ultimate goal of “perfect health”: they can be mistaken as another set of directives that would not generate the desired healing effect. The careful modulation of this will be a key aspect for the progression of healing.
Ayurveda’s wide-ranging toolbox of interventions is beyond the scope of this research paper, however several impactful interventions will be discussed below. Prior to creating a treatment plan, it is wise to rule out underlying issues driven by hormonal or neurotransmitter dysfunctioning like for example thyroid disease, adrenal fatigue, auto-immune disorders or nervous system dysfunction, investigating comorbid addictions or other health-destructive behaviors that might be buried even deeper in shame and subconsciousness as well as creating an understanding of the sensitivity of senses that might be altered. The results of these will be driving the direction of the individual approach. Trust in the practitioner – and the treatment – is of utmost importance for long-term success. Hence the Ayurvedic approach is highly individualized, lives between the practitioner and the patient and can not be simply copy and pasted as is common practice in allopathic medicine.
Prepared with these precautions, several aspects of Ayurveda’s interventions for addressing overeating are pointedly using the physical body as an access point to modulate mental states.
The first three concepts are of special importance for they are considered the “pillars of life” and will ultimately have to be addressed in all disease patterns for they are paramount to living feeling whole and healthy [41].
Food: Proper and reliable consumption of nourishing food is important for health and wellbeing. Our bodies extract nutrients from food and create our own body tissue from this source. It provides the baseline for the intake of pranic energy that governs the physical and mental energies circulating in our body and mind[42].
This is a delicate topic for individuals with a stressful relationship to food. The first step will be to reduce the charge present in food and eating with the initial goal to neutralize it. From there a new, supportive and healthy relationship can slowly be built. This often means to let go of fear-based behaviors like calorie counting, restrictive dieting, tracking weight and persistent self-observations. Underlying aspects of these behaviors may need to be extracted from the subconscious without dysregulating the trigger-sensitive nervous system and will take the most time and effort for recovery [43].
It is interesting to note that the salty and, especially, the sweet taste are the preferred tastes during binge eating [44]. From the Ayurvedic perspective, the sweet taste provides resilience via stability and satisfaction, and is the baseline for all other body tissues [45]. Ayurveda states that the salty taste increases appetite, bravery, courage and reduces fear. Of the six taxes, the sweet and salty provide the most direct relief to the strong emotions experienced prior to overeating (figure 3). If this direct effect of the tastes is combined with eating a large volume of food, the body’s capacity to digest the food will get overwhelmed and it will unambiguously aggravate the Kapha dosha[46].
The craving towards especially the sweet taste carries the body’s healthy desire to nourish and stabilize the unbalanced organism.
Well beyond the basic need for plain food intake or the taste, Ayurveda focuses on several additional aspects of the quality of food: matching food to the constitution of the patient as well as how the food is handled, prepared and eaten. Dr. Halpern’s fifteen guidelines to eating set high standards that emphasize the importance of a healthy relationship towards eating and are challenging for individuals who consider themselves as having a healthy relationship to food (see figure 4). Hence these will need to be cautiously introduced once the individual has regained a solid connection between mind and body. In this case, suggesting the consumption of Golden Milk (Milk mixed with Turmeric, Cardamom, Cinnamon and a pinch of salt as well as some Ghee) will be deeply nourishing and can be the beginning of expressing self-love via nourishing food intake.
If practiced and established, this simple ritual of self care could become a replacement for situations that previously triggered overeating.
Healthy eating and digestion is essential for healthy sleep and relationship to sex which are the remaining two pillars of life [47]:
Sleep: Rest and sleep is necessary for the recovery, repair and healing of the body of damage that accumulated during the active times. Deprived of this time, the body can not upkeep itself and accumulated lack of recovery will lead to the body breaking down physically and mentally [48], [49]. For the case of overeating, and the underlying aggravation of the mental Vata and Pitta doshas, the issue will be insufficient sleep and down time. The ability to slow down and sleep is incompatible with a hyperactive nervous system that traps the body in a state of alertness from the evolutionary need to survive [50]. Resolving sleep issues requires finding the root cause for the aggravation of Vata and Pitta doshas that are creating the overeating pattern. Additionally to the mental aggravation, sleep might be disrupted due to the body’s need to eliminate the waste products from excessive consumption as well as the diet-induced thermogenesis that creates heat as a result from upregulated metabolism [51], the later might affect especially those individuals with Pitta dosha who are constitutionally heat sensitive.
Sex: The management of sexual energy is of major importance to health and wellbeing and considered the third pillar of life. There are several interpretations of this concept across practitioners and religions, however they all point to the fact that sexual energy and its products (sperm & egg) are metabolically costly and hence the most precious products that the human body produces. Hence the release of sexual energy reduces the ability of the unwell body to heal and recover. Interestingly enough an ill body will reduce the sexual interest in the attempt to preserve its resources towards healing[52]. Ayurveda is suggesting to not suppress sexual urges [53] and practice sexual moderation that is aligned with the state of overall health of the individual which translates to neither over- nor underusing this energy. While providing bumpers to extremes, it allows freedom to adjust sexual energy to the everchanging energy levels that result from life as well as the creative and alive individual that inhabits it.
According to the Charaka Samhita, as long as the three pillars of life are managed well, a person will be strong and healthy [54].
Following below are Ayurvedic treatment options that target the subtle aspects of the body via the physical body and are well suited for overcoming overeating. The information presented is an accumulation from the two base courses offered at the California College of Ayurveda: Principles of Ayurvedic Medicine as well as Clinical Ayurvedic Medicine.
Routines: The Ayurvedic bedrock for recovery from Vata and Vata/Pitta disease manifestations is to create stable and steady nourishing routines. These provide dependable nourishment across the day for the body, but long term even more impactful is the structure and support across the day by creating a reliable rhythmicity that serves like mental scaffolding: as the routines become stronger with practice, so does the stability of the mind. Over time, it creates an authentic framework that can support the challenges and stressors of life ever better as the overall physical and mental stability improves. While this might be one of the most powerful inventions, such impactful lifestyle changes will require effort, time and practice in order to be successful and obviously can not be rushed.
In the ancient story of the rabbit and the snail, this approach is the “snail” which is hard to embrace in a society of “rabbit” for it requires swimming against the stream of the norm and will require to support the individual from the outside.
Herbs: From an Ayurvedic perspective, food and herbs are both medicines. Foods have a milder – and herbs have a stronger action [55]. Herbal formulations can be targeted towards disease patterns of the body and mind directly and can address highly individualized situations. This aspect does require the sustained care of a Clinical or Medical Ayurvedic Specialist for the formulations will need adjustment as the individual progresses through the healing process.
Aroma Therapy: Smell is the oldest of our senses and deeply connected to the limbic brain [56]. This allows aromas to work directly on the mind by modifying emotional states. Aromas beneficial to calm emotional upset are Sandalwood and Lavender. They can be used in an oil diffuser or in small spray bottles that can be carried and used whenever the need arises.
Nasal Therapy: The administration of medicated oil drops into the nasal cavity is common practice in Ayurveda for the nose is the gateway to the head and reaches the mind [57]. Hence medicine administered through the nose reaches emotional states directly which makes this another excellent treatment option for the problematic of overeating. Using an oil combination that is nourishing and pacifying to the mind would be most appropriate for the symptomatic of overeating. This medicine can be used in the care of a Clinical or Medical Ayurvedic Specialist.
Oil Therapies: The Sanskrit word for oil “sneha” also translates as “love”, which is making this an excellent choice to directly counter the challenge of overeating. Oil therapies provide deep nourishment to the body and mind, increase self-love and self-esteem and are the best remedy for alleviating Vata[58]. They can be used externally and internally.
Abhayanga is the mindful application of oil that helps to stabilize the mind and improve self-esteem – it can be other- or self-applied and practiced daily.
Sirodhara is given more likely in a spa setting where large amounts of warm oil are poured on the forehead. It strongly quiets the mind and is a good fit for Vata and Pitta.
An oil combination beneficial to pacify Vata and Pitta like in the case of overeating are Brahmi oil in a sesame base.
Internal Oleation: The intake of oil is beneficial for both Vata and Pitta and makes this a great alternative to overeating. Plain ghee or ghee medicated with Brahmi or Triphala can be used. Caution may be required as consumption of high calorie foods may trigger old fear patterns of calorie counting, body image and shame.
Yoga Nidra: The practice of “Yogic Sleep” expands awareness in a state of deep relaxation that is deeply calming to body and mind by activating the parasympathetic nervous system and can be used to manage stress and manage mental health challenges [59]. With instructions offered online or in recordings, it can be practiced in a variety of ways. This practice is useful to change deeply rooted patterns once they have been noticed and named. The powerful long term impact of this practice on body and mind can not be overemphasized.
Yin Yoga/Slow Yoga: Almost every yoga studio is noticing the increasing need to help bodies slow down and are offering grounding and calming classes like yin yoga, slow yoga or sound baths that require little or slow movement while being highly supported by props with emphasis on maximum comfort, nurturing and feeling well. These classes are getting more easy to find and are a good fit for soothing the over- or hyperactive nervous systems as well as nurturing the body-mind connection due with repetitive yet gentle reminders for interoception.
Soundbath: These classes are also gaining popularity and offer a relaxing and restorative environment with the auditory input that stimulates healing and calm.
Expression: To help process the stressful emotional states just prior to overeating, it is helpful to find alternative outlets for this energy to run through. Here lays great opportunity for creativity however the method(s) that is/are most aligned with the individual will be the best choice. Common examples are journaling, dancing, drawing, acting, playing an instrument, crafting, singing, writing, gardening, building, going for a walk- and my son swears by LEGOs.
Meditation: Once the nervous system is sufficiently calm and the mind-body connection established, the practice of meditation is powerful to reconnect the individual with the true nature of spirit. While the West is looking at meditation as a tool to manage stress and disease, Eastern practitioners understand that true power and spiritual evolution is driven from the most subtle energy forces from within by opening up to deeper aspects of Self that are intimately part of love, joy, peace and lightness which are expanding the practitioners awareness. This sense of wholeness and completeness that is inherent in all living creatures of this earth was lost in the rough and tumble of life – and created the issues surrounding overeating in the first place.
Alongside the implementation of the abovementioned modalities for addressing overeating, Ayurveda will encourage the below activities and habits during regular daily routines for reasons that will not be discussed in more detail here.
Do less: (self-) hate, (self-) judging, (self-) doubt, competition, comparing, overheating, movement, travel, action, full schedule, restlessness, hot, spicy, dry foods, alcohol, coffee, caffeine, drugs, smoking, fasting, purging, vomiting and -of ultimately- overeating, color: red, dark blue
Do more: (self-) love, (self-) compassion, (self-) nourishment, (self-) trust, kindness, calm/slow down, rest, nap, sleep, recover, recharge, ground, faith, spend time in nature & near water, creativity, wear pearl, color: gold & brown
Even without any Ayurvedic background, it is in plain sight that these will create balance across body, mind and spirit in individuals suffering from emotional unrest and challenges with overeating.
Conclusions
For individuals driven to change their stressful relationship with food, resolving the overeating is often at the forefront of their motivation. This powerful energy can be harnessed to create awareness of the deeper, unconscious patterns driving it: like a loop that does not get internally closed, the physical eating is a mis-match to the underlying mental cause. By not addressing the emotions – or their cause – at their energy level, the subtle need is not satiated which results in overeating. This everpresent open loop is creating fatigue, repetitive frustration and a sense of failure which continuously undermines the individual’s empowerment and selftrust. Finding what closes the open mental loop for the individual will resolve the overeating by pointing towards a healing path through the pain of the individual [60].
This challenging journey is aided by rebalancing the body systems, especially the relationship with the body and mind. By scaffolding the individual with ritualized self-care across the day, the goal is to find deep joy in the nourishing aspects of life especially surrounding food and includes the purchasing, preparing and eating. Alongside the body, the nervous system needs to learn to return reliably to the ventral vagal state which leads to systemic homeostasis, adaptability and resilience [61]. The hormone oxytocin might play an especially important role in this process [62].
Like no other substance, food is the substrate that interconnects all forms of life and holds the potential to the ultimate spiritual growth that reunites All. There is no better word to close this research paper than the expression of the “divine in oneself bowing to the divine in all”: Namaste
Figures
Figure 1: https://happyhealthyyou.com/blogs/articles/parasympathetic-sympathetic-nervous-system
Figure 2:
Kerstin Uvnäs-Moberg et al., The Yin and Yang of the oxytocin and stress systems: opposites, yet interdependent and intertwined determinants of lifelong health trajectories, Front. Endocrinol., 15 April 2024, Sec. Neuroendocrine Science, Volume 15, p.12
Figure 3:
Dr.Marc Halpern, Principles of Ayurvedic Medicine, 13th Edition, Harmony is Health Press, Nevada City, California, March 2020, p.343
Figure 4:
Dr.Marc Halpern, 15 Guidelines for Healthy Eating, Principles of Ayurvedic Medicine, Chapter 8, Complementary Materials