Interview of Jean-Philippe Zermati about impulsive eating


Last time, I told you doctor Zermati would come back here to talk about this delicate question of impulsivity. Not the one that sometimes makes us do inconsiderate things but nevertheless positive like French kissing that simpleton of a boy who’s been looking at you for three months in the social rights class without daring to approach you.

No, the bad impulsivity. The one that presses you to empty your food cupboard because that bastard of a simpleton didn’t call you back since you French kissed him. Or because the last one didn’t sleep for the whole night and you’re exhausted. Or because your big boss is putting pressure for tomorrow’s meeting. Or… or… simply because you don’t know what to do, what can I do?

Doctor Zermati, it has been bothering him for a while, this question. Because it’s after all at the heart of his patients’ almost every difficulties. It’s bothering him all the more since he created with Gérard Apfeldorfer the site Linecoaching. Because members seems overwhelmed by emotions which drive them to compulsions. And from a distance, helping them is complicated. In short, Mister Z has thought long and hard and, a few days ago, he left me a slightly weird and inevitably very puzzling message: “Caroline, I’ve found something. It called it the chocolate pump. If you want me to tell you what it is, call me.”

You can guess that with such a name, the system could only excite my curiosity. Here are, thus, Jean-Philippe Zermati’s explanations. That, I think, are perfectly timed, right before Christmas and its trail of hard to control cravings. Without mentioning family which is certainly a softness cocoon but also a good ball-breaker sometimes and then, not other solution than raiding chocolates.

Let me give the floor to the expert.  

Why did you look into this issue of impulsivity?

Jean-Philippe Zermati: Since I’ve treated patients with eating disorders or weight issues, this question is central. But clearly, the experiment we conduct currently with Linecoaching drove me further into this thought. Why? Because a lot of members of this program suffer from compulsions and stumble over this issue of impulsivity. An appropriate answer to their questions had to be found and they had to be helped in handling this impulsivity. Food impulsivity is a reflex desire to eat, triggered by a situation of emotional discomfort.

How to handle these drives that press us to eat in a highly emotional state?

Jean-Philippe Zermati: It’s THE biggest question. The idea is not to fight against these emotions or try to suppress them. Life is made of positive or negative emotions and it’s a delusion to think you can get rid of them. On the contrary you must learn how to bear emotional discomfort and make sure it doesn’t trigger an immediate desire to eat. Or at least not a desire to eat that overrides everything else. With this purpose in mind, I’ve tried to re-orientate mindfulness exercises, which were not initially designed to address this specific issue. In a first step, I used them a lot in my office to identify and accept hunger sensations. Indeed, for some, hunger sensation can trigger true panic states. While practicing mindfulness within the office when the patient is hungry, I’ve noticed spectacular results in two or three sessions. That’s how I’ve decided to apply these exercises to emotions handling. Because after all, an emotion is not physically more painful than hunger or many other troubles we go through during our daily life.

How does the « chocolate pump » work?

Jean-Philippe Zermati: The initial principle, thus, is to observe your emotions right when you feel like eating when you’re objectively not hungry. You observe without judging the thoughts and physical sensations that go with them. Without trying to chase them away. Then, if you can, you put words on what you’re feeling: is it boredom, anxiety, joy, fear, tiredness? Once this emotion is identified, the patient has two possibilities: either she comforts herself with the desired treat. It implies having worked beforehand on how to enjoy your treat and on restriction behavior. In order to allow yourself to eat any sort of food without lurking negative ideas. In order for that comfort expectation not to turn into a compulsion. Or: maintain yourself for a few moments in that emotional discomfort to improve your tolerance to this type of discomfort and observe how it evolves with time. After this observation, again two possibilities ending the emotional exposure and choose food comfort, or again, wait a little, still observing your emotions. In the case of the option consisting in choosing to eat, if the savouring proves to be uncomforting, the principle is the same: observe again your emotion and possibly eat again, a small quantity of the same food, twenty minutes later.

Why this wording « chocolate pump »?

Jean-Philippe Zermati: because I was inspired by the morphine pump. Initially, when morphine pump was introduced, it gave rise to much criticism and many fears. Some were convinced that patients were going to give themselves much more painkiller than what they were given by nurses. Yet quickly it was noticed that the exact opposite was in fact happening and the sick were waiting for much longer between two takes, simply because they could control their decision and the length of their exposure to pain. Here, it’s finally a similar principle. At any moment, you can decide to stop bearing the uncomfortable emotion by enjoying a piece of chocolate, of cheese or any food synonymous with relief.

And it works?

Jean-Philippe Zermati: Yes it does. Mind that you must be able to observe an emotion without being overwhelmed, which implies training on mindfulness exercises. It must also be kept in mind that the experience doesn’t aim to prevent you from eating. It’s there to provide a choice between truly relieving food comfort or work on uncomfortable emotions tolerance. The outcome is usually a greater psychological flexibility and an access to a wide number of efficient answers to your emotions. This experience doesn’t aim either at calming the emotion, but at learning how to better bear it. So you shouldn’t expect to “feel better”. As such, I add that, from the accounts we gather on Linecoaching, emotions that most often trigger eating compulsions are rarely very painful. The most listed is thus… boredom. Yet in general, a bored person, who’s anxious about it, is being told: “occupy yourself”. That is totally useless. Getting busy all the time to “forget” the desire to eat amounts to an avoidance or emotional bypass strategy. A life without boredom doesn’t exist and at one point or the other, the inactivity will come back. So you must learn to accept boredom moments, even if it means comforting yourself with food, but because you’ve chosen it, and provided it is not a compulsion.

Edit: If you want a diagram that sums up this “chocolate pump”. It’s there.

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