Q: How can I manage my quarantine cravings?

A: After several months of living in a global pandemic, COVID-related anxiety is on the rise. In our struggles to stay safe, the stress is affecting how we eat, drink, exercise, and socialize. Subsequently, it has affected how we take care of ourselves both mentally and physically. If you find yourself less motivated to make healthy choices these days, you are not alone.

I have not blogged in a while. Like the rest of the country, I was overwhelmed by the fear of this novel virus. As an essential worker in health care, I had to brave the halls of our local hospital. With the lowest risk of complications in my household, I was the one who wrapped my face and hands and went to the market. A triple-folded bandana coupled with my stress level left me breathless as I maneuvered my overflowing cart down the aisles. Every day, I feared that I would bring the virus home to my family.

The fear has ebbed and flowed since those early days. The state had progressed in its reopening plan. The summer months allowed more outdoor excursions. Telehealth enabled me to help most patients through video visits and phone calls. The world was learning more about the spread of this virus, and it appears that social distancing, mask wearing and hand washing can help to significantly reduce exposure to an infectible dose of COVID-19.

But now, I'm just sick of it all. It is now Fall, and the days of sipping cocktails on a restaurant patio will soon be on hold. I have seen very little of friends and family in the past 8 months, and the upcoming holidays will either be lonelier or riskier than usual. I just want to get away from it all, but the thought of going on a plane still scares me, even though the Delta credits from my COVID-cancelled Spring Break will be expiring soon.

Based on my Facebook and news feeds, I realized that I am not alone. I have noticed more articles popping up about anxiety, depression and stress. At work, many patients have attributed cravings and low motivation to the pandemic crisis. Many are frustrated with being stuck at home. Some find themselves snacking out of boredom. When gyms were closed, a lot of patients found it hard to stay active. For others, stress-related fatigue prohibited them from finding different ways to keep moving.

As a dietitian, emotional eating is a topic I'm faced with daily. I find that most people do some form of emotional eating. Whether it's a small indulgence to wind down after a busy day, or a coping device to push through the work day, or even a celebratory snack to enhance a good time, most people use food for reasons other than physical hunger alone. For some, emotional eating can be severe, rooted in a deeper mental health issue that requires professional care. While the spectrum of emotional eating can be broad, the very existence of it appears to be human in nature. After all, food represents survival. As such, many people have some emotional connection to food, and it presents in a variety of ways. Using food for stress-relief and coping is quite common, and perhaps even more these days. For me, there's definitely been an uptick in potato chips and wine on my Friday nights.

If you feel your stress or anxiety is more than you can handle alone, reach out to your doctor, especially if you find yourself unable to care for your health or manage daily activities. Your doctor can offer various options for treatment, from a referral to a therapist or social worker to support programs to medication management.

If your COVID-crisis cravings are less severe and you are ready to take action, below is a strategy to help you identify emotional eating, tackle it head on, and get back on track.

Step 1: Rate your hunger. The next time you find yourself reaching for a snack, rate your hunger on a scale of one to ten, with one being "starving" and ten being "stuffed."

1 to 2 = starving

3 to 4 = starting to feel hunger signals, a mild grumble in your stomach

5 to 6 = not starving, but ready to eat if it is meal time

7 to 8 = feeling satisfied, no hunger signals at all

9 to 10 = feeling full, maybe even uncomfortably stuffed

If you rate your hunger as 6 or below, then it may be meal time. If dinner is a couple of hours away, then have a healthy snack to tide you over. A piece of fruit or a handful of nuts are easy to grab and go. However, if you rate your hunger as seven or higher and you are craving salty, sweet, or other less healthy treats, then you are likely reaching for food for different reasons.

Step 2: Face your feelings. Once you identify that you are not physically hungry, ask yourself what you are feeling. How do your current feelings relate to your surroundings? For example, are you at work worrying about a project? Or are you feeling stuck at home? Or did you just put the kids to bed and you want some "me time"?

Step 3: Try something different. Once you realize that you are "eating your feelings," consider alternative activities to addressing those emotions. Some examples:

• Call a friend or chat with a family member.

• Escape with a book.

• Turn on music.

• Take a walk.

• Meditate.

• Be creative--write, knit, paint, or do whatever other craft you enjoy.

Many of us have established a habit of emotional eating. For example, I often found myself snacking while winding down in front of the TV at night. I cherish that time of day because I consider myself off duty--no work, no cleaning, and even the kids don't need me. However, I noticed that no matter how I tried, I could not watch TV without craving salty snacks. As much as I tried to ignore my cravings, I could not resist the Ruffles. I came to realize that I might not be able to break the TV-snack connection. However, I have found alternative ways to wind down at night. While I still enjoy a TV date with my hubby a couple of nights a week, I have now added new evening hobbies such as reading, writing, or listening to podcasts. With less time in front of the TV, I have found myself snacking less throughout the week.

Step 4: Move on. After trying something different, one of two results may occur:

a) You will take yourself away from the situation and your cravings will subside. If this occurred, remember this strategy next time your emotions get hungry.

b) After trying something different, you may find that you still want that snack. If this is the case, prepare a mindful portion and enjoy. By taking a moment of pause, your emotions may be more steady, and you may be satisfied with a smaller portion than you originally would have eaten.

Step 5: Forgive yourself. Remember, emotional eating is common and is a part of human nature. If you find yourself giving in, be kind to yourself afterwards. Our individual relationships with food took years to develop. Making change will take time, practice and patience.

Step 6. Plan ahead. If you notice a pattern of emotional eating in yourself, don't wait until the next episode to decide what to do. Make a plan when you are feeling calm. That way, when the moment presents itself, you will already have an option to try. And if that option does not work, go back to Step 5 and try again.