Reviewing her diet diary, I was perplexed as to how my patient had developed pre-diabetes in the year since I’d seen her. A business woman in her early 50s, she had long been attentive to eating well and exercising regularly, was a healthy weight, and, until this visit, had maintained normal blood sugar and insulin levels – important makers of glycemic control, which we tested because diabetes runs in her family.
Her diet consisted of modest portions of healthy foods, mostly prepared at home, and eaten at reasonable intervals and times of day. Her latest numbers just didn’t make sense based on her diet diary.
Food as Love
Digging a little deeper, I asked if anything else had changed in her life. Less exercise? More stress?
“Weeelllll…” she began, “After dinner most nights I’m now having a brownie, an ice cream sundae, or a cookie or two. Sometimes I’m also having something sweet in the late afternoon because my energy crashes.” Her voice trailed off for a few seconds. “My mom always made homemade baked goods … as a kid I always had dessert after supper. She died about a year ago.” She began to cry softly and through her tears said, “I really miss her. I’ve started eating dessert every night – it’s really important to me.”
Now I understood. Of note, her mom had died of complications of Type 2 Diabetes.
My grandmother always had a pot of freshly cooked soup, warm and waiting for me on the stove, when I arrived at her house. The soup was usually vegetable, barley, or chicken noodle, or a traditional Eastern European stew called flanken, made with vegetables and beef short ribs. I would eat soup and she would ask me about my week, or what had happened since I saw her last. When I reflect on grandma’s love, my earliest to my latest memories always seem to include soup. Soup remains one of my most pleasurable foods though she passed away 15 years ago.
Food holds some of our deepest emotional memories.
Food as Pain
Not only does food bind us to positive experiences, but negative ones as well. One of my patients, a slim, intelligent, athletic woman in her late 30s told me that she was a little chubby as a kid, while both her mom and grandmother were slim. “They had eating disorders. Mom was always weighing herself and skimping on food. And Grandma would comment about her body a lot. When it came time for meals, because I was the only chubby kid in the family, I would get served different food than everyone else. Vegetable sticks, lean meat – I felt ostracized and embarrassed. At 16 I was hospitalized for an eating disorder. I still struggle with food. It’s just not pleasurable for me. Eating is just something I have to do, but I really fight with food in my head.”
I rarely meet an adult woman whose relationship with food is not or has not been stressful at some time.
It is difficult for most women to eat without thinking about weight or calories. Stress, confusion, guilt, and self-judgment are frequent mealtime companions. Food choices are fraught with complexity. In an eternal quest to be thinner many women base their daily food intake on their daily weight, or on how much we ate during the day or meal prior.
Sometimes disordered food thinking has to do with feelings of emptiness or loneliness – we reach for food for comfort, to fill our empty places. The comfort, however, is generally short-lived, only to be replaced by self-loathing and feelings of being out of control for eating emotionally. Sometimes it has to do with negative preoccupation about our bodies – we live in a culture filled with very specific images of the ideal body – which few of us typify. And though we know these are Photoshop-generated ideals, many intelligent women are nonetheless plagued with the pursuit of the perfect body – affecting how we eat.
I have not been immune to food struggles. My grandmother and mother were always on a diet. I had an uncle who only dated fashion models (I’m serious) who would say, just as I was about to eat, “If you don’t watch it you’re gonna’ get a big fat ass like your mother and grandmother.” (Yes, an exact quote: words emblazoned on my brain!) Though I entered high school at 5’3” and barely over 100 pounds, I spent the year eating my way through stress at home and long hours at a competitive high school. Dunkin’ Donuts’ colored-sprinkled, chocolate-topped donuts were my weekday breakfast. I finished my freshman year weighing 138 pounds. By the time I was 18 I learned to eat well and I settled into a healthy weight at which I’ve remained for 30+ years. But 30+ years later I sometimes still hear my uncle’s voice in my head!
As a country we are in a diabetic crisis – overloaded with sugar, fat, calories, and choices – so yes, healthy eating is paramount to the wellness and even the fiscal health of our country, because we are bleeding out billions in diabetes medical management. But healthy eating can also become as much of an obsession as wanting a bag of chips or a candy bar.
In fact, a new type of disordered eating, orthorexia, the preoccupation with healthy eating and avoiding foods believed to be unhealthful, has emerged. It is accompanied by some of the same obsessive thinking and behaviors as other eating disorders – and can be restrictive enough in calories and nutrients to become dangerous. If you are compulsively cleansing, following highly restrictive diets without a reason (i.e., you don’t have food sensitivities or a specific illness necessitating this), please take a close look at whether your relationship to food – even if the food choices seem healthy – is truly healthy and pleasurable.
As if the emotional and cultural issues that shape our relationships to food and our bodies aren’t enough to complicate our lives, top those with a side of deep-fried, sugar-laced food addictions and sprinkle with a dash of salt! Food addictions are just as real as addictions to cigarettes, cocaine, and alcohol, and contribute to a mess of medical problems.
Almost daily in my clinical practice I hear a new patient say “I am trying to control what I eat but I have no self-discipline,” or “I try to eat well but then I just can’t control myself when there’s a bag of chips or M&M’s in front of me.” Women are struggling with loss of self-esteem due to perceived lack of self-control over the foods they are consuming – and beating themselves up for it emotionally. Yet food addiction is not simply a matter of self-discipline.
The BIG FOOD industry is no dummy. Entire research and development teams at BIG FOOD companies thrive on creating non-food junk with just the right amount of sugar, salt, or fat (or all 3 rolled into one tasty package) to make us want more – and more – and more. This is the very same neurological wiring that is activated in drug addiction! A separate blog will address food addiction, which can be conquered. The mindfulness steps below, accompanied by stress reduction and blood sugar balancing, are the gateways to freedom.
Breaking Free: 5 Simple Rules for Food Mindfulness
The key to enjoying eating is approaching your food with mindfulness. The first step to mindful eating and breaking free is to learn to be completely honest with yourself about your food issues and your eating habits and patterns. There is no judgment, good, or bad. There is only choice. A mindful relationship to food allows you to identify and change unhappy eating patterns. This is not always a quick or easy road, and additional support (i.e., cognitive behavioral therapy, counseling) might be needed if you’ve struggled hard with an eating disorder in the past, but it is very possible to transform lifelong patterns.
- Learn to identify hunger: Eat only when you are hungry. A lot of feelings masquerade as hunger: boredom, fatigue, depression, anxiety, and loneliness. Learn the difference. If you’re unhappy, agitated, or eating out of anything but hunger, wait a little while to eat so that you only eat when you are hungry and feel calm.
- Make each meal an intentional pleasure: Sit down to eat. Always. Your car and computer desk don’t count. Put a placemat down – even at work – you can use a cloth napkin that you keep folded in your lunch bag as one of my colleagues does. Set out your fork or spoon and food. Enjoy 30 seconds of silence and gratitude before you eat. Learn to prepare delicious food. Eat slowly. Chew. Taste your food.
- Let go of the food battle in your head: There is no good girl vs. bad girl, no cheater vs. good dieter. There is only choice. And the choice is yours. If you’re in the middle of a food battle with yourself, refuse to participate. Consciously give yourself some understanding, patience, and love. Once letting go of the battle becomes a habit, it will become second nature and the battle will cease.
- Eat what your body needs: At first it can be a little tricky to know what your body needs, but learning to become body-wise can get you there. Instead of standing in front of the open fridge or kitchen cabinets, or instead of grabbing something fast at a deli or restaurant, step back, take a few deep breaths, and get centered in yourself. Close your eyes and ask yourself what you really need to eat in that moment. What is your body really hungry for? Nobody has ever told me his or her body really asked for a Twinkie. Usually it’s a salad or something with protein. You’d be amazed at how wise you are – and what information you’ll get just from listening to your intuition.
- Hara hachi bu: This is a Japanese term that means eat until 80% full. Being satisfied but not stuffed is an art. As kids we were taught to eat until we cleared out plates, regardless of satiety. Also, many of the foods in the Standard American Diet confuse our ability to tell when we are full – they were designed this way, actually, in labs, to increase our consumption of them. Thus it takes some paying attention and adjusting down large portions to be able to identify that feeling of satisfied that should precede feeling full. Once you figure it out, learn to stop eating there. If you are struggling with overeating, this practice will help you to shed pounds; if you are struggling with an eating disorder, this will help you with your sense of control over how much you are eating – just make sure your sense of satisfaction matches up with eating enough. Hari hachi bu is associated with greater longevity so it’s a win-win for everyone.
Once you start to feel more mindful about eating, you’ll love eating again! You’ll also be amazed at the transformation that can happen in your life. The time you previously spent thinking about, planning around, obsessing over, or worrying about food, your body, and your weight will now be available for thinking about your life, your work, and other interests. You will feel stronger and confident in many areas of your life – and you will make healthier choices in general. I love watching this sense of confidence grow in my patients. I am confident that you, too, will find yourself thriving in ways you never imagined!
I look forward to hearing insights in the comments below.
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Wishing you health, peace, and lasting pleasure,