Just Drop It and Eat

Tuesday, October 30, 2012

Record Keeping to Change Your Perspective--And Your Eating

I'd LOVE to eat your food record, but I'm really not that hungry!

“My dog ate my food record.” “Oh, I left it at work.” “I know what I eat, I don’t need to write it down.” And finally, the very honest and most insightful comment I’ve heard, “I just couldn’t bring myself to do it. Because if I don't write it down, then maybe it didn't happen." This, perhaps, sums up why, in spite of knowing that food record keeping is recommended, it is often not done. But of course you know I can't just let it go at that!

First, let me clarify. A food record, generally speaking, is a journal of what you ate including the quantity of food, and when you ate it. A valuable food record also includes some other critical information—your perceived hunger when you begin eating, your thoughts and your feelings—both physical and emotional. Noting where you ate is also quite useful, as we’ll discuss in a bit. Oh, and if food was consumed but eating disorder behaviors followed, that should be noted as well.

And calories? In my view, these have no place in your food record. “But don’t they count and impact my weight?” Absolutely. Yet counting them is not my idea of a healthy way to change your relationship with food and normalize your weight. We are trying to get out of your head—away from your over-analyzing what's acceptable to eat—and into your body, aware of its signals to eat and to stop eating. A goal of record keeping is to help you learn to rely on these signals so you can trust your body—I know you're not there yet—but this is a great way to start.

Why all the fuss about keeping a food record? Why do Dietitians like me recommend it and why do so many struggle against doing it?

Accountability, compassion and shifting perspective

If you know that someone is going to be looking, you certainly think twice about what you eat. Now you may think that you already are painfully aware of what others think about your eating. And that recording only makes you obsess more about what you're eating. But writing it down in the way described below does something different. It allows you not to hyper focus on the meal you overate or the fact that you ate when you think you didn't need to. Rather it allows you to look at the bigger picture. Truthfully, this is where having another set of experienced eyes makes all the difference.

Just saw this in NYC--can you imagine?!

Most of my clients find that my perspective on their eating helps them to be less critical of their eating. They see that their overeating followed too long a span of time, or that their recurring hunger makes perfect sense, given the large volume of food devoid of adequate calories they were consuming.

Recording allows you to distinguish between physical hunger vs other eating triggers. Recognizing that you weren't hungry helps you to realize that something else contributed to your eating. Seeing that you were hungry but didn't eat, forces you to ask yourself what your intentions of restricting were.

Recording the food you've eaten also takes it out of the closet, so to speak. It legalizes eating. And hearing someone like a Dietitian react not in the way you'd expect—rather, acknowledging how delicious the brownie might have been, or that you only had 3 versus the whole package of cookies, or that you seemed to have needed to eat when you did and it was great that you entitled yourself to do so—get the idea? These messages help to counter the negative assumptions you have about your eating, and may help you feel more justified to eat in a balanced way. No, not the way you think you should be eating—full of restrictions and deprivation, but a more human way of enjoying food.

Would you sleep or do other things on your kitchen table?
(Ok, you don't need to answer that.)

Identifying the location you eat in is also quite important. Do you only eat when driving—where no one can see—not even you? Do you do a lot of eating in your bedroom late at night? Must you eat your food alone, out of the watchful eye of family members?

And what do you choose to eat? Do you limited your selection to diet foods, light in calories and in satisfaction? Do you include a range of nutrients including fats, carbohydrate and protein—or tend to shy away from one or more of these groups? Do you allow yourself to really eat what you like—not just to eat it, but to see it and take it in with all your senses?

Sure, there are some of you that feel so overwhelmed that recording feels like just another chore—which it is. And some of you feel you just can't get organized to remember to write things down. But largely most readers may prefer not to know—not to see it, not to acknowledge what you've eaten—at least on the days you didn't think you ate as you should have—and so you don't record.

If you're serious about shifting your relationship with food, get yourself a notebook you can keep in the kitchen. Or do you live with your smart phone at your side? Check out a fabulous free app, Recovery Record, which leaves off the nutrition details common to so many apps, but appropriately includes the thoughts, feelings and behaviors that so influence your eating, and how you feel about yourself. Then get started. And be sure to share this info with a professional experienced in this area—not the gym trainer who may have a slightly different way of seeing things.

And do start by moving your scale out of site. It is much more challenging to begin to trust yourself when you are being jerked around by that object on your bathroom or bedroom floor constantly.

Thoughts? Comments? I'd love to hear from you.

Saturday, October 6, 2012

Trying to Change your Relationship with Food? A Letter to your Loved Ones May Help

I frequently describe the chat that needs to happen—between those of you struggling to normalize your eating and move away from compulsive overeating or binge eating, and your loved ones. I spend so much time talking about this in patient sessions that I decided to write it down in a letter form, so all of you in this position can use it.

Why such a conversation, you ask? Because in order to start to change your relationship with food, you need to let go of the fear and the shame you’re all-too-familiar with. To do so, it helps to put it right out there to those who will be seeing you eat and may be surprised by what they see. The last thing you need is more judgment—you’re critical enough of your own eating, you don’t need anyone else’s judgment! So read on and test it out at home!

Dear All-who-really-care about me,

While I know you are worried about my health and my eating please realize that you are not alone. Just because I don’t talk about it with you doesn’t mean I am not concerned. In fact, I am actively working to try a different approach to change my relationship with food, so I thought I’d let you in on it.

Remember all those diets you’ve watched me start and stop, those failed attempts to take control with rigid, senseless rules? Those days are over. “What now?” you’re wondering? “You’re giving up again?” you’re thinking? Think again! Here’s what you can expect to see, so brace yourself.

You know those foods you think I shouldn’t be eating? The foods you and I really like to eat? It’s time to make peace with them, to legalize them. Because now they feel forbidden, and when something feels prohibited I want to eat more of it—just like anyone would. Yes, that’s normal. What isn’t normal is thinking I will never eat cupcakes again—or ice cream, or chocolate, or bread or ‘white carbs’. No, that’s absurd, unrealistic and quite frankly, unnecessary.

What I’ve been learning from an experienced Registered Dietitian who deals with helping people like me is that it’s not the food that causes the weight gain. No, not the carbs themselves, nor the sugar, nor the fats, but rather how much we eat of them. And I’m learning how to start to take control of my portions of such foods.

First, I’ve got to welcome them back into my diet. You see, when I feel I’m not allowed to eat them, it sets me up for trouble. I feel ashamed if you and others see me eat things, so I’m more inclined to eat them quickly, mindlessly, just because there’s no one around. And trust me, I do. And this goes against what I need to do—to eat them mindfully whenever I’m hungry and choose to eat them.

But I fear the reaction from everyone. So I’m giving you this letter so you won’t be surprised when I sit down at the table and have a couple of cookies. I’ll eat them without distraction and I’ll really enjoy them this way—as opposed to just shoveling them in. Please recognize that I am doing this because I care to feel better and be healthy, so be open-minded. Realize that the diets and restriction have only set me up for problems.

So when you see me at the table eating something you think is ‘bad’, think again. Perhaps you’ll join me and we can normalize our eating together.

Be patient with me--this is a process. It's not going to get better over night.

Thanks for supporting me and for understanding.

PS: Learn more about my struggle from http://www.dropitandeat.blogspot.com/2012/09/what-ive-learned-about-food-addiction.html

Let me know how it goes!

Saturday, September 29, 2012

What I've Learned About Food Addiction

This post applies to all so read on.

I'm addicted to desserts and I can't keep them in the house. They just call to me. I can't simply eat a piece or a small portion—no, not me. Once I start I can't stop and I have to eat them until their gone or I need to throw them in the trash—although sometimes, I’m embarrassed to say, I dig them out of the trash because I just can't let them slip away. And I never know when I'll get to eat them again. Avoidance—total avoidance seems like the only way—yet it never seems to work. I just have no willpower.

No, that's not me speaking—although these statements were certainly true for me at some point in my life. Yes, that time in my early twenties when my eating was emotionally driven and I had no idea what hunger and comfortable fullness felt like. Rather, the comments above were spoken by many patients that walk into my offices—by the overweight who have unsuccessfully struggled to lose some weight with rigid diets and deprivation, and by those of average weight and below who now approach food in a black and white way, seeing food as the enemy.

And why wouldn’t they, and you, feel that there is no hope, that you must be addicted to food in the way others are addicted to drugs? The debate about food addiction has again emerged, with media distortions and outrageous researcher conclusions on rat studies and MRI findings. And it will leave you feeling hopeless—unless you see how you are being manipulated and left to believe you are powerless.

Yum! Salted caramel.

The Wall Street Journal put out a rather balanced piece on food addiction. Yet the NY Times article on this subject is an embarrassment. "Can Food Be Addictive?" makes reference to several studies suggesting that overeating is an addiction, perhaps not much different than addictions to drugs and alcohol. The examples cited?

"...Princeton University and University of Florida researchers have found that sugar-binging rats show signs of opiate like withdrawal when their sugar is taken away — including chattering teeth, tremoring forepaws and the shakes. When the rats were allowed to resume eating sugar two weeks later, they pressed the food lever so frantically that they consumed 23 percent more than before", they tell us.

Well, I’ve never had my paws shake and my canines never chattered, but this sounds like sugar dependency is a serious culprit! That’s what they’re leading us to believe. But a more detailed review of this 2011 study sheds a whole different light on things. We learn that rats were first deprived, going 12 hours without food to eat, prior to being given the sugar solution. And, this binging was dependent upon the timing of the feeding. One blog describes how "... rats who had received only the food chow on this intermittent schedule, or had unrestricted access to food and sucrose, did not show these effects." That's right—not depriving the rats and actually allowing them access to food including sugar prevented binge eating. The blog reporting on this study appropriately summarizes:

I don't wait for special occasions to eat these!

“This means that after being deprived of the food or drug the rat will self-administer extremely large quantities of the substance once it is available again. This behavior tapers off once the animals are sated, but these binges will consistently occur after each period of deprivation.”

Ok, so they binged when given sugar. But more importantly the research actually confirms the very problem with food deprivation and the resulting out of control eating that we see in our clients who feel trapped in this cycle. No, there was no problem when they could freely feed on food and sugar as desired. Rather, the problem with binging resulted from the withholding of food for long periods, which set the rats and sets my rat-like readers up for trouble.

Might I add that we are not rats in our ability to step in and change our situation. We are not limited to our cages—we can choose to step out of our environment and to control our triggers. And we can certainly avoid deprivation—the biggest trigger for binge eating. You didn’t need a rat study to tell you that, though!

Another study referenced by the NY Times article to support the food addiction theory drew equally absurd conclusions. Researchers at Oregon Research Institute surveyed 151 teens who were in a healthy weight range about their eating habits and food cravings. Then they did brain-scan studies on them while the kids looked at pictures of chocolate milkshakes—more activity in the brain was considered to be linked with greater cravings. Next, they gave them a milkshake to drink while they were having an MRI scan. The kids who'd reported eating the most ice cream over the past few weeks prior to the MRI scans registered lower activity in their reward centers from the milkshake—in other words, less craving for the milkshakes. To me that’s a good thing. Those very kids who had access and consumed these items regularly did not have their brains light up as if they were getting some big reward when offered a milkshake—no, it was no big deal to them.

Yet the NY Times states that these findings "suggest that just as drug abusers and alcoholics need increasingly larger doses over time, children who are regular ice-cream eaters may require more and more ice cream for the reward centers of their brains to indicate that they are satisfied." One study author similarly concludes that not having as great a response to eating the food (based on MRI) is problematic—that “over consumption of these foods down regulates reward processes. That may, in turn, make you eat more." Really? That's quite a strange conclusion to draw, in my opinion, especially as these kids were not overweight. (in spite of their more frequent ice cream consumption.

Further, this study attributes possible addictive-like qualities of ice cream shakes, made with Haagen Daz ice cream, to the high fat content. But if it is about the fat, why don’t we have addictions to such high fat items as prime rib or deep fried chicken? Or whole milk, even? No, this just isn’t seen.

High fat and satisfying!

So maybe it's not the nutrient, the fat or sugar (as implicated above) content at all but the conditions under which we eat. Is it any surprise that those reward centers of the brain would light up in MRIs, similar to what occurs with other addictions, when these very food items are used in our culture as rewards? You know, you had a hard day, so you indulge yourself with an ice cream, ironically just as the old Haagen Daz ads suggested? Or as a young child, you scrape your knee and your mom gives you some cookies to feel better. If we could only allow ourselves to enjoy such pleasurable foods as ice cream without the value judgment we add to it!

The take home message.

What's not in question is how you feel. Clearly, when you experience out of control eating you feel as if your are addicted to food—that you have no control over certain food items or types and that it therefore must be out of your hands to seize control. And with the recent studies I referenced, you might be convinced this is true. But the only clear link with what feels like food addiction is food deprivation.

This is not a meal!

Continuing to use food as a reward for a hard day or for eating healthy all week is a huge mistake.

If you’re feeling like you’re addicted to food, consider changing your relationship with food and move from black and white thinking, giving yourself permission to eat those foods you enjoy but think are forbidden.

Eat in a balanced way--and I don't mean by following the My Plate way. Rather, make the foods you eat enjoyable. Sure, include satisfying less processed foods, too--but not at the exclusion of other foods.