Just about anyone who has tried to lose weight for at least a month or two has sooner or later experienced a very frustrating phenomenon: the weight loss plateau. It is something that happens when you begin to lose weight on a diet but, for no apparent reason, the weight loss stops, seemingly forever.

This happens even though you continue to take in far fewer calories than you need to maintain whatever weight you’re stalled at. That gap between what you weigh now and what you should weigh based on your current caloric intake can be baffling and frustrating. When it goes on long enough, you’re likely to just throw in the towel, admit defeat, and go back to your old eating habits.

Understanding why this happens can help you to be more patient with the process and to have reason to be hopeful about a positive outcome. So let’s try to understand why your body does this and what it means for you in practical terms.

We’ll begin with the understanding that your body works in the ways that it does because there is some selection advantage to it. Ultimately, your body is concerned about only one thing: survival. More specifically (and later I’ll explain why this is an important clarification), its job is to ensure the survival of your genetic line through reproduction.

Historically, humans have lived through frequent periods of food scarcity and those who were able to survive those episodes passed on their genetic hardiness to later generations. The ability to survive longer without eating is accomplished mainly by storing body fat when food is abundant and using that as a strategic reserve of energy when it’s not.

This has been called the “thrifty gene hypothesis.” The original idea behind this theory is that now that food abundance is the norm, while our bodies are still adapted for the lifestyle of hunter-gatherers, we are predisposed to keep storing fat for a famine that never comes. On the surface, that makes a lot of sense.

The main problem with this explanation is that there are hunter-gatherer societies today that do not store extra body fat during periods of famine. If the same was true of humans prior to the development of agriculture, that would throw a major wrench into the theory. If, on the other hand, it was an adaptation to feast-famine cycles related to agricultural factors, it wouldn’t leave a lot of time for this genetic trait to take hold so widely. (A mere 12,000 years, tops.) So how does it work?

That’s where the point about reproduction is relevant. Body fat helps with more than survival; it also enhances fertility. British nutritionist Andrew Prentice pointed out that the combination of viability and fertility both being enhanced by storing body fat can significantly speed up the process of genetic selection favoring the thrifty gene.

So that’s likely how – and why – it still works for us. How does that relate to the weight loss plateau? Because if your body senses that you’re suddenly taking in significantly fewer calories, it will “assume” (it’s easier to explain this as if our bodies are thinking this all out logically) that there is some food scarcity or even a famine going on. It does not assume you’re going to starve yourself if you have food available, so it doesn’t get the idea of dieting.

To make sure you’ll survive through the supposed famine, your body will slow down your metabolic rate, or how quickly you burn off calories, to conserve energy. It does this by reducing its expenditure on less vital needs, such as skin, hair and nail regeneration, and your mental and physical energy. It’s the same way we conserve energy by driving less during an oil shortage or conserving water or electricity during peak consumption in the summer months. That’s why people who are malnourished have flaky skin, dull hair, and brittle nails. It can also explain why you might have a hard time concentrating when you’re on a restrictive diet. (Aside from the fact that you’re thinking about food all the time.) Your body is doing everything it can to preserve that stored body fat for as long as possible because it may come in handy pretty soon.

This is why after initially losing weight, and feeling really hopeful, you experience long plateaus where your weight remains steady despite your best dieting efforts. It’s enough to make you want to give up the fight since you feel you’re doing everything you can. Well, you are; it’s just that your body is doing everything it can do to protect you from starving. You want to say “Thanks, but stop trying to help!” Well, don’t complain; that’s how your genetic line survived to the 21st century. The main challenge is to be patient; the laws of physics say that it can’t hold out forever and will eventually have to dip into the strategic fat reserves.

There are ways to minimize it, though. The best strategy is to try reassuring your body that there is no food shortage by eating smaller meals and smaller portions while eating more frequently. This way you’re still getting the same (reduced) amount of calories, but your body will understand that food is plentiful since you can eat whenever you want to, and that the calorie deficit is simply due to your choice to eat less for some crazy reason, not because of your inability to find enough food.

At that point, your body resumes the response that you would expect when you cut down on your calories, and you will once again lose weight.

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We’ve talked about the experience of eating in a casual dining restaurant and the negative effects of focusing on value to define a good meal. Now try to recall a really great experience you may have had while eating at an expensive restaurant.

Many different elements merged together to enhance your experience: the taste, texture, aroma, and presentation of the food, together with the ambiance created by the décor and soft music, the service – from the parking valet at the curbside, to the host greeting you and the server’s attention and knowledge, all combining to create a feeling of total satisfaction that made it worth every penny.

You ate slowly and savored every bite. Of course, you were paying a lot per morsel of food, so part of this is because you want to get your money’s worth. But you really chose to go there because of the memorable experience you expected to have. The expectation was not that you would leave the restaurant feeling full or having saved money; it was about the total sensory enjoyment of the experience. In fact, if you left the restaurant feeling stuffed, it would actually have taken away from your overall enjoyment.

When the focus is on quantity, the cue to stop eating comes primarily from one sensory experience: the physical feeling of fullness that’s related to the sense of touch. The total sensory experience of the high-end restaurant meal, on the other hand, includes the sense of touch, namely, the texture of the food in your mouth, but it also includes the senses of smell and taste when eating the food, the sense of sight from the presentation and décor, and the sense of hearing from the soft music and quiet murmur of conversation.

So when the focus is on the quality of the meal rather than the quantity of food consumed, less food is required to attain the feeling of satisfaction that signals you to stop eating. As Barbara Rolls writes, “Satiation, the end of hunger, is affected not merely by your previous experience with the food and the visual cues you get about its size, but by…smelling, chewing, and tasting the food; even the act of swallowing is important. These sensory experiences…play a role in satiety.”

Imagine two pillars, both of the same height, one made of a single block of concrete and the other made of several sections. Now think of these two columns as two different approaches to eating. The first approach relies on the feeling of fullness and mild discomfort that comes from the experience of pressure on the stomach wall. The amount of food consumed is the cue to stop eating.

The second approach is represented by the other column which, in addition to quantity, is made up of flavor, aroma, texture, presentation, and ambiance. All of these elements together add up to a very satisfying sensory experience. As a result, the person who takes that approach to eating is able to feel satisfied with a much smaller quantity of food. The overall sensory experience of satisfaction is the cue to stop eating. The difference between these two approaches is not about the quality of the food itself, but by the attention paid to it. This is mindful awareness.

What’s Your Food Size?

August 24, 2012

Imagine that you need a new pair of shoes. You go to the shoe store, look around at the styles on display, and you find one that fits you perfectly. It’s comfortable, looks good on you, and the leather really feels great to the touch. In fact, you like the way it looks and feels so much that you decide to buy the largest size that they have in stock, so you get more shoe for the same price. Great deal, right?

No, it’s insane.

Now think about a similar scenario, but instead of shoes imagine you’re ordering a meal in a casual dining restaurant. You see that the special for the day is a dish that you really loved the last time you had it. That time it was served in a moderately sized, but very satisfying portion. Today, though, the server tells you that they are offering the special in the “value sized” meal.

For the same price you can get twice as much of your favorite meal! You’ve never been one to take home a doggy bag or leave anything on your plate, but you’re really hungry and you love this dish so you’re confident you’ll be able to handle it. Would you consider the offer? Even if you reject it, it doesn’t sound quite as ridiculous as buying big shoes, does it? But it is.

In both cases you assign value to some useless material that will soon make you feel uncomfortable and sorry that you chose it. But one scenario seems crazy and the other one doesn’t. This is a perfect example of how habitual but irrational ways that we think about food affects our behavior, weight, and, ultimately, our health.

Here’s another common mental habit that is closely related to taking large portions: the idea that leaving food on your plate is a moral transgression of some sort and the act of scraping off any edible food into the garbage is sinful.

Think about it like this: you had a good meal. You’re no longer hungry; you may even be stuffed. You have no real desire for the last pieces of whatever is left on your plate, but you feel a compulsion to eat it. By now, your body is processing all of the nutrition it needs from what you’ve already ingested. What do you think it will do with the rest? It goes to waste just as surely as if you put it in the garbage can. The only difference is that it goes through you first.

What happens to that extra food? Whatever calories your body doesn’t need gets converted by your liver into triglycerides which are then stored as fat cells in different areas of your body. That fat storage is s a great adaptation that all mammals have so that they can hibernate during the winter and survive droughts in the summer. Chances are you’re not in danger of starving through those events, so instead of getting you through the crisis, the fat will just stay there until you start taking in fewer calories. Then your body will begin to siphon off some of the energy stored in those strategic reserves and you’ll lose weight.

I’ll describe just one more common example of distorted thinking that, like the other two, is related to portion control. It’s about how we behave at a buffet.

I’m sure you’re familiar with the scene at a catered event where the food is spread out on a self-service buffet table. People sharpen their elbows and crowd around the table as if they haven’t had a decent meal in weeks. Then they pile up their plates, apparently according to how much food is on the table. It’s almost as if each individual estimates the appropriate percentage of food that’s allotted per person and that’s what they take.

Do you see a pattern here? In all of these situations, the amount of food you eat is based on external factors rather than individual requirements. Whether it’s the amount of food available or what’s left over on the plate, the cue to eat does not come from what you need or want, but from what is available.

How do you change that kind of behavior? It starts, as does all behavior change, with how you perceive the situation. Before eating, try to apply what you really do when you go to buy shoes. Before you even step into the shoe store you know your size. You’ve bought shoes often enough as an adult to know what will fit and what won’t. Well, you’ve also eaten enough in your life that it should never surprise you to discover that you’ve eaten too much. You should know your size when it comes to food portions at least as well as you know the size of your shoes or clothes.

Before you put anything on your plate look at it and visualize what volume of protein, starch and vegetables fits your real need to feel satisfied without overeating. Then you take the appropriate amount of each, with a ratio of about twice as much of the vegetables as each of the other two groups. Try to leave enough space between the different foods to be able to see some of the plate to keep from piling it on. That’s your size.

If after you finish that you feel that you can still comfortably eat more, wait about five minutes before putting any more on your plate to give your brain a chance to catch up with your stomach. It takes a while to register that you feel satisfied. When you’ve had enough, enjoy a few bites of dessert and call it a meal. You’ll be quite content.

Whether you record what you eat every day or not, it’s useful to do an eating self-assessment before deciding what needs to change in your current eating routine. The first step in this process is to apply the five W’s of journalism: What, When, Why, Where and Who. That will help you get a more thorough understanding of your eating patterns so you’ll know where to focus your change goals.

What: When you try to recall your usual eating patterns, it may be easiest to go through your daily routine, and write down (with brutal honesty, if necessary) the types of meals and snacks that you tend to prefer and are most likely to eat throughout the day. What do you have for breakfast, if at anything at all? What choices do you make and what portion sizes do you take? Do you prefer to prepare your own meals, like cooked or raw salads, or do you go for convenience? If it’s the latter, is it usually frozen meals, diet plan trays, or take-out? Another important ‘What’ question is, what are you doing while you eat? Are you reading, watching TV, working at the computer? Or are you simply focused on the experience of eating whether alone or with others?

When: Once you think about what you usually eat and how much, you can think about your daily pattern of when you get the cues to eat and respond to them. Do you eat at scheduled mealtimes, or do you graze throughout the day? When do you usually eat the first meal of the day? At what point do you stop eating at individual meals? When in the day do you stop eating? Are you a late night snacker? Think about whether your total calorie intake is spread throughout the day, or is it more packed into the one part of the day or another. Is your pattern to eat a lot but infrequently or less and more frequently?

Why: Next, take note of what typically prompts you to eat at each of those opportunities. Of course, I have been talking about emotional eating throughout this book and how feeling controlled tends to trigger an episode of emotional eating. So identifying what the experience is that made you respond by eating is one example of how to answer the Why question. When it’s not a response to an emotional trigger, you can track the timing of your eating. Is it mainly the time of day that makes you think about having a meal, or do you respond mostly to hunger cues? Or do you eat simply because food is in your line of vision and available? (My father, a master of lame dad humor, used to call that his see-food diet.) If your eating has no discernible pattern, then that’s your pattern. Make note of the cues that prompt you to eat when you do.

Where: Now think about where you are at each of those occasions. Are you standing or sitting? Are you at a kitchen or dining room table or at a coffee table or TV tray? Do you eat in the company cafeteria, at your office desk, or in a restaurant – fast-food or other? Do you eat in the car? (Here’s a hint: don’t!)

Who: Do you usually eat with others or by yourself? When you eat around other people do you tend to make better choices and limit how much you eat or are you influenced in one way or another by the choices of others?

This self-assessment is the first step in behavior change. Understanding your eating patterns can help you identify obvious problems. In the next few posts, I’ll go over some of the less obvious patterns that research has shown to increase calorie consumption and where making some changes can be especially helpful. But first I’ll start with some of the more irrational mental habits that may not be obvious but really should be. As you’ll see, you don’t need a researcher to tell you that they add calories, just a little common sense.

I’m very ambivalent about the issue of keeping a food diary. I know that when people do it, the impact it has on their eating can be very impressive. So what’s the down side of recommending it? For one thing, when someone who is just trying to be helpful, tells you that you “really should” keep a daily food diary, that’s one more rock dropped into the pan that hangs on the external control side of the scale.  It’s just as likely to have a negative effect as a positive one.

People differ in how they feel about keeping journals, diaries, or scrapbooks. Personally, if I was told to record everything I ate, I would either give up after about a day, or if I did stick with it, the information wouldn’t be worth the electronic pixels that it’s recorded on. And I know from my patients’ responses to this recommendation that there are many people who have the same attitude toward recording everything they eat as I do.

Even dedicated diarists who are knowledgeable about nutrition can be way off in their estimates of portions and calories that they consume. A study published in 2002 showed that although dietitians who were asked to record their food intake over a seven-day period were more accurate than non-dietitians, they still underestimated the calories they consumed by more than 10 percent. The non-dietitians in the study were off by more than 20 percent!

I believe, however, that the accuracy of the details recorded is not the key factor in explaining the effectiveness of keeping a food journal. The real value of the diary comes back to mindful awareness. Just the process of thinking about what you have eaten forces you to stop and reflect on your eating behavior. That alone can be a very sobering experience for many people who eat so automatically they’re not even aware of having other more appropriate options. If you’re not aware that you have options then literally, you don’t have a choice. From a practical point of view, it’s no better than being forced to eat. More than that, the fact that what you’re about to put in your mouth will be recorded, makes a big difference in whether you eat it or not. Or, put another way, it allows you to make choices.

There’s an old joke about a couple on vacation in the Catskill Mountains in one of those old resorts. They were looking at their menus and pointed out to the waitress that under side dishes it just says “choice of vegetables.” “So?” asked the waitress. The man asked, “Well, what’s the choice?” The jaded server rolled her eyes and said, “The choice is, do you want it or don’t ‘cha?” When you consider any global behavior change on the microscopic, nano-level, it all comes down to individual decisions: Should I have this one or that one? Should I take another portion or not? Do you want this or don’t ‘cha?

How frequently are we confronted with choices about what we eat? A study done by Brian Wansink at Cornell looked at how many food-related decisions we think we make every day and compared it to how many we actually make. The results were pretty astounding. The researchers found that we’re aware of making about 15 daily decisions concerning food. The reality? We make over 200 food-related decisions every day! That difference is where most of your excess calories come from.

So the real low-hanging fruit, where a minor effort can have a major impact, lies in being more aware of even a small percentage of those 185 or so unconscious decisions you make every day. The accuracy and details of your food diary are not the critical factor in its effectiveness. Instead, the value of writing it down is that it encourages you to open your eyes to the many opportunities you have every day to make better decisions.

What does that mean for those of you who, like me, don’t care for keeping track of everything you eat? It means two things: one, you don’t have to obsess over the details. Just making a quick note – even a mental note – in the evening of whatever you can recall eating during the day can make a difference. Second, you don’t have to do it for the rest of your life. You can quit when you start thinking automatically about what you’re eating rather than just eating automatically.

There is a concept in economics called diminishing marginal utility. This means that as a person increases consumption of a product there is a decline in the satisfaction or benefit that person gains from consuming each additional unit of the item. Applying this concept to eating may be one of the most useful things you will learn from this entire blog.

We have all had the experience of robotically eating something simply because it is in our line of sight and within arm’s reach. We may have a real desire for a piece or two of whatever it is, but if there is more than that available we are liable to continue eating far more than what it would take to satisfy that desire. Being mindfully aware of the enjoyment or pleasure that we are experiencing from that food is a critical element in preventing overeating.

The best way to illustrate this process is with what I’ll call the Food-Pleasure Curve, illustrated below. Think of each point on the curve as a unit of some food that you like but also recognize is an indulgence and can sometimes be a problem for you to resist. Let’s say it’s Hershey’s Kisses, which are about 25 calories each, and there’s a candy dish in front of you with eight individually wrapped candies in it. Seeing those makes you think about the taste and feel of what one would be like in your mouth, and that creates a desire for it, so you take one from the bowl.

The Food-Pleasure Curve

You unwrap it, pop it in your mouth and experience exactly what you imagined. The taste is very satisfying, it brings back memories of eating them when you were young and you get a fair amount of enjoyment from it. If you would rate it from 1 to 10 on a scale of chocolate pleasure, it would perhaps score a 7. That’s great! That’s what I would call an excellent return on a small investment. You’ve achieved a high degree of anticipated pleasure for a cost of only 25 calories. In fact, you’re so pleased with the outcome of the experience that you decide to have a second one.

You go through the same process and your pleasure from this one goes up from a 7 to, let’s say, a 9. After all, you’ve already experienced it once, which took you from 0 to 7. Now you just want to add to that experience so it’s likely to bring it up a just a few points. Now you’re at 50 calories and at 9 out of 10 on the pleasure scale, which is still what I would call a nice return. You know that your pleasure is not going to go any higher than a 9, but the experience was enjoyable and there are still six more pieces in the candy dish. You’re not quite ready to walk away from it so you eat one more to prolong the experience.

At this point you’ve had three candies and you’ve already maxed out at 9 on the pleasure scale, but you want just one more as a way of letting go and putting it aside. So you have one more for the road. Although it doesn’t increase your enjoyment, it also does nothing to diminish it, so the curve stays flat.

The bowl still has a handful of chocolates in it, though, and they’re still right there within easy reach; but you feel that you’ve already satisfied your initial desire to experience what you anticipated when you first saw the candies, and you’ve consumed 100 calories, so you decide to stop.

You distract yourself for a few minutes; you walk around a bit, and maybe do a little work. But on some level you’re still thinking about the chocolates in that dish. You finally convince yourself that you’re just going to have one more. So you eat it, but immediately feel a twinge of regret.

Now here is the important part: that small feeling of regret just cancelled out some of the pleasure you had initially experienced. This is where the marginal utility begins to diminish. It’s true that the fifth one tasted exactly the same as the first, which you fully enjoyed; however, you’ve already satisfied that initial desire, and in terms of your emotional state, you were kind of disappointed in yourself for not controlling that impulse to have more.

At this point, however, you also feel that you’ve already lost this round in your bout with self-control, and you think, why keep fighting it? So you have another, and adding that one to how you’re already feeling about yourself, you say “Oh, what the hell!” and, abandoning all restraint, you have the last few in the bowl. Now, in addition to the emotional letdown, you begin to feel a little physically disgusted. Your sense of self-loathing and weakness, to say nothing of queasiness, wipes out any enjoyment you got out of the first few chocolates. To add insult to injury, you’ve just taken in an extra 200 calories and have nothing to show for it.

We have all had this experience, even those who do not consider themselves emotional eaters. It’s not a sign of a disorder; it’s a sign of being human. The question is, what can you learn from it?

The part of this that is very human is our natural and mostly adaptive tendency to tune out our routine behaviors which allows us to focus on other, more complex mental processes. That’s what allows us to multitask; when we do that we’re really focusing on only one thing at a time, but we can accomplish other more routine tasks at the same time because they don’t require the same degree of cognitive effort.

The problem is that this “efficiency” comes at a cost. The lack of attention leads to errors, not because we’re using poor judgment, but because we’re not applying judgment at all! The process I described with the Hershey’s Kisses is actually an exaggerated version of reality. It’s typically not the way we consciously process the decisions we make, but it reflects what happens on the level just below conscious awareness.

The way to change this is to be mindfully aware of the following thoughts: your desire for something to eat, whether the item you are considering will satisfy that desire, how much it would take to do so, and at what point do you reach the maximum level of satisfaction that you’re likely to get without doing anything to diminish the pleasure you got out of it. Keeping the Food-Pleasure Curve in mind as a mental image can be very helpful in accomplishing that goal.

You may have noticed that restaurant portion sizes are inversely proportional to the prices on the menu. High-end restaurants with famous chefs tend to serve small portions with entrees that look like more like appetizers, while casual dining restaurants will often serve entrees on enormous serving platters that could feed a family of four and still have enough left over to fill a doggy bag.

There are good reasons for that. Think about a meal you had at a casual dining restaurant, or even better, an all-you-can-eat buffet. The emphasis there is not on the quality of the food, although it’s usually pretty decent. The real appeal of these places is getting the most value for your money. From a business point of view, that’s also the expectation in that market segment so if they cut back on portions they risk losing market share. They make their profit by standardizing the whole process and through economy of scale. As the overnight TV ads for retail stores that sell at wholesale prices say, “How do we do it? Volume!”

From the consumer’s point of view, the idea of getting a boatload of food for $6.99 challenges you to get your money’s worth. Some places actually dare you to eat a gi-normous serving of something, like a four-pound steak, by offering it for free if you can polish it off. One patient of mine described a memorable – she called it “horrifying” – experience she observed at an all-you-can-eat restaurant when a very obese father and son sat down to consume a mountain of meat loaf, fried chicken and mashed potatoes with gravy over everything. When they finished, they both paused and let out a heavy sigh, the father pulled out a handkerchief to wipe off his forehead, and they went back to the buffet to load up their trays again. Hey, it’s hard work, but think of the savings!

This experience has become increasingly frequent for most consumers because of the low expense and as a result has contributed to significant changes in how we eat. For one thing, the idea of a “normal” portion has expanded considerably over a short period of time. As the Obesity Education Initiative of the National Heart, Lung, and Blood Institute points out on its enlightening yet rather frightening online presentation, called “Portion Distortion,” the portion sizes – and thus the calorie content – of most food items have gone through a period of hyperinflation over the past twenty to thirty years.

For example, a typical restaurant serving of chicken ceasar salad was 1.5 cups or 390 calories in 1980, and more than doubled to 3.5 cups or 790 calories by 2000. In that same period of time, a typical box of movie theater popcorn grew from 5 cups or 270 calories to 11 cups or 630 calories. A chocolate chip cookie that was 1.5 inches in diameter and only 55 calories is now 3.5 inches across and 275 calories. The list goes on. It should come as no surprise that the average weight of American adults has also increased by about 20 pounds over that time span.

What is perhaps even more disconcerting is that the visual image that we have of what a typical portion size looks like in a restaurant has carried over to how we eat at home and has become the new normal. On some level we’re probably thinking, “Hey, these guys are experts; they must know what a serving of mashed potatoes should look like.” Then we replicate that image at home and it becomes the new standard.

Ultimately, though, what counts is not how much you put on your plate, but how much you actually eat. That’s where expanding portion size becomes a real problem, because we don’t rely on knowing what we need or what we want to limit our eating, we rely on what’s in front of us in addition to countless other environmental cues.

As Brian Wansink points out in his book, Mindless Eating, his research has demonstrated that how much people eat is determined to a large degree by the context that the food is in. We eat more from a large bag of chips than a small one and we put more on a 12-inch dinner plate than a 9-inch one. People will eat more if they are using a larger serving spoon to dish the food onto their plates, or if the bowl that the food is served in is larger.

Barbara Rolls, in her book Volumetrics, has similarly demonstrated in her research that people eat as much as 50 percent more when they are with friends than when they are alone or eating with people they don’t know. The solution, of course, is not to eat alone, but to be more aware of what you are eating, how much you are eating, and when it’s time to stop eating.