Would you prefer to be free as a wolf in the wild, free to roam, or secure on a dog-sled team, safe and well-fed, with purposeful work?

I came across this beautifully filmed short documentary called Vargsamtal, which means wolf call in Swedish. It’s about a dog sledder, Sven Engholm, working in the extreme north of Norway, far above the Arctic Circle. Engholm tells how a group of stray dogs joined his dogsled team on an expedition, and imagines what the howls exchanged between the harnessed dogs and the wild wolves nearby might have meant:

“We had crossed the Obi River where there were various fishing camps. Russian stray dogs were roaming around the camps. They seemed to be surviving on the leftovers from the fishing.

“The dogs began to follow our trail, some of them for several days. We felt bad about them leaving the camps, so my friend said, ‘Let’s give them a harness along with the others and see if they’ll pull the sled.’

“It went surprisingly well as they were big and healthy dogs, pretty similar to ours.

“At night we noticed three or four heads popping up behind the dunes…a wolf pack stalking us for several days.

“When we were freezing in the tent we could hear the wolves howl and the dogs answering back. It was like they were talking to each other, as if they were having a conversation, understanding each other.

“The wolves say: ‘You dogs are so dumb pulling that sled without purpose. We’re wolves and we can run free. We represent freedom and we do as we please.’

“The Russian stray dogs answer, ‘We also know what it’s like to be free: that means being hungry, getting hunted. That freedom of yours has a heavy price. We like this expedition. They give us food and shelter and we work from 9 to 5.’

“That’s how we imagined an argument between dogs and wolves.”

Freedom versus security is really a false choice, since we always want both and try to maintain a reasonable balance between them. But sometimes, one side may feel too extreme for comfort and the balance becomes skewed. When that happens, we feel the need to offset it.

Unwanted behavior like emotional eating is motivated by something, whether we’re aware of the motive or not. When the control that security or conformity requires begins to feel constraining, we may counterbalance it by acting in some way that goes against our normal preferences to emphasize our autonomy and restore equilibrium.

Often, the need to achieve psychological balance can be even more important than acting in our own best interest.

 

My book, 8 Keys to End Emotional Eating: Autonomy and the Spirit of Rebellion is forthcoming from W.W. Norton in the Summer of 2019. It’s available now for pre-order on Amazon.

 

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In the Winter of 1944, World War II was ending and there were horrific stories of widespread starvation across Europe. The American government would soon be responsible for a massive refeeding project overseas, but there were no medical guidelines for how this should be done. Ancel Keys, a professor of physiology at the University of Minnesota, had been involved at the start of the war in the development of field rations for the American military. Now he was asked to design a study that could provide data to guide the refeeding project. Thirty-six men volunteered to participate in a year-long study of starvation. These men were all conscientious objectors who were allowed to participate in human performance studies as an alternative to military service.

During the first three months of the study, each participant was fed a tightly controlled diet intended to standardize his weight to match the average for American men of his height. Most needed to gain a fair amount. After the three-month standardization phase, during which the volunteers’ three daily meals totaled about 3200 calories, the six-month starvation phase of the experiment began. In a single day, the men’s calorie allotment was cut approximately in half.

To put this in context, if an adult male today asks for guidance about going on a quick yet still safe way to lose weight without medical supervision, the recommendation would be to limit his daily intake to 1500 calories. That’s low but is still considered safe and nutritionally adequate. For a woman, that number would be 1200 calories a day. In contrast, to reproduce the effects of involuntary starvation, the average number of calories allowed in the Minnesota experiment was 1570 per day—more than many dieters would now be advised to eat on a non-medically supervised weight-loss regimen!

This made me wonder about the more restrictive dieters who I see in therapy. Although it’s considered a medically safe level of intake, what are the psychological consequences of such a diet? How might it affect adherence when meals aren’t being carefully controlled as they were in the experiment? After losing weight on such a diet does eating just return to normal? What are the long-term effects of this kind of self-deprivation on the body’s metabolism afterward?

In the starvation experiment, the psychological effects of the diet began quickly and soon became dramatic. After just a few weeks, volunteers who kept diaries began to describe how the time between meals had become difficult. One participant began to have nightmares about cannibalism—dreaming that he was the cannibal. This affected that volunteer’s adherence to the routine as well. In an effort to end these dreams, he began cheating on the diet. During their unsupervised free time, he began to leave the university campus where the experiment was being held, to go into the nearby town where he would buy milkshakes and ice cream. The cheating was quickly discovered because his expected weight loss had leveled off. But even after he was caught and his freedom to leave campus was taken away, he found other ways to cheat on the diet and he was soon released from the experiment.

Although this was the earliest psychological reaction among the participants, the others soon began to show signs of abnormal food preoccupation as well. One notable incident occurred when Dr. Keys, the director of the experiment, decided to offer a “relief” meal to the group in order to boost morale and hopefully prevent others from cheating. The calorie content of this meal was considerably more generous than the typical ration, and it included an orange for dessert. When the men finished eating and they were ready to return their trays, nothing was left but the silverware, plates, used napkins, and orange peels. As Todd Tucker described the scene in his book, The Great Starvation Experiment, “None of them could bring themselves to throw it away. The idea came to them collectively. They picked up the orange peel and ate it, every one of them.” Keep in mind that this was after a relief meal of 2,366 calories, after fifteen weeks at the starvation level. The impulse to eat orange peels was not borne of hunger, but psychological scarcity.

As the days wore on, there were more incidents of cheating. Another person was dropped from the experiment when, alone at his night job in a grocery store in town, he suddenly found himself binging on stale cookies and rotten bananas that he was about to throw into the dumpster. Another had to fight the urge to root through a trashcan full of decaying garbage while on his daily walk.

Although the purpose of the experiment was to learn how to safely refeed starving civilians, the volunteers’ stories also highlight important lessons about the effects of dieting on the mind and body.  The key lesson is that even restricting food to a degree that might be considered reasonable for a normal weight-loss diet, can have profound psychological and behavioral effects. It’s worth taking that into account if you’re thinking about starting–or recommending–a diet.

 

My book, 8 Keys to End Emotional Eating: Autonomy and the Spirit of Rebellion is forthcoming from W.W. Norton in the Summer of 2019. It’s available now for pre-order on Amazon.

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.