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.

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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.

A car’s engine keeps it going until it runs out of gas. Even after the fuel is gone, though, the car doesn’t just stop; it will continue to coast until you apply the brakes. Similarly, when you successfully go through the steps I described to overcome emotional eating, you may cut off the emotional fuel supply that was driving the behavior, but lifelong eating habits may still provide enough momentum to keep the behavior coasting for quite a long time and undermine your efforts to change.

In one of the earlier posts on this site, I wrote about overeating with the head, hands, and heart, which refers to the idea that overeating may be due to any combination of ignorance, habit, or emotion. Educating yourself is the best way to deal with ignorance about healthy eating (the USDA dietary guidelines and books like Eat This, Not That, among others, are especially helpful with that), and we’ve dealt with the emotional aspects of the problem in the four-step process. Now let’s look at the issue of overeating with the hands; that is, not having bad table manners, but mindless, habitual eating.

Habits are usually thought of in terms of behavior that’s repeated so many times it becomes automatic. But there are cognitive habits as well, which can work the same way but can play an even larger role in overeating. These are beliefs that may once have made sense but are now obsolete. More often, though, they were not valid to begin with. The problem is, once they are accepted and ingrained, these beliefs tend to go unchallenged, and continue to maintain the behavior the way gravity affects a car coasting downhill. Applying the brakes requires recognizing these beliefs and challenging them, or “turning on the crap detector,” as I tend to call it; it’s the essence of mindful, attentive behavior.

In the next few posts I’ll look at some of the more common habits and beliefs about eating that can undermine the best of intentions. Here are some examples:

  • Skipping breakfast
  • The fear of wasting food
  • Filling all the white space on your dinner-sized plate
  • Big buffet spreads and all-you-can-eateries
  • Casual dining restaurant portions
  • Choosing “virtuous” but unappealing food
  • Waiting until you’re hungry
  • Concern about spoiling your appetite
  • Eating while watching TV or web-surfing
  • Eating straight from the package
  • Eating in any position other than sitting upright at a table
  • Eating faster than your brain can register taste or satisfaction
  • Being seduced by value meals, economy-size packages and BOGO-free sales
  • Misjudging servings per unit of packaged foods
  • Confusing low-fat labels with low-cal foods

These are the some of the common ones that come immediately to mind, but I’m sure there are many more. So I can really use your help with these! Please let me know which common eating (mis)behaviors I haven’t listed. I would also be interested in hearing about some of your own “unique” eating habits, especially if you think they cause you to eat more than you should. You may be surprised to discover that they’re more common than you think.

Please write your own irrational food-related beliefs or behaviors in the comments section and I’ll try to include them in future posts. Thanks!

If you feel that you have a good understanding of how I explained autonomous control, then this part may or may not be useful to you. If that’s the case, feel free to skip it. At the risk of overexplaining it, this schematic serves my need to clarify things visually. That’s how I learn best, so I like to use visual images to explain things as well.

This is a graphical depiction of the important role that a balanced sense of autonomous control plays in behavior, and how that can be set off-balance by a shift to the extreme on either side. As the term implies, true autonomous control combines autonomy, or independent action, with control, or responsibility and structure. Going to an extreme on either side of the scale can throw everything off-balance which is psychologically unsustainable.

When that does happen, the imbalance tends to be restored by going to the extreme on the other side. Too much structure begins to feel like externally-imposed control, which is counteracted by defiant or oppositional behavior. Since the counter-reaction, rather than the outcome, is the primary motivation, this behavior is often acted out on impulse rather than by weighing costs and benefits.

It would also follow that lacking a sense of control and structure would be equally destabilizing by creating a feeling of internal chaos, and could lead to restoring balance in the other direction by becoming overly structured or self-restrictive. This may explain what motivates certain behaviors such as anorexia or other types of extreme dieting.

The ideal approach is to maintain balanced moderation by having a sense of authority and self-direction, but also by taking into account a sense of responsibility: to others, to your work, to society, and so on. That responsibility can take the form of conforming to external expectations, like getting up to go to work in the morning, obeying the law, adhering to a schedule when necessary, or offering a compromise when your legitimate autonomous needs conflict with those of someone else.

When there are moderate and reasonable limits on your freedom, then you are able maintain an emotionally even keel. This allows you to pursue goals autonomously, guided by your own needs and by how those are met by the behavior, rather than impulsively acting in opposition to your perception that someone else is trying to control you.

I call this a dynamic equilibrium model of autonomous control. Dynamic equilibrium is a term used primarily in the natural sciences, but has also been used in the social sciences. The idea is that a system is maintained in a relatively steady and balanced state (homeostasis) while the elements that maintain the balance are in flux and they react to each other to maintain equilibrium. That is, they move in tandem mirroring each other so that if one moves to the extreme, the other does too to maintain constancy. It’s a zero-sum game.

When the counter-balancing elements involve emotions and behavior, and they shift to the extremes, you can see the kind of problems that may result (in the boxes at the bottom of the graphic). That brings us back to our topic and illustrates how emotional eating fits in.

Of course, understanding the theory and successfully applying it to your behavior are two separate things. The four-step approach that I outlined here is necessary for overcoming emotional eating, but may not be sufficient in conquering overeating. A long-standing pattern of emotional eating may become so habitual that even without the external control stressors triggering the behavior, simple habit can keep it going. In future posts I will focus on the mental habits that over time tend to groove a rut in your eating behavior and how to get a handle on pulling yourself out of them.