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.

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.

This step is the take-away, bottom line, upshot, payoff, etc. for everything we’ve discussed up to this point. So pay close attention. Once you have identified the reason (or reasons) you feel controlled, the next step is to take a good look at the situation that is causing the stress to see if you can change how it impacts you.

The key to doing this successfully involves the effective use of coping mechanisms. In psychology, coping with stress is broken down into three basic strategies. Depending on the nature of the stressor, each of these can be used to reduce or eliminate the impact of the problem that is making you feel controlled. These are:

  1. problem-focused coping
  2. appraisal-focused coping
  3. emotion-focused coping

Problem-focused strategies are simply solution-oriented approaches to dealing with a situation that causes stress. If the problem is due to something that can be changed, you can solve it by reducing or eliminating the source of the stress. Let’s say you’re tense and anxious due to your hectic schedule. You feel like you’re running from one meeting to another, while always being afraid that you’ll be late to the next one. You would look at how you are managing your appointments to see how you can reduce the problem.

A patient of mine was dealing with an extremely stressful work situation. He is a doctor working in a busy outpatient clinic where there tends to be a lot of patients who don’t show for their appointments. As a result, the clinic administrators looked for a way to balance patient flow without causing too many gaps for the doctors or delays for the patients. They found a good balance by looking at the average number of no-shows for the clinic and developed a practice of triple-booking each appointment slot to manage the patient flow.

This worked well for the most part. The problem was that cancellations and no-shows varied according to specialty and my patient’s specialty area had fewer missed appointments than the others. As a result, he was constantly overbooked, running late for each appointment and working late every day. The simple fix was to show the administrator how his cancellations and no-shows differed from the others, and that his appointments should therefore not be triple-booked. Problem solved.

This simple approach is the best way to deal with problems that are causing stress, so it should be the first thing to look for when you identify the situation that is causing you to feel controlled. If you’re overwhelmed with work, hire an assistant or delegate responsibilities to others. If your office desk has developed geological strata and finding things you need requires the skills of a trained archeologist, enlist the help of an organized person to help you come up with a better system.

These are fairly straightforward solutions to problems that can really end up controlling your life. In reality, though, it’s usually not so simple. Most of the time, the problem you’re dealing with is not so readily solvable but is rather an ongoing situation that does not lend itself to a simple fix. That leaves you with the next option: appraisal-focused coping strategies.  This means reappraising and challenging your assumptions – or in plain English, turning on your mental crap detector.

Without getting too philosophical about it, when we respond to any event, we feel and believe that we are responding to the plain reality that’s out there. That’s a reasonable and common shortcut that we use to unclutter our brains and streamline how we think. Unfortunately, it’s not true. The idea that we see things as they really are is a simplified but wrong view of the cognitive process we go through when we respond to events. The truth is that we’re really responding to our interpretation of the experience, which can be very different from the reality. So it’s essential to challenge the assumptions we make about how we first view the event.

Everything we see and experience first has to pass through a process of perception and interpretation before we respond to it. That interpretation of what we perceive is our own addition to the experience and it colors or even completely distorts our understanding of the event. It’s like a filter that we use on the camera lens of our mind. It distorts the picture we take of reality in a way that is unique to us. Often, we may apply the same filter to many different experiences. We don’t give too much thought to it when we do this, because it occurs at a level beyond our conscious awareness, and besides, most of the time it has no practical impact.

However, when we respond emotionally to our experience of an event, and then behave in some way that is in turn triggered by that emotional response, how we filter reality can make a huge difference. For the purposes of our discussion, it can determine whether or not an event will trigger an episode of binge eating or not.

It’s too easy to accept the sense of being controlled as the reality and to respond to that perception by eating. But what if your perception is not the reality? It is very possible that your filter tends to allow perceptions of external control to pass through more easily than alternative interpretations. So the most important question to ask is, “Am I really being controlled or are there ways that I can look at this situation differently?”

Appraisal-focused strategies are appropriate when there is no straight-forward solution to a problem. Instead of changing the cause, you modify how you think. This is what I wrote about in some detail concerning Hamlet’s prison. Whether you feel trapped or not may depend entirely on how you look at things.

Another patient of mine grew up as the oldest of six children. Her parents, whether by their nature or necessity, were very rigid about expectations of behavior and fairness. Among those rules were that the older children had to be responsible for their younger siblings. This wasn’t just a matter of watching out for their safety, but also making sure they were happy.

As a consequence, my patient had to do things like include her younger sister whenever she went out with friends, give up her right to an extra piece of pizza if her sister wanted it, and so on. Now, as adults, she doesn’t particularly enjoy the company of her younger sister, but feels incredibly guilty about not wanting to spend more time with her. Unlike the other person’s work schedule problem, this is not a situation that lends itself to an easy solution. So what does she do about the overwhelming stress that comes from the guilt she feels about not liking her sister? She had to reappraise the situation.

First, she had to recognize that perhaps her parents’ expectations were not fair to her. True, she was the oldest, but she was still just a little girl herself and had her own need to be a kid, not a nanny. So a lot of her resentment toward her sister was probably redirected from feelings she had toward her parents that were unacceptable for her to acknowledge. Second, she and her sister are very different people as adults, with different interests and personalities. Sometimes people who are members of the same family wouldn’t choose to be friends with each other if they weren’t related and they don’t have to feel guilty about that.

For this patient, of course, that was not an acceptable option growing up, and she never got the memo as an adult that this rule had ever been repealed. Allowing herself to admit that she would probably not choose her sister as a friend if they met as adults was a revelation to her. That doesn’t mean that she can ignore her as if they had no connection, but including her in her life her as one would any family member is not what was stressful to her. Essentially, she had to give herself permission to disregard rules that were at best obsolete and probably were never a good idea to begin with. This, not surprisingly, was a pattern that repeated itself in her relationships with friends, co-workers, and the men she dated.

This process of reassessing how one interprets and responds to reality is in fact the majority of what goes on in therapy. It’s what most of the talk in talk therapy is about. It’s a process that requires examining patterns of events and relationships and noting how you tend to respond to them until there are enough data points to connect the dots and see a consistent picture emerge.

Since the process relies on no one but you to accomplish, together with a therapist who supports your budding independence, it is a very good example of how to develop a sense of autonomous control in your life. If you commit to it and put what you discover into practice, it is usually a very effective and powerful way of implementing change. But even then, there will be lifelong habits of thinking and behaving that slip through, no matter how effective therapy is. That’s where the third coping technique, emotion-focused coping, can be very helpful.

Emotion-focused strategies involve dealing with the feelings that are stirred up as a consequence of the stressor. This can include managing hostile feelings by counting to ten, or reducing anxiety by meditating or using relaxation techniques. Unlike the first two strategies, which are directed at reducing the source of stress, emotion-focused coping is more tactical than strategic, since it is aimed at the effects of the stress. Distracting oneself from the urge to binge would be an example that is most relevant to emotional eating. This is what many therapists who work with emotional eating recommend when they encourage people to “surf the urge,” meaning, distract yourself from the urge to binge until it passes.

Other useful responses could include any type of pleasant activity that serves as a distraction and occupies your attention, preferably while occupying your hands as well. Any kind of needlework, doing crossword puzzles or taking a hot bath, might be some examples of emotional-coping behaviors. Going for a walk, exercise or reading could also work well. Watching TV might be an effective way to divert your attention, but it could also allow for having a snack while you watch, and the opportunity for habitual eating could defeat the purpose of distracting yourself from emotional eating.

Surfing the urge, and any other response that you might choose to take the place of emotional eating, can be helpful advice when you feel like bingeing and have no other way of dealing with it. However, I see this as a last resort, after the attempts to address the source of the stress has failed. That’s because emotional eating is the effect; the stressor, whether it is a problem that can be fixed or a perception that can be changed, is the cause. Whenever there is a cause and effect relationship, the most effective way to minimize the effect is to first address the cause.

With most of my patients, even those who have binged on a daily basis for years, I don’t begin treatment by getting them to change their behavior. If anything, that would just introduce a new form of external control that sooner or later would have the exact opposite effect of what we are trying to accomplish. Instead, I help them defuse the power of food by encouraging them to view all food as on the menu. Then we’ll look at their experience of external control and discuss the coping techniques I describe here. Often, after only a few weeks of therapy with someone who has been struggling daily, I’ll ask them how their eating has been. They’ll usually think about it for a few seconds and look up with an expression of puzzlement when they realize that it’s been a week or more since the last time they binged.

When it comes to emotional eating, perceived control is the cause; rejection of control is the effect. First try to solve the problem that causes the experience of feeling controlled; if that’s not possible, change your perception of that control. When that’s not enough, find better ways to respond to those feelings. The unwanted behavior will often take care of itself.

If you’re like every other human, and chances are that’s the case, stress can enter your life in all forms, from every possible source, and in every possible way. Therefore, saying that emotional eating is due to stress is like saying that an illness is due to being sick. It’s circular and meaningless. Unless you can identify a specific cause that can be linked to the effect you will be unable to eliminate the symptom.

However, with all the possible suspects as the source of the stress behind this behavior it can be very difficult to identify the ones that are actually causing it. Fortunately, it should be clear by now that emotional eating is a specific type of response to a specific type of stress. It is a defiant act of self-liberation from the domination of external control, so the search for a cause can therefore be more focused. The first question to ask, then, is not “Why am I stressed out,” but “In what way am I feeling controlled?

As I described in the previous section, the source of the problem is often related to control around eating, such as explicit or implicit pressure to lose weight. But it can also come from any other situation in which you feel you bear the full responsibility for getting something done, but your freedom or authority to do it your way is being limited by other people or circumstances. (I want to emphasize that you feel that’s the case; it doesn’t mean that it is! This is an important point for finding alternative solutions, which I’ll address in the next step.)

A simple and fairly common example is when someone asks you for a favor. You may have no time, energy, or desire to say yes, but there’s a part of you that feels unable to say no. Perhaps you’re concerned that this person will be angry with you or will see you as a bad or uncaring person. Maybe being seen as the kind of person who is always available to help is more important to you than commitments that you’ve made to yourself to get certain things done. So even if this means that the items on your own to do list get downgraded in priority, you have to make that sacrifice to maintain your image.

All of this is very nice, but not so deep down, you may feel resentful. Whether you acknowledge it or not, you may be grumbling to yourself about how inconsiderate this friend is for “forcing” you to give up what you need to do, and instead do something that is inconvenient and time-consuming. How rude!

Of course, none of this is true. The friend may have been very accepting if you explained that you’re unable to comply with the request, even without providing a good excuse. But there’s some part of you that has internalized the idea that complying with every request is the right way to behave. You may even be able to recall some such explicit message, spoken in a voice that sounds suspiciously like one of your parents.

Whatever the reason, you feel forced, compelled and controlled. If this is an ongoing occurrence, you will likely feel that your sense of independence, what psychologists refer to as self-determination, is out of balance. To correct that, you unconsciously feel the need to engage in some behavior that makes it right again by reassuring yourself that you’re still in charge. Any situation in which you find yourself feeling that your sense of independence is impinged upon may be a likely candidate for causing a counter-reaction type of behavior like binge eating.

This behavior feels like a satisfying correction to the imbalance caused by the impaired sense of autonomy because you’re able to break the rules without hurting anyone else. “After all,” you tell yourself, “I’m the one who made the rule, so I’m the one who can break it.” Yes, you have the freedom of the proverbial fox that’s guarding the hen house. On the other hand, of course, “not hurting anybody else” implies that you are hurting yourself with this behavior. So why isn’t that enough to prevent it?

If the object of the behavior is to feel free, then that would include feeling free of having to worry about the predictable outcome. “I may feel bad later,” you tell yourself, “but I don’t care!” That’s the point of the freedom – you have the freedom to ignore consequences.

Recognizing the source of the perceived control is the key to overcoming that counter-behavior, because this pattern only “works” if you’re not fully cognizant of why you’re doing it. If, however, you use the urge to binge as a signal to think about how you might be feeling controlled, you defeat the supposed purpose of acting in opposition to that control, which is to feel independent. As Edward Deci puts it in his book, Why We Do What We Do, “When people are either complying with or defying controls, they are not being autonomous, and they can know that.”

Being aware of your options and choosing to act out of preference, not out of defiance, is the key to true independence.