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.

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.