What’s Your Food Size?

August 24, 2012

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

No, it’s insane.

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

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

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

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

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

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

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

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

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

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

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

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


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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.

Now that we have discussed the positive or healthy reasons to eat, let’s look at what I think are the main motives for unhealthy eating. Before talking about what they are it may be helpful to consider three ways to classify motivations behind overeating. Just as healthy eating can be categorized according to bio-psycho-social motives, as discussed in the previous post, unhealthy eating might also be thought of as falling into three general categories: the head, the hands, and the heart. These correspond to rational or intellectually motivated eating (the head); habitual eating behaviors that we engage in without any real awareness of the thoughts or feelings that motivate them (the hands); and eating that’s motivated by an  emotional state (the heart). Obviously, the “head” is behind all of these, but it’s an easy way for me to describe (and for you to think about) what they are.

Overeating that is related to the Head category would include being ignorant of basic information; that is, eating that’s due to a lack of knowledge or awareness about fundamental principles of nutrition. This can happen when such information is not available, accessible, or interesting enough for that person to pay attention to it. Not knowing how to understand the information on nutrition labels is an example of this. Similarly, someone who doesn’t realize that ordering a twenty-ounce steak and eating it in one sitting is not a healthy choice and perhaps assumes that the restaurant must know what it’s doing if it’s on the menu, is, let’s just say, misinformed.

Another type of poor eating that falls under this category is when someone makes a seemingly rational but poor decision. For example, when you go to an all-you-can-eat buffet the cost is fixed, usually prepaid, and the food is virtually unlimited. Does eating more simply because you paid for it and it’s available provide a good value for the money? Or when someone goes to a fast-food place and the sales person offers a “value” meal with a larger burger and fries for just a little more, or when you go to a movie theater and ask for a small popcorn and before getting it for you they’ll offer you a silo of popcorn for an extra fifty cents; is it really a good value? It may seem so, but if the extra amount doesn’t fit into the categories of biological needs, social obligation, or desire, it makes no more sense than buying dog food that’s on sale even though you don’t own a dog. I know – good deal, right?

This kind of thinking applies to how people deal with ingrained messages that they grew up with as well. Even small children usually realize that finishing everything on their plate is not going to help children who are starving elsewhere in the world, but the message that “we paid for it, now eat it and be grateful” is hard for a child to argue with. It may even seem rational to adults too. But once you really stop and think about it, what happens to the excess food that’s eaten? I’ll pause here and let you think about that. Got it? That’s right; it goes into the municipal waste system. Why would you let yourself be a human garbage disposal? It would make a lot more sense to put the food straight into the trash without going through you first.

The Hands represent the kind of mindless habits that have become so routine that we can’t recall making a decision to eat. You may at times have found yourself holding an empty snack bag while watching TV and don’t remember eating what was in it. Of course your body recorded all the calories consumed, but you didn’t even get a chance to enjoy them. Charles Duhigg talks about these routines in his excellent book, The Power of Habit. He describes how the habit loop develops after behaviors are repeated so frequently that it would feel like something is missing if the routine was not performed when the cue that usually triggers it appears. This is what we experience as a craving.

When eating is the routine in that habit loop, it’s not about the enjoyment of or the physical need for the food as it is the satisfaction of that craving. There’s a useful place for mindless routines in life, such as driving, where habits can allow you to focus on and respond to unexpected events instead of expending time and mental energy on deciding whether to move your foot to the brake or accelerator. But with eating, you need to be mindful in order to enjoy the food and know when you have satisfied your hunger or desire so you can stop without overdoing it.

The third category of unhealthy eating, the Heart, is the real subject of this blog, emotional eating. I’ll discuss that in detail in the next post.