Elizabeth Barrett Browning, a 19th century poet, was not thinking about food when she began her sonnet, "How do I love thee? Let me count the ways." Yet these words could very well describe the American love affair with food, a passionate relationship that has resulted in the massive spread of obesity: Nearly 70 percent of American adults are either overweight or obese.
Our love of eating is shared around the globe. Worldwide obesity has doubled in the last 30 years, and is triggering alarming increases in heart disease and Type 2 diabetes. Experts warn us that the medical consequences of unhealthy weight threaten to rival the scourge of the Spanish flu, smallpox and bubonic plague.
Two weeks ago, a recently formed consortium of European researchers from 21 academic institutions and key players in the pharmaceutical industry said that Type 2 diabetes "is a pandemic disease which currently affects 285 million people worldwide and which is anticipated to affect 439 million people by 2030."
Let Me Count the Ways I Love to Eat
In reporting these dire trends, I would like to distance myself from the looming crisis; however, like my neighbors and friends, I struggle with weight management. And like Elizabeth Barrett Browning, I can count the ways I love to eat.
Eating in response to hunger is, of course, an obvious way I enjoy food. Celebratory eating associated with special occasions, such as eating a piece of birthday cake, is another. Closely related to celebratory eating is ritual eating, for example, the traditional turkey dinner with second and third helpings at Thanksgiving. Eating lunch out with a girlfriend or going out to dinner with my husband qualifies as recreational eating.
Then there's emotional eating -- maybe for comfort, to relieve boredom, to combat fatigue or to stuff anger. And preventive eating occurs when I eat even though I am not hungry so that I won't get hungry later. And we mustn't forget hedonistic eating -- that is, eating because the food is so delicious that we can't resist another bite or two.
Frugal eating -- not wanting to waste food -- can cause me to clean my plate after I am satisfied. Food preparation and cooking (a little tasting here and there) and kitchen cleanup (a little bite as I am storing food) can trigger invisible eating. Olfactory eating is triggered by the smell of something delicious, like a chocolate chip cookie warm from the oven. Obligatory eating occurs when I am under pressure to enjoy and praise a special dish fixed by a relative or friend. Lastly, "monkey see, monkey do" eating is prompted simply by watching others eat.
Hunger Is Seldom the Trigger
To gain insight into the various reasons we eat, I turned to Dr. Edward Abramson, a clinical psychologist and internationally recognized authority on emotional eating, weight control and eating disorders. Dr. Abramson has written five books on the issues surrounding eating and has authored 20 scientific studies.
I asked Dr. Abramson what percentage of our eating was a function of genuine hunger and how much of our eating falls into the other categories described above:
In general, people eat for one of three reasons: (1) physical hunger (for example, low blood sugar, gastric motility); (2) external cues (for example, the sight of others eating in television commercials); and (3) emotional arousal.
Experts estimate that we make 221 eating decisions each day. Most eating seems to be prompted by external cues that are all around us.
In my clinical experience, I find that emotional eating is more common in women than men, but men have more trouble with portion size, so they would report more eating to satisfy hunger. Plus, any eating episode may be a combination. For example, you could start a meal because you're hungry but then continue eating because there's tasty food in front of you.
Dr. Abramson's comment that most eating is prompted by external cues is confirmed by researchers at the Max Planck Institute of Psychiatry. The production of ghrelin, the hunger-producing hormone, increased in healthy male subjects when they were shown pictures of appealing food. Simply viewing a picture of appealing food makes us hungry! (No wonder television ads for burgers and pizza have such an impact.)
Another study at the Radboud University Nijmegen in the Netherlands demonstrated that we mimic our partner's eating speed. Researchers concluded that eating behavior is strongly influenced by dining partners.
Given these and other external pressures, how can we manage our eating and appetite? Hungry Girl, a website that provides "tips and tricks for hungry chicks," is a great resource. The ideas and products can be put to use immediately.
Food for Thought
A longer-term project involves adopting a mindful eating style. The mindful eating approach originated with Buddhist teachers who "encourage their students to meditate with food, expanding consciousness by paying close attention to the sensation and purpose of each morsel."
Staying conscious while eating is the goal. The point is to eat without distractions -- watching television, working at our desks, talking on the phone or texting a friend. Although mindful eating sounds deceptively simple, the practice is demanding, particularly for those of us who feel inefficient unless we are multitasking.
For those new to the practice of mindfulness while eating, Dr. Abramson recommends beginning with a two-minute pause in the middle of each meal during which the food remains untouched.
To manage our weight, we must manage our eating and appetite. And unless we opt for a mechanical solution (such as lap band surgery) or a chemical one (such as orlistat or phentermine, which can be taken only for a limited time), we must become aware and mindful of the invisible pressures that induce us to eat more than our bodies require.
"Consciousness of our powers augments them," according to Vauvenargues, an 18th-century French writer. Whether we like it or not, taking control of our health, well-being and weight demands an ongoing commitment to mindfulness.
That same mindfulness, however, can be applied to any endeavor. Maintaining active, open attention in the present moment throughout the day is a discipline that can enrich every aspect of our lives. Deepak Chopra, a mind-body healing pioneer, says that "Once your mind begins to pay attention, your brain can build new neural pathways to reinforce what you learn ... It has always been true that applying awareness in any form, through such things as resolve, discipline, good intentions, and mindfulness, has the power to create change."
Who knows what other self-discoveries we will make when we practice mindfulness? As a secondary benefit to learning how to manage our eating and appetite, we may be delighted to discover that we are handling other dimensions of our lives more successfully. That's a nourishing side dish clearly worth savoring.
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While your Dr. Abramson has learned much, there is more too it than he knows.
I lost 140 pounds in 1984 with a unique approach of Behavior Medicine that frames habitual overeating as a kind of addiction. I have helped thousands since to solve their weight problem and now I teach other therapists. Please read my article on the question of food addiction: http://theandersonmethod.com/category/is-there-such-a-thing-as-food-addiction/
William Anderson, LMHC
Author of 'The Anderson Method - Secrets of Permanent Weight Loss'
www.TheAndersonMethod.com
I would also add that people use food as part of a transition from one activity to another. if you're at home and finish one activity the chances are that you'll 'find" yourself looking in the refrigerator before you start doing anything else, what is called a displacement activity.
But the real kicker is emotional eating, and here there's interesting work from the field of neuro-energetics. The brain doesn't really store energy so when it needs some it can a) get it from the body or b) go directly to the food source. Because emotion is associated with increased processing, it is associated with increased brain energy requirement. So, if you train your brain to go directly to the food source when energy is required you're going to have a big problems. The different ways of getting energy help explain why some people under stress lose weight while others gain it.
As a dietitian, I believe it is also helpful for future weight management that we teach our kids the sensation of feeling hunger and feeling full. Stopping to eat when you are full. Serving small portions that can be refilled on a plate. Educating your child to know that when they are no longer hungry they can stop eating. And forget about the clean plate club. Eating is such a joy and pleasure, what a waste to eat for other reasons than hunger.