My local newspaper has been running a series of articles about the obesity epidemic. There have been pieces on the physiological factors that contribute to a preference for calorically dense, nutritionally poor foods, on diet tips from nutritionists and smart phone apps that offer nutritional information, on the importance of a healthy diet and regular exercise, on weight-loss success stories.
What I’ve not seen mentioned in these stories is how we eat— not just what and how much we eat. This concerns me greatly, because I believe that no matter how much we learn about nutrition, exercise, and our metabolic processes, the obesity epidemic will not be cured, and disordered eating will flourish, if the focus isn’t shifted from the “what” and “how much” to the “how.”
I work with many clients whose disordered eating manifests as overeating without any of what are known as “compensatory behaviors:” attempting to undo caloric intake via inducing vomiting, misusing laxatives, diuretics or enemas, fasting and/or exercising excessively. Many have lost and regained hundreds of pounds. Time and again they have dieted and exercised, been “good” (i.e., avoiding “bad” foods, stuck to their diet plans) and received accolades from friends, family and co-workers, but they’ve fallen off the wagon, returned to overeating, regained the lost weight, and felt terrible about themselves.
When new clients and I sit down together and talk about their struggles with weight and their relationships with food and with their bodies, something that I always, without fail, learn is that how they eat is mindlessly. That is to say, when they eat, whether it be a 3-oz. grilled chicken breast with a cup of steamed green beans and a dry baked potato, or a bag of chips and a pint of Ben and Jerry’s, is that they eat in front of the TV, or at the computer, or wandering around the kitchen, or while they are driving. And I begin my work with them by focusing not on the food choices they are making or portion control, but on eating mindfully.
Mindfulness is a practice that has its beginnings in Buddhism and has become an increasingly common component in the treatment of physical and psychological maladies. Jon Kabat-Zinn, founding Executive Director of the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School, has found that practicing mindfulness can decrease physical and psychological symptoms and increase coping abilities and self-esteem. On the UMass web site, Kabat-Zinn defines mindfulness as, “intentionally focusing attention on moment-to-moment experience without being swept up by judgments or preconceived ideas and expectations.” This means noticing what we are experiencing in the present moment physically, mentally and emotionally.
To sit and eat without distraction, to focus on the taste and texture and smell of food and to notice the feel of food in the body and body’s reaction to the intake of food, to notice the emotions that come up as one does this is an experience that I believe to be essential to healing one’s relationship with food and body. It is also an experience that is initially foreign to my clients.
It seems logical that a person who overeats (and I define “overeat” as eating beyond the amount a given person’s body needs) loves food. It follows then that focusing solely on this beloved thing, food, would be a pleasurable experience. Nothing could be further from the truth. I find that getting my clients to eat mindfully is like herding cats or trying to catch a greased pig. Lovely, intelligent people come up with all kinds of reasons for not having eaten mindfully during the previous week. When we examine this more closely, they report that they either completely forget, or they thought at the time, “I’ll eat mindfully tomorrow; right now I’ve had a long day at work and I just want to relax in front of the TV.” Often they become aware of an inner voice saying, “No! I do not want to sit down and eat without something else to do!” We explore this in therapy, working on the reasons for the resistance.
When they do begin to eat mindfully, they often report experiencing feelings of emptiness or loneliness. Only by changing the “how” of eating can one get to the underlying “why.” I find that the greater the intensity of the compulsive, addictive or emotionally-driven aspect of one’s overeating, the more potent the effects of eating mindlessly. In other words, the degree to which an overeater’s relationship with food is disordered (that is to say, a psychological condition expressed in a disturbed relationship with food) reflects the degree to which the food-distractor combo functions to counteract psychological distress. Removing the distractor and focusing only on the experience of eating puts one face-to-face with the very discomfort he or she wants to avoid.
Kabat-Zinn describes mindlessness as, “a loss of awareness resulting in forgetfulness, separation from self, and a sense of living mechanically.” This describes the experience of the overeater eating while lounging in front of the TV or standing in front of the kitchen cupboards. This kind of behavior usually began as a means of protection from emotional pain and evolved into a way of operating on a regular basis. The price the person paid for protection from the pain was disconnection from self.
Only by staying present and conscious while eating can an overeater heal. The articles I’ve been reading in my paper emphasize behavior change and the development of a healthy lifestyle, but neglect the internal mental and emotional conditions that drive the behavior. Long-term, meaningful change starts with living in the moment, with being present and connected to our internal states. From there, we can cultivate reverence for ourselves, and we can do this by feeding ourselves good, healthful foods and exercising because we care about our well-being. Instead of waging a war on obesity, let’s set about to make peace with our relationships with food and body by paying attention more deeply and fully. Health will improve, but the healing that results can’t be measured on a scale.
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