But now what? If diets don't really work what are we to do? We know that health and weight aren't particularly connected, but for most of us health and some level of fitness are definite values we'd like to honor.
Ellyn Satter, dietitian and social worker, has developed an approach she calls competent eating. She saw that the standard nutritional advice of watching what you eat, controlling portions, and counting calories wasn't working with her clients. Rather, it taught people to not trust their own appetites and go into cycles of over and under eating. It demonized whole categories of foods and brought shame, guilt, and worry to the forefront.
Satter defines competent eating as follows (taken from here):
Feed yourself faithfully. Reassure yourself you will be fed. Structure is the supportive framework for taking care of yourself with food.
Give yourself permission to eat. Reassure yourself: “It’s all right to eat. I just need to sit down and enjoy.”
- Take time to eat.
- Develop a meal and snack routine that works for you.
- Include foods you truly enjoy. Don't worry about lists of food-to-eat and food-to-avoid.
- Make eating times pleasant. Relax. Pay attention. Take your time.
- Experiment with new food when you get ready; take it slowly.
Notice as you learn and grow. Becoming a competent eater is a process, and it takes time. As you combine structure with giving yourself permission to eat, you will find your eating falling into place.
- Eat what you want. Your body needs variety and your soul needs pleasure.
- Eat as much as you want. Your body knows how much it needs to eat.
- Go to meals and snacks hungry (not starved) and eat until you truly feel like stopping.
- Pay attention to your food. Taste it! Enjoy it!
- Eat it if it tastes good; don’t if doesn’t!
- You feel good about your eating and are reliable about seeing to it that you get fed.
- You get better and better at eating as much as you are hungry for.
- You eat fruits, vegetables, whole grains, and other nutritious foods because you enjoy them, not because you have to.
- Having “forbidden foods” at meals and snacks makes them ordinary foods to eat in ordinary ways.
- Big servings don’t make you overeat. You eat it all if you want to, not if you don’t.
I think all of this is far more easily said than done, but it speaks to a shift in paradigm around eating. While following this would be a lifelong process, it could potentially lead to eating without the shame, confusion, and lack of trust we so often have around food. As Satter says, “normal eating...varies in response to your hunger, your schedule, your proximity to food and your feelings” which can be done by trusting one's self and following the three key principles.
To do it means to learn how to feed yourself all over again. It means learning what one's likes and dislikes really are. It may mean learning to tell when one is hungry or full (something I struggle with from time to time). It may mean learning when we actually want to eat something as opposed to eating something “bad”, for example, automatically without awareness around the action.
Competent eating or any other model or approach, whether a more formal one or a personal one entails bringing awareness around how we eat. To do so is to enter into a lifelong contract with yourself, tracking the "stuff" around our decisions involving eating, food, and health.
In the past year of tracking this for myself, for example, I have noticed several major trends. I love cookies and use running, emotions, and friends to justify eating them. Sometimes I berate myself but I've found the best approach for me is to eat them freely, which ends up satiating me far sooner and ironically resulting in fewer cookies eaten. I've also noticed a worry that I won't have enough food when I am away from my house for longer periods of time, and often would over eat in anticipation of future hunger. My own solution was to both watch this and be ok with getting hungry for a while (definitely hard for me) or to plan to bring food with me or be ok spending money out (also rather challenging).
Having the support of my partner, friends, and family has been crucial for this process. And as I look around, I am starting to learn that there are larger groups and communities that work with these issues as well.
A growing social movement called Health at Every Size (HAES) emphasizes living a joyful and healthy life unattached to any weight outcome. Its basic tenet is that good health can be realized independent of weight, and we can address health directly rather than by trying to change our weight. It values respect, compassionate self-care, and critical awareness. It says that healthy behaviors can be incorporated into our lives regardless of weight.
After a two-year study found HAES superior to more traditional approaches, the US Department of Agriculture (a more conservative agency) endorsed it. Contrary to critics deriding HAES as something that promotes obesity and unhealthy lifestyles, HAES has been found to be more focused on health precisely because it doesn't try to fix everything through changes in weight.
Harriet Brown, in her excellent book Body of Truth, makes a very good point, however. The decisions we make in order to feel healthy and take care of ourselves are highly individual. It may include these things, or it may include a different approach. Physical exercise, enjoying food, stopping when full, sleeping sufficiently, spending time with friends and family, and letting go of self-loathing are habits Brown suggests and I try to do as well.
But there are no die hard guidelines, and the reality is that the science on health and weight is an evolving one that is only now beginning to move beyond a blind assumption that the two are both correlated and cause one another in nearly all cases. Experimenting with what works for you individually is crucial. And so I'll leave you with Brown's wise words:
“That's the challenge I want to leave you with: to think beyond the messages we're getting a thousand times a day. To question conventional wisdom. You may wind up making the same exact choices in your life as you do now, but at the very least you'll be making those choices more consciously. Or you may wind up with an entirely different point of view, one that could help set you free from the painful and punishing rules we've been living by for so long.”