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Dismantling Diet Culture in a Pivot Towards Mindful Eating
Contributed by: Elizabeth Mariutto, PsyD, CEDS at Lindner Center of HOPE
Americans are pummeled with the importance of fighting obesity. Individuals that are in larger bodies are pressured by our society, including the medical community, to lose weight to improve their health. However, data indicates that weight loss is notoriously ineffective, with 95% of those who lose weight gaining that back, and more, within one to five years (National Eating Disorders Association, 2018). Research has indicated that while weight can be stable over time if there are not changes in how much nutrition is taken in and then burned, this settling point can be impacted by long term changes in energy balance, or the amount of calories burned vs. those that are taken in. Specifically, changing this balance of energy too drastically leads to lowered metabolism, making it easier to regain the weight lost (Martin et al., 2007).
Not only is weight ineffective, but often unnecessary. While there is research that obesity is correlated with chronic illnesses, the causal effect has not been demonstrated. The studies that have found these correlations have rarely factored in exercise habits, nutritional intake, or weight trends over time, and when these have been factored in, the correlation is significantly lowered or eradicated (Bacon & Aphramor, 2011). Furthermore, weight loss attempts can be harmful physically and psychologically. Dieting leads to increased production of cortisol, the stress hormone that has been correlated with increased risk of disease. Dieting has also been found to lead to reduction in bone mass, menstrual irregularities, headaches, fatigue, dry skin, hair loss, and increased risk of heart disease and premature death (Bacon & Aphramor, 2011). It is associated with the development of eating disorders, increased preoccupation with food, avoidance of social situations involving food, and a feeling of deprivation which leads to decreased willpower (Tribole & Resch, 2012). Dieting disconnects individuals from hunger and fullness cues, teaches the body to retain more fat when one resumes eating normally again, and leads to weight regain in the stomach area (Tribole & Resch, 2012).
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An alternative way to change one’s relationship with food is follow non-diet approaches. Non-diet approaches focus on physical and psychological characteristics as better indicators of health than weight and do not view changes in weight as signs of success or failure (Herrin & Larkin, 2013). They promote following one’s hunger and fullness cues, do not set labels of “good” vs. “bad” foods, and acceptance of one’s body (Herrin & Larkin, 2013). One such approach is mindful eating. Research has shown that mindful eating can reduce binge eating (Godfrey, Gallo, & Afari, 2015), cultivate overall healthier eating behaviors (Rogers, Ferrari, Mosely, Lang, & Brennan, 2006), and improve depression, anxiety, and eating attitudes (Rogers et al., 2006). While many can benefit from this approach, those going through a weight restoration process or in the early phases of being exposed to eating normally, such as those with Anorexia Nervosa, are not appropriate, as they commonly experience gastrointestinal symptoms that interfere with accessing hunger and fullness cues (Herrin & Larkin, 2013). They often feel discomfort at normal levels of fullness and feel chronically full even when eating less than their body needs (Herrin & Larkin, 2013). Furthermore, others with gastrointestinal symptoms that may make it hard to access accurate hunger and fullness cues, such as nausea, significant bloating and constipation, or abdominal pain, should not pursue this approach until symptoms resolve (Marek, Ben-Porath, Federici, Wisniewski, & Warren, 2013).
Mindful eating includes several components, include being aware of hunger and fullness cues, the sensory aspects of food, and the triggers for mindful eating (Albers, 2008). It may start with individuals doing a body scan of symptoms that can indicate hunger, such as energy level, ability to focus, an empty stomach, and/or irritability. Patients are encouraged to identify what is leading them to start and stop eating. This may be an internal cue, such as one’s hunger, or an external cue, such as others deciding to eat or the time on the clock. It may even be an emotional factor, such as wanting to consume food for pleasure, comfort, or to distract oneself from what is going on. Mindful eaters will check in with themselves around how they will likely feel if they choose the option they are craving. For instance, eating a donut may result in short-term satisfaction and joy, but may lead to a sugar crash later, or eating a lunch that consists only of vegetables may not lead one to feel satisfied shortly after the meal. Individuals who mindfully eat learn to explore the relationship they have with food, including the role that foods serve in managing one’s emotions. They learn to soothe emotions in other ways, tolerate urges without giving into them, and allow themselves to feel emotional pain (Albers, 2008). Mindful eating does not mean one eats “perfectly” all the time, but allows one freedom, flexibility, and compassion while cultivating a better relationship with food and one’s body.
Resources:
Albers, S. (2008). Eat, Drink and Be Mindful. Oakland, CA: New Harbinger Publications, Inc.
Bacon, L., & Aphramor, L. (2011). Weight science: Evaluating the evidence for a paradigm shift. Nutrition Journal, 10, 9.
Godfrey, K. M., Gallo, L. C., & Afari, N. (2015). Mindfulness-based interventions for binge eating : A systematic review and meta-analysis. Journal of Behavioral Medicine, 38, 348-362. doi: 10.1007/s10865-014-9610-5
Herrin, M & Larkin, M. (2013). Nutritional Counseling in the Treatment of Eating Disorders, 2nd ed. New York, NY: Routledge.
Marek, R.J., Ben-Porath, D.D., Federici, A., Wisniewski , L., & Warren, M. (2013). Targeting premeal anxiety in eating disordered clients and normal controls: A preliminary investigation into the use of mindful eating vs. distraction during food exposure. International Journal of Eating Disorders, 46, 582-585.
Martin, C. K., Heilbronn, L. K., de Jonge, L., DeLany, J. P., Volaufova, J., Anton, S. D., Redman, L. M., Smith, S. R., & Ravussin, E. (2007). Effect of caloric restriction on resting metabolic rate and spontaneous physical activity. Obesity, 15, 12.
National Eating Disorders Association (2018). Statistics & Research on Eating Disorders. Retrieved from https://www.nationaleatingdisorders.org/statistics-research-eating-disorders
Rogers, J. M., Ferrari, M., Mosely, K., Lang, C. P., & Brennan, L. (2016). Mindfulness-based interventions for adults who are overweight or obese: A meta-analysis of physical and psychological health outcomes. Obesity Reviews, 18, 51-67. doi: 10.1111/obr.12461
Tribole, E. & Resch, E. (2012). Intuitive eating: A revolutionary program that works. New York: St. Martin’s Griffin.
Lindner Center of HOPE offers a disciplined approach to eating disorder treatment that combines psychiatric management, psychotherapy, nutritional services, and family engagement throughout the entire process. Board-certified clinicians offer the wisdom, compassion, and proven treatment modalities to successfully treat complex illnesses such as eating disorders, returning patients, and their loved ones, to more fulfilling lives.
The Harold C. Schott Foundation Eating Disorders Program at Lindner Center of HOPE includes services for adults and adolescents, females and males, while also incorporating research.
The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Published November 29th, 2021, on EatingDisorderHope.com
Reviewed & Approved on November 29th, 2021, by Jacquelyn Ekern MS, LPC
