Much has been said recently on what people should eat in order to manage or prevent obesity. There has been discussion on the social, genetic and metabolic environments that are conducive to obesity. However, beyond circling around these issues, little attention has been given to the psychological issues that may drive or act as co-pilots in such situations and what it really feels like to be in the shoes of a person struggling with an imbalanced relationship to food.
I feel this is a critical factor in creating a workable and sustainable national policy for health and well-being that has tended to throw advice at those with eating issues rather than making room for answers to come from the sufferers themselves.
Offering early education is indeed the nuts and bolts of changing eating patterns, though the nature of patterns being as they are – ingrained – things will be slow to change.
Furthermore, if it were as simple as providing education then the wealth of information online and the smattering of the same already available at school (PSD classes) and the recommendations that are being given by supporting dieticians or general practitioners would have trickled down and sunk in. Instead, the numbers of people facing obesity, diabetes and their related health issues seem to be growing both within the younger and adult populations.
The way I see it, you can know for example that sugar is to be had in moderation but, like a diet, it still takes inclination and impetus to transfer this knowledge into your daily eating habits.
To someone who binge eats, or overeats compulsively or struggles with food choices due to diabetes, cardiovascular issues or others, a diet may only be effective in the short term, if it is adhered to at all.
We know that, in the long term, some of the reasons why diets and other types of health promotions do not take effect are that people lose heart and feel deprived or cannot work a new menu into their already chaotic lifestyles. Furthermore, to those lost at sea with binge or compulsive eating issues it is not always about what to eat; they may know a whole lot about calories and have attempted every diet in the book. Overlooked in this scenario is how and why we eat.
Elissa Epel, founder and director of the Centre for Obesity Assessment, Study, and Treatment at the University of California, San Francisco, has been researching the role of stress in overeating which turns out to be one of the most reliable paths to obesity.
We often overlook how and why we eat
Epel notes that surveys show 50-60 per cent of women eat for emotional reasons rather than because of hunger. They may have completely lost touch with hunger signals, what it means to feel full and real enjoyment of food as opposed to choosing foods or eating when you aren’t actually hungry – mindlessly.
Mindless eating is the opposite of mindful eating. The latter has quietly been providing a life raft for concerned therapists, dieticians and sufferers and one that goes beyond ubiquitous diet and exercise regimens.
Mindfulness is the moment to moment awareness and acceptance of our thoughts and feelings and the core concept of the Mindfulness Based Stress Reduction (MBSR) programme created by Jon Kabat Zinn.
These same principles have been applied to the everyday activity of eating with the development of a 12-week programme by Jean Kristeller, called Mindfulness Based Eating Awareness Training (MB-EAT). It blends mindful eating exercises, such as being aware of hunger, chewing food slowly, tuning in to taste and noticing fullness, with mindfulness meditation practice to cultivate more general awareness of self. Traditional techniques for tackling obesity often don’t take into account the strong drivers of eating: negative emotions, cravings and impulsivity, particularly in the face of highly-palatable food.
Mindfulness training allows us to tune into and through these strong drives making us more aware of the triggers of overeating.
Informed by research on food intake regulation, the MB-EAT programme teaches participants three principles: to get in touch with awareness of hunger and what it feels like in the body; awareness of what it feels like to be full; and the practice of savouring – slowing down to truly taste food and be mindful of the various flavours and sensory experiences associated with each bite.
The result: once you pay attention to your body’s signals, brownies and chocolate cake or ross fil-forn (baked rice) and imqarrun (macaroni) are best experienced and savoured in much fewer mouthfuls than you think. It’s about finding satisfaction in quality, not quantity.
Kristeller advocates no particular diet and no foods are off-limits. The plan is to eat while eating, rather than mindlessly eating while reading the paper, watching TV or driving.
Unlike dieting, mindful eating is a life-long learning process that encourages curiosity and non judgement instead of fear, about what happens when you eat in different situations, under different stress levels, in different states of health or as you grow older.
Research using mindful eating programmes is in its early stages but the results show decreased bingeing, more balanced eating and emotions, decreased belly fat and reduced risk of diabetes. Though weight loss has not been the focus of the research, the more participants practised mindfulness meditation, the more they lost weight.
Before education around food can translate into appropriate food choices, a healthy relationship to food has to be established which may include increased understanding and acceptance of one’s self and one’s relationship to food.
A large body of research is showing that people who use mindfulness increase the size and function of their pre-frontal cortex, the area of the brain connected to decision making and long-range planning. It hypothesises that mindful eating strengthens this same area of the brain, making it easier for people to cognitively process their desire to eat, rather than feeling victim to the emotional centre that often drives eating.
It seems to me that, while mindfulness doesn’t advertise itself as a panacea, it can be supportive of any intervention in food issues and addresses some very visceral aspects of the everyday experience of troubled eating in an empowering way – beginning from the inside.
fmazc@yahoo.com
www.mindfulnessprogrammesmalta.com
Francesca Zammit Cutajar is a counsellor, nutritionist and mindfulness teacher.