How to develop a healthy relationship with food

WebMD Weight Loss Clinic - Live Events Transcript
Event Date: Oct. 9, 2003.

Why do you eat? What do you eat? When do you eat? In this live chat we talked about developing a healthy relationship with food with Wendy Oliver-Pyatt, MD, author of Fed Up: The Breakthrough 10-Step No Diet Fitness Plan

The opinions expressed herein are the guest's alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

Moderator: Hello, Dr. Oliver-Pyatt. Why is it important to have a "healthy relationship" to food?

Oliver-Pyatt: That's a very good question and a source of much confusion as it relates to a person's efforts to attain a healthy and reasonable weight range. In our society we place tremendous importance on whether or not particular foods are "healthy" or "unhealthy." In fact, it seems that there has even been a correlation between our emphasis on health of particular foods and our tendency as a society to have gained weight. Why is this? It is because we have lost, as a society, the understanding of what it means to have a healthy relationship with food. To have a healthy relationship with food means that one is able to eat for the reasons of physiological rather than emotional hunger and to stop eating at a point when the body and mind are truly satisfied. In order to have a healthy relationship with food, one must first have permission to eat. Our diet mentality has robbed us of even having permission to eat.

Member: How has our society made the wrong turn, developing the psychological "need" for food?

Oliver-Pyatt: To say that we don't have a psychological need for food is inaccurate. However, in our culture we have come to use food as a tool for numbing and distancing ourselves from our emotions. Why is this? Because when it comes to dealing with emotional issues, we tend to follow the path of least resistance, which is usually directly into our kitchen or pantry. As food and particular foods are more prohibited in our minds from being acceptable to eat, they become more and more powerful as a numbing mechanism.

Member: Doc, when I decide to start watching what I eat, I immediately feel deprived and want forbidden foods more. How can I stop this cycle?

Oliver-Pyatt: When you say you're watching what you eat, it implies to me that your food intake is externally regulated. We have discussed the importance of internal versus external regulation of food in previous chats. What I mean by this is that when you're "watching what you eat" I wonder if you're actually experiencing your physiological reactions to the intake of food.

When particular foods are prohibited, it creates in our mind a mental barrier or wall prohibiting us from eating the forbidden foods. Unfortunately, however, dietary restraint is temporary; we inevitably break through the wall and eat the forbidden food. In order to break through the wall, we are forced into a mental disconnection, otherwise described as dissociation. We have therefore linked the very active eating the "forbidden food" to the powerful mental act of disassociation where our mind and our body are no longer connected. This disconnection is also what helps us numb ourselves from the negative emotions we seek to avoid.

Member: Dr. Oliver-Pyatt, I want to eat when I am hungry, but I also eat when I am stressed. How can I tell the difference between the two?

Oliver-Pyatt: This is also a very important question. I think first of all we must be able to learn how to tolerate inactivity, to actually just be able to sit there for a minute or two. For many people this can be extremely difficult. I think one thing that is useful is to find a time when you're not particularly stressed and think about the times and the places you tend to eat for emotional reasons. I call these "trigger times" and "zone outs." For many of my patients they're readily able to discover particular times and places where they are likely to binge or emotionally graze on food. Also, many patients who have not worked on this have a hard time even discovering what the sensations of hunger are actually like. It can be very difficult to learn to wait long enough to experience the sensations of hunger.

But your question pertaining to differentiating stress from hunger is important because there are some people who experience hunger as an anxious feeling. Learning to exist without activity where you can actually have an opportunity to connect your mind and your body will help you to learn to differentiate between the two. Sometimes when patients do experience anxiety as a symptom of hunger, they also notice that they even feel a little "spacey" or even slightly confused or with difficulty concentrating. One must learn how to differentiate their particular cues of hunger as well as satiety in order to develop a healthy relationship with food.

I must, however, make an important point about satiety. There is a very big difference between satiety and feeling full. This is a source of tremendous confusion, in part because of many fad diets, which endorse bulk or quantity of food over whether or not the person actually attains a sense of satisfaction from eating the foods. In other words, we are told to eat foods we don't find particularly satisfying, but eat as a tool for weight loss. What we are left with is an empty, anxious, deprived state of mind that drives our compulsivity with food.

Member: I find that when I'm tired I head for the fridge. How can I turn that around?

Oliver-Pyatt: That is an excellent point. You are now describing a trigger time. What can you do instead? would be my first question, and my next question is why are you so tired? Some people have extremely demanding and hectic lifestyles, and it is an unfortunate reality in our society that many of us are overextended in terms of our obligations. I have found that many of my patients who struggle with their weight tend to be people pleasers who have a difficult time disappointing others or saying no to others. A common trend among those of us who have suffered with weight issues is our tendency to place over-attention to the needs of others and under-attention to our own needs. We are worn out, depleted, and emotionally hungry and find comfort and retreat in the act of eating.

Member: I also find that the week before my period I feel ravenous. Yet, even though I know what is causing it, I am so hungry. Is there a way to combat/curb this?

Oliver-Pyatt: It is wonderful that you are noticing your relationship to your body and your tendency to eat. Why I find this so important is that rather than blaming yourself or condemning yourself you are beginning to take seriously the mind and body connection. It is important to, as I discuss in my book Fed Up, "Get your doctor on your weight loss team."

Premenstrual syndrome, or otherwise called premenstrual dysphoric disorder, is often characterized by:

Binging, particularly on high carbohydrate foods
Food cravings
Fatigue
Irritability
Anger
Sadness
Depression

If symptoms are severe, a person may benefit from certain medical treatments, for example, with the use of SSRI antidepressants and certain mineral supplementations. There have been large-scale studies that link premenstrual syndrome to calcium deficiency and show that calcium supplements can decrease PMS symptoms significantly.

Member: I grew up in a large, poor family. I developed some very bad habits (eat fast before it's gone; eat whenever the food is there because it wasn't always there). How can I break these habits? I am no longer in that situation, but I'm still eating like a poor hungry child, unsure of my next meal.

Oliver-Pyatt: The first step is the step you've already taken, which is to develop the insight between your relationship with food as a child and how it connects with your behavior now. I would ask you to explore in more detail the feelings you have associated with eating. For example, at mealtime you can begin to journal:

Write down your feelings before eating. Is there a sense of urgency, a sense of anxiety, a sense of obligation?
Then begin to eat your meal.
When you're about halfway through it, drink a sip or two of water, pause for a moment, take a few very deep breaths and begin to journal your emotions.

You may discover what is driving you to rush through the food on an emotional level rather than an intellectual level. After dinner is done, find some quiet time and write even more about your experiences. Think about the child you once were and how he or she might have felt during those rushed meals. You may notice a sense of compassion that you feel for this harried child.

All of this is part of taking yourself seriously. When we take ourselves seriously emotionally, it also helps us to take ourselves seriously in all areas of our life, including the act of eating. When we take ourselves seriously as it relates to the act of eating, we are able to take notice and take serious our physiological cues of satiety and hunger.

Member: For me, certain foods have strong associations with childhood memories. It seems as if I can be back in happier childhood times when eating those foods. For example, my grandpa used to be the one who got us ice cream. Eating ice cream reminds me of him and visits to his farm and I always end up overeating it.

"[Children] are the ones who will decide if and how much they will eat. That is their job, not yours."

Oliver-Pyatt: My first question would be whether or not you have actually granted yourself permission to eat ice cream. I would guess that it might be on your list of "forbidden foods." Of course, we are all told what foods are healthy and not healthy to eat. It is very difficult to break through these messages and form our own unique relationship with food and our body. It is very natural that certain foods would symbolize or represent important events in our life, but it is through the power that these foods hold over us when we do not have permission to eat these foods that we become compulsive with them.

Member: As the mother of teens, I realize how soon they will be gone. So I make a big deal out of dinner. The rest of the family teases me a bit, but we have a good time at dinner. I think it very important that we all sit down together as often as possible (four to five out of seven nights a week). I love the time we spend together, but because it is over dinner, I am wondering if I am doing a disservice to my kids; am I over emphasizing food and making them associate good times with food? I can't get them together for much else; everyone has their own interests.

Oliver-Pyatt: Your question really describes the depth to which you're thinking about things, which is commendable. I believe that in our society we have lost structure, order, respect, tradition, and appreciation for the presence of food in our lives.

One of my central beliefs is that we can only really enjoy and appreciate food if we are actually paying attention to the fact that we are eating on some level. Sitting at a table together as a family, I believe, is a grounding and stabilizing force, which although we may be talking and sharing memories, reinforces the fact that it is mealtime. I believe it is normal and healthy to share joy and life together at the meal table with food, and restoring the tradition to the act of eating creates a healthy relationship with food. Furthermore, the fact that your children know that there will be a consistent meal on the table gives them stability and reassurance as it relates to food, and it also symbolizes that you give them permission as well as yourself permission to eat.

My only concern is whether or not you're doing all the cooking. You mentioned your kids are teenagers. Are they participating in helping prepare the meals or are you the lone chef? Involving them in the preparation of the meal as well is not only good for them, but relieves some of your own burden.

Member: Do you think mindless eating (munching in front of the TV, etc.) is responsible for some of the worst eating habits in our society?

SLIDESHOW

Foods That Aren't as Healthy as You Think See Slideshow

Oliver-Pyatt: Absolutely. As I stated earlier, it's my belief that we have lost our ability to truly enjoy and appreciate the presence of food in our life with our chaotic, high-pressure society. True enjoyment of food requires that we first declare and acknowledge the fact we are eating. A truly healthy relationship with food requires again that we declare and acknowledge the fact of eating. Many of us sneak food in, eating it mindlessly while we watch TV, drive in the car, and sit in front of a computer. Are we truly enjoying food or are we creating a numbed emotional state in which our mind and body are disconnected?

On a behavioral level, by simply making a commitment to turning off the television and sitting at the kitchen or dining room table and eating food off of a plate or out of a bowl is the first step toward connecting your mind and body while you eat. Incidentally, I think it is very important for everyone in the family to do this, whether or not they are children or adults, or whether or not they are concerned about their weight. There is a direct correlation for children's tendency to become obese and the number of hours they spend watching TV.

Member: What steps can we take with our children to help them avoid an unhealthy food relationship?

Oliver-Pyatt: Step 10 in my book Fed Up is called "Give to the Next Generation." There is tremendous confusion about how to help children develop a healthy relationship with food. Many children are indeed obese or overweight in our society. In fact, there's been an increase of 50% since the 1960s of overweight, obese, or extremely obese children. Our children put on excess pounds because of a steady diet of junk food, television, and video games, and sometimes they merely put on a few pounds of baby fat as a normal and healthy result of aging.

We respond, in our society, by doing the same thing with children as we do to ourselves, that is, we attempt to put children on diets or to externally control their intake of food. Unfortunately, our children will respond in the same way that adults respond to dieting, that is to develop increased food compulsity. Furthermore, dieting is the first step in the direction of developing eating disorders. No youth wakes up with an eating disorder on a Saturday morning. Eating disorders start off with dieting.

So what can we do instead? I outline the seven essential keys to preventing eating disorders and obesity in my book. I will tell you the first key is to love your child unconditionally. This is especially important if your child is developing a weight problem, because one can be fairly certain that they will be teased and that they may have a tendency towards developing low self-esteem. We must therefore teach our children to respect and love themselves based on values that are truly meaningful. To be fit, your child must first love him or herself and have your unconditional love, as well.

Moving on to another key point, it is important to foster healthy attitudes about food, for example, as I mentioned earlier, by eating in the kitchen and the dining room with the television turned off. If you are a parent who is uncomfortable in your relationship with food, it is important to contain this and not model disordered eating for your children. In other words, watch the comments you make about your own relationship with food, such as "I'm such a pig, I shouldn't be eating this or other demeaning self-talk that your children may hear.

It is very important to provide consistent meals and snacks for your children. They are the ones who will decide if and how much they will eat. That is their job, not yours. It is your job to provide them with consistent meals and snacks that are satisfying and diverse.

Member: I can see so much of myself in what you say. But how do we change a lifetime of habitual behavior?

Oliver-Pyatt: To change a lifetime of habitual behavior we must make a decision to recognize the problem and to prioritize our need to address the problem. It is truly far past the time in our society for us to become "fed up" with the diet industry and with cultural pressures to pursue a body size and shape that makes no biological sense. Dieting trivializes the relationship between food, body and self. It is time to take ourselves seriously as human beings with physiological and emotional needs that are important and serious.

One must be willing to embark upon emotional work that is necessary to address this problem. It is through this emotional work that we can achieve fitness of mind and body for the duration of our lives.

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