Notes on Food Rehab

continuing to take notes on The End of Overeating.

Treatment Framework

• He says that it makes more sense to focus on overeating as a biological challenge rather than an absence of willpower.
• It's a chronic issue to be managed through life though it will get easier as time goes on.
• Deprivation is not the answer; new learning can stick only when it generates some satisfaction.
• Lapses are to be expected and in fact, it's possible to learn from our mistakes, as "tools for recognizing where we might stumble" (this part was encouraging to me because it's easy to catastrophize and give up)
• Over time the new habits become easier to follow than the old ones so that while vigilance is still required it's not as effortful as it was at first.
• Different people will have different temperaments and different responses so it's important to have enough flexibility so that you can find what works for you.
  

Four Elements of Planned Eating:

Replacing Chaos with Structure

This means taking away the need for decisions in vulnerable moments and allows you to "set up a parallel food universe" while continuing normal life activities. Basically you set up a behavorial "switch track" where you replace the old behavior with a specific (and pre-planned) new one.

He says that at first this means having a plan for every eating occasion. You write out your menus ahead of time, you plan all your interactions with food. Where this has helped me so far:

Mother's Day chocolate -- I have a plan that I am allowed to eat 3 squares of my large chocolate bar with almonds. I have to eat it at bedtime and it can only be three, though I can give a square away to someone if I want to. What ends up resulting is that I know it's an option but generally don't actually feel the craving for chocolate right then so I only actually have the snack once or twice a week.
Going to a restaurant -- I went to my niece's baby shower this weekend and we had lunch at a restaurant. I planned that I would eat 50% less breakfast, and only eat 3/4 of what was on my plate at lunch. Then I ate 50% less of an afternoon snack and a normal dinner. For me the vulnerable part of going to a restaurant isn't AT the restaurant but when I get home -- since I already "busted the diet" I'm tempted to just keep going. But this plan helped me get back on track quickly.

Just-Right eating

This means figuring out how much you need on your plate to feel satisfied until the next meal or snack. He says it's usually less than one thinks.

To find out what will satisfy one until the next meal, he suggests trying to eat half your usual portion and then keeping notes -- how you feel 60 minutes later, 90, etc. Most Americans don't eat the kind of food that gives them clear fullness signals so most of us put too much on our plates.

Personally I plan to eat every three hours during the day -- at 7 am, 10 am, about noon, 3 pm and 6 pm with an option for a bedtime snack. My area of vulnerability is blood sugar crash but if I know there is a solid snack in the near future I can hang on.

Choosing Satisfying Foods

High fiber foods, proteins and fat are way more satisfying than simple carbs -- that is, they take longer to pass through your system. He says that this is why low-carb diets often work better than low-fat ones. He says there is a "fat trap" though -- the body registers fullness from fat quite slowly so you can eat a lot before you realize you are full, and its reward value when it's combined with sugar or salt can overcome natural restraints.

For these reasons he recommends the basic diet of complex carbs (vegetables and grains), lean protein and a small amount of fat. Personally I get by better with not worrying too much about fat percentage so long as I avoid the simple sugars and excessive salts.

Eating Foods You Enjoy

This is very personal, he says. This is why some diets work for some people and don't for others. For example I hate messing around with special menus but other people enjoy it, I suppose. I like to be able to eat what the rest of the family is having but just have less of the carbs (garlic bread or whatever) and pile on more vegetables.

He mentions a technique called "harm reduction" where you have just a bit of some treat that you can control.

Mental Rehearsal

This has a cognitive and a motivational aspect.

• Cognitively, you rehearse your strategies and "game plan" before actually carrying them through.
• Motivationally, by rehearsing you minimize anxiety and build confidence and desire to carry through.

This allows you to replace the habitual track with a planned one. It seems to me that it provides an instant gratification to replace the old one of impulsive eating. It always feels good to carry out one's intentions so long as they aren't impossibly difficult intentions.

My problem is that when I let the intentional thing lapse (which is what happens with me) I slide back into the old default framework. I suppose this is why he says management is a lifetime thing. In the beginning stages of a program, spending lots of thought and effort is in a way, fun. But over the long haul, probably spending a lot of time weighing food, planning menus, etc, loses its gratification. So for maintenance it becomes important to simplify, perhaps -- this will have to be something I think through since it's where I usually fall down -- not just with food issues but with almost everything. I can hyperfocus and succeed in carrying out almost anything in the short term but making it a permanent and natural part of my life seems somehow like a whole different undertaking.