When I meet with each new member of Kansas City Direct Primary Care, I make sure to take time to sit down with him or her and explain that my overarching goal is to keep my patients well and healthy, and — oftentimes — there is no magic pill or quick fix to achieve this aim. Rather, we have to return to the basics to take a closer look at our habits and lifestyle to see what sort of foundation we’ve developed for our health.
With that in mind, I thought this was a perfect time to talk about food and eating. This isn’t about diets. Or feeling guilty about our food choices. Or dictating that you need to shop for and prepare some sort of grass-fed, organic, paleo, gluten-free, low-sodium, 100% natural, non-GMO cold-pressed meal in order to be healthy. All of that misses the point*. It’s much simpler.
My father is a confident 6-foot-3 and has been overweight for a good portion of his adult life. I remember as a child that he was lighter, but at some point the year-after-year uptick kept upticking and he found himself in his 40s, and then in his 50s, carrying around all this excess weight and trying to figure out what to do with it. When I asked him if he could remember a sudden change or instigating event that led to it — after all, there was the divorce when he was 40 — he didn’t really have any one thing to blame. He’s fairly objective about it: he thinks he just got into bad habits and never tried to change them in a meaningful, lifelong way.
He had tried diets, but they didn’t work. When I asked why he thought this was so, he aptly noted, “They don’t represent real life. They work — because they’re some sort of gimmick that gives you quick results. But are you going to do it the rest of your life? No — you’ll waste away to nothing! They don’t teach you how to keep at a healthy weight. It’s an artificial behavior.”
He’s right. They don’t work. There’s no quick fix to weight loss, and most of the dramatic changes that are associated with dramatic diets (i.e. avoiding all carbs on the Atkins diet or severe calorie restriction in general) don’t hold up over time.
With that in mind, I’m proud to report that Dad’s down 34 pounds since February. He’s not exercising more. He hasn’t cut carbs. He isn’t avoiding things. I recently invited him out to lunch — he picked a local Mexican restaurant — to pick his brain about his new routine, but when he answered my question, “How’d you do it?” the answer was absurdly simple.
“Mindful eating.”
I wanted to hear him wax poetic about all the little nuances and tricks he created to accomplish this and for him to dictate a list of maxims and rules for success, but he didn’t. Because, to him, it isn’t that complicated.
That’s because he’s been thinking about this — and learning about it — for almost 9 months now. He’s made a new habit, and it’s working. The bad habits that got him into trouble in the first place are starting to fade, and he’s making progress.
He’s a recovering shoveler. You know the type. In fact, Dad pointed out a few as we ate our lunch: “Just sit here and watch people, especially overweight people. Watch them eat — they’re shoveling it. People shovel it down.” Sure enough, as I watched the other patrons in the bustling restaurant, I could see it playing out at every other table: people chatting, mouths full of food, forks perched and loaded on the edge of the plate, hovering, then ascending to mouths that were barely empty. Conveyor belts of chips to dip to mouth, repeating on a loop. It became clear to me as I surveyed the scene: nobody in this restaurant was thinking about how they were eating.
So we got down to business, and I asked Dad to point out a few action steps for success:
- He starts with a simple mantra: “Eat when you’re hungry, and not when you’re not.” This is silly, really, to put in print, but it’s foundational! When I’ve explained this concept to people with restrictive jobs, I get a huge eye roll as they remark, “It must be nice to get to choose when you can eat.” I get it: we all don’t have the luxury of eating on a schedule that responds to our biological needs. But herein lies the power: it’s ok to eat a small (small!) snack when you feel you’re getting hungry but know a meal is hours away. A few almonds, or peanut butter crackers, or an apple/piece of fruit may do the trick here. The whole point is to make sure your hunger doesn’t get to a ravenous level, and that once you’ve started eating, you don’t eat until you’re far past “hungry” and moved on to “stuffed.”
- When you eat, Dad says, “Eat slowly and enjoy your food. Because your tastebuds are only on your tongue — not in your throat or stomach, so what’s the point of hurrying?” This is a phenomenally huge shift for Dad. I have vivid memories of him at the dinner table, eyeing my plate as he inhaled his second serving and simultaneously made the mental calculation about how much of my meal he was going to be able to nab (yeah, I saw you, Dad!). To slow down, consider chewing all your food before loading the next bite. Consider putting your fork down between bites. Consider sitting in silence and just tasting your food. All of these pointed actions will slow down the rate at which you eat and will help you keep from overeating.
- Moreover, figure out how to read your hunger levels and react to the process of eating. Dad shares: “I’m enjoying food. I’m not starving myself. But I’m more aware, I guess, of when I’m not hungry any more — and that’s different than being full.” After you’ve been eating for 5 minutes, take a break and deliberately ask yourself: am I hungry? Chances are, you’re not! Set your fork down, and take a break. Come back if you’re hungry, and if you’re done, be done!
- Lastly: Portion control! Even one generation ago, we had smaller plates, smaller glasses, smaller servings, and smaller waistlines. The supersize me movement is in full swing, and our bodies just aren’t designed for it. Dad enlightened me on this one: “Your stomach is about as big as your fist, so just” — he stuck out his fist over my plate — “take a look at that. That’s all the bigger your stomach is.” I glance down at his fist and note that it covers a third of my plate of tacos, enchiladas, and beans. I pause and make a mental note: I think I’ll be getting a box.
Once we had hashed out the basic foundation of mindful eating, I brought up the real reason I wanted to talk to him: how’s he going to deal with the onslaught of the holidays and holiday parties? How do you mentally prepare for the gluttony? His answer, again, was frustratingly simple. Armed with the tools described above, he admits, “I’m not really mentally preparing for it because it’s just like any other day where you have food — you have food every day.” Ok. Fair.
But it’s pretty hard to be mindful in a room of chatter, tinsel, and free-flowing alcohol, and, Dad admits, “when you’re around a lot of people, you tend to eat without thinking. The more people you’re around when you’re eating, the more you eat. You eat past what you really need.”
Still: it goes back to those basics: eat if you’re hungry, chew your food, stop when you’re satisfied, and don’t take too much food. To enact those things while your mind can’t be mindful (because it’s busy socializing!), it may be important to show up to the party armed with a plan: “I’m going to go through the buffet once, scope out what I want before committing, and only go back for seconds if I am actually hungry,” for example. When we deliberately plan and force ourselves to commit, we tend to be more successful in the end.
And even if one party gets a little out of control, you can always turn to my Dad for sage advice: “if you overdo it, there’s always tomorrow.”
Happy holidays!
Allison Edwards, MD
*While each of these ideas has some basic element of benefit, when people get hyper-focused on one of these as dogma, they lose sight of the fact that the low-sodium, gluten-free snack they’re eating is actually ice cream…which really isn’t healthy! I call this the “Halo Top” phenomenon: you’re still eating ice cream (and I don’t care if has fewer calories and more protein. It’s ice cream.). Now. I LOVE ice cream and wish I could eat it every day, but I also know that eating dessert every day isn’t sustainable, so I have to go without. Really — without! Not with reduced calorie, high-protein ice cream. The trouble is that as humans, we’re detrimentally influenced by mass marketing, viral hits on social media, and fads in general, and we forget that the most important food is the food that isn’t being marketed to us: whole fruits, vegetables, and grains. That’s it. Simple. Ok, rant over.