Think back over the times you ate in the last 24–48 hours. What were the reasons why you made the decision to eat? Nowadays, eating for reasons other than hunger (which I have termed “non-hunger eating”; Nash, 2013), and without full awareness of what we are doing, is extremely common (Rothman et al, 2009). Although education is a vital part of tackling obesity, there can often be an “education–implementation gap” (Butland et al, 2007).
In theory, food is designed to solve a single problem, hunger, but there are over 30 reasons why we eat (Nash, 2016), and we often use food to solve problems it was not designed to fix, such as relieving stress, boredom or tiredness. In an age of abundance, food has become the ultimate problem-solver.
Increasing motivation is often seen as the ideal way to achieve weight loss. Alongside encouraging people to increase their motivation by focusing on the long-term goals of health, healthcare professionals may be effective if we help them solve the problems they are using food to deal with, rather than trying to “motivatee” them to remove food as a way of coping with the complexities of life.
The complex problem of obesity requires a range of tools to tackle it. The Eating Blueprint™ is one such tool, designed to provide the psychological skills to support traditional weight management advice. This article is the first in a six-part series that will outline a number of the psychological skills involved in the Eating Blueprint starter programme, which nurses may want to try using in their time-limited consultations. This article covers the first five of these strategies, themed around five Fs: Focus, Feelings, Feeders, Failure and Finishing.
Focus
Lots of the time, our eating happens on auto-pilot. Before you realise it, your hand is in the biscuit tin and the biscuit is in your mouth. Sound familiar? We’ve all been there! This is called “mindless eating” – eating when your mind is somewhere else, and eating for a reason other than hunger. Perhaps the food was there and you picked it up without thinking, or perhaps you wanted a distraction, a break or something else.
Rather than changing what they eat, people can benefit from paying attention to the conditions in which mindless eating occurs and ask themselves, “Is food what I really need?” The three-step “WHY process” can help with this. WHY is an acronym:
W is for “Wait” – pause before eating.
H is for “Hungry?” – ask yourself, “am I hungry for food or something else?”
Y is for “Yes” – say yes either to food or to the real need that you have.
The first step, waiting, is the hardest part because mindless eating is often unconscious. In the short term, perhaps for 2 weeks, I suggest people use a reminder on their dominant hand, such as wearing a charity band, wristband or elastic band, or putting a plaster on the back.
Step two, now that they’ve paused, is for people to ask whether food is what they really need right now. Finding their “hunger number” can help: rating their hunger on a scale of 1–10, where 1 is so hungry they’re about to faint and 10 feeling like they’ve overeaten. Most people place true hunger between 3 and 6.
If their hunger number tells them that they’re not truly hungry, they may be trying to solve a different problem using food. They can, therefore, start to experiment with themselves by asking, “What am I hungry for?”
Feelings
We often eat in response to feelings. These might be negative, like being upset or lonely; positive, like excitement and celebration; or neutral, like boredom. There’s nothing wrong with using food to cope with feelings some of the time. Food is great at regulating our emotional states, and it’s a strategy that has been around for as long as we have – ever since we were babies and were soothed by our caregivers’ milk.
We often need help understanding other ways to deal with our emotions. This is a big topic but, as a simple experiment, I invite people to try and identify what they’re feeling as they reach for the food. Some examples might be:
- “I am upset at my partner because he/she forgot our anniversary.”
- “I am cross at myself because I didn’t get my work finished.”
- “I am frustrated that the kids don’t keep the house tidier.”
In later issues I will review strategies to help people to make a choice other than food when they’re feeling emotional, but for now, just identifying their feelings, rather than immediately covering them over with food, is a great start.
Failure
Most people have “failed” at one or more weight loss attempts in the past and may see this as a sign that they are wrong, bad, weak-willed, unmotivated or (fill in your self-criticism of choice). I’m about to say something controversial: Embrace failure.
The bit that doesn’t get talked about in the weight loss conversation is that losing and maintaining weight is not about a pass or fail. It is a skill. In fact, it’s a little like learning to walk. It’s unlikely that anyone was called a failure when they failed to walk on their first attempt. Rather, their parents probably encouraged them for trying, comforted them when they fell and remained entirely confident that, with enough trial and error, they would get there in the end.
Infants can teach us so much about weight loss in the way they learn to walk:
- They don’t get lost in looking back at their “failure.” Instead, they get back on track and focus on the next attempt.
- They enjoy the rewards of the praise and encouragement they receive for trying.
- They accept support from those around them, whether it’s a helping hand, a cuddle when their bottom hurts, or a table to lean on.
When discussing this theme, I encourage people to try this idea of re-writing their past weight loss failures. What got them off track? Did they:
- Get lost in looking back at past “failures” rather than seeing them as opportunities to do something different?
- Not reward themselves for making the effort, even if success wasn’t possible 100% of the time?
- Not have support from a person or group who understood them?
What got the person off track before? What can people learn from their failure that can support them in moving forward in the future?
Feeders
“Feeders” are the people in our lives who we may find it difficult to say no to. In many cultures, food is seen as a way of showing love and care, particularly (but by no means exclusively!) by women. Feeders can come in many forms, including family members, colleagues and friends. Most behave this way for positive and loving reasons. It can be useful for people to think about what might be motivating these “feeders”, and how to use this motivation so they can both get what they want and need. A couple of examples of needs that a “feeder” might want fulfilled, and some ideas of how to respond, are given in Table 1.
I encourage people to consider whether there are any “feeders” in their lives and think about what the food they are offering may symbolise: love, care, connection, to have an “eating-buddy”, to say thank you? They could prepare a friendly way of saying no to experiment with for the next time.
Many people can also see themselves in the description of the “feeder”. There’s nothing wrong with this, but they may want to consider whether there are other ways, as well as through food, that they could get these needs met.
Finishing
This theme represents the feeling that one should always finish the portion of food that has been served, whether it’s on one’s plate, in the packet or in the cupboard. People may feel like it’s a waste of money or rude not to finish the food that’s available. Perhaps they feel they are denying themselves if they leave any. It may be a cultural norm or rule, or perhaps it is simply a habit they’ve got into.
If we can figure out why we are finishing, we can figure out how to do things differently. I invite people to think about why they feel the need to finish. At one meal, they could perhaps experiment with doing something a bit differently, by leaving a mouthful on the plate or in the packet and then paying attention to what thoughts, feelings and impulses come up. If the food is still “calling” after a minute or two, they can always choose to go ahead and finish.
Remember there is no right or wrong outcome, it’s just about noticing the inner clues that trigger them to eat, to help them learn more about their relationship with food.
Next steps
I hope readers and individuals who may be struggling with their weight will find these five strategies useful. In the next issue of the journal, we will continue with five more taken from the Eating Blueprint starter programme.
About the Eating Blueprint
The Eating Blueprint is a “psychological skills” approach to weight management, equipping individuals with a simple-to-use toolkit of strategies delivered within an online/video programme.
The Eating Blueprint method was created by Dr Jen Nash, Chartered Psychologist. A recovered emotional eater herself, Jen has spent the last 10 years immersed in the heart and mind of eating behaviour, unlocking the missing link of her own food–weight journey, and she now loves nothing more than to inspire others to find theirs.
The programme is available for NHS commissioning or, alternatively, the strategies in this article are available as a book and accompanying online Starter Programme for £12. To access or for further information, please email [email protected] or visit www.EatingBlueprint.com
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