For years, eating disorder specialists have been telling us that we need to eat “mindfully,” that we need to “listen to our bodies,” and that we need to sort out emotional causes of overeating from genuine hunger. My PT colleague Mitchell B. Liester recently wrote a post about research showing that healthy eating can improve depression in some cases as much as an antidepressant. But despite the panoply of available therapies to address these issues and find a way to be comfortable in our bodies, minds, and lives, these sensible directions can be difficult to follow.
Although I no longer work specifically with eating disorders, I have found that many of the clients I work with in psychotherapy have a troubled relationship with food and with their bodies. That’s not really surprising to me. Most of the people I know outside of my work have similar difficulties.
You know what to do. What makes it so hard to do it?
Which brings me to the question: what makes it so hard to follow the healthy suggestions of so many psychotherapists, nutritionists, and, increasingly these days, psychiatrists? And my answer is: the psychological underpinnings of food and eating issues are widespread and complex.
But they can be dealt with.
The universal fantasy about weight loss
One factor is an almost universal fantasy, as Mary Anne Cohen, author of Ozempic for Smarties: A Psychotherapist Tells the Straight Skinny, writes in a recent post, “that weight loss will finally make you whole, happy, and more lovable.”
For another, we have so many different voices in our psyches that it’s hard to sort out what is “really” coming from us. These opinions, coming from family, cultural, medical, and general interactions with others, cloud our ability to trust ourselves.
You can eat well and also enjoy so-called “junk food”
Cecily* was a perfect example. She had struggled with an eating disorder in her teens, but now, as a 27-year-old, she was making a conscious effort to eat well. Most days she had a healthy breakfast of yogurt and fruit every morning, lunch of a salad and soup or a sandwich of fresh chicken with extra lettuce, and a protein, starch, and two vegetables for dinner. She drank plenty of water and had an occasional snack of dried fruit and nuts.
But there were days when she grabbed a donut off the office coffee cart for breakfast and had a bag of chips and a candy bar for lunch. And on far too many nights, dinner was a slice of pizza or some other fast food.
From her psychotherapist when she was an adolescent, she had learned that fast foods and packaged snacks like potato chips appeal to an evolutionarily based craving for salt and fat, which helped our ancestors survive. “But they also are easier and cheaper than cooking for myself,” she said. She also knew that her binges were often triggered by emotional issues. “I’ve learned to address those problems head on,” she said. “And I haven’t binged for ten years.”
Still, Cecily, like many of us, often felt ashamed that she could not control her cravings. She worried that she was “just lazy,” and she assumed other people had the same criticism of her.
Your internal map
“My therapist told me I had to learn to listen to myself,” she said. “When I want chips or a candy bar, I’m listening to myself. And when I think I’m too heavy, I’m listening to myself. But those thoughts are supposed to be wrong. I’m confused. I’m probably remembering wrong, or maybe I’m just not remembering at all. Maybe she said something else that I’ve just forgotten.”
I believe that we each have an internal “map” that guides us as we move through life. That map starts small, with just the self that interacts with our family. As we grow and mature, the map expands to take in the rest of the world with which we interact—friends, teachers, religious leaders, and eventually the world around us as well.
Internal conflict: Choosing a direction over and over again
From very early, we have to deal with internal conflict about what direction to take, which road to follow on our map. For a small child, that conflict may start as a disagreement between what they want and what their parents want, but before too long it becomes an internal question of whether they want to please their parents or please themselves.
I told Cecily that I thought she probably was remembering correctly, but that what she was describing now was one of the things that makes listening to yourself difficult: internal conflict. “You want to eat healthily,” I said, “but sometimes you want to eat something that’s not quite so healthy. That’s internal conflict—an internal argument about which direction to go on your personal map.”
Cecily said, “That’s so interesting. I know I eat pretty well. I exercise regularly, sleep well, and have a terrific guy in my life who tells me he loves how I look.” But recently several people had told her that she looked like she was losing weight, and that had triggered her self-doubt.
“Are you losing weight?” I asked.
“I don’t think so. I don’t weigh myself, but my clothes still fit the same.”
“So if these people hadn’t said anything, you wouldn’t be concerned?” I asked.
She nodded. “Even though you sometimes grab chips or candy or fast foods?” I asked.
“Well, I don’t love that. I try to eat well, but sometimes you have to cut yourself some slack,” she said.
You’re not alone: Other people have their own food and eating issues
The people who commented on her weight probably had their own food and weight issues—something it’s always important to keep in mind when considering someone else’s opinion about your body. Their comments triggered some of Cecily’s own concerns and highlighted that she was straying from the direction of “healthy eating” outlined on her personal map.
As we talked, though, Cecily realized that her map included side-trips to “fun” eating. “A slice of pizza isn’t completely unhealthy,” she said. “Maybe a candy bar or bag of chips is; but on my map, getting off the main road is perfectly OK and maybe even worthwhile, as long as I don’t stay on that path too long.”
My PT colleague Gia Marson would probably agree. In an informative post about healthy, mindful eating, she points out that “diets rarely create lasting, healthy change.”
This information can be added to your personal eating map. It will not end your internal conflict, but the additional choices can provide more information that allows you to choose the path on your personal map that makes the most sense for you.
*Names and identifying info changed to protect privacy.
