the HAES® files: “Do I Really Get to Eat What I Want?”

by Health At Every Size® Blog

by Ellen R. Glovsky, PhD, RD, LDN

Ideas about nutrition and dieting are a common topic of conversation in my life. I am a Registered Dietitian, and once people find out what I do for a living, they often want to tell me about their struggles with diet, food, and weight. In this context, I often hear the argument that being overweight is bad for one’s health, and simply bad. Sometimes people don’t really know why they think being fat is bad, but they are sure it is. I try not to miss a chance to “carry the message” that there’s an alternative to the struggle with food and one’s body. This alternative is the Health At Every Size® (HAES) approach to weight and health. The HAES idea is just what its name says, a focus on health rather than weight. Part of HAES is a “non-diet” approach to managing one’s relationship with food. As I describe these ideas, some people are interested and curious, while others listen politely and change the subject. I’m guessing they think I’m simply insane, or at best, misinformed about the “truth” about “weight management”.

While I really don’t like the name “non-diet” because I feel it is negative, it tells the story clearly. We are not dieting, which implies restriction, and an outside authority telling you when, what, and how much to eat. Whether you are dieting for weight loss or other reasons, it is restrictive. There is evidence that restriction can actually cause bingeing. I’m guessing that if you have tried to diet, you have had the experience of becoming obsessed with food. I certainly have! It’s normal; the body interprets a lower intake of energy (calories) as starvation, and will work hard to find food to keep from starving to death.

The non-diet approach centers on three basic questions when you are thinking about eating:

1) Am I hungry, really physically hungry?

2) If I’m hungry, what do I really want to eat right now?

3) How much of this food do I need to feel satisfied?

“What do I really want to eat?” sounds like a simple question, but it’s always surprising to me that people either don’t know what they want, or are so used to “the rules” that tell them what they should eat that they are out of practice in discerning the answer. The first thing to consider is whether or not you are hungry. Food tastes best when you are hungry! Check it out next time you eat! Because of this phenomenon, it’s easiest to answer the question of what you want when you are physically hungry. If you are physically hungry, the next question is, “What do I really want to eat?” This question centers on what food would feel satisfying, really good right now in your body. If you have been dieting for a while, this question can be really hard to answer.

One way to begin to explore the idea of knowing what you really want to eat is to think of the four characteristics of food. The food you choose should be as close to perfect for you as possible in terms of flavor, texture, color and temperature. The table below offers some ideas of foods that fall into each category. If a hamburger and fries are what you really want, and you choose a green salad with chicken (to save calories, for example), it probably won’t be satisfying and is might make it more likely that you will overeat or binge at the next opportunity. These two example meals are not the same at all in the characteristics of food noted.

Another way to think about what you really want to eat is to ask yourself “what hums for you?” When we hum, our voices and chests vibrate. What are you “vibrating” for, or humming for? What food do you want from deep inside you? The idea here is that when we eat what we really want, that hum, or craving disappears. We have satisfied that urge.

Chart

Often I hear in response “But that can’t be possible! If I ate what I really wanted I’d eat junk food all the time and that’s not healthy.  I’d be as big as a house, too!” What that means is that you don’t trust yourself to stop eating if the food choice is something you really want. Well, that turns out not to be true. It’s the dieting mentality that tells us “You can’t possibly trust yourself. Look where trusting yourself got you. Do it my way and you’ll be all set.”  This diet mentality can sound good, but we know that dieting almost never works over time. Research has shown that, in practice, people actually eat less and binge less when they learn to tune into their own hunger and fullness signals. Further, the idea that left to your own devices you would eat “badly” turns out not to be true, either. Once all foods are possible, most people select the best choices for their own situation.

The main idea of the non-diet approach is that when we eat when we are hungry and eat what we really crave or “hum” for, we are more likely to be satisfied and ultimately need less food. This goes back to the basic HAES concepts described earlier in this article. These emphasize internal signals of when, what and how much to eat, and focus on moving one’s body in ways that feel good and leave you feeling strong, with little to no focus on body weight.

You really can trust your body to guide you towards a healthy life!

 


Ellen Glovsky, PhD, RD, LDN is a Registered Dietitian and a member of the teaching faculty of Northeastern University in Boston, MA. Dr. Glovsky conducts workshops and consultations for a variety of organizations around the country on Motivational Interviewing (MI). She is a member of the Motivational Interviewing Network of Trainers (MINT), the professional group of MI practitioners and trainers. Dr. Glovsky maintains a private practice in which she offers treatment for eating disorders using a Health At Every Size approach. Her contact information follows:

Motivational Interviewing Trainer – Registered Dietitian – Nutrition Therapist –Author- Speaker  www.TrainingwithDrEllen.com

Author, Wellness, Not Weight: Health At Every Size and Motivational Interviewing

Coaching for Nutrition and Wellness  www.nutrition-coach.com

(781)890-1618 (office)       (781)290-8886 (cell)

5 Comments to “the HAES® files: “Do I Really Get to Eat What I Want?””

  1. I’m pretty good at tuning in to the “what do I want to eat” signals described here.

    However, I’m wondering about intuitive eating being a sufficiently reliable guide to food choices, when there are complicating health issues such as allergies, intolerances, diabetes, kidney or liver disease, and so on. As a minor example, I really want honey in my tea, but my blood sugar and kidneys would be better served by stevia. Or, i would be best satisfied by a sandwich for lunch, but wheat makes me ill and, depending on what else I’m eating, two slices of bread may raise my blood sugar too high.

    It feels to my like I’m trying to follow conflicting guidance systems – intuition/felt body sense, vs. the medical needs of my body. The result is often not knowing what to eat, grazing, and/or adopting an “I just don’t care anymore” attitude.

    Any suggestions on resolving the conflict and finding peace in my food choices?

    • Hi Anne,

      I’m no expert (except re. my own body, on which I think I really am an expert having lived in/as it for 60+ years now), but here’s my thought.

      I think our “wants” are regularly (as they should be…) informed by our rationality. For example, I may “want” to play a computer game more than I “want” to get out of bed in the morning to get ready for an ugly day at work … but its not that simple. I actually have several layers of wants.

      What I don’t do is tell myself, “Don’t you dare even turn on the computer when you wake up, no, no, no, no, no, bad, bad, bad!” What I do is more like asking myself, “Well, you know you have to go to work in the morning most of the time if you want to keep your job, so let’s think about this for a minute. How important is it to me to keep that job? (turns out its pretty important) And how much do I think the immediate decision at hand would jeopardize it? (on any one given day, probably not all that much, all by itself)

      The honest truth is, there have been >0 times when I have decided, “Sc*ew it; I’m calling in today,” and stayed at home playing computer games. How MANY times? Well, probably between 4-7 times in the last 10 years. I’m not sure, but I know its not 0.

      There’s another part of me that knows, and figures into the equation, that I can probably still keep my job, and maybe even be happier and more productive in it, if I’m not SO rigid that I can’t even let myself even consider taking a frivolous day off, EVER. So I allow myself that option. Sometimes. And I do take that frivolous day off on occasion. Sometimes. But not every day, or even every week or every month; probably not even every year. And certainly not during my first few weeks at a new job, or if I know I’m being considered for a salary increase right at this very moment.

      I do the same thing with eating. Its kind of hard to explain, but there’s kind of another (several) levels or layers beyond “just” the raw “want,” although that “want” is genuine and real.

      I try to notice all of those wants and take them all into consideration as I decide what I’m actually going to do.

  2. Rg, I like how you explained the multiple layers of “want” and how our rationality can help us when we need to decide whether we should follow that want or not. I think it’s very important, like you say, to not be too strict when it comes to controlling our wants with our rationality.

    When it comes to food, there are thankfully many options available. For example, if I crave peanuts but I’m allergic to them, I can try eating other nuts instead or if I’m lactose intolerant but I’m craving milk I can try soy or coconut milk. In my experience cravings are rarely specific but tend to revolve around food groups and this allows us to make choices that will align our wants with our bodies’ needs.

    Thanks for the thought-provoking post Anne!

  3. So… I am going to push back a little bit on one of your points.

    “1) Am I hungry, really physically hungry?” (special emphasis on “physically”)

    If this is the first step in a decision tree its a non-starter in my book.

    I will speak in the first person here, but I don’t think I’m unique in this respect.

    While this might work for younger people who’ve never contemplated that question, it definitely is a non-starter for me. After 6 decades of being gaslighted about whether or not I’m “really” “PHYSICALLY” hungry … and being told (not once, but incessantly, over decades, and over all objections) that whatever I’m feeling, it can’t possibly be physical hunger (and then remember when we were supposed to figure out whether what we were feeling was “mouth hunger” or “stomach hunger”?) .. I honestly am no longer able to tell the difference between whether or not I’m “really” “PHYSICALLY” hungry or whether I feel hungry for some other reason — and I’ve gotten to the point that I no longer care and am unwilling to torture my psyche every time I “think” I feel hungry in order to try to answer that question.

    I remember over the decades trying to do research on this subject… asking average weight people, lots of average weight people, how they knew when they were hungry (average weight people give answers that are just as vague as fat people’s answers) … asking nutrition professionals to please explain to me what “real” “PHYSICAL” hunger actually feels like. Is it vague stomach discomfort, a gnawing grinding sensation, or is it a severe doubled-over with hunger pains feeling? Is it always in the stomach? How disabled to you have to be (just mildly aware, seriously uncomfortable, doubled over, etc.) before you know for sure that you are “really” hungry? Is it lightheadedness or a feeling of low energy with thoughts returning repeatedly to thoughts of food (during the many MD and RD supervised dieting attempts I’ve made, ALL of them reassured me that even when I was eating as little as 400 calories/day, whatever I was feeling it was NOT “real” hunger).

    Picture this: on a 400 calorie/day (VLCD) diet being required to journal incessantly about all the feelings I had that I “thought” were hunger and then having to journal about all my emotional feelings and then analyze them to determine which things that were “really” boredom, emotional neediness, neurosis, etc., etc. I was “mistaking” for physical hunger. You have no idea what a lifetime of this kind of gaslighting can do to a person.

    Psychotherapeutic techniques are very powerful things and can be used for brainwashing as easily as they can be used for healing. When told (or brainwashed) — over decades — that I must come to believe that “whatever” I was feeling and no matter what the circumstances, it most definitely was NOT “real” hunger, so whenever I “thought” I was hungry there were only 2 acceptable responses: ignore it, or start psychoanalyzing myself to figure out what I “really” felt that I was “mistaking” for hunger … that messes up your mind so much that, honestly, you get to a point where you don’t know (and I am at a further point where I don’t CARE) whether you’re “really” hungry or not.

    I acknowledge that I am not passing out, not doubled over with stomach pains, I am not losing my cognitive abilities or suffering repeated infections due to an ineffective immune system (typical symptoms of starvation) but I nevertheless still have the right to eat if I feel like I am hungry, WITHOUT first having to psychoanalyze myself to determine whether I’m “really” hungry or mistaking some other feeling for hunger.

    Even average sized people sometimes eat because they’re bored, tired, emotionally upset, feeling unloved, distracted, etc., AND SO DO I in all likelihood, and I have as much right as anybody else to do that w/out torturing myself mentally every time I feel hungry before allowing myself to eat.

    • Heh heh. I forgot to even mention the long term hypnotherapy I underwent to install in my brain a long term post hypnotic suggestion that whenever I “thought” I felt hungry I would instead re-interpret that feeling as a desire to exercise.

      I don’t know how long that kind of post hypnotic suggestion is supposed to last but I know that I regularly “think” I feel hungry these days and don’t conflate that with a desire to exercise.

      Maybe it wore off after I no longer had a device on which I could play the hypnotherapeutic cassette tapes I was supposed to listen to every day.

      I’m just detailing all this to try to give some sense of the magnitude of the mind-f***s that some (maybe many) lifelong (particularly older) fat folks have already been subjected to surrounding the question, “Am I “really” “PHYSICALLY” hungry?”

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