The joy of eatingBy Ellyn Satter, MS, RD, LCSW, BCD

Eating is okay. Eatingenough is okay.Eating what you like

is okay. To be consistentand effective in feedingyourself and your family,build on enjoyment.

Ellyn Satter, MS, RD, Optimism, pleasure,LCSW, BCD and self trust are goodmotivators. Pessimism, avoidance, andself-doubt are poor motivators (1).

Today,eating is the enemy: don't eat somuch, and don't eat the foods you like or youwill get fat and then you will die. Only 40% ofpeople admit they enjoy eating, down from50% 20 years ago (2). Eating "enjoyably"comes loaded with guilt and fear; eating"properly" comes loaded with dreariness andcontrol (3,4).Often we veer between the twolike the Parade magazine survey respondentswho say they eat a healthy mix of foods, thenreward themselves with "pleasure foods:' (5)Many resolve this discord by rejectingnutrition information (3,6).

We have trouble feeding ourselves andtrouble feeding our children. The division ofresponsibility is the gold standard of feeding:Parentsdo the what, when, and where offeeding, and children do the how muchand whether of eating. However, almost allparents of preschoolers limit menus to foodstheir children readily accept, then bribe andpressure them to eat (7).Despite the nationalhysteria about child overweight, over 90%of parents don't believe their children whenthey say they are full and encourage themto eat more (7,8).Pressuredoesn't work:pressured children eat lesswell and behavebadly at mealtime (9).

Teenagersare the canaries in the mine. In12-year-olds,over half of girls and a quarterof boys diet, and dieters get fatter, not thinner(10).Dieting increasesthroughout adolescenceand asteenagers move into young adulthood,with particularly sharp increasesin extremeweight control measuressuch asvomiting andtaking diet pills, laxativesand diuretics (11).It islittle wonder that adolescentsdiet. Children areraisedto ignore their sensationsof hunger,appetite, and satiety.Asthey get older andtake on grown-up ways,they seetheir parentsdieting (up to three-quarters of adults regularlydiet to loseweight) (12)and assumethat iswhat grown-up eating isall about.

It doesn't have to be this way. Consider TheSatter Eating Competence Model (ecSatter),a clinically proven and evidence based wayof feeling, thinking, and behaving witheating. I created and refined ecSatter inover 30 years' working with patients whohad distorted eating attitudes andbehaviors similar to the ones I describedabove (13) and it has been extensivelytested (14-18). The fundamental principleof ecSatter is to trust rather than trying tohold back on your natural tendencies toprovide yourself with ample and enjoyablefood. To be competent with eating,emphasize permission and discipline:

• The permission to choose enjoyablefood and eat it in satisfying amounts.

• The discipline to have regular andreliable meals and snacks and to payattention while you eat (13).

You may worry that such permission willsend your eating out of control. Not so.Being able to eat foods you like in satisfyingamounts gives order and stability to eating.Foods that are no longer forbidden becameordinary foods that you can eat in ordinaryways. Disproportionately large portion sizeslose their appeal when you can lookforward to getting enough to eat at regularmeals and snacks."Healthy" foods becomeenjoyable when you can eat them forpleasure rather than for obligation.

Will such giddy self-indulgence scuttle yourattempts to be healthy? Entirely theopposite. Eating competent people do

2Fall 2011Weight Management Matters

better nutritionally, have healthier bodyweights (17,18), higher HDLs,and lowerblood pressures (16,18). Remarkably, theyare also healthier emotionally and socially.People with high eating competence feelmore effective, are more self-aware and aremore trusting and comfortable withthemselves and with other people (17).That is not surprising. In raising children tobe competent eaters, we raise them to becompetent people. Eating competencerelies on being trusting and comfortablewith inner experience: the sensations ofhunger, appetite and satiety.

It is time to unpack your bags from yourguilt trip about eating. Instead, take anenjoyable and permanent vacation fromshoulds and oughts by becoming EatingCompetent.

Ellyn Satter is an internationally recognizedauthority on eating and feeding. Practical,warm and empowering, Satter integrates her40 years of experience in helping adults bemore positive, organized and nurturing incaring for themselves and their children.She founded Ellyn Satter Associates, whichprovides resources for professionals and thepublic in the area of eating and feeding.The business offers professional training,publishes training materials, teachingresources and books for parents andprofessionals, and generates magazineand journal articles. For more seewww.ellynsatter.com.

;

REFERENCES1. Satter EM. Part 1: How to Eat.Secrets of

Feeding a Healthy Family: How to Eat,How to Raise Good Eaters and How toCook. Madison, WI: Kelcy Press;2008.

2. Taylor P,Funk C,Craighill P.PewResearchCenter; 2006.

3. American Dietetic A. Nutrition Trends2002: Final Report of Findings. Chicago, IL:The American Dietetic Association; 2002.

4. Rozin P,Fischler C, Imada S,Sarubin A,Wrzesniewski A. Attitudes to food andthe role of food in life in the U.s.A.,Japan, Flemish Belgium and France:possible implications for the diet-healthdebate. Appetite. 1999;33:163-180.

5. Hales D.What America really eats: MarkClements Research;2005.

6. O'Key V,Hugh-Jones S. I don't needanybody to tell me what I should bedoing'. A discursive analysis of maternalaccounts of (mis)trust of healthy eatinginformation. Appetite. Feb 172010.

7. Sherry B,McDivitt J, Birch L, et al.Attitudes, practices, and concernsabout child feeding and child weightstatus among socioeconomicallydiverse white, Hispanic, and African-

American mothers. J Am Diet Assoc.2004;104:215-221.

8. Orrell-Valente JK,Hill LG,Brechwald WA,Dodge KA, Pettit GS,BatesJE."Justthree more bites:" an observationalanalysis of parents' socialization ofchildren's eating at mealtime. Appetite.2007;48:37-45.

9. Galloway AT,Fiorito LM, Francis LA,Birch LL.'Finish your soup:' counter-productive effects of pressuringchildren to eat on intake and affect.Appetite. 2006;46:318-323.

10. Neumark-Sztainer D. Preventing obesityand eating disorders in adolescents:what can health care providers do?J Adolesc Health. 2009;44(3):206-213.

11.Neumark-Sztainer D,Wall M, Larson NI,Eisenberg ME, Loth K.Dieting anddisordered eating behaviors fromadolescence to young adulthood:findings from a 1O-year longitudinalstudy. J Am Diet Assoc. Jul 2011;111(7):1004-1011.

12. Serdula MK, Mokdad AH, Williamson DF,Galuska DA, Mendlein JM, Heath Gw.Prevalence of attempting weight lossand strategies for controlling weight.JAMA. 1999;282:1353-1358.

13. Satter EM. Eating Competence:definition and evidence for the SatterEating Competence Model. J Nutr EducBehav. 2007;39 (suppl):S142-S 153.

14.Stotts JL, Lohse B.Reliability of theecSatter Inventory as a tool to measureeating competence. J Nutr Educ Behav.Sep-Oct 2007;39(5 Suppl):S167-170.

15. Krall JS,Lohse B.Validation of a measureof the Satter eating competence modelwith low-income females.IntJ Behav NutrPhys Act. 2011;8(1):26.

16. PsotaT, Lohse B,West S.Associationsbetween eating competence andcardiovascular disease biomarkers.J Nutr Educ Behav. 2007;39 (suppl):S171-S178.

17. Lohse B,Satter E,Horacek T,GebreselassieT,Oakland MJ. MeasuringEating Competence: psychometricproperties and validity of the ecSatterInventory. J Nutr Educ Behav. 2007;39(suppl):S154-S166.

18. Lohse B,PsotaT,Estruch R,et al. Eatingcompetence of elderly Spanish adults isassociated with a healthy diet and afavorable cardiovascular disease riskprofile. J Nutr. Jul 2010;140(7):1322-1327.

3Weight Management MattersVolume 9 No.2

rif¥