So consider this the post that makes up for my oversight – the groups are starting this week and next, and you should sign up for them.

[/end marketing spiel]

Every round of groups, there is something that I want to work on for myself. For the past three months, it was eating regular meals at regular times – something that I struggle with given my flexible and unpredictable schedule, and the fact that I eat with people for a living.

Early in the year, thanks to a post-traveling readjustment crisis, I was pretty awful at feeding myself for a while. I was scrounging up the bare minimum required for survival at random times of the day, and not giving any thought whatsoever to frivolities like “vegetables” or “food groups” or “not feeling like total crap.”

And given that I deal with depression on a semi-regular basis, this is something that comes up cyclically – one of the first things to go with my mood is eating well.

For me, eating well looks like this: I eat a breakfast that contains multiple food groups soon after waking up, and then about four hours later (five if I’m drinking coffee through the morning), I eat a lunch that also contains multiple food groups. Then around three hours later, I have a snack, and then dinner in another three or four hours. Dinner contains multiple food groups, and possibly even more than one dish. In another three or four hours, I will have dessert or a snack.

In the course of all this, I end up eating fat, protein, and carbohydrate at each meal, and I make an effort to offer myself roughly five fruits and veggies throughout the day, as well as a couple servings of meat/nuts/legumes.

Everything else kind of takes care of itself. I remind myself that I do not need to clean my plate or finish my vegetables if I don’t want, but that I have permission to get seconds or thirds if I do want.

So that is what I focused on for the past three months, while I worked with my group on eating competence.

At first, I just made a deal with myself that I would eat food before drinking coffee in the morning, because I noticed that if I drank coffee first, it killed my appetite, but that the lack of breakfast left me lethargic and tired for the rest of the day.

That was my first step – food before coffee, and preferably soon after getting up.

This probably took a week or two to get going. Then I focused on having lunch at a reasonable time each day – I eventually settled on 1pm because it fit into my work schedule, and because it was long enough after breakfast that I would actually feel hungry, but not starving. If I tried eating at noon, it felt like I was just forcing it.

After practising for another week or two, I started getting predictably hungry right around 1pm each day. Sometimes 12:45 and sometimes 1:15, but relatively consistent. And on the days when something came up and I didn’t get around to lunch until 2pm, I was very hungry but not desperate.

The last, and most difficult, was dinner. Dinner requires cooking. Cooking requires planning, and when I’m feeling gloomy, planning is my least favourite thing to do. But after a few weeks of eating frozen lasagna and other no-plan delights, I was tired of it, and willing to put up with some amount of planning to get a more decent variety of food.

I hauled out my meal-planning sheet (yes, I actually have one), put it in a plastic sheet protector and stuck it to the fridge, next to a dry-erase marker. Then I started by writing down three easy dinners to make in the coming week, and I filled in the rest of the nights with leftovers or more frozen lasagna.

It began with a few of my no-brainer favourites – spaghetti, clam linguine, pork chops. Then the next week, I added a day for beans (usually Sunday, to accommodate slow cooking) and a pizza night on Fridays (because it’s Friday, and we always want pizza on Friday, so I may as well plan for it.) The bean recipes usually made a ton of leftovers, so I began freezing them in individual containers, and then I also had an easy lunch.

Eventually, after a few more weeks, I worked my way up to planning 5-7 meals per week. Sometimes the plan literally is “frozen pizza and pre-prepared salad” because, goddammit, it still counts as a meal. It’s got food groups and everything! Plus if I don’t buy a frozen pizza, I will just order one at some point anyway. There’s no point in fighting it.

For a while, the plan was almost the same rotation every week (spaghetti on Tuesday, linguine on Thursday, pork chops on Monday, chicken on Wednesday, etc.), and then I got bored of that, too.

The past couple of weeks, I’ve been experimenting more. I made some marinated salmon, tried a new green bean recipe (hint: Parmesan cheese), and last night we had Moroccan-style pork tenderloin. One weekend, I made a very labour-intensive stir-fry that I hadn’t made in years.

It’s been nice, and along the way I’ve developed a bunch of short-cuts and sanity-saving techniques to help myself along. One of them is that I rarely cook a recipe all in one session – I always do some pre-prep in the morning so that the burden doesn’t all come crashing down at 6pm. For the stir-fry, I actually made the sauce the night before, then chopped up all the veggies in the morning, and then just assembled it and cooked the noodles in the evening.

Because I’m terrible about doing too much at once, and then never wanting to do it again, this is essential for me. I also started making my meal plan and grocery list the day before I go shopping, because I hate doing them both on one day.

Overall, I’d call this past three months of putting my eating back in place a success. Right now, I’m operating at a pretty high level – although we still have frozen pizza night on Friday like clockwork, and I intersperse a bunch of easier recipes along with one or two more complicated ones during the week.

But here’s the thing: it won’t always be this way.

Something will happen to mess up my routine again, and it will all fall apart. That’s life. Once I get used to whatever has changed I can work up, step-by-step, from the bottom of the pyramid again – because I know how. And I also know that periods of just getting by, and just doing the bare minimum with eating, are survivable. They’re not going to hurt me, and they don’t say anything about my worth as a human being, or my overall capacity to feed myself well.

I used my boredom with repetition to help push me along, because if I’d set out with a goal of “cook fancy new recipes all week” I would still be eating frozen lasagna every day. I did it because I wanted to, and because it felt good.

Eating falls apart for everyone, from time to time, but it doesn’t have to stay that way forever – and it won’t if you refuse to beat yourself up about it, and focus instead on doing what helps you to feel good.

Now I have to figure out what I’m going to work on for the spring groups. I’ll let you know what happens.

If you have been eating regular meals at regular times for a while, then chances are pretty good that you are developing regular and consistent hunger signals. This tends to happen when your body becomes accustomed to getting fed at particular times during the day, which actually makes responding to that hunger a lot more convenient, because it is predictable. I know I will be hungry around 1:00pm each day; therefore, I can plan to have food on hand before things get desperate.

In the past, I would have waited until I felt hungry before I even started thinking about what to eat, and then by the time the decision-making was finished, the food acquired and put together, I would probably be cranky and famished. Not a good way to go! So, eating at regular times for a while, even, at first, when when I am not hungry at those times, sets up the predictable-hunger system.

As a result, having predictable, moderate hunger signals seems to make it easier to figure out how full you are. After all, if you start eating in that nebulous state of not-quite-hungry, you’re probably only going to finish eating when you’re either not-quite-full, or else seriously-overfull. Neither of which are great options. We’re looking to establish a habit of both comfortable hunger and comfortable fullness.

Once you are coming to the table hungry, on a regular basis, and finding that table laden with enough tasty food, and giving yourself full permission to eat that food, then you are in a good position to start listening for the sounds of fullness.

I do this by checking in with myself when my plate is about 3/4 empty.

This does not mean I am necessarily going to stop eating or declare myself finished. A lot of the time, it might mean I actually need to get up and get seconds, because I’ve miscalculated how much food was there, or how hungry I was. The important part of this end-of-plate check-in time is permission.

Yes, that again – permission to still want the food, and permission to go and get more if I want it.

I find that it’s important to continue eating until my mouth, or my aesthetic hunger, is satisfied – not just my stomach. I have sometimes messed this up, and stopped eating when my stomach felt full, even if the food was still incredibly appealing to me. The result was simply that I was hungry again within the hour – not a tragedy, but not super-convenient, either. I need to know that I can eat enough to not feel hungry again for a few hours, because otherwise I will never stop thinking of food.

Different people choose to reach different levels of fullness, but almost everyone knows that feeling of being unpleasantly full, and almost no one wants to go there on a daily basis. There may be occasions, like holidays, where the discomfort is worth the experience, but who wants to put themselves into a state of pain regularly? Not me. But before “painfully full” there is a range of experiences of fullness, from neutral to kinda-full, to good-n-full, to really-full-but-not-in-pain-yet. And you get to decide which one you like, at every meal you eat.

This is a learning process, and one that will require you to make mistakes in choosing a level of fullness. You will sometimes leave the table under-full and be hungry again soon (but if you have a snack coming up, it won’t be a big deal.) You will sometimes leave the table feeling like you blew it, ate too much, and now will be uncomfortable for a while until it subsides – but it will subside, and you may find yourself naturally wanting to eat less at your next meal or snack. This is how self-regulation of food intake works – you take in feedback, and then you respond to that feedback in the way that helps you feel most comfortable.

Never, at any point, is there a reason to beat yourself up for what is a simple miscalculation. Getting overly full, even if it happens a lot, does not say anything about your character, your worth as a person, or your willpower. It simply says that something is getting in the way of your fullness signals, or some anxiety is pushing you to override them.

That anxiety is most often related to a fear of not getting enough to eat – and it can take time to build trust and soothe that anxiety by continuing to feed yourself regularly and give yourself permission, regardless of whether you get overfull. The anxiety might also feel like a form of rebellion or resentment, where you purposely eat too much for your own comfort because, screw the world that tells you not to eat, you want this food, dammit! But the root of the problem is the same – lack of permission, and fear of not getting enough.

The answer to both of these problems is more permission, more trust, and more commitment to continuing to feed yourself reliably.

When you are calm enough around food, you can feel the sense of fullness that Ellyn Satter terms “the stopping place.” It is more than just stomach fullness, more than just satisfaction from the food, and more than just the relief of nutrient stores being replenished – it’s a combination of all three, plus the overarching sense of well-being that comes from knowing you can, and you will, take good care of yourself with food.

When all the forms of hunger are extinguished, you will find a stopping place that is subtle but definite, and slightly different from anyone else’s. It might require a slightly different mix or amount of foods, but you will know it when you feel it.

If you trust that more food will be coming later, when you need it again, you can calmly let go of eating when you’ve reached the stopping place.

It will take some practise, permission, tuning in, and the healing of broken trust. But it will be worth it.

This is basically what is meant by “mindful eating” when it is discussed as part of intuitive eating, and I do think it has its place. However, I feel like the term “mindful” has some connotations that make it challenging for lots of people. It seems to imply full, willful attention given to the food. Even the circumstances of mindfully eating a delicious food can seem rather ascetic – no distractions allowed. The focus is solely on the food.

However, in real life, not all eating can be this way. And maybe all eating shouldn’t be this way.

For example, eating is often a social experience. We eat with family, we cook for friends, we go out to restaurants on dates, we eat at parties. Socializing while eating, when you get down to brass tacks, is a form of distraction. It is also a wonderful way to eat.

There are other cultural food rituals in which distraction is embedded, and I really can’t bring myself to have a problem with them – popcorn and Jr. Mints at the movie theatre, pizza in front of the TV on Friday night. You can pry these from my cold, dead hands.

“Mindful eating” terminology also conjures up, for me, images of the previously-mentioned foodgasm. Real talk: not every meal is foodgasm material. Sometimes you just have to get the job done, quick-and-dirty style. Sometimes eating isn’t pretty.

Mindful eating is also often promoted as a sneaky method of food restriction, either overtly by intuitive eating approaches that promise weight loss, or we do it accidentally to ourselves, because our neurotic feelings about food can creep into even the most benign and food-positive activities.

And for these reasons, I’ve chosen to think about mindful eating a bit differently, and in a way that removes some of the pressure — since we looooove to pressure ourselves about eating, and even when we’re rejecting the idea of dieting pressure, somehow we manage to find ways of flagellating ourselves with the idea of Doing Intuitive Eating Right.

I think about mindful eating, at regular day-to-day meals, in terms of checking in.

Checking in with your food does not require a sustained level of monastic attention and being-in-the-present – although if this is something you do well, then by all means, knock yourself out. Checking in takes only a few seconds. It will not make you look weird. It is not even noticeable at all to the people I eat with. In fact, I’m willing to bet it’s something you may already do from time to time.

If you don’t, then having an explicit, sustained practice of mindful eating – the intense kind, where you sit down and eat food without distraction – on a regular basis, actually can start to generalize itself to other situations. It can become a completely unintentional habit that feels damn near effortless – this is how it happened for me.

After practicing having some pretty intensely mindful meals and snacks (mainly because I had reached the desperation point and couldn’t take another moment of alternately over- and undereating and feeling like crap about it, so I finally just went and did the thing that my dietitian was telling me to do), in a few months I started to notice that I do this thing, and I don’t really do it on purpose. It looks like this.

While I’m eating dinner with my family, or even just eating Kraft Dinner out of a mixing bowl in front of the TV (it happens), there will come a point where I stop for a second. Maybe five seconds. I stop picking up food with my fork, I stop looking at the TV, I stop talking, I even stop listening, and I just look at my food. Or I just close my eyes briefly and taste what’s in my mouth. I give my mind a moment to float, and listen to my little caveman thoughts of “Mmmmm, food. Food good.”

On occasion, I’ve been known to make a yummy sound.

And then, I go back to the rhythm of eating and talking, or eating and watching.

It happens several times during any given meal – tiny moments of food appreciation. Even if the food is not spectacular, I can still appreciate the sensation of hunger becoming satisfied.

Checking in also allows me to eat exactly what I want of what is offered – no more, no less. It tells me when I’m full, when I need seconds, or when I’m done with dinner but still want dessert. It tells me whether or not I’m still enjoying the food, and thus, whether to keep eating. It brings the food I’m eating into brief bursts of focus, enough to let me enjoy what I’m doing and truly get enough – so that I can then be truly finished with eating, and move onto other things.

Eating is one important part of your life. Whether you are having a sandwich or a five-course meal, practise spending a few moments to give it its due – no obsessing needed.

There are a few reasons for this.

One is my belief that, until you have a solid foundation for how to eat, it’s very, very difficult to make positive changes to the “what.” Before you can decide which food is best for you to eat, you need to be eating food, period.

Plenty of people who read this blog, and who I work with, have major trouble with this step. And this is why I’m here – this is the core of my job and my writing.

Another reason I don’t focus on “what” is because it is my opinion that nutrition is quite individual. Okay, it’s not just my opinion – it’s even tacitly admitted by the fact that such a thing as the Recommended Dietary Allowance for most micronutrients even exists – the RDA is based on a bell curve, which is a graph that says “some people need a tiny amount, some people need a lot, and most people need an amount somewhere in the very broad in-between.” Individuality is also the reason why the Acceptable Macronutrient Distribution Range is a “range” instead of a single, prescribed number: people vary.

The idea that people vary is further confirmed for me by my education in clinical nutrition, which taught me that perfectly nutritious food for one person can constitute a major health crisis for another – because sometimes people have food allergies, food intolerances, as well as various diseases with a nutritional component (one big caveat here: not all diseases have a confirmed nutritional component or treatment – though we often talk about all disease as if it were caused and/or treated by diet. There simply isn’t evidence to support this.)

Different people seem to feel and function well by eating different things, and different amounts of things – this I’ve based on my own little observations about life and people and eating in general. You could also say that the existence of differences in cuisine by region and culture seems to fit this observation – especially in cases where a person suddenly stripped of their culture and its attendant foodways gets very ill. Which happens.

This leads into yet another reason not to focus on “what” – because health is more than just food, and food is more than just nutrients. And before you think I’m going there with this, I want to say that food is also much more than our hunches or culturally- or cognitively-biased definitions of “real food.”

“Real food” (a term I find almost as distasteful as “real women”) looks a lot different to different people. And here we revisit the Hierarchy of Food Needs again – and take a look at the second tier, which is “acceptable food.”

Food that would be perfectly acceptable to some people is abhorred by others, for lots of reasons. Heck, as a very mild microexample, my husband was put off when he learned that I made a regular habit of eating crayfish (I use the proper term “crawdads”, which is translated from the original Grandma-ese to mean “delicious tiny lobsters from the crick”), because to him they are bugs. And he doesn’t eat bugs.

On the other hand, I find his habit of putting ketchup into Kraft Dinner totally unappealing. Still. After living in this country and spelling things with extra u’s for well over a decade now. And neither of us is right or wrong.

Slight (very slight) cultural differences between central Canada and west coast USA, as well as different growing-up experiences, different families, different social norms, and different habits cultivated over years and years of living, play into these disagreements. So, imagine if you will, the much more extreme differences, on a much larger scale, that exist between various places and cultures all over the world.

Then you may get an inkling of how difficult it is to sum up (to borrow again from the original Grandma-ese) all good eatin’ in that one condescending term, “real food.”

It is similarly impossible, and I would argue undesirable, to divorce food-as-nutrients from food-as-identity and food-as-emotional-experience. All eating is emotional, remember? Even on a strictly biomedical level, isn’t it possible that the stress induced from being deprived of an emotionally meaningful, culturally significant food source might negatively impact your health? I think it might.

That’s not to say that sometimes the cost of some stress isn’t worth the health benefit someone may receive by cutting a particular food out of their diet, especially when that food is doing them direct and measurable harm – but it is to say that monkeying with food restrictions isn’t a purely benign practice. There are consequences to physical health, and to quality of life. Sometimes the consequences are overwhelmingly positive. Sometimes not.

(See how complicated this already is? Phew.)

And the last reason I’ve mostly neglected the “what” on this blog is this: despite having spent four school years allegedly learning what is the best, healthiest food to eat, I just don’t know.

I have a lot of learning to do in this area, and I have a funny feeling that it’s not just me who does. Nutrition is a young science, as fields of inquiry go, and it studies incredibly complicated systems – and I think we, as a species, still have a lot to learn about it.

So, I don’t know. And I caution you to be skeptical of anyone who claims, unequivocally, that they do.

My first foray into the world of figuring out what to eat was probably back in 1999 or 2000, when I did a Google search for “healthy eating” or “nutrition” or something equally vague. (I wouldn’t recommend trying this if you are struggling with disordered eating of any kind. Or if you just want to have a nice day.)

The results of that search, as you can probably guess, were bewildering and slightly terrifying. Guess what? They still are in 2012 — maybe moreso.

Of course a random Google search cannot represent Our Current Scientific Understanding of Human Nutrition, but it tells me a few things. It tells me people are interested in nutrition. It also tells me people are scared. Plenty of them are zealous, vociferous, and sometimes obsessive – and I believe this is because they are scared. It tells me that there is a lot of confusion, and a lot of mistrust of official guidelines on health and eating. It tells me there is a lot of dichotomous, black-and-white, all-or-nothing, good-against-evil thinking and discourse.

I can sympathize with all of this. I have, at various points, been guilty of all these things, and I probably still am, and I probably will continue to be. Because I am just muddling my way through this, like everybody else. My brain takes lots of the same shortcuts, and thereby makes a lot of the same mistakes, that all brains do in their attempt to find patterns and make sense of the penultimate human fear – the unknown.

If the unknown were a place, it would be a scary place to hang out. A dark closet, the place just beyond the circle of campfire light, the mouth of a black cave. The lack of light is really just imagery for a lack of information. A lack of information makes it more likely you’ll get into very bad trouble. Something might kill you, which is, in my opinion, the ultimate human fear. The unknown is death’s handmaiden.

Being in the unknown is like being out to sea. You very badly want something to grab onto, some solid sense of security instead of just endlessly shifting, changing, inscrutable depths of water – depths that probably contain something dangerous and deadly.

This means it is tempting, intellectually, to grab onto a theory, any theory, and there cling.

I don’t think people pick nutrition theories at random – but they pick ones that feel suited to their particular beliefs (ethical, observational, aesthetic) and that complement their worldviews. These are actually very good reasons, not some kind of humanoid silliness to be scoffed at from on high. It’s only logical that you’d be more inclined to align yourself with something that makes sense to you on multiple levels – but here’s where our sometimes-clunky habit of pattern-finding intrudes.

You generalize the theory to everyone else.

The one that seems custom-tailored for, uniquely-suited to, and perfectly paired with your life – which was the reason you chose it in the first place.

I want to stop for a moment and clarify something: I don’t think we always choose a way to eat that is best for us, physically or emotionally. I think we mess it up fairly often, but I also think having the freedom to mess it up is part of what being an autonomous human is all about.

Thankfully, in the absence of disordered eating, we can usually learn from feedback of various kinds whether or not the food we’re eating is doing us harm, and then we get to decide what to do about it. And I actually trust that most people have the capacity to do that, to make their own choices, provided they have some supports to help them (a safe and varied food supply, access to appropriate and respectful health care, shelter and enough food to eat, and the skills and facilities to prepare it, in the first place.)

So — back to generalizing. I think we do it because it makes the world seem like a less scary place. Taking that one thing to cling to and then extrapolating that everyone else can be saved if they will only cling to it, too, feels very reassuring. It feels like making sense of an incredibly complicated and counter-intuitive world. Unfortunately, in practice, it can also make that world a more miserable, divisive place, because it almost invariably results in judging other people’s choices, which are based on factors so diverse and complex that it might be impossible to truly understand them.

I also think that, in our current state of nutritional understanding, it’s inaccurate to generalize from one theory to one whole population, let alone the entire species. We simply don’t know enough yet.

So, at this time, I consider myself mostly agnostic on the subject of what to eat. Even my dearly-held theories about how are, I recognize, probably limited to certain people in certain circumstances — though many of them are readers of this blog. And I’m okay with that.

Tolerating ambiguity and not-knowing, I believe, is also part of the human condition. Floating in the water, accepting what can’t be seen, and making sense of our own experiences without assuming that those experiences are shared by everyone else, is about the best we, as individuals, can do.

One of my peculiar beliefs is that no one should need a degree in science or nutrition in order to figure out what to eat. No one should need to spend their day reading and analyzing studies in order to make a reasonable choice about what to have for dinner. (If you have the time, resources, and inclination to do that, then Godspeed and good luck.)

We might, at some point, have a better answer about what everyone should be eating for optimal biomedical health — and even then, this might not overlay neatly onto what type of food provides meaningful social and hedonic experiences, which makes it an incomplete answer, at best — but until then, we can guess that variety and not too much or too little of any one thing is probably a good idea.

Until then, we can take comfort that our life expectancy, at least in certain parts of the world, is the best it’s ever been. That we have cures and treatments for many diseases that once ravaged entire populations.

And until then, we still need to eat, which means we all need to tread water and make our own choices as best we can.

Very scary, very definite-sounding.

I tried to avoid looking at the study all day, because I knew it would make me angry. I suspected shenanigans from the get-go. Why? Because pretty much nothing in science is ever that unequivocal. Science is, allegedly, the study of material reality – when it’s done well. And material reality is incredibly complex and nuanced and unsure. Bets must always be hedged when observing it.

So I knew that, at the very least, the mainstream media reporting of this study — which might have been a very good study — was oversimplified and sensationalized, as any juicy news story is.

Finally, late last night, I gave into temptation and clicked on the LA Times link, which led me to the abstract of the study. And before I even got into the full-text, by looking at the numbers and methodology reported in the abstract, I was…deeply embarrassed.

I’m a nobody — I have a measly undergrad in applied science, and I have never been the best at math. And I was so dreadfully embarrassed for the researchers whose names were emblazoned on this study, for the journal who published it, and for the Harvard School of Public Health’s nutrition department. (My condolences to the rest of the Harvard School of Public Health.)

Why? Because it is an incredibly bad study – worse than I, a notorious crank with a streak of bias a mile wide, could have ever possibly hoped for in my wildest, crankiest dreams.

This study used a ridiculous methodology to determine how often people ate red meat – they used a food frequency questionnaire, something I was taught in school should never be used alone to assess a person’s actual food intake. It’s simply not precise enough – it is only a rough guesstimate, and it is vulnerable to faulty memory, to misunderstanding food amounts, and to embarrassment or shame.

Even if you gave a person a food frequency questionnaire every single day for the duration of the study, it would not be great data.

Sadly our friends, The Absent-Minded Scientists, didn’t even go to that much trouble. They based their analysis on food frequency questionnaires that were only updated once every four years.

I’m going to give you a second to let that sink in.

Once every four years.

Every four years, subjects in the study were given a piece of paper with a bunch of check boxes on it, next to a long list of foods, and asked to check off how often they ate each food over the course of the past four years. Totally accurate, I’m sure — accurate enough to pinpoint with reasonable certainty the type of food each person ate every single day for the 24 years of the study.

Oh wait a second, no. Not at all.

Then, based on this rigorous assessment of each subject’s diet, the researchers managed to find an association between people who reported eating a serving of red meat every single day…

I’ll give you another second.

A serving of red meat Every Single Day…

[Interlude: this is not to say that no one, anywhere eats red meat every single day for 24 years. Plenty of people around the world probably do. But one may assume they are not the vast majority of the population from which this study's subjects were drawn -- and even if they were, the results of the data from this study would give them no reason to worry.]

…was associated with a 20% higher risk of dying during the study.

That actually still sounds pretty scary, doesn’t it?

I mean, nobody wants to entertain a 20% higher risk of dropping dead at any moment. Death is the worst bad thing that could ever happen to you, and if avoiding a couple of hamburgers can stave it off, why the hell not?

Yes, it does sound scary — until you point out that the average risk of each person in the study dying, in the first place, was actually very low.

Per person, per year of the study, the risk of dying was less than 1%.

For the people who (allegedly) ate red meat every day, the risk of dying was…also less than 1%.

I’ll give you another second.

The risk of each person dying, per year of the study, was less than 1% — whether or not they ate red meat.

In fact, the risk of people in this study dying was quite a bit lower than the risk of the average person of the same age in the general US population (for year 1994, right in the middle of the study period.)

The subjects would have been between the ages of 44 and 89 years old by the middle of the study, and the risk of an average USian (of roughly this age group) dying in the middle year of the study was 2.5%. (I’m just grabbing rough numbers to make a point here – please don’t mistake for Actual Science.)

Which tells us something important – and probably not that Being In A Study Reduces Your Risk of Death by 67%!!! – it tells us that not only did the people in this study who allegedly ate red meat every single day for 24 years have a lower risk of death than the average person, it tells us that the people in the study don’t represent average people.

You could very well say that not being a predominantly white health professional or nurse is associated with an increased risk of death. Investigating why that is might be a pretty interesting question, no?

But, sadly, it’s not as newsy as saying that red meat will kill you.

Last layer of the onion: this study was not a clinical trial, which means it can only draw correlations between things – it cannot prove causation.

So even if the dietary assessment strategy were sound, even if the population of the study did represent the average person, and even if the difference in risk of death between meat eaters and not-so-much meat eaters was very large, it would only signal the need to do a more rigorous study to get to the bottom of the association, and to find out whether it’s likely that eating more red meat makes you die faster. Nothing more.

Results of the study aside, if a wholly unimpressive person like myself can read the abstract and see some pretty big problems in this study, then certainly a doctor, or a biochemist, or a dietitian, or an epidemiologist, or anyone who has taken a statistics course most definitely can and will. Which should be rather embarrassing for its authors.

Which leads me to think that I, and all the people out there with real scientific training, are not the target audience for this piece of scholarship.

So who is the target audience? Who might take it at face value?

It would have to be someone who wouldn’t look at the abstract, let alone the full text of the study. It would have to be someone, if they did look at the abstract, whose first instinct wouldn’t be to pull out a calculator and do some arithmetic. Someone like, say, a hurried journalist who reads the press release, hears what seems a plausible and common-sense conclusion, and leaves it at that.

Someone like a person who leads a real life, in a complex world with a bunch of information flying at them from all sides, and who counts on the news to at least resemble the truth — and who doesn’t have time to fuss with a bunch of statistics. Who furthermore, in an honest world, wouldn’t have to.

I’m convinced that this study, embarrassment that it is, was not written to gain respect from people who would read the full text, calculator in hand, as part of their day job. It wasn’t written for other scientists, doctors or, actually, for anyone like the health professionals who were actually in the study.

It was written for the sake of headlines. It was hand-crafted for newspapers, which we count on to deliver at least a Reader’s Digest version of the truth. Last, and most importantly, it was written for someone like a person who leads a busy, complex life, and who doesn’t always carry a calculator.

Someone who might never know that the data is bad, and the headline misleading. Maybe someone like your friends who are Facebooking it, and your mom who’ll now think twice about buying dad’s favourite beef jerky. Maybe even someone a lot like you.

This study didn’t prove that red meat was bad, because it didn’t prove anything at all — except that predominantly white health professionals die less often than the average person, and that while the nutrition department at the Harvard School of Public Health can easily drum up media attention, they are not easily embarrassed.

The foundation of nutrition as we know it remains variety. And variety, as we know it, can still include red meat if you like it and are inclined to eat it. I personally wouldn’t suggest eating it every single day for 24 years, but even if you wanted to, this study wouldn’t give you a single good reason to worry.

I’d be more concerned if I were not a predominantly white health professional, since their risk of death is so much lower than average — probably because they have the luxury of not being terrorized by studies like this.

ETA: Some commenters have pointed to some other critiques of this study, which you may want to take into consideration:

http://evimedgroup.blogspot.ca/2012/03/unpacking-meat-data.html

http://summertomato.com/red-meat-is-killing-us-all-or-not/

http://www.marksdailyapple.com/will-eating-red-meat-kill-you/#more-27840

I believe the occasion was a cookie exchange, and it was something my friend did once a year. Her mom’s friend, who also worked at the hospital with my mom, was called Georgia*.

She was delightful in every possible way – warm, funny, sweet, without a sharp edge anywhere. She put up with wild shenanigans during sleepovers and let us dress like Madonna on Halloween and eat as much candy as we wanted. She always kept cinnamon Graham crackers in the house. She let us coax her onto a giant trampoline once, to bounce gingerly and scream in delighted terror. She loved her daughters openly, broadly, and unashamedly, and raised them to be as wonderful as she was.

Her husband had died suddenly of a heart attack a short time before. He, she, and their entire family were large people — tall, broad, and stocky. They were also, I thought, nice to look at, and comfortable to be around. From what I could tell, they ate and moved and lived their lives just like everyone else. I admired that.

After exchanging cookies, we gathered in the living room and drifted into chat. At some point, probably following some hospital gossip, Georgia recounted to my mom the story of a recent doctor’s visit.

The visit had not gone well. I believe Georgia went in for some reason related to her husband’s death, maybe to get help with stress or grief. The doctor — a slender, athletic woman in her 20s — had, after haranguing Georgia about her weight, asked how her husband died. Georgia answered that he had died of a heart attack, and the doctor snapped, “Well, no wonder he’s dead. He was obese and he was a smoker. What did you expect?”

The mothers in the circle fell into a stunned silence. I looked at Georgia’s face, and she seemed somehow apologetic.

How anyone could say something so cruel to a person I knew to be unfailingly kind and sweet, and whose husband’s death had recently devastated their entire family, was an utter shock to me for about two seconds. And then I knew something, and I didn’t know how I knew it, but I knew it with such angry certainty that it just came out.

“That doctor is scared of death,” I said loudly.

How else on earth could you explain a doctor expressing anger and blame at someone for accidentally dying? And to then vent that anger on his grieving wife? You couldn’t. There was no other explanation but the fear of death, utilizing the Just-world Hypothesis as its conduit.

The Just-world Hypothesis is the cognitive bias that causes people to blame other people for their misfortunes, even in cases where blame is not appropriate or not proven. Because we want to believe that we live in a fair world, and that people get what they deserve. If they do something wrong, bad things happen to them. But if they do everything right, and follow all the rules, nothing bad will ever happen to them.

It’s a mental shortcut we use, a theory that seems to have the power to predict what will happen — because to an animal, the power of prediction is essential to survival. It helps you to avoid the very worst bad thing that could ever happen, which is death.

If you die, the doctor was saying, clearly you did something to deserve it. When you deserve it, death is expected, which should somehow rob it of its terror. And because I, a doctor, am smart enough to avoid doing the wrong things, and actually dedicate my life to doing all the right things, I don’t deserve to die, and can therefore predict that it will not happen to me.

Last night, one of my group members quoted Anne Lamott –

I think perfectionism is based on the obsessive belief that if you run carefully enough, hitting each stepping-stone just right, you won’t have to die.

I tend to agree.

I have discovered, through questioning the lovely people I work with, that at the bottom of every fear of eating too much, or of gaining too much weight, resides the fear of death. In the final analysis, it always comes down to this — the awareness that we have to die, someday, and that anything we do might hasten the inevitable.

Some philosophers claim that entire fields of inquiry, entire cultures and civilizations, perhaps the social contract itself, are founded on the awareness and fear of death, and the simultaneous effort to deny it.

Ernest Becker, in The Denial of Death, calls these “immortality projects,” ways that we attempt to create something that might not only forestall death in the immediate sense, but that lives on after we do to achieve a sort of abstract immortality. Great books are written, tall towers constructed, fame and fortune sought, all in the faint hope that our name will live on, long after our body lies beneath the stone on which it is carved.

Even in the absence of dramatic efforts to achieve posthumous fame, our entire lives and all the decisions we make may be interpreted as coping mechanisms for managing, and suppressing, the fear of death. The cracks we step over on the sidewalk, the locks we check over and over (literally or figuratively), the black cats we avoid, the salt we throw over our left shoulder, the pleasure we systematically deny ourselves for the sake of seeming to purify our one immortal organ, the soul — and the trust we withhold from our body, that traitor, who can’t be counted on to keep any promise but the inevitable one.

Fear of physical pleasure, and fear of the seeming bottomlessness of our physical appetites, are disguises for the fear of death.

Responding to your body requires admitting, first of all, that you have a body, that you are a body, that your head does not float on a metaphysical balloon somewhere just north your body, untouchable. This admission requires you to acknowledge that bodies die, and that you will die too. The separation of mind and body, soul and body, spirit and body, is itself a coping mechanism, a sort of immortality project.

All of this would be well and good if it did not cause us to make such tragic decisions during our uncertain, finite, and invaluable lives. Decisions that cause us, effectively, to deny life itself. The fear of death, and the denial of the few concrete things we can touch and cling to as real and worthwhile, can lead to wasted lives. People wrung out and demoralized, lives spent and used up, running on a treadmill toward a mirage that never comes any closer.

How then shall we live?

Health can be redefined as the manner in which we live well despite our inescapable illnesses, disabilities, and trauma.

-Jon Robison

My proposal is that we live in the way that best reflects how we most want to use our precious time, right here, right now. My proposal is that we live well despite our inescapable fear of death. Our time is valuable in more than one way, both in quantity and quality, and neither one should be sacrificed for the sake of the other.

We may instead try, as best we can, to strike a balance between the two, and not go to extremes in an attempt to escape what we all know is coming — but neither to hasten it purposely by squandering what little we do have in a blaze of reckless glory.

This means, then, that I would never suggest running out to smoke and drink yourself into oblivion. Or to gorge yourself on food that makes you feel like shit, even if it tastes like anything but. Or to avoid exercise at all costs, out of a stubborn refusal to (again) admit that you have a perishable body and that it requires a certain measure of care — and in doing so, to deny yourself your life.

Do the things you can reasonably do, without unduly burdening yourself, to be a good steward of the gift of life.

I equally would not suggest that you force yourself to eat food you hate, or eat too little of the things you enjoy and feel deprived, or slog away at life like you’re putting in your time at a dismal job, waiting for the blessed release of quitting time. That you mortify the body to purify the soul. That you sacrifice yourself, your invaluable time, doing things that you hate, hurting yourself mentally and physically, to prove yourself worthy of escaping death, somehow superior the weak mortals living their pathetically finite lives around you. In short, to live a delusion — and in doing so, to deny yourself your life.

If you genuinely enjoy marathons, run them. If that would be torture to you, don’t. Find something else to enjoy. If you love salad, eat it. If salad is punishment, for God’s sake, there are a million other foods to take its place. Food that isn’t enjoyed isn’t worth a damn. Find something better. You deserve it.

If you feel unfit, if you feel tired and exhausted and find it difficult to move, be good to your body. Feed it good food, give it fresh air and light, and move it gently and compassionately until it is stronger. When it is strong enough, use it to do things that inspire, excite, and even scare you.

Do something that makes you scream in delighted terror.

This is a limited time offer — don’t deny it. Make it count.

*Not her real name.

TREND ALERT: Jokes about diabetes are totally trendy, because diabetes is hilarious!

Let’s break this trend down to essentials, to get a better grip on what makes things funny:

1. Mostly fat people get diabetes (also unwhite people and poor people and old people)
2. Classy people know that food is unhealthy (refined carbs!!)
3. Only gross people (fat, unwhite, poor, old people) eat food
4. Gross people are not classy (or healthy)
5. Diabetes is nature’s punishment for being gross
   1. (And un-classy)

Put it all together and you get devastating wit.

We all know that diabetes (type 2, the yucky kind) is the world’s premier disease caused by being gross. It is also a hilarious indictment of your worthlessness as a human being.

In case you missed the memo, there are two types of people in the world: good people and bad people.

Good people do good things like exercise and eat vegetables, “take care of themselves” as directed by medical professionals and Craigslist personal ads, are good-looking, describe themselves as “upper middle class,” are mostly white, go to university, work hard to stay thin, inspire bonerz, and come from families without a strong history of diabetes, or other endocrine or autoimmune diseases. In short, they are morally superior and make the world a better place.

When they get sick, it is a tragedy.

Bad people do bad things like not “taking care of themselves” which means they steal money from rich taxpayers to underwrite their gluttony, don’t have the gumption to make money or go to university or lose weight, tolerate having losers in their families, are not bone-worthy, are too tired from their shitty jobs to exercise or read Mark Bittman, maintain dark skin, and are generally yucky. They are everything that is wrong with the world.

When they get sick, it is hilarious.

Back in old-timey days, we used to divide poor people up by whether they were “worthy” or “unworthy.” This was a generous and benevolent way of making sure taxpayers didn’t waste their hard-earned money on gross people. In our advanced modern times, we have learned to apply this idea to sick people: are you worthy of our respect? Because there is really only so much to go around.

If you get sick while in the act of being gross, well I am sorry, but that makes you a burden, and you also probably brought it on yourself.

Gross people eat gross food, like carbs. Gross food causes gross people to get gross diseases. When you get a gross disease, it is then your responsibility to cure yourself through reeducation about ways to not be so gross.

Here are some tips:

1. Insulin resistance causes weight gain, making it more difficult for people with diabetes to lose weight? Maybe you should try losing weight, and stop being so gross.

2. Type 2 diabetes is highly heritable? Try not having such a gross family.

3. Type 2 diabetes is highly associated with socioeconomic status? Get a job and stop spending all your money on Flamin’ Hot Cheetos.

4. Type 2 diabetes is highly associated with being of Aboriginal, Asian, African, South Asian, or Hispanic descent? Way to play “the race card.” Try personal responsibility.

5. Not having enough food is associated with both “obesity” and diabetes? Maybe try eating even less.

6. Type 2 diabetes tends to occur more in older adults? Old people are gross. Try not being so old.

*Not actually hilarious.

However, in doing so, I do not hate freedom, free speech, or America ™. I also don’t have any problem with people using humour to cope with their own lived experience. But when humour is used to further marginalize people, while betraying and promoting loathsome, sophomoric stereotypes…no. I don’t think it’s hilarious.

It struck me as an odd coincidence that, just last night, I was talking with one of my groups about the thing I call the Last Supper Phenomenon.

Here’s how it happens: Something happens that makes you feel bad about your weight. You feel fat.

Because you’ve been inundated since childhood with the message that being fat is the worst thing that could ever happen to you, an uncomfortable tension (between the fat body you have, and the thin body you think you should have) builds.

Almost automatically, to release the tension, your brain rides the crazytrain straight to restrained-eating-town.

Even if just momentarily, you think of food restriction. You tell yourself, “On Monday I’ll cut back.” Or even, “I’ll start making Smart Choices ™ ” (which is translated from the original Jerkbrain to mean “eat food I dislike, and avoid food I do like.”)

And then the Last Supper Phenomenon kicks in.

As soon as you have that thought of restriction, or that thought of possibly-maybe-in-the-misty-uncertain-future restriction, you begin to think about food – specifically, the foods that will soon become forbidden. You want them. An uncomfortable tension (between the foods you want to eat and the foods you think you should eat) builds.

To resolve the tension, you hit on what seems like a brilliant solution – feast now, fast later. You empty the pantry, make a special run to the store, to your favourite pizza place, in anticipation of self-imposed food scarcity. You make what looks for all the world like a valiant effort to EAT ALL THE FOODS!

Which is kind of like Mardi Gras – the last hurrah before Lent, the time to get all the fat out of the larder and make delicious things. Things you will very soon have to go without. Things that you must eat ALL OF. RIGHT NOW. OR ELSE.

For some of us, because we are completely sick of dieting, Monday never actually comes. Nevertheless, just the thought that Monday might come, that the other shoe might drop, is enough to keep the restraint-disinhibition cycle alive.

Because you are, in effect, threatening yourself. You’re threatening to take food away from yourself, and especially if you have a history of chronic dieting or disordered eating, this is going to scare the shit out of you, and you are going to react violently to the fear of food scarcity.

After the violent reaction, you feel guilty. The dissatisfaction with yourself deepens, and you begin to look forward to NEXT Monday morning, when you will finally, really this time, once-and-for-all, stop eating food like some kind of dirty human being.

Which leads to the reappearance of the Last Supper Phenomenon, which has now escalated to the Last Supper Syndrome – a cycle of bouts of wildly eating, threatening never to eat again, and then even more wildly eating until you have finally become a flesh-and-blood substantiation of a Cathy comic.

The trick, then, to ending the Last Supper Syndrome is to stop threatening yourself.

You do this by first becoming aware of when it happens. You listen to your thoughts, especially the quiet, slippery ones in the background that seem to have a mind of their own. The ones that come automatically, like a knee-jerk reflex, on a bad body-image day. If you listen carefully, you’ll hear them.

They say things like, “On Monday, I’ll cut back.” Or “I’m going to start making Smart Choices ™ .” Or “All I need is portion control.”

The gist of all of them is “I feel fat and that is unacceptable and I need to do something about it RIGHT NOW.”

When you hear them, it means you’ve caught them in the act. When you catch them in the act, you can drag them out of their preferred obscurity into the light, and force them to undergo rational scrutiny. You talk back to them, again and again, as many times as it takes.

You remind yourself that, no matter what your weight, your first duty is to take care of yourself. Which means feeding, not depriving, yourself.

Finally, you make a promise to yourself – that Monday will never come again.

It is tempting, always so tempting, to rely on the panacea of dieting (or whatever term you like to give to intentional weight loss attempts) to fix these problems. Because, at least in the short term, it can. And when you’re feeling horrible RIGHT NOW, naturally, a quick fix is incredibly attractive.

Here’s how I deal with that urge: I allow myself to have these feelings.

I am not a Body Image Superhero, despite being a Health at Every Size and fat acceptance activist. I go through many more good times than bad, thanks to HAES and FA – but I still live in this culture, and I get all the same messages everyone else does about how I’m yucky and gross and no one will ever want to have sex with me, ever.

My body image is, and likely always will be, a work in progress.

As part of that process, I rely on a Body Image Crisis Algorithm – a sort of Socratic series of questions I ask myself to get to the root of, and solutions to, the crisis. Let’s begin.

So, what’s going on under the hood, beneath disliking my weight or “feeling fat”? What does that really mean?

It means feeling shitty about myself. Feeling undesirable. Not liking the way I look. Feeling socially anxious. Feeling like I am not welcome, and do not belong in this world. Sometimes, it’s feeling physically unfit, and like my eating is very disorganized and chaotic.

Has losing weight in the past helped any of these things?

No, actually. I did like certain things about how I looked when I was losing weight, but it also made me feel weirdly disconnected from my body, and I kept holding myself to higher and higher standards of how I should look. It’s also never helped to make my eating or exercise more healthy and enjoyable for the long-term, and actually caused some disordered stuff there.

Even if it did, or could, help these feelings, is losing weight likely to be a permanent fix?

No. We all know that. The failure rate is somewhere between 80-98% after five years. And given my body’s apparent propensity to gain weight, and given how triggering I find the barest hint of possible food restriction, I seriously doubt I would be one of the lucky ones.

Are there more direct ways of dealing with these problems?

Well, yes. There are body image exercises I can do. There are social anxiety exercises I can do. There are practical, immediate things I can do to help my eating, like eating my meals and snacks on time, offering myself a variety of foods at each meal and snack, and giving myself permission to eat what I want, and NOT to eat what I don’t want. And I have actually been doing that, and I have been feeling a lot better about eating.

[Ed: eating is complicated for me because, ironically, as part of my job I eat strange foods at strange times of the day with my clients. Which makes structure, the part of eating competence that I especially rely on to feel sane around food, uniquely difficult.]

If I’m concerned about weight gain, I can go get a physical – I already know what the factors are that likely have influenced my weight (new medications, major life changes like moving and changing jobs, episodes of depression.) I already know that my blood pressure and blood sugar are good.

What about not feeling welcome in the world?

This one is trickier. It goes to a somewhat philosophical place.

Well, first of all, when you see someone as fat or fatter than yourself, do you feel like they shouldn’t exist?

No, of course not. But then, I’m not a total asshole.

Do you believe most people are total assholes?

It’s tempting sometimes, but actually? No. However, I do know that appearance-based prejudices of all kinds are quite widespread.

That’s true. Maybe prejudiced people don’t welcome you in the world. Does that mean, objectively, that you don’t belong here?

No. I think I belong here. I think I have the right to exist, as I am, and to go about my daily life.

Do you require a welcome from all people in the world in order to live your life?

It’d be nice, but no. I don’t actually require that to live my life.

And is your body objectively wrong in any sense?

No. There is no objective “wrong” when it comes to bodies – it’s mostly a cultural judgment.

Is there a purpose fulfilled even by bodies that are considered outside the norm, or culturally “wrong”?

Yes. “Wrong” bodies add diversity to the population, and even to the sum of human knowledge. They house people who are awesome and valuable in their own right. Even “wrong” bodies allow people to exist in the world and live their lives.

So, could it possibly be argued that the mere fact of a body’s existence may render it objectively “right”?

I guess you could argue that. The cultural tradition is to say that man is made in God’s image.

Do you think there is some truth in that, even from a secular perspective?

Yes. Because I believe in the intrinsic value of all life.

Even yours?

Even mine.

As Ellyn Satter says, food is one of the great pleasures of life – but only one of them.

It is important, but it has its place – which is to say you should not have to be thinking constantly about it. And you want the thought and attention you do give to be of the useful and pleasurable sort, not of the fretting and obsessive variety.

In this lesson, I’m going to talk both literally and figuratively about putting food in its rightful place.

Let’s get the literal out of the way first, because it is astoundingly simple.

Put it away.

Yes, that’s right – put your food away. Be neat and tidy with it. Organize it a bit.

Don’t leave random stuff laying around on counters, coffee tables, desks, bookshelves. Don’t put food somewhere it will hover right in front of your face, especially if you are slightly food-preoccupied due to chaotic eating and lack of permission, a history of dieting, or just because you are a primate who is immediately attracted to tasty, tasty food, regardless of whether you actually want it at just that moment.

Because if any of these are true, having it constantly before you gives the food more power than it deserves. It interferes with genuine decision-making. It calls to you in that really annoying food-voice.

In a sense, the food begins to boss you around.

We don’t want that. You’re the one in charge here. You get to decide what you eat, what you like, and how much feels good.

You don’t want those important decision-making criteria pushed into the ditch by RANDOM COUNTER COOKIES!!!

Now, it’s one thing to think, “Yeah, some cookies would be awesome right now,” and then you go and get some cookies, and indeed they are awesome.

It’s another thing entirely if you pick cookies by default because they were there and you didn’t have any better ideas.

If they’re right in front of your face, you will probably never come up with tastier or more nourishing ideas, because you’ve got an easy out – something sweet, perennially tasty (even when you’re not particularly feeling cookies), and that requires no thought, effort, or preparation.

You’re human, which means you are an animal. Animals like to conserve effort wherever possible – including when it comes to acquiring food. So of course you’re going to take the easy way out.

However, a strong aside:

This is not a trick to get you to eat less.

This is, however, a trick to help you be the one making the decisions about it. I really don’t care how much you eat, because that is none of my (or anyone else’s) fucking business. That’s entirely between you and your stomach. I only care about your eating being enjoyable, nourishing, and satisfying.

At the same time, especially if you’re of the “Oops, I forgot to eat lunch!” variety, it’s important that food be reasonably convenient to you, so that you can continue having regular meals at regular times.

That still doesn’t mean it should be staring you straight in the face. It means that, if you’re busy and don’t have much time or energy to cook, you should find some quick and easy meals, even frozen or instant stuff…and then put them away until it’s time to eat.

It means that, if you sit at a desk all day long and often forget to take a lunch break, or bring a lunch to work, you should get some tasty, filling snacks…and put them in your desk drawer until it’s time to eat.

Or create a snack box.

I have a snack box. It’s where I store the food that I eat with my clients during sessions. Because we’re dealing with food issues like guilt, or shame, or vague fears about “unhealthiness,” a lot of this food is of the delicious, immediate-gratification variety. Otherwise known as “junk food.”

I discovered long ago that leaving this food just sitting on my desk – a Snickers here, a bag of chips there – instigated both Jeffrey and me to primal feeding sessions of the type not seen since Wild Kingdom. Which was rather inconvenient, since then I would have to go back out and buy the food all over again, and also since we’d not be very hungry for dinner. Which is a crappy feeling.

The solution cost like two bucks at Ikea – one of those cardboard cassette boxes with a lid.

I set that puppy on my desk, all the tasty snacks went in there, and it was just…no longer an issue. Not because we were disallowed from eating the tasty food (we can still raid it, in a pinch, and we still sometimes do), but because it suddenly just didn’t occur to us anymore.

This works because, first of all, neither one of us is a restrained eater, meaning we’re not abnormally preoccupied with food – and second, because it is no longer bossing us around by gazing into our hungry ape souls.

When we do decide to open the snack box, it’s because we really want that food, and it’s going to be awesome enough to be worth the hassle. Win-win.

That said, now for the figurative aspects of putting food in its place.

Food is only one important aspect of your life.

It is necessary for survival, yes, just like sleeping and going to the bathroom and drinking water. But, ordinarily, none of those activities consume our thoughts when we are not doing those things, or preparing to very soon do those things.

When we do start to become preoccupied with them, it’s usually because something is out of whack – we’re stuck in traffic with no bathroom in sight; we’re burning the candle at both ends to get a project done, or to nurse a baby; we’re hiking in hot weather and the water bottle is empty.

So, what does that mean for food? When you are preoccupied with it, outside of planning for meals to happen, or actually sitting and eating, then it could be a sign that something is out of whack.

Normally those things are either 1) you’re not getting enough to eat, or 2) you’re not getting enough permission to eat.

If you’re not getting enough to eat, it may just be a practical issue – you need more time. You need more money. Or you need to be a bit more organized about getting groceries into the house and food on the table.

You need to make getting fed more of a priority, just like most people normally do with sleep and going to the bathroom.

When you gotta go, you gotta go – and when you gotta eat, you gotta eat.

It may also stem from a lack of permission, which is the second issue, and which is something I see very often in my clients.

You need to give yourself permission – by saying explicitly to yourself that you have it, and then following through as though you believe it – to eat as much as you want. To eat the food you really, really like. And to eat frequently enough that you’re not starving in between times.

Sometimes a lack of permission is present even when you are getting enough (or sometimes too much!) to eat – though that sounds totally counter-intuitive. Even so, merely the hint of a thought of possible future food restriction, maybe, at some point, on the Fourth of Vague – that can be enough to set off the alarm bells in your crazy monkey brain.

And here’s how it responds:

“OMG SHE DISAPPROVES. MAYBE SHE WON’T FEED ME AGAIN. WHEN WILL WE EAT? WHAT WILL WE EAT? WILL IT BE GOOD, OR WILL IT BE THAT BLAND CRAP SHE EATS WHEN SHE FEELS BAD ABOUT HERSELF? WILL IT BE ENOUGH? CAN WE GET DESSERT JUST THIS ONCE? MAYBE WE SHOULD EAT THE LEFTOVERS RIGHT NOW JUST IN CASE.”

This is not only the sound of crazy-monkey-alarm-bells, it is the sound of food taking over your life in a completely inappropriate, and totally useless, way.

How do you get over it? Present yourself with enough tasty food at regular times, and then give yourself the permission to eat it. Even give yourself the permission to overeat it, since that is probably going to happen anyway for a while, until your crazy monkey brain starts to trust you again.

You may as well short-circuit the shame spiral, right now, and interrupt the feast-famine cycle. And since it’s hard to interrupt the panic eating part of the cycle, target the thing you can control, and stop beating yourself up about it. And for God’s sake, stop threatening yourself with thoughts of future restriction.

Once you’ve calmed down and stopped obsessing, you can work on directing your attention toward other things – like pre-planning some of your meals for the week. Like asking yourself what you’re hungry for, and then putting in some effort to make that happen. Like making a list of what you need to stock your cabinets and fridge, and then actually going and buying those things.

Like eating with a reasonable amount of attentiveness, and pausing to give yourself explicit permission.

You know – useful stuff. In manageable quantities. Right where it belongs.

Even in the intuitive eating world (see #7), it’s presented as something undesirable, something that indicates you’re emotionally unstable and Not Very Good at Eating, but most of all, something that causes you to get fat. I’ve even heard emotional eating blamed for the Obesity Epidemic ™ (I’m not going to address that here, except to say: I Really Doubt It’s That Simple.)

But, to be honest, eating is inherently emotional. First, in the sense that it provides us pleasure, otherwise we probably wouldn’t take all the time and effort to find food, prepare it, and eat it. Because it is so essential to our survival as a species, it has, of course, become embedded in our brain’s pleasure-pathways as something intensely enjoyable (much like, ahem, other species-propagating activities.)

So whether you think you’re eating for emotional reasons or not, whether you’re doing it intentionally or not, all eating is fundamentally emotional.

On top of that basic biological foundation, we can place the obelisk of culture – all cultures use food as a way of bonding, expressing aesthetic values, celebrating regional flora and fauna, and marking both sad and happy occasions. To attempt to divorce food from this context and view it purely as biological fuel is not only overly simplistic, it is practically impossible.

This is a large reason why strict diets often do not play well with real life – because as primates, we live social lives, and as Homo sapiens, our social lives are organized into culture. We run into it at every turn: going out for coffee or lunch with a friend who needs some quality time; eating as a family on a Wednesday night; popcorn at the movies; holiday dinners; Shrove Tuesday; casserole to a grieving neighbour; cake at a birthday party.

When dieting turns you away from these traditions, or significantly complicates them for you, that is isolating. Sometimes it’s necessary, when it comes to a food allergy or therapeutic diet, or ethical and religious food restrictions, but its impact can be minimized, or it only centres around a limited set of foods to begin with, and the outcome is vital to survival or one’s moral values.

But I cannot help feeling that, when a voluntary weight-loss diet (by cutting out or significantly reducing broad swaths of the diet) imposes such demands on you, it’s destructive. It’s isolation from the larger culture and a way of bonding with others, done through emotional blackmail of the evillest sort: No one will love you unless you’re thin, or at least repenting of your fatness by making a visible, distinctly pleasure-renouncing effort to become thin.

Which makes dieting, itself, a form of “emotional eating” – eating a certain way in an effort to gain love and acceptance.

But, the way that emotional eating is most commonly understood and portrayed is eating directly in response to an acute emotional upset – stress, trauma, anger, sadness, rejection, worry. This type of eating is institutionalized in media through the trope of Sad Girl Eats Ice Cream from Container; or Harried Woman Eats Chocolate with Eyes Closed; and even Woman Laughs Alone with Salad.

(Which brings me to an important pet peeve, that “healthy eating” is never portrayed in images by anything other than FRUITS AND VEGGIES!!! and, most often, a white lady eating/cooking them. However, one cannot live by salad and laughter alone. Not for very long, anyway.)

I find this annoying because it presents emotional eating in a good-food, bad-food light (and images of orgasmic chocolate experiences have become part of that good-food narrative now that chocolate, or specifically, dark chocolate, has been officially approved by the Foodguilt-Industrial Complex), but also in a very gender-stereotyped way.

Women eat when sad. Women orgasm for chocolate. Women eat virtuous salads.

Men eat things like Manly Steaks and Beef Jerky and Dos Equis and Delicious Bacon and Dr. Pepper Ten (and they wash their faces with soap that comes in gunmetal grey packaging, and their shower gels don’t contain moisturizers, they use HYDRATORS, and they don’t even wash, anyway, they DETAIL because their bodies are machines, MANLY EMOTIONLESS MACHINES.) And they do it all between kickin’ ass and takin’ names. Women, meanwhile, eat and moisturize between bouts of laundry and bathroom-scrubbing.

Why yes, I have been drinking many cups of coffee. Emotionally.

Anyhow. The thing with emotional eating is that we, as a society, are in denial about it. Because it’s bad to have and express emotions, somehow, and that leads us all to do this thing that every single person in the world and all of human history has done at some point, in a secretive, guilty, furtive way.

Herein lies the problem.

When you are secretive, guilty, and furtive about your eating, it is not satisfying.

I absolutely agree that eating cannot solve life circumstances or emotional problems, but it can provide pleasure, comfort, a shared experience, and enough distraction to distance you temporarily from the problem at hand – and this is not a bad thing. We all need things like this in our lives – it is a legitimate coping mechanism for when things get a bit overwhelming. And, if anything, food is one of the more benign substances we can use for this purpose.

Used exclusively for escape, no, it is not healthy. But, ironically, forbidding emotional eating may actually cause people to use it this way – forbidden fruit syndrome being what it is. Forbidding it is also going to distract us from doing the thing that can help – using emotional eating as a trigger to investigate our emotions, and to acknowledge what is actually going on that food can’t fix.

Because we will be too busy feeling guilty and trying to hide the evidence to matter-of-factly assess the situation – or even to enjoy the goddamned food in the first place.

So – emotional eating: learn to do it well. Here’s how.

1) Acknowledge that something is going on for you emotionally. Take a moment to name it, if you can. It can help to write this down on a piece of paper – even just one word or phrase, like “sad” or “bored” or “freaking out.”

2) Pick a food that is really, really enjoyable – not just the random thing sitting on the counter, or even the thing that you always go to, out of habit, without asking yourself “What do I really want right now?” Get enough of it, too – you can always save extras for later, by storing them in a convenient but not distracting place (we’ll talk about this next time.)

3) Find a comfy place, without external distractions, to sit. (Put on pajamas or comfy pants too, if practical.) A recliner or couch is awesome. Turn off the TV and the computer, or turn your chair away. Close the book or the magazine or the newspaper. This will only take a few minutes, and then you can go back to what you were doing.

4) Remind yourself that eating is morally neutral – you are not doing something “bad” by eating delicious food. You are simply being human. (And if you have worries about the ethics of food production, you can address those things with more upstream, systemic approaches – beating yourself up at the point of food-on-plate, or depriving yourself of foods that matter a lot to you, won’t fix a problematic food system.)

5) Give yourself full permission to have as much as you want. Say it out loud if you can, or say it internally, sort of like saying grace before a meal.

5) Eat the food. Pay attention to how it looks, smells, and tastes, how it feels in your mouth and throat, and how it settles in your stomach. Give yourself the mental space to just have the physical experience of eating.

6) Pay attention to whether the food reminds you of anything, has family or other associations, brings up familiar feelings and memories.

7) Your mind will wander to random things – let it. Just check in, periodically, with the food and your body.

8) Eat until you are truly, honestly satisfied. Even if that means going back for more.

9) Afterward, assess how you feel again – have you felt comforted? Do you have a little distance? Is everything feeling a little less…intense? What else do you need to take care of yourself? Go and do that, or make a promise to yourself to do it later, when it’s practical. Write it down.

In short, emotional eating can be healthy and useful – if you do it with your eyes open, and short-circuit the shame spiral with permission.

This will take practice – guilt is not something you can unlearn with one try. If you do it consistently, daily or a few times a week, even when you are not in emotional distress, you will be ready for the times when you are.

So, here’s the thing: I’m not a registered dietitian.

I know it’s confusing, since I have an accredited degree in dietetics, I’m a member of Dietitians of Canada (and formerly of the American Dietetic Association too, but they sent me too much shit in the mail from food and diet companies), I’ve received extra training through DC- and ADA-approved workshops, I’ve attended honest-to-goodness dietetic conferences, and I’ve worked in legit hospitals doing legit clinical nutrition stuff.

But, still, I’m not a dietitian – and I use the generic, mostly meaningless term “nutritionist” to describe myself.

What I am is someone who teaches people about normal, healthy eating.

I teach people to give themselves permission to enjoy food and eat enough to feel satisfied, to have regular, reliable meals, to find out which foods help them to feel good, to pay attention when they eat so that they can enjoy it and learn from it, and to learn to value healthy eating in its own right, because it feels good and makes one’s life better, without it being contingent on weight loss.

Here’s what I don’t do: clinical nutrition. I don’t assess, diagnose, or treat disease with nutritional therapies.

Sometimes my clients, people who want to learn the basics of normal eating, also have diseases with a nutritional component – diabetes, celiac disease, high cholesterol, etc. And I don’t refuse to work with people who have diseases, provided they receive diagnosis, support, and treatment for that disease from a qualified professional – who isn’t me.

Because I don’t practice clinical nutrition. So I guess it’s a good thing I never actually wanted to.

In October I graduated with a science degree that, without the attached RD behind my name, is essentially worthless in my field. I have spent the last nine years not only learning about nutrition at an accredited school, but working in nutrition at various hospitals, and, according to the way the profession is set up in Ontario, I have achieved nothing. I am qualified to do…nothing. Because I have not endured the professional hazing of dietetic internship.

I’m sure you can detect my bitterness.

I am, and always have been, a fan of the scientific method. I believe science is limited in what it can prove, but remains the best way we have to investigate the natural world. Is it perfectly objective? No, but only because it is practiced by hopelessly flawed human beings. But, battered as its practice has been by our nasty little biases, I still love it, and still believe it is the closest we can come to being objective, to learning whatever does exist of universal truth.

I’m a science girl, and a nutritionist in the lay sense of the word. I have a good education, good training, and good experience. The one thing I’m not is a registered dietitian.

When I refer to a dietetic internship as a “hazing,” it’s not because I believe dietitians are mean or evil. In my five years working in various nutrition departments at various hospitals, my bosses have always been dietitians, and I have loved, really loved, them – as people, as practitioners, and as scientists. Because that’s exactly what they are, despite hardly ever being credited as such.

But I’ve also experienced the necessary underbelly of that world. The conveniently gender-, race-, and class-stratified social and professional hierarchies of the clinic. The interpersonal tensions, the brutal systemic limitations, and even on occasion, the subtle violence of professional jealousy.

I had enough – I got my experience, learned what I could learn from the truly remarkable women whose decades of experience made me feel like a tiny speck in a huge, wondrous world; I took my lumps; I jumped through hoops; I got out so I could finish what I started.

Eleven years ago, I decided to study nutrition because I read a passage about normal eating from Ellyn Satter in the book Losing It by Laura Fraser. It was a revelatory answer to the question I’d asked myself – “How then shall I eat?” – and spent my time and energy searching out, only to find a cesspool of lies, disorder, unscientific thinking, and shameless contortions of logic. I decided then that this – teaching ordinary people to eat normally, based on sound science – was what I wanted to do.

Ellyn Satter was (and is still) a registered dietitian, and I wanted to do what she did – so I set out to become a dietitian and to learn about the science in the answer I’d stumbled upon.

Along the way, I figured out that I didn’t actually want to be a dietitian, nor did I need to be to do what I’ve wanted to do all along.

So in October, I walked across a stage and took possession of a hard-won piece of paper that made me…nothing. After spending a third of my life and tens of thousands of dollars on this project, I’m no one of consequence to anyone who matters professionally, and may eventually be called a quack and a charlatan because I do a job that hardly anyone in the world does – defending normal eating against the encroachment of a disordered, deeply classist culture, helping ordinary people pick their steps through the muck of anti-intellectual horseshit that is pop nutrition – and I do it audaciously without those two letters, R and D, behind my name.

Because I don’t have the resources, emotionally or financially, to spend a year doing hard, unpaid labour as an intern at the same hospitals that used to pay me by the hour for doing similar work. And maybe because I am troubled by the financial connections between the letter-granting organization and various food- and diet-industry concerns.

I have an education that makes me more qualified than most of the authors who write mass-market diet books – but because I’m not a dietitian, it doesn’t matter. I exist in the gray margins, professionally and scientifically – and our society does not do margins (or shades of gray) very well.

Do I think it’s unfair? Yes. Does it make me angry? Yes. But I accept it for now, because, thankfully, what I do and what I’ve learned still matters a whole lot to me. If you’re reading this, I suspect it matters to you, too.

So, until I figure out all of this big professional mess, I remain

Yours truly,
Not a dietitian.

If you’ve been dieting for a long time, or just eating chaotically and inconsistently due to practical or emotional constraints, you are very likely out of touch with hunger signals. It can help to have a primer to guide you in first identifying them for what they are – and what counts as hunger might surprise you a little.

Ellyn Satter describes the drive to eat as both hunger (physical) and appetite (aesthetic and emotional.) Hunger is what drives you to seek out food in the first place, to just get the job done with feeding, but appetite is what mostly guides the type of food you choose – something salty, something crunchy, something meaty…or something creamy, soft, and sweet.

Other intuitive eating approaches describe these drives as “mouth hunger” and “stomach hunger,” which makes a lot of sense and is easy to remember, but which, I think, leaves something to be desired.

For one thing, splitting the two into stomach and mouth leads to the tendency to de-legitimize and de-prioritize “mouth hunger.” It seems frivolous to our ears, because, in this culture we tend to give short shrift (at least theoretically, if not in practice) to mere food wants and desires, and give precedence to real, honest-to-goodness Nutritional Needs and Physical Requirements – of which your stomach alone is the judge.

Through personal experience, I’ve come up with a different version of the hunger/appetite, “mouth hunger”/”stomach hunger” dichotomy – both of which closely parallel mind/body dualism, which I still use to describe things to my students, since it is the language we largely speak as a culture, but which I try to get away from in theoretical work.

It’s a bit more complicated, but to me it legitimizes three different forms of hunger, all of which deserve equal attention. They are:

1. Mechanical Hunger
2. Aesthetic Hunger
3. Chemical Hunger

Mechanical Hunger is the easiest to understand, and sometimes to recognize – it’s the feeling of an empty stomach, often accompanied by growling or churning, or a sense of hollowness or tightness in the stomach. (Keeping in mind the physical reality of the stomach – that it hovers higher up than most of us visualize, just below where your ribcage parts, close under the bust.) This is the hunger that, if you ignore it long enough, can go away altogether, or get really uncomfortable and lead into the desperation of Chemical Hunger (we’ll talk about that in a minute.) It’s something that many people I work with haven’t felt in a long time, but which is probably the most obvious of all the types of hunger.

Aesthetic Hunger is the longing for food – similar to what Ellyn Satter refers to as appetite, and what intuitive eating approaches refer to as “mouth hunger.” I use the word “aesthetic” because I believe the need for pleasure in food mirrors the human need for beauty – in this sense, the beauty of how food tastes and feels. But it’s more than just needing the taste and physical feel of food, it’s also eating for emotional reasons – celebration, grief, comfort, nostalgia. It is the need of enjoyment, since enjoyment is actually a critical part of good nutrition.

In national food surveys over many years, people consistently answer that the number one reason they choose food is because of how it tastes – enjoyment. The enjoyment of food is intrinsic motivation to eat, pure and simple – which means it’s more productive to work with it than against it. The need for enjoyment drives people to seek out flavours and textures, which in turn leads to experimentation and nutritional variety – a critical component of nutritional excellence.

Aesthetic hunger also drives people to practice their regional and cultural foodways, which in turn comprise a crucial part of one’s cultural identity and sense of social belonging (one of the fundamental steps on Maslow’s Hierarchy of Needs.) And it drives emotional eating – again, a cultural practice institutionalized in the form of birthday parties, holidays, wakes, but also a legitimate psychological coping mechanism. And this is where eating competence parts ways with many other eating approaches.

Eating competence recognizes and legitimizes comfort eating as a thing that can actually do some good. It is not the dirty, shameful little secret that you think you’re hiding – it is something that all of us do. The problem, as Ellyn Satter explains, only comes when people do it poorly. They do it furtively, guiltily, without proper attention and enjoyment, and end up with more shame than comfort when all is said and done.

When done well, comfort eating can’t solve the underlying problems you’re experiencing, but it can distract you, soothe you, and provide a bright spot of much-needed – and harmless – pleasure on a dark day. Compared to many of the other distractions people may seek when they need an emotional lift, comfort eating is truly benign and can even be helpful. More than that – it is damn near universal. Lesson Four will go into more detail about comfort eating, and how to do it well.

Bottom line – aesthetic hunger is a legitimate need, since emotional health is a hugely important part of overall health, and because “when the joy goes out of eating, nutrition suffers.”

Chemical Hunger refers to the feeling that lies beyond the garden-variety grumbly stomach. It is generally subtle, but if not attended to, can become a deafening roar. It is the sense that “something is missing” or something didn’t quite hit the spot. I often get this feeling when I haven’t eaten the amount of fruits and vegetables I need for several meals or several days. I also get this feeling after a stretch of illness where my appetite is shot and I can’t eat very much – when I start to recover and refeed myself, even when I eat enough that my stomach is physically full, there is still a gnawing sense in the background that my needs are not fully met, and it’s going to take several more meals before I get there.

Lastly, chemical hunger can come in the form I referred to earlier, in Mechanical Hunger gone too far – low blood sugar. That shaky, weak, lightheaded feeling you get when you’ve forgotten to eat entirely, or gotten stuck in traffic between work and dinner. These are not feelings that come directly from the stomach, but from your blood, your glycogen stores, and even sometimes depleted vitamin and mineral stores.

When chemical hunger is fulfilled, you won’t only get full, and the food won’t only taste and feel good, but you’ll feel satisfied for a while after eating, and maybe even get an overarching sense of vague well-being that follows you around over the days or months that your eating continues to be consistent, varied, tasty, and nourishing.

When you put regular meals, and the permission to eat them, into place, you will start to feel these signals more clearly. You will also start to learn what you need to do in order to satisfy them, by non-judgmentally observing what various foods do for you. You’ll notice which foods give you an emotional lift or satisfy a flavour craving, which foods and amounts give you the sense of fulness you like to have in your stomach, and what foods and combinations provide that sense of having “hit the spot.” You’ll also be far less likely to get into desperation hunger – the chemical hunger that indicates an acute deficiency of glucose, or longer-term deficiency of micronutrients.

When you make your hunger happy – in all forms – you’ll be healthier physically and emotionally. And you’ll be a lot closer to eating competence.

Even after you start giving yourself permission.

I imagine that, inside all of us, is a small, vulnerable animal (one of my wonderful students calls it the “fuzzy self”) who just needs to know it will be taken care of, and that it will be fed.

And who’s responsible for the care and feeding of fuzzy self? Yep, it’s you.

If you no longer feel clear hunger or fullness signals (aside from desperation hunger or uncomfortable overfullness), there’s probably been a breach of trust, and it’s probably been going on for a while.

If you want to get back to a state of normalcy with hunger and satiety, and to regain comfort with the idea of eating, then it’s time to repair that relationship.

But rebuilding trust requires more than just saying the words of permission; it requires action.

One of my favourite quotes from Epictetus is -

“True happiness is a verb. It is the ongoing, dynamic performance of worthy deeds.”

Part of growing up emotionally is accepting that actions speak louder than words. It is accepting that happiness is not a passively euphoric state of mind randomly visited upon you by the fates – that true happiness is, indeed, something you build from the raw material of your behaviours, and the nitty-gritty of your daily choices. None of which may be all that fun in the immediate-term, but produce tranquility, contentment, and satisfaction over time.

Happiness is an investment of effort.

Love, including self-love, works the same way. As an adolescent, love is the crushing force of intense, uncontrollable sentiment. As a grown-up, you take up love as a practice, something you repair and build over time with kind words, kind actions, responsibility and consideration.

“Love is the active concern for the life and the growth of that which we love.”

-Erich Fromm

And that’s where we come to the damaged relationship between your mind and body. In order to heal this relationship, you need to express self-love in the form of action.

Even on days when there are no attendant warm fuzzies, you need to stand by a commitment to care for yourself – even if, at first, you must start from the humble position of promising just not to harm yourself any longer. Guess what?

Not eating, whether you do it intentionally or through neglect, is an act of self-harm.

When it comes to food, here is how you fix your relationship to your body: commit to feeding yourself on a regular basis.

It sounds ridiculously obvious, perhaps even simple, but you wouldn’t believe what a struggle it can be, both for practical reasons and for emotional ones.

In a practical sense, the way you implement regular meals and snacks is going to depend a lot on your schedule and where you spend most of your time. Working from home is a lot different than being in an office, or on the road, or at school.

It’s probably the hardest step to take, and it is also probably the most critical. It is the way you live out your intention to stop dieting, to stop restriction, to break the scarcity mindset around food, and to actually communicate to that small, vulnerable animal inside: “I want you to live. You are worth taking care of.”

If you are not eating at regular times already – if you are either grazing constantly throughout the day, or forgetting to eat for long periods of time; simply not eating enough altogether, or alternating eating too little with eating way too much for comfort – the way to begin doing this is to take one step at a time.

Pick one time of the day when you will eat. Pick a time that you know will be the easiest to implement – when you already have a scheduled break during day, or before the day gets busy, or after all your other commitments are finished.

Treat it the way you would treat a standing appointment. It should be something that you know you can make happen, at roughly the same time (give yourself an hour of leeway, because life does happen) every single day.

I literally need to mark my eating times in my daily appointment book because my schedule varies so wildly, and because I eat meals and snacks with students as part of my work.

Write in your day planner, set an alarm on your phone, an appointment reminder on your computer. A piece of paper taped to the fridge, a reminder on your desk. A string tied around your finger. Whatever works.

When I worked a typical nine-to-five job, I made a commitment to take my legally-entitled morning, lunch, and afternoon breaks. When I had an even less structured schedule than I have now, I used a rough interval system of eating every 3 to 4 hours, based on what time I woke up and had breakfast. I checked the clock, and at the end of each meal, I made a mental note that I would need to eat again at X o’clock. Then I simply moved on until next time.

And when I say “meal,” all I mean is the food you would normally eat, gathered together at one time, in one place. You do not have to cook anything, or use real silverware, or sit down at the table. Eat whatever you want to, wherever you want to. If you were going to graze on chips and cookies throughout the day anyway, put the chips and cookies together in front of you and eat them at the appointed time. Then put them away and move on.

The food itself is not important at this stage of the game – we are still working on the bottom level of the hierarchy of food needs.

Through the rest of the day, let yourself eat however you would normally eat – graze, forget to eat, whatever – but when it comes to that one time you have marked aside for an established meal, put food in front of yourself, give yourself permission, and take a least one bite. That’s enough to establish and maintain the habit. Take that bite while you’re working, while you’re standing up, while you’re sitting in your car in the parking lot – I do not care.

Mindfulness is not what we’re working on right now – just make eating happen at one, specified time of the day.

Do this for a full week. Then add one more time during the day that you can make eating happen, and do the exact same thing for another full week. Eat whatever you are already eating, or whatever sounds good to you.

Don’t worry about nutritional balance for now – that will come later. Taking some time for now to set up the framework, even if your diet looks wildly unbalanced for a while, is not going to hurt you. Your body has the ability to balance out nutrition over the long-term – months or years – so that having a perfectly balanced diet at every meal, on every plate, is unnecessary. In fact, right now, trying to do that could trip you up.

Add in meal after meal, snack after snack, week by week. Give yourself permission to eat whatever and as much as you want, and then put food in your mouth at predictable times every single day. That’s it.

Take your legally-mandated 15-minute breaks at work and have a fucking snack so you’re not completely useless at work. I know it looks better to somehow be inefficiently shuffling paper and making rash decisions in the office, but trust me, you’ll be more effective at your job if you just have some damn cookies or half a tuna sandwich and move on, already.

Eat while you’re working, if you have to. Sneak food, if you have to – but just eat.

As you build on meals and snacks by the week, pay attention to times during the day when you get consistently tired, cranky, spacy, or preoccupied with food (for me, this is the afternoon.) This is a sign that you need to work a meal or a snack into that time – so do it.

Most people end up eating between four and six times a day – this is completely normal.

If you need an afternoon snack before you head home, so that you can be sane enough to get dinner, do it. Turn off your computer for the day, or turn your chair away from it, and eat a little something before you leave work. Eat on the bus or the subway, or while you’re walking. Sit in your car for five minutes in the parking lot and have a granola bar. You’ll be safer on the road, and making dinner won’t seem like such a gargantuan chore.

This is eating like a grown-up – being matter-of-fact about your needs, and taking the time to meet them. It is loving yourself in the most important sense of the word.

You do this for your pets, your children, sometimes even the other adults around you – you can certainly do it for yourself, and for the small, scared animal inside who needs to know you are trustworthy.

It can be a long, drawn-out process, full of tears and frustration and mistakes. There’s also good stuff in there, but make no mistake, it is not an easy task.

And that’s why writing is so nice. It’s more abstract, it’s less emotional, and it helps me to reinforce the nuts and bolts of what I do. So, both for myself, and for all of you out there who just want to know how to do it, already without all the hand-holding and emotions, here you go. Here’s how it works.

Lesson One: Permission

There is one golden rule to normal eating, and it is this: no one decides what or how much goes in your mouth but you.

You are an adult. You are an autonomous human being. You make your own choices with food. I do not care how much you weigh, or whether you have a disease or an allergy – you have unconditional permission to eat anything in any amount.

There are no laws, legal or moral, to stop you.

That’s what being an autonomous human being is all about.

Even if you have a disease or an allergy, it is your choice to either follow the therapeutic dietary recommendations for your condition, or not. (It is also your choice to figure out what works for you, personally, since not all therapeutic diet recommendations are written in stone. Some may not even be based on good evidence.)

Would I recommend that you eat something that will cause you immediate death or illness? No, of course not – but that is not my choice to make. It is yours, and only yours.

Even in the most extreme scenario, you make that choice. Is it a fun choice? If it’s between peanuts or death, no. It’s not fun at all. But from a philosophical perspective, it is still a choice, and you are still the only one who can make it.

You also have the unconditional right to eat. Eating is a human right, no matter how fat you are, no matter how screwed up around food you think you are, no matter how much you know or don’t know about nutrition, no matter what your concerned family or friends say, no matter who harasses you on the street.

You have the right to eat, because you are a human being.

You also need to eat, because you are a human being. There is no person out there, fat or thin, who can live a healthy, functional life without eating a reasonable amount of food.

There is a misconception that somehow being fat beyond a certain arbitrary line drawn in imaginary BMI sand means you have the superhuman ability, and the moral obligation, to live without food. Which is total bullshit.

Quick nutrition interlude: your body, every cell in your body but particularly your brain, runs on sugar. Glucose is the preferred day-to-day gasoline that makes you go. And, believe it or not, our body only has a short-term store (usually measured in hours) of glucose to draw on.

Which means? You need to eat. Regularly. You’re not going to be able to think clearly for very long without it, and you’re going to feel like ass, physically.

To sum up:

• You need to eat.
• You have the right to eat.
• Only you can choose what you eat.

All of which can be distilled into a single concept: permission. Unconditional permission to eat whatever, and however much, you want. Healthy food? Junk food? A lot? A little? It’s your choice. You have permission.

Because we don’t live in a world that naturally encourages your autonomy around food, you will need to put this into practice. To put permission into practice, you need to say it to yourself every time you sit down to eat:

“I’m allowed to eat this, and I can have as much as I want.”

Permission works both ways, too – you do not have to eat anything you don’t want.

Ever see a toddler spit out strained peas against his mother’s best efforts? That’s you.

You do not have to eat anything you don’t like, don’t want, or aren’t in the mood for. No matter who is pushing it, who thinks it’s for your own good, or what magazine says it’s the new superfood. You do not have to.

You don’t have to count calories, or Points, or measure portions out and leave the table feeling hungry. You also don’t have to get so full that you feel uncomfortable, just to assuage someone’s insecurity about their cooking, or their guilt for being an absent parent, or whatever.

You do not have to clean every plate in sight because someone, somewhere in the world, doesn’t have enough to eat. You are not the Human Garbage Disposal, and you can’t solve world hunger by eating leftovers.

You are responsible only to yourself, and your stomach. You are allowed to eat only what feels right, in amounts that feel right.

Say it to yourself – “I’m allowed to eat this, and I can have as much (or as little) as I want.”

Say it like you’d say grace over your food. Even if you don’t believe yourself at first. Even if it feels stupid and pointless. You do it, and you do it again and again and again.

Why? Because it is absolutely true.

So, here’s the takeaway – write a permission note to yourself, right now. Put it on a Post-It, or make a big sign, or embroider something. It doesn’t matter.

Put it in your own words. Put it somewhere you’ll see it and remember it. And then say it, either out loud or in your head, every time you eat, as often as you can remember.

Some of you have emailed me with questions. So here are the answers!

Hey!

I’m keeping this super-short so I don’t waste your time.

Just a reminder that it’s still not too late to sign up for an Eat Without Drama group if you’ve been secretly wanting to and just got sidetracked by the weekend.

The Monday afternoon group (that’s today at 3pm Eastern) has plenty of room left, and the awesome group starting tonight at 7:30pm Eastern has one seat left.

If the Friday night group (Saturday morning for my Kiwis and Aussies) is more your style, you can still sign up and start this week – a couple of people had to miss the first session anyway, so you won’t be alone!

As always, sign-ups are at www.eatwithoutdrama.com.

Cheers for a lovely week!
Michelle

Ahem.

This is kind of last-minute, but the long weekend really threw me off.

For a long time, I’ve been doing individual sessions teaching people how to eat normally after giving up dieting (in addition to writing this blog, of course.) Doing individual sessions means that they are pretty expensive, and it limits the number of people I can help.

Luckily, back in 2008, someone had the brilliant idea of doing the same program I do, but for small groups. They published this paper on it (it works.)

So, at the end of July, I started seeing small groups. I see more people this way, and it’s cheaper for them.

It also works, and has the bonus of being EXTREMELY FUN.

It’s sort of like going to fat camp, except online, and the point is not losing weight.

Mostly, the point is figuring out how to eat well, while at the same time laughing your head off with other fat people.

So this is what I’m doing now, and some new groups are starting for the fall. We’re calling it Eat Without Drama because, well, that’s what it’s about: eating without all the drama.

One group starts TOMORROW NIGHT (Saturday morning, if you’re in Australia or NZ), and the others start on Monday the 12th.

For the sales pitch, the times, the price, and the big buttons to push, go here.

If it’s not for you, no worries. You don’t need to buy my shit! We’re cool.

That’s all. Thank you for your attention.

*mic screech*

• The bottom line is that you provide yourself the opportunity to eat at regular times.
• The bottom line is that, at those times, you give yourself free reign to eat WHAT and HOW MUCH you want.

Until you’ve got those things down, don’t even bother with “nutrition.” It will only fuck you up.

Eating at regular times doesn’t mean “three measured meals with no snacks in between.” That is some depriving, dictatorial bullshit right there, pushed by groups like Overeaters Anonymous. Do NOT mistake any of what I’m saying here with any of the many, many tricks diet programs have pulled on you to try to get you to eat less.

I don’t want you to eat less. I want you to eat well.

Eating well means eating in a way that feels good, both emotionally and physically. It, emphatically, means getting enough to eat, and getting enough of the foods you really like.

Eating at regular times means, for most people, three meals with one or two or three snacks thrown in for good measure. Unfortunately, most adults have somehow internalized the idea that snacks are bad.

Stop right there. Snacks are not bad — snacks are essential.

Snacks are just as, and sometimes more, important than meals. Snacks get you through the period of desperation between lunch and dinner. Snacks give you a chance to eat some of the fun, bizarre, ridiculous, delicious, non-staple foods (like Cheetos) that it might otherwise be hard to incorporate into a fully-orchestrated meal. (They can also help to regulate your blood sugar, if you want to get all technical.)

They legitimize the hunger that you naturally feel at the mid-morning lull, the mid-afternoon lull, and the late-evening munchy time in front of the TV. We all feel hunger at one or all of these times. There’s no sense in denying it, so we may as well admit it, make it official, and get on with our lives.

Snacks are legitimate, snacks are official, and when you decide that you are going to eat them and make them a non-negotiable part of taking care of yourself with food, you can stop feeling guilty about them immediately.

So let’s do that right now: you are going to eat snacks. (Or snax! Because it’s so much more fun to say. Snax!) Why? Because snacks — official, pre-planned snax! — are part of life. They just are.

Providing yourself with regular opportunities to eat means that you will either pick rough times (like 6am, 9, 12pm, 3, 6, and 9pm again), or pick rough intervals (two or three or four hours) at which you will sit down with food in front of you.

You do not have to eat. But you have to sit down and look at that food and give yourself real, unconditional permission to eat if you want. And to go back for seconds, or thirds, if you need them. Or to eat half of it and change your mind and throw it away. Or to take a couple of bites and hand it to your husband. (Ahem. What?) Or wrap it back up and stick it in the fridge or freezer for another time.

Sound ridiculous and pointless? It’s not. It’s a crucial part of rebuilding trust with your body. It’s caring for your body as you would care for a child.

It’s making a promise to yourself: I will feed you. I will love you. I will let you grow.

Until the promise is made, and kept, and a relationship has been re-established, you cannot go forward toward the top of the pyramid without feeling scared, rebellious, resentful, and suspicious of yourself.

For now, build the bottom of that pyramid. Next time, we’ll dance at the top.

Since I started doing this crazy accept-my-body thing eleven years ago, there has been a series of ups and downs with my own body image. I go through good times, I go through bad times. Sometimes really, really bad times. Over the years, the good times get longer and the bad times get shorter.

What doesn’t change, though, is the amount of pressure on me — on all of us — to look a certain way. To be feminine, to be light-skinned, to have smooth hair, to fit into straight-sized clothes.

As you get fatter, gravity doesn’t get weaker or kinder. It stays the same. Your body is more subject to it, in fact, because apparently the earth is a fat admirer, and wants to keep you as close as possible. As this happens, as the scale creeps up to numbers a previous version of you would have fainted at, you have two choices: to attempt to loosen the bonds of gravity, and Earth’s apparent amorousness, by making yourself smaller — or to use gravity to your advantage, to get stronger, strong enough to carry your weight happily through the world.

History has taught me that I’m not very good at getting smaller, but that my strength? It is awesome. And it can grow.

As one gets bigger, or even just as one becomes more aware of the sickness of the body-obsessed culture, the pressure increases. It drags on you, eventually to the ground, the point of crisis, the valley of decision.

Do I lay here and starve until I am light enough that gravity rescinds its uncomfortable obsession? Then get up and walk fearfully away, knowing I am weakened against the next time it drags me down? Or do I allow myself to rest briefly, then begin to move any muscle I can feel: an arm, a leg, an eyelid — working continually against the pressure, until I’m strong enough to stand the fuck up, under my own power, and walk toward the things I want?

The things the world says it won’t give to me unless I am white, thin, and wearing makeup? The things that I am now strong enough to take for myself, any way I want them?

Each time I’m dragged down, I’m stronger and quicker at pulling myself to my feet.

Gravity doesn’t go away. I get better at remaining upright.

I’m thinking today about body image. My body image, to be specific, and the way I feel when suddenly confronted with photographs of myself taken by other people, showing my whole body.

The experience is one of immediate shock, often followed by a weird cognitive dissonance. My body doesn’t Look Right. Because apparently there is a Right Way for bodies to look, and whatever I’ve constructed in my head as that Right Way sure as hell has nothing in common with the photographic evidence of my squat, round, rather sticky-outy body.

Bodies, in my head, are supposed to be straight up-and-down, to have clean, spare lines and angles. The head should be a particular size in proportion to the rest of the body — not too large, or, in my case, too small. The feet should not be too long in comparison to the length of the legs; the shape from the front of the thigh to the back of the calf not such a dramatic S-shape.

And, for the love of all that’s holy, the whole thing should not be so damn big.

After the emotional reaction, I have to start thinking rationally again. That’s when I realize: hardly anyone spends much of their time daily considering images of themselves, especially not full-body images. Hardly any of us are constantly taking full-body self-portraits, or are surrounded by full-length mirrors. We don’t spend a few hours here and there watching video of ourselves.

We are too busy being in our bodies daily to spend more than a few minutes confronting how we actually look in them.

Then it occurs to me that all those articles decrying the apparent fat-person curse of Being In Denial of One’s Fatness are actually just restating the obvious: when you’re not spending all day staring at yourself, but do spend a considerable portion of your day observing media depictions of bodies that are not much like yourself, isn’t it natural that the part of your brain dedicated to constructing the Platonic composite of How Bodies Look will be mostly filled with images of sparse, clean lines, slenderness, and a particular head-to-body ratio?

Won’t you go through your day, in your body, almost implicitly assuming that it looks more-or-less like the definition of Body you have mentally constructed, based on the images and people you’re constantly surrounded by?

And won’t you then experience a cognitive dissonance when confronted with an image of a body that breaks all those Platonic rules — especially when you realize that it belongs to you, that it is, in fact, you?

Of course. Of course you will. Not because you are a stupid fat person in denial about your fatness, but because the culture we live in has erased fatness (and other forms of physical variation) from most of its artwork and entertainment.

If you’re like me, and fatter than about 97% of the population, you’re also not going to see a whole lot of other people like yourself in daily life. Most people you see, even the relatively fat ones, are going to be a bit less sticky-outy, have proportionally-larger heads, etc. You will also incorporate those impressions into your little Platonic file cabinet, along with the much thinner media impressions.

And your first reaction on seeing a photograph of your body will be one of shock, possibly horror, and an indefinable sense that Your Body is Wrong.

The secret, of course, is that there is no Right Body, no matter how hard our culture tries to define one. There is no Platonic Body floating in indisputable ether — only real bodies that exist in the real world, available in an extravagant assortment of shapes, colours, sizes, and conformations. None of them wrong or right. All of them just are.

And now I can understand that the experience of cognitive dissonance and disgust with how my body looks is an artifact of my cultural training, not a Real and Inescapable Truth About Me, requiring a dramatic gesture of repentant food restriction and mortification of the flesh through exercise.

If anything, the dissonance is a reminder that, because my body is different and even somewhat rare in this world, I must take special care to fill my Platonic File Cabinet with images that make sense to me, that I can identify with. That my own indisputable body shall now be the starting point for my definition of Body, and that I can spend a few minutes daily filling the file cabinet with pictures of me.