Getting good at eating.

by Michelle

When I was recovering from dieting, I was terribly conflicted about how to eat. I went through a period where I ate chocolate by the box, and then stopped paying attention to nutrition entirely for several years, because it was too fraught for me. Eventually, I got to the point where I alternated between undereating and overeating because I just had no idea what to do.

During that time, I encountered Ellyn Satter’s approach to nutrition in the first book I read on fat acceptance, Losing It by Laura Fraser. Reading that book brought me the realization that I no longer wanted to diet, and, because of the interview with Ellyn Satter, I also realized I wanted to work in nutrition, helping people to overcome chronic dieting and disordered eating.

So, just the other day, a conversation on one of Lesley’s posts at Fatshionista brought me to the point where I had to introduce the idea of eating competence.

A lot of what I’ve written on this blog has been leading, slowly, up to this. But I haven’t broached it yet, because it’s been critical for me to first build the foundational argument that it is your right as an adult to eat whatever, and however you want.

And that it’s no one’s business to tell you to do otherwise. End of story.

So, what of eating competence? Also known as ecSatter, it’s a concept developed by Ellyn Satter (and protected by her — this will become important later) that’s based on her clinical observations of how people who do well with eating…eat:

I consistently found prescriptive dietary interventions to undermine my patients’ foodways, to destroy their ability to intuitively regulate food intake, to worsen their nutritional status and to spoil their attitudes about eating. Because eating is so central to life, my patients were not only demoralized about eating, they were demoralized overall. Because it was so glaringly clear to me that the harm far outweighed the benefit, I changed my ways. Rather than trying to control or subvert their natural tendencies to regularly provide themselves with ample and enjoyable food, I learned to build on those tendencies by emphasizing permission and discipline:

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

Basically, eating competence describes how “normal” eaters eat. It’s descriptive in that sense, and prescriptive only for those people who are uncomfortable with their current eating, or who worry about their nutrition and health, and seek to make a dietary change.

People who already feel they are doing fine? Excellent.

This is not a set of “shoulds,” nor is it a prescription to change the way you currently eat. Discard at your leisure.

But the people who come to me to learn to eat don’t feel they’re doing fine. They have considerable anxiety around food, and feel lost or resentful when it comes to nutrition. And the purpose of my work is to help them get good at eating.

I do that by using the best-researched approach available, which is the eating competence model — and, not, incidentally, Weight Watchers:

Even Weight Watchers, which many people tout as the best of the diet centers because of its reliance on real, fresh food and flexible menu choices, doesn’t help people learn to develop a sense of inner competence about eating. ‘What it comes down to is the issue of trust versus control,’ says the nutritionist Ellyn Satter…who treats what she calls ‘dieting casualties’ in her practice. She believes that people need to learn to trust that they will get full, even on food they consider highly desirable, and know that they can reliably regulate their own food intake, rather than depending on outside rules to manage those choices. ‘Weight Watchers is pretty good at liberalizing food choices, teaching people how to eat attentively, and encouraging them to increase the variety of food in their diet,’ says Satter. ‘But it’s still fundamentally a control stance they use.’ When people rely on outside rules, scales, and diet cops to regulate their eating, their relationship to food remains brittle.

-Laura Fraser, Losing It

As it turns out, there are four factors that comprise eating competence:

  1. A good attitude toward food and eating. People with good eating competence enjoy eating, and they don’t feel guilty about either food or their enjoyment of food. They are pretty relaxed about it.
  2. They are also decent at trying new things, and at eating not-super-favourite foods when the situation calls for it. They are not afraid of food — even “unhealthy” food — and, as such, they manage to eat a decent variety.
  3. They are pretty good at internally regulating how much they eat. They can feel hunger. They can feel satiety. They can comfortably eat until they are truly satisfied, both physically and emotionally.
  4. They plan ahead to feed themselves. They do the work necessary to ensure there is food on hand, and they have regular meals. They give some thought to nutrition, as well as taste, when selecting food. They make the time to eat, and to give some attention to their food while eating.

What are the outcomes for people who tend to eat this way? Well, they tend to have stable body weights (even if they are fat.) They also tend to have better blood pressure and blood cholesterol levels, which translates into a lower risk of heart disease.

The basis of Ellyn Satter’s message is that good nutrition depends on the enjoyment of food, first and foremost. She is famous for saying, “When the joy goes out of eating, nutrition suffers.”

From the perspective of ecSatter, enjoyment and pleasure are primary motivators for food selection, and nutritional excellence is supported by enjoyment and learned food preference based on subjective reward from eating.

J Nutr Educ Behav. 2007 Sep-Oct;39(5 Suppl):S142-53.

That’s why, when it comes to teaching people eating competence, the first priority is to enhance their enjoyment of food, and reduce their anxiety and guilt about eating — before any thought to nutrition enters the picture.

Population food surveys have consistently shown that people’s first priority in selecting food is how it tastes. This is not going to change just because the nutrition establishment thinks it should — instead of fighting against people’s desire to eat pleasurable food, the eating competence model works with it.

And, instead of fighting against your own body’s natural weight tendencies, eating competence also endorses self acceptance.

This has just been a brief introduction to the concept. We’ll discuss it in more detail in posts to come.

Pelt me with rotten (or sundried) tomatoes in comments.