By Michelle May, M.D.
(This is the second of three articles about making dietary changes without feeding the Restrictive Eating Cycle. The first article, A Diet by Any Other Name is Still a Diet, explored the idea that when people make a voluntary change in their eating in the name of “health” without mindfulness, they may find themselves hyper-focused on food with less energy left to focus on living the healthy life they set out to achieve. This article is about mindful eating with health issues, such as diabetes, without feeling restricted.)
Sometimes when people hear that my books are called, Eat What You Love, Love What You Eat, they say (or think) “But what if I can’t eat what I love?” Sometimes they are afraid to eat what they love because of past problems with overeating certain foods; I’ve written extensively about fearless eating in my books and other articles, so this article will focus on the concerns people have about mindful eating when they have medical or health concerns. For example, I’ve heard many variations on “I can’t eat what I love!” such as:
- I have diabetes so I’m not allowed to have sugar.
- I’ve had bariatric surgery so I have to follow a special diet.
- My doctor told me that I shouldn’t eat salt because I have high blood pressure.
- I am sensitive to gluten so I can’t eat bread, pasta, or some of my other favorite foods.
The real problem in each of these statements is the perspective: “not allowed, have to, shouldn’t, can’t…” Words like these can leave you feeling powerless, or even rebellious, and those feelings can feed the eat-repent-repeat cycle. As a result, despite your best intentions, you continue to yo-yo diet, but with increased risks and potentially worsening consequences—like a blood sugar that vacillates between too low and too high.
Is Mindful Eating with Health Issues Possible?
The following questions will help you eat mindfully, without restriction, even when you have health reasons for dietary limitations.
1. Is it really true that you “can’t” eat a particular food?
Many people say “I can’t” when what they mean is “I believe I shouldn’t.” It is important to acknowledge the difference because obviously, if you have a serious allergy or severe reaction to a particular ingredient, then you really can’t eat a particular food or ingredient. If that’s the case, remind yourself that you are choosing not to eat it because you want to feel good (or live!). In that way, you are still making a conscious choice rather than feeling like a victim to your allergy or reaction.
If you don’t have an immediately life-threatening reaction to certain foods, then just drop the word “can’t” altogether because it puts you in a deprivation mindset rather than a self-care mindset.
2. Is it really true that you “shouldn’t” eat a particular food?
Sometimes people have picked up rules about eating that aren’t based in fact. As a result, they keep “shoulding” themselves over myths, fads, half-truths, outdated information, or misunderstanding the facts.
A common example of where this applies is type 2 diabetes. Many people with diabetes believe that they “shouldn’t” eat sugar or “can’t” have carbs. While it is true that a person with type 2 diabetes doesn’t process carbohydrate as efficiently as they once did, they can experiment with different “doses” of carbohydrate with their snacks and meals to figure out how to keep their blood sugar in the target range. (From Eat What You Love, Love What You Eat with Diabetes.)
3. Is it really true that you must completely avoid this food?
Many people who struggle with food lean toward dichotomous thinking (“black and white,” “good or bad”). In other words, if a food isn’t particularly healthful (whatever that means and for whatever reason), it becomes labeled as a “bad” food that must be completely avoided. As a result of this same dichotomous thinking, if you eat any of that particular food, you feel like you are “bad.” The resulting guilt often leads to more overeating—not less—and that certainly doesn’t lead to the desired benefits!
If you struggle with all-or-nothing thinking and find yourself resisting or “cheating” when you are given restrictive advice, an important question to ask your health care professional is, “Would this food (or ingredient) be harmful if I ate it in moderation?”
4. But what if certain foods worsen certain medical conditions?
It obviously makes sense to limit or steer clear of certain foods if they have health or medical consequences. However, even when you don’t have a choice about what you eat, you do have a choice in how you think about what you eat! In other words, you may choose to limit certain foods in order to feel good, not to be good!
An example of this is when someone has had bariatric surgery (aka weight loss surgery or WLS). Often they are given a list of guidelines to follow about when, what, and how much to eat. These guidelines can feel like a lifelong diet—with uncomfortable or embarrassing consequences when they break the “rules.” When dietary limitations (even necessary or practical ones) feel like a diet, you are likely to struggle with the eat-repent-repeat cycle (and depending on the problems you have when you eat certain foods, the “repent” phase can be significant). Instead, remember that you are in charge of making choices that work for you. (From Am I Hungry? Mindful Eating for Bariatric Surgery Workbook and Awareness Journal.)
5. Is eliminating, or even limiting, this food the priority for you?
Many people think they have a problem with food when in actuality, it is a symptom! In other words, many people who are struggling with food need to first address why they are eating. Until they do, focusing on food is just a distraction from exploring the root cause of the problem, and therefore, won’t lead to lasting change and improved health. Once they have healed their relationship with food and built mindfulness skills to notice how certain situations, people, thoughts, emotions, and foods affect them, they are better able to modify their eating and their diet to feel their best.
An important example of this is Binge Eating Disorder (BED). When a person is suffering BED, the priority must be on healing the eating disorder. Making changes to their diet may come later—or may even become unnecessary once BED is resolved. (From Eat What You Love, Love What You Eat for Binge Eating: A mindful eating program for healing your relationship with food and your body.)
6. Do you have to go from point A to point Z in one leap?
When certain dietary changes are recommended or necessary, a common error people make is attempting a huge overhaul that they are unable to sustain. A more effective approach is to ask yourself, “What is the smallest change I am confident I could make that will be (nearly) painless?” By practicing small changes consistently, you will build on your success little by little.
7. Instead of “following a diet,” could you just “eat a diet”?
Over the last hundred years or so, the word “diet” has come to imply restriction, so when you are “on” a diet, it is likely that you will eventually go “off” the diet. Since the word “diet” simply means “food and drink regularly consumed,” can you reframe the way you eat as simply a description of your pattern of eating instead of a program or plan you are on or you are following? (By the way, this applies to mindful eating too! It is not a temporary program you are following; it is a way of life!)
The last article in this three-part series 7 Am I Hungry? Mindful Eating Strategies that Help You “Eat Better” will apply specific strategies from the Am I Hungry? mindful eating programs to help you make dietary changes for health reasons without developing a Restrictive Eating Cycle.