Attuned eating, by contrast, supports people in their journey to reestablish a natural, anxiety-free relationship with food. The first step in this process is to ask clients if they know when they're physically hungry. At workshops, I always pose that question to my audience, and find that therapists, as well as clients, are frequently disconnected from the physical sensations of hunger. Typical hunger cues participants bring up—weakness, light-headedness, irritability, headaches, and poor concentration—actually indicate that they've waited too long to eat. Unfortunately, when we let ourselves become that ravenous, not only do we experience physical discomfort, but we also feel desperate and are much likelier to eat whatever is available.
After years of dieting, Lucy found herself completely disconnected from physical hunger. When she was following her diet, she ate by the clock at prescribed times, following a rigid, low-calorie food plan that had little to do with physical hunger. When she broke her diet, her eating became chaotic. She'd either skip breakfast or grab a few cookies and her morning coffee on her way out the door. For lunch, she often opted for the convenience of fast food, eating quickly in the car to save time, and then frequently continued to munch on the candy and chips available in the nearby vending machine as she tried to tame the boredom and stress of her afternoon. But on other days, she might have only a diet soda and yogurt, so that by the end of the day, she felt headachy and crabby, indicating that she'd waited too long to feed herself. In fact, she reported feeling so ravenous one day that when she met her friend at a restaurant, she consumed half the bread basket, a heaping plate of pasta Alfredo, and a hot fudge sundae.
I helped Lucy learn to check in with her stomach on a regular basis by asking herself, "Am I hungry?" every 15 to 30 minutes. If she noticed physical hunger, she needed to eat, so that she could develop the hunger-food connection that's essential for breaking out of overeating patterns. I suggested that she welcome her hunger by saying to herself, "This is terrific. I get to eat!" But after so many years of feeling guilty about food, she found it hard to believe that she was truly entitled to eat and could trust her body to tell her when to eat.
Lucy found it useful to think of a young child who was hungry, realizing that she'd never say to that little girl, "Too bad if you're hungry. I'm not going to feed you." I instructed her to carry food with her when she was away from home and take it to her office, so that even if she got caught up in a project, she could take care of her need to eat. She noticed that, as she learned to listen to her body's reliable internal signals, she became less focused on food and her anxiety about whether she "should" or "shouldn't" eat decreased.
After so many years of deciding what to eat based on diet rules and food plans—or eating in rebellion to those rules—Lucy was surprised when I asked her in our session what she was hungry for. She'd had breakfast earlier in the day, but it was now 12:45 p.m., so I'd asked her to check in with herself and see whether she was hungry. She said she could feel some hunger, but didn't have a clue what she wanted. Usually she ate whatever was in the house, or whatever was convenient. The idea that her body could guide her in her food selection was truly novel.
Most of us have had the experience of craving something—and the wonderful feeling of actually getting it. Many of us also know the feeling of wanting something to eat, deciding we "shouldn't" have it, eating something else, and, feeling deprived and unsatisfied afterward. It's this experience that often leads to standing in front of the refrigerator, grabbing and eating whatever's there.
As she sat in my office, Lucy said that she didn't have a specific craving and really didn't know what she wanted for lunch. I asked her to think about whether she wanted something hot or cold, and she quickly responded, "Hot." I then asked her if she wanted something mushy or crunchy, spicy, bland, or salty. As we narrowed down what would taste good to her and feel good in her body, she settled on Kung Pao chicken with noodles from a local Chinese restaurant.