Mindful Eating: Strategies for a Better Relationship with Food with Dr. Susan Albers

Podcast Transcript

Deanna Pogorelc:  Hi, thanks for joining us for this episode of The Health Essentials Podcast brought to you by Cleveland Clinic. I'm your host Deanna Pogorelc, and with me today here at Cleveland Clinic main campus is Dr. Susan Albers. Dr. Albers is a psychologist and author who has written nine books on mindful eating. And today she is here to share some strategies with us for overcoming unhealthy eating habits and building a better relationship with food. Thank you so much for being here, Dr. Albers.

Dr. Susan Albers:  Thank you. Thank you.

Deanna Pogorelc:  For our listeners, please remember this is for informational purposes only and it's not intended to replace your own physician's advice. Dr. Albers, I'm going to jump in with just the million dollar question right off the bat. Healthy eating seems so simple. We know what we're supposed to do, eat more veggies, eat less sugar, all of that. Why is it so hard for so many of us?

Dr. Susan Albers:  We do wish it was easy. Something that we do all the time, at least three times a day. We wish it was simple but it's really complicated. I have a lot of clients who come in who get very hard on themselves and I say don't it because there are a number of different factors that stand in the way. And there are three in particular that make eating so challenging.

Dr. Susan Albers:  The first is our emotions. 75% of our eating has nothing to do with our physical hunger. We eat because we are stressed, we are bored, we are anxious, we feel overwhelmed, and all of those factors stand in the way every single day because we feel so much in a day.

Dr. Susan Albers:  The second is our environment. We live in a mindless eating environment. We are surrounded by food 24/seven, it's all around us. We can be not even thinking about food and we see a commercial and all of a sudden we're craving something.

Dr. Susan Albers:  And the last reason is dieting. There's a lot of different fad diets that are out there in the world. And in fact, a recent survey said that over the course of our lifetime, we try over 162 different diets, which is astounding number. And in that same survey, people admitted that they go to Google often for their information instead of a quality resource. They also look to celebrities. And if you're confused about the information, it's hard to know what is really good quality, solid information and a lot of its conflicting. So many people get very confused and overwhelmed, but it's important to eat well. Very important.

Deanna Pogorelc:  Yeah. Can you talk a little bit about what happens? I guess the psychological process of eating, feeling hungry. We have these built-in that tell us when we're hungry and when we're full, but how does eating work in our brain?

Dr. Susan Albers:  Our brain is actually very important. We think that eating is about our stomach, but actually it has a lot to do with our brain and our biology and our chemistry. Our hormones are involved, our serotonin level is involved, our neurotransmitters. So there's a lot of things that are happening below the surface that we aren't really in touch with. But one of the things that really blows me away is about our mindset, about how our mindset impacts how our body processes food. And this is why it's so important to have a good relationship with food.

Dr. Susan Albers:  For example, let's say that you are somebody who likes vanilla ice cream. You love it, you crave it. So as soon as you start thinking about vanilla ice cream, your body gets primed, you start to salivate, you start to get excited, those hormones start going off the neurotransmitters and your body's getting ready. And when you have that food that you love, it's like the dopamine is released. So it's a pleasure hit to the brain.

Dr. Susan Albers:  Now imagine another person who doesn't like ice cream or doesn't like vanilla ice cream, or they feel a lot of shame and guilt whenever they eat a food that they perceive is bad or is against their diet. And suddenly their response to food, their mindset takes their body in a whole different direction. Suddenly they start thinking about ice cream and it's not dopamine that's released. It's the chemical cortisol, the stress hormone, and their body starts to tense up. They don't digest it in the same way. So the very same food can be processed by two different people in very different ways based on what their mindset is.

Deanna Pogorelc:  You mentioned shame and guilt. Does that kind of almost create a cycle then? Because if we're eating because we're emotional and then we eat terrible and then we feel shame and it just... Is that how that works?

Dr. Susan Albers:  Shame and guilt don't motivate us to eat well. And unfortunately, a lot of the diet language out there is based around where it's shouldn't and don't and you're bad if you eat certain foods. And that's why I really love the concept of mindful eating because it turns the language around. It's really about being more aware of your hunger, responding to it instead of reacting to the first thought of I want eat, but really responding in a mindful, conscious way.

Deanna Pogorelc:  Can we talk about some of the other common eating or unhealthy food habits that people have that you would recommend mindful eating for? What are some of those habits that you see in your patients?

Dr. Susan Albers:  We have a lot of mindless eating habits. Some of them we aren't even aware of. Maybe we're sitting on the couch eating where we get to the bottom of the bowl as we're watching TV and we get to the bottom, we say, "I didn't even really taste that or enjoy it." We're just mindlessly popping it in our mouths. Distraction is often a number one cause of mindless eating as well. We're sitting in front of our computers typing or our screens and eating at the same time. In fact, a recent study showed that about 20% of people admit that their screen is their only dining companion.

Deanna Pogorelc:  Oh, wow.

Dr. Susan Albers:  That they eat the majority of their meals in front of a screen. And our bodies just don't process food in the same way when we are distracted. And we're much more or less in charge or in control of how much we're eating, when we're distracted. So my motto is when you eat, just eat, be in the moment, focus on what you're doing.

Deanna Pogorelc:  Okay. Let's talk a little bit more about what mindful eating is and what are some of the benefits and I guess what it just means in general.

Dr. Susan Albers:  Yeah. Mindful eating, it's not a diet. There are no menus or recipes. It's more about how to eat than what to eat. As a psychologist, I don't tell people not to eat certain foods like sugar, it's more about our relationship to food, our habits around food. And so if you're somebody who wants to eat more mindfully, there are a couple things that you can do that are very easy to get you started on that path. Well, they sound simple, but they can be challenging. And there are around five Ss of mindful eating.

Dr. Susan Albers:  The first one is to sit down, sit down while you eat. Many of us are standing in front of the refrigerator, picking food right out of it, leaning against the counter, walking while we eat or driving. And research indicates that if we sit at a table that that helps us to be much more mindful of how much we're eating, but enjoy our food more because it's right in front of us and we're focused on it. And so my motto is always eat off your feet. There was also another research study that looked at people who were walking versus sitting, and they ate 5% more while they were walking and distracted. So sitting at a table is really important.

Deanna Pogorelc:  That's the first step?

Dr. Susan Albers:  The first step.

Deanna Pogorelc:  Okay.

Dr. Susan Albers:  The second one is to slowly chew. And again, it sounds easy but we are highly influenced by the people around us. There was a study that looked at people who ate with strangers and they actually chew in tandem at the same rate with the people that they eat with. So if you have a family that eats very, very quickly, it's likely that you will eat quickly as well. So sitting down when you eat and setting your pace at the beginning. My motto is please don't race. Encourage yourself to slowly chew. And that can be really, like I said, very challenging to do.

Deanna Pogorelc:  Is there like a magic number or just...

Dr. Susan Albers:  Research said about 22s, but I say just be very intentional about slowing down when you eat. We have this hurried person syndrome where we're constantly like, "Hurry up, let's go." With ourselves and kids that were constantly rushing through things. So, it can be a real challenge.

Deanna Pogorelc:  Okay. Was that the second S?

Dr. Susan Albers:  That's the second.

Deanna Pogorelc:  Okay.

Dr. Susan Albers:  Third S is to savor your food. Now, research indicates that the first bite is actually the most flavorful because as we continued to eat, we become habituated to the taste of food. And so the first bite is really the most important one. If there's one thing that you do, that first bite, really ask yourself, "Do I like really like it?" And we eat a lot of my mediocre foods. So if you like it, keep going. If not, maybe that's a food to skip. And then really enjoy it and savor it. Because we can eat an entire plate of food and not taste one single bite.

Deanna Pogorelc:  Yeah. Okay. That's the third S?

Dr. Susan Albers:  Yes. The fourth S is to simplify your environment. Our environment, it can really push us towards mindful eating or towards mindless eating food that is around us because we often will walk past food and just kind of mindlessly pick it up. One of the things that I encourage people to do is to take a tour of either their desk or their kitchen and look around to see what food is out and available. Studies show that people who have a fruit bowl out and available actually weigh less, have a lower BMI than people who have a soda and cereal sitting on their counter. So take a look around and see what is available.

Dr. Susan Albers:  In my own house, what I love to do is I have a bowl right next to the door, the exit, and it's filled with healthy snacks. Things like mandarin oranges, nuts, and everybody who leaves the house, they stop at the bowl, pick something up, put it in their pocket so they have it available and that helps them to avoid stopping at fast food or going to the vending machine. If we have it handy, we know we should have a snack, but it's just remembering to bring one with us.

Deanna Pogorelc:  Sure. Okay. And then the last S.

Dr. Susan Albers:  The last S is my favorite. It's to smile between bites. That smile, you can take a pause between each bite to ask yourself, "Am I really satisfied? Can I stop here?" Because we often eat the whole plate before we even take a pause or a breath. So doing the smile between bites can help you to take the pause, but the second benefit is that when we smile, it releases to our brain serotonin. And so that actually helps us reduce emotional eating because as we smile, we feel good, and so we're going to do less emotional eating overall.

Deanna Pogorelc:  Wow. Okay. You mentioned quite a bit of research in that when you were going through your five Ss. There has been a lot of research done about mindful eating. It's not just this kind of concept that's hoity-toity or not really supported by research.

Dr. Susan Albers:  Absolutely. And I think that's a myth. Is that we think that it's just a concept out there. There was actually a recent study that looked at over 68 different published studies to look at the overall benefit of mindful eating. What they found is that it's very helpful with reducing binge eating. It's also helpful with reducing emotional eating and they found more modest success with weight loss. However, and I know sometimes people are like, "Oh, no." But what I've found with my patients and also in these studies is that it's slow and consistent. So in contrast to some drastic diets that will show quick weight loss, these studies show very slow but steady over time.

Dr. Susan Albers:  Probably one of my favorite studies looked at people who went to their [inaudible 00:12:22] population, or people who went to restaurants on a routine basis and they taught them mindful eating skills. Not what to eat, but some of these different habits around food. And they found that just from learning how to interact and be more mindful and conscious of what they're eating, they ate 300 calories less a day. And so they didn't change what they eat, they just changed how they were eating.

Dr. Susan Albers:  The research overall shows a lot of benefits, and what I particularly love as working with patients myself is that over the years I've seen that fad diets are one of the biggest triggers for eating disorders and also disordered eating. So someone may have a great relationship with food, and then they try a diet that asks them to restrict a certain food, and forever after that there's this little bit of tug of war that they have emotionally with a specific food, let's just say sugar for example. And so it causes a lot of disordered eating.

Dr. Susan Albers:  And so what I love about mindful eating is that it's for everybody. Everybody can benefit from it. And any style of eating that you have, whether you have a specific diet that you have to follow if you're vegetarian or gluten free, you can bring those mindfulness skills to it. And it's not triggering of any kind of disordered eating. That's what I love and appreciate it as a psychologist who works with people who struggle around food. Is I want something that they can do long-term and is not going to create some other issues in their life.

Deanna Pogorelc:  How does someone know that they are a mindful eater? I mean, how do they know they've reached that really healthy place?

Dr. Susan Albers:  Well, I think what I also like about it is that I think one of the myths is that it takes a lot of time. That we have to have a long period of time to sit down and eat in a mindful way and close our eyes, which is not that at all. I mean, sometimes it's just a simple mental shift of being in the moment when you sit down to eat and being very present. So I like that it's something that doesn't take a lot of time.

Dr. Susan Albers:  And what I noticed is that when people know they've become more mindful eaters, is they'll kind of catch themselves in the moment. They'll say things as they're eating. They'll say, "Wait, I'm not eating in a mindful way." Or before they eat, they'll have something that they love and crave and they'll say, "I'm going to eat this piece of chocolate in a really mindful way." And they sit down and they eat it slowly and they savor it. Then you know that they've turned this corner. At first it takes some conscious effort and practice, but once you've got the hang of it, it becomes very easy and routine.

Deanna Pogorelc:  Does the concept of mindful eating also address any of these other lifestyle contributors to maybe poor eating habits like stress or not getting enough sleep? Is that part of it at all?

Dr. Susan Albers:  Absolutely. When someone comes into my office, oftentimes before we even talk about food, what they're eating, what they're not eating, we'll do an overall assessment of their lifestyle. And the number one thing I find is that people are often really stressed, really stressed, and that stress stands in the way. So we don't even touch talking about their eating until we address their stress level. That's a huge factor. Because if you think about it, again, the cortisol, when you're feeling stressed is pumping through your body. And that is really interacting with your appetite, your cravings, and so once you get that stress level down, it makes it a lot easier. So if you're somebody who's really stressed out, address the stress first.

Dr. Susan Albers:  Sleep is also, I would say number two. That when you're not getting enough sleep that impacts your appetite hormones significantly. And research is very interesting. They've done many different studies on different hours in which people have slept. There was one recent study that looked at people who got four hours of sleep versus eight, and the people who got four hours of sleep actually ate close to 500 calories more the next day. People report that they have a higher appetite and just you know, when we're tired, we don't make great decisions around food. We're just not as thoughtful about it and just say, "Oh, whatever. Whatever." So sleep, I would say to prioritize that as well, do go a long way with helping you to be a more mindful eater. And that's not even changing your food habits. It's just being more mindful of when you go to bed.

Deanna Pogorelc:  Right. If someone is struggling with these issues, when is the right time to seek help and to come to a professional and say, "I really could use some help with this."

Dr. Susan Albers:  We all do a little bit of emotional eating and that's perfectly normal. We all do it. We all have a bad day and we need some chocolate. That's okay. When it becomes a problem is when it's a pattern that we see it happening over and over again. Or if food is your only way of coping. That whenever you're feeling stressed or having a bad day, that's the only thing that you turn to. And then the third thing is if it's impacting the functioning of your life in some way. So if it's affecting your sleep or your weight or your health, that your eating is somehow disrupting or causing unhappiness or distress, then that is really some time to get some additional help and you've tried some other things. Maybe you've tried some self-help books or you've tried some other strategies and they just don't seem to be working. That's when reaching out to a professional can be really helpful. They can just help give you new strategies and look at it from a different perspective.

Deanna Pogorelc:  Okay. Anything else you want to share with our listeners about mindful eating? Any more tips? Your five SS work great. Is there anything else?

Dr. Susan Albers:  Well, like I said, there's, there's lots of things in it. Our psychology impacts how we eat in a lot of different ways. One of my other favorite tips is to eat off of a red plate. Because red is a color that when we approach it, we automatically slow down because our minds are encoded when we see the color red to stop or slow down. When we see a stop sign, we just automatically slow down, we don't have to think about it. So eating off of a red plate can be one of those subconscious things that helps to slow us down.

Dr. Susan Albers:  My other favorite tip is eating with your non dominant hand. So I'm right handed, putting my fork in my left hand, study showed that it can reduce the speed of how much you eat by about 30%. And you can imagine that, that it feels strange to eat with your left hand, but it also helps you to just be more mindful and slow down. Also, using your fork to turning it over and piercing instead of scooping. That's another thing that can help to slow you down. So mindful eating has a lot of these different just ways of interacting with food that shake you out of your everyday routines because we get invites that we are not even really aware of. And when we start to look at and observe our behaviors, I think it makes a big difference.

Deanna Pogorelc:  What about cravings? At 3:00 PM, I get that chocolate craving. What can we do to get through those?

Dr. Susan Albers:  Well, yes, and we all get cravings. We all have certain foods that we love. What I walk people through is what I call the three Ds. So the first one is to delay. You have a craving, pause for a moment. Often we think I want to talk late and we just make a beeline for that chocolate. Delay for a moment. Ask yourself, "Am I really craving chocolate or am I feeling something else?" The second D is to distract. Distract yourself for a little bit and see if this craving passes. And then the third D is to decide. If you really still want that chocolate, that is fine. Get what you really want and then eat it mindfully. Get that chocolate, sit down, savor it, eat it, but you may pick something else. I mean, you may say, "Okay, well that's not really what's going on. I'm feeling stressed, I'm feeling bored." And doing something else may make that craving pass. But it's okay to give into that craving sometime as long as you do it in a mindful way.

Deanna Pogorelc:  Mindful way. Just one piece of chocolate instead of the whole thing.

Dr. Susan Albers:  Right. And you know, actually that amazes me too of that. We think that a lot of chocolate is what's going to make us happy. And I do a lot of workshops around mindful eating and I use chocolate, traditionally used raisins, but I don't use those in my workshops because people don't really struggle with raisins. They don't wake up in the morning and say, "No raisins for me today." They say that around chocolate.

Dr. Susan Albers:  What we do is we eat one piece of chocolate in a mindful way, and you'd be amazed at how often people are surprised by the experience because we're often thinking about the next piece of chocolate before we finish the one we have. "The next one is going to make me happy. The next one is going to make me satisfied." And when they slow down and eat that one piece, they're often surprised at how satisfying it can be, but really tasting it too. We often just eat and we don't really taste our food anymore. So I would encourage people to do chocolate exercise, eat that piece of chocolate in a mindful way.

Deanna Pogorelc:  Okay, great. Well, that was wonderful advice. Thank you so much Dr. Albers. If you'd like to schedule an appointment with Cleveland Clinic's Center for Behavioral Health, please visit clevelandclinic.org or call (216) 636-5860. And to listen to more podcasts with our Cleveland Clinic experts, visit clevelandclinic.org/hepodcast, or subscribe wherever you get your podcasts. For more health tips, news, and information, follow us @ClevelandClinic, and that's all one word, on Facebook, Twitter, and Instagram. Thank you.