Monday, September 26, 2016

Type 2 Diabetes, a Dietary Disease #348: Nervous Eating

In an earlier column (#342), I asked, “Is cheating okay?” I answered “no,” with an explanation. I stipulated:
“So long as I remain in a state of mild ketosis (remember: without hunger), IF I EAT, it is for another reason, and there are many: a) the sight or smell or food, b) the thought of food, c) rationalizations (an open bag or box in the pantry), d) social pressures (when a dinner guest, food is offered), e) unsolicited food (bread at the restaurant table, hors d’hoeuvres at a party), e) thoughts of deprivation (everyone else is eating dessert at the pot luck), and habit, such as eating two or three meals a day. To all these things I have – in fact, I need, only one reply: I ask myself, “Am I hungry?” The answer, of course, is “no,” and that is almost always sufficient.”
It occurred to me afterwards, however, that the most common “other” occasion for my non-hunger driven eating is “nervous eating”: eating (alone mostly) and for no good reason! How could I have overlooked this!
I have managed somehow to mostly stick to the plan. It has gotten easier and easier, because so long as I eat mostly foods that are protein and fat, I’m never hungry. Day after day, week after week!
In the morning I have cream in my coffee. That’s it. Enough to take pleasure from it, and swallow a few pills.
For lunch, I have a small meal, a snack really. Just a can of kippered herring in brine, or 2 hard boiled eggs with some homemade mayo. Sometimes, I eat a can of sardines in EVOO. Why do I eat lunch? (I’m still not hungry, and therefore I’m breaking Rule #2 in #326, “Eat only when hungry”). My rationale? Habit? Boredom? A break from morning activity? Who knows… but it’s a small meal, and it’s all protein and fat, I rationalize.
Then, for supper, my wife prepares a small plate of protein/fat and a low-carb vegetable. Last night it was two small New Zealand grass-fed lamb chops and cauliflower pureed with cream cheese and pecorino Romano. Delicious! I wanted more, but not because I was hungry; it was that good! My supper was accompanied by a 2nd red wine spritzer, to wash down my evening pills. The first one preceded supper – a happy hour of sorts.
And then as we settled in to watch Jeopardy, I got “restless.” I say “restless” because it was an urge of sorts. I was tempted to eat, but not because I was hungry. I was in a “fed” state; my stomach was not the source. Yet I wanted something else? Was it an emotional need? Hey, I’m not of a mind for the couch – too much there to explore, and way too dangerous (LOL). But if my need was not alimentary, then the gastrointestinal tract was not the road to fulfillment. If the need lay elsewhere, I reasoned, I would need an alternate way to satisfy it.
I recall that when I addressed this issue 4 years ago in #63, “Impulse Control and Metacognition,” I relied on a substitution approach, using an alternate thought (to the urge to eat) to replace and distract me from temptation. This usually worked, but it was indirect. It replaced one thought (the “temptation”) with another, such as becoming engrossed in a book. The approach advocated in #326, #342 and reprised above and again here is, “To all these things [temptations or urges] I have – in fact, I need, only one response: I ask myself directly, ‘Am I hungry?’ The answer, of course, is ‘no,’ and that is almost always sufficient.” It really is. It completely eliminates the emotional or “nervous need” to eat. It is entirely rational, and it’s working for me.
I have been helped in this direct approach by insights I’ve obtained from Daniel Kahneman’s brilliant book, “Thinking Fast and Slow.” It is premised on his concept of System 1 (fast) thinking which operates automatically, intuitively, involuntary, and effortlessly, and System 2 (slow) thinking, which requires slowing down, deliberating, solving problems, reasoning, computing, focusing, concentrating, considering other data, and not jumping to quick conclusions. Nervous eating is System 1. Not eating when not hungry is System 2.  
Of course, slow thinking is made easier if you are “keto adapted.” When you are mildly ketogenic, with low serum insulin, and low and stable blood sugar, your body is breaking down stored body fat for energy. Your metabolism is “pumped;” it’s in a happy balance, called “homeostasis.” It’s “the normal state of man.”

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