Appetite Awareness Training

I recently reread "Appetite Awareness Workbook " by Linda Craighead, PhD. When I first read that book (1-2 years ago), I liked the author's suggestions but wasn't ready to use her techniques. Now that book seems very helpful. Maybe that shows "When the student is ready, the teacher will appear." I will review (and quote) that book in this and future posts.

Appetite Awareness Training (AAT) is very similar to other intuitive or 'normal' eating approaches. However, AAT emphasizes STOPPING when full even more than starting to eat when hungry. Although I easily learned to only eat when physically hungry, I continued to eat past comfortable (moderate) fullness about once a day for years. So I value what AAT taught me about how to stop eating at moderate fullness.

The author says "The most fundamental concept of AAT is that you learn to use internal, stomach-based signals to make decisions about eating. Obviously, you have to first notice your stomach signals ... the first step is to identify the 2 critical stomach signals: moderate hunger and moderate fullness." People with histories of restriction or overeating (or both) learn to ignore or override those signals. Waiting too long to eat 'tunes out moderate hunger signals'. Bingeing or overeating tunes out moderate fullness signals. I realize that I continued to tune out those moderate hunger/fullness signals, even as I attempted to learn 'normal eating' over the years. Some IE approaches (namely ThinWithin) emphasize starting to eat only when really hungry (or at a '0' hunger level). So I have often ignored moderate hunger in order to identify 'REAL' hunger. I also override (keep eating past) moderate fullness signals once I finally start eating.

The author describes 4 eating paths:

(1) The "'normal eating' path is not 'typical' but 'feels right, because the normal eater focusses on regulating the amount (not type) of food. The normal eating goal is to avoid getting too hunger before you eat because it is too easy to overeat when you start out very hungry, and pay close attention as you eat, so you can stop at the critical moderate fullness."

(2) 'The normalized overeating path is when you continue to eat past your moderate fullness signal.' Although I almost always start when I'm moderately hungry, I often follow that path. Eating for pleasure, eating cues from available food (like leftovers and/or dessert) and emotional eating can all influence 'overeating'. However "The goal of AAT is to stop at moderate fulness no matter why you start eating. When you can maintain this boundary on amount, you will stay on the normal eating path instead of ending up overeating or perhaps triggering a binge ... Everytime you overeat (choose to ignore fullness), it is harder to notice and stop at the moderate fullness level next time." I see how I have continued to 'practice' overeating whenever I ignore my moderate fullness cue.

(3) On the 'restricted eating path' you "deliberately refuse to eat when hungry or when you really want a particular food ... Deprivation can lead to restriction backlash' or the 'oh what the heck' response." That response always precedes my decision to binge. I don't refuse to eat, but I often delay eating when hungry. However, feelings of restriction deprivation also precede my binge episodes. The author says "Excessive restriction, either of calories or of types of food, is the most common reason that women develop binge eating." I did both when I first began binge eating years ago. Now I endure many medical (diagnosed food allergy) restrictions, which can feel like deprivation. However, restricting any nonallergy foods is a direct path to bingeing via restriction deprivation.

(4) The 'binge eating' path feels abnormal, distressing and 'out of control'. However, "the first goal of AAT is to eliminate eating large amounts and getting stuffed, regarless of whether or not you feel loss of control". The author lists 3 routes to binge eating: (1) planned binges; (2) breaking a food rule; (3) overeating can turn into a binge through the "oh what the heck" response. I liked how the author described "what these (binge) episodes do for you in the short run", even though "binges always end up feeling distressing". People don't do things they don't enjoy. "Some people enjoy the process of eating large amounts of food, even when they feel uncomfortable ... Many people report feeling numb or tuned out during the binge process, so we infer that their binges help them avoid experiencing negative emotions ... (which) is the POSITIVE consequence that maintains binge eating. Because this reason isn't usually obvious, many people have a difficult time explaining ... why they binge. The most negative consequence of binge eating is that is maintins your lack of awareness of the critical moderate fullness point. You frequently override your moderate stomach signals, and consequently you lack awareness of these signals. That lack of awareness leaves you quite vulnerable to overeating ... As long as you binge, you ... mask the very signals you need to be using."

The author next describes 7 points of intervention, places you can make different decisions that will take you from the 3 abnormal eating paths back to normal eating. I'll list in my next post those 7 points and describe how ignoring those intervention points influenced my abnormal eating.