Charles Schmittdiel, Ph.D.
Most people trying to change their eating habits often have a set of foods that are harder to give up or say “no” to. In the beginning, you may want to try to focus on totally avoiding those foods. But in the long run, avoidance-based coping strategies do not promote a sense of personal control over the difficult-to-resist food or dealing with difficult situations that involve food.
After bariatric surgery eating some high sugar or fatty foods may result in you having very unpleasant experiences that are referred to as “dumping,” although what will affect you may not be predictable. Many patients assume that dumping will stop them from problem eating in the future. While this is likely true in the short run, research has shown that in general, having a very unpleasant bodily consequence is not a very effective way to change behavior in the long run. Even in the short run, dumping is still a form of external control over your behavior, and may not result in developing better self-controls over poor eating habits.
In the long run, successful people develop a sense of self-control (often referred to in behavior therapy as a sense of self efficacy) over time by directly dealing with problem foods and problem situations that used to lead to poor eating. Research has consistently shown that high levels of self-efficacy, based on actual experiences of self-control, tend to promote higher levels of long-term success in maintaining behavior change.
One way to increase your self-efficacy is by a process of gradually exposing yourself to more challenging food-related situations, starting with simpler ones first. You will most likely experience the urge to eat; the goal is to allow the urge to eat a problem food to peak, pass, and eventually go away, while not acting on the urge. All urges are like waves that will pass, if allowed. Over time, you should find that the strength of the urge decreases.
Another example is to learn how to eat small portions of challenging, but acceptable foods. That can be done by repeated episodes of eating a few bites, allowing the rest of the food to sit on your plate in view while trying to be mindfully aware of the urge to eat until it passes, and then later putting up the remaining food. Over time this creates a sense of control over that food item, and the ability to eat a small amount and stop. In contrast, eating a few bites and then rapidly throwing out the rest of the food does not promote a sense of self-control, because basically you are telling yourself that you cannot stop in any way other than by throwing out the food.
Another example would be going to a social event in which you know that there will be a number of problem foods. Of course, making sure that there are other good food options is a necessary part of a successful plan. Allowing yourself to walk through the food area, observe the problem foods, while mindfully noting the urges to eat those foods peak and pass, without eating, can over time increase your sense of self-efficacy about dealing with both those foods and that type of situation. In the same way, successfully and politely declining offers and/or encouragement from others to eat problem foods can also over time increase your sense of self-control. In those cases, you may also need to develop better self-assertion skills to be more able to skillfully refuse offers of problem foods. And, any time you are successful in managing a problem eating-related issue, it is also important to provide lots of praise for yourself and to recognize that you were able to deal with what was once a very difficult situation.
What is generally not helpful for dealing with urges to eat are attempts to suppress those urges by trying to not think about the related food, or to replace that urge with some other thought. Research shows that attempts to make yourself not think about some thought, emotion, or image generally results in having that thought or image more often. And trying to push out an urge with some other thought or image can accidentally result in that new thought becoming associated with the thought being suppressed, and making them connected.
