Mindful Eating & the Bariatric Patient

Who has time to be mindful? You might think you already have enough chatter in your head around your eating but, mindful eating is an effective tool for anyone who has battled their weight with chronic dieting. Most diets teach that your appetite and feelings surrounding food are irrelevant to the process of managing your weight. Just follow the written plan, right? However, after many years this can result in a disconnect, or a feeling of being "numb" to your physical feelings of hunger and satiety (fullness) unless those feelings are extreme such as extreme hunger or extreme fullness. You might be able to see how the resulting disconnect can disservice you with long-term weight management. Often, without a mindful approach to eating habits, I hear patients say, "I feel out of control when it comes to eating."

The mindful eating approach

Mindful eating can be a powerful tool to experience more control over your eating by simply bringing conscious awareness without judgement to the eating process. We tend to be very judgmental while we are eating, thinking things such as, "I really shouldn't eat this" or "I am not sure this amount will fill me up." Our cognitive brain tries to figure out answers before we are there, in the moment, experiencing it. Mindful eating is all about the moment.

Understanding mindful eating

To better understand and practice mindful eating, it is necessary to first gain knoweldge about your body's true ability to sense your physical hunger or satiety levels. True internal hunger and satiety mechanisms maximie internal cues while simply noticing rather than being dictated by external influences like food advertisements, a coworker's birthday party or the time of day.

Hunger and satiety may be interpreted on a scale of 1-10 with 1 being the most hungery and 10 being the most full. Becoming more knoweledgeable and practicing can enable you to discover the subtle gradations in between the numbers as you listen to your inner navigational guide to eating. At the beginning of a meal, evaluate and assess whether you are in a range of 1-4. Remember, something may look appetizing and you may feel an appetite but that does not necessary mean that you have true physical hunger. During your meal, take the time to stop when you are half-way finished and check in with how you feel physically. Are you in a range of 5-7? How would you feel if you stopped eating then? If you decide to continue eating, consume your food very slowely, mindfully determining your fullness as you go.

Eating slowly helps you guage your levels better and stop when you have had enough so that you can feel your best after the end of your meal. When you have decided you are done with your meal, assess where you are on the scale.

Are you in a range of 7-10? Are you comfortable or did you have to unbutton your jeans? If you decide that you are still physically hungry, wait five minutes to let your stomach (and your hunger and fullness hormones) settle.

The hunger scale

  1. The most hungry
  2. Extreme hunger
  3. Over hungry
  4. Very hungry
  5. Neutral
  6. Barely satisfied
  7. Completely satisfied
  8. Full
  9. Overfilled
  10. The most full

According to the Center for Mindful Eating, to bring yourself to a mindful space while eating is to realize the nurturing and positive qualities of the foods chosen and to respect your own inner wisdom that can develop throughout the process of eating. To practice mindful eating effectively involves utilizing all your senses and responses to the chosen food and to the eating process without judgement while you become aware of your physical hunger and fullness cues. Listening and leagning in the moment is to experience mindful eating in a way that can guide your decisions about beginning and ending your eating.

10 steps to becoming a mindful eater

Someone once told me, "We are what we practice." To feel more in control about your eating style and choices, see these 10 steps to becoming a more mindful eater.

  1. Sit down at a table while eating.
  2. Notice how your body feels as you sit in the chair and place your feet on the ground.
  3. Pause and feel your breath and take a deep inhalation, filling your body with oxygen and reasling it with a long outward breath.
  4. Asses your surroundings and then assess your feelings both related to appetite and those unrelated. Just notice them.
  5. Re-direct your attention to the plated food in front of you and slowly take a medium bite. Close your eyes and feel the texture, taste and temperature of the food while you begin to chew. Try to keep the food in your mouth, chewing everything slowly and tasting the changing flavors and textures before you swallow.
  6. Notice upon your swallow how the food feels going down your esophagus and into your stomach .Notice if you feel different or the same.
  7. Put your utensil down or your food (if you are dining on finger food) and pause. Take a sip of water and check in with your body. At this early point you may feel very hungry and somewhat impatient with the process. It is important to note to yourself that the food is not going anywhere and that you will get satisfied.
  8. Continue step five, revisiting step two and three as needed to become calm and centered again. 
  9. Upon completing 50 to 60 percent of your meal, slow down even further and notice the hormones changing in your body, notice your changing appetite, notice that the food is still there and it is going to be okay to continue to take it slow.
  10. Upon completion of the part of the meal that you have chosen to eat, stop all activity and assess your satiety level. Just notice this and observe without judgement. Re-check after five to 10 minutes and notice if you become more comfortable or more satiated as the food settled. Note your experience without judgement.

Often we are the first to point the finger at others, "Aren't you full yet?" Or, "You're only going to eat that much?" Judgement for others and judgement for self, irrelevant of honest feelings. It is no wonder, without mindfulness principles, we begin to feel out of control when it comes to eating.

In summary

With continued patience and practice, an inner trust around food and your body can develop. It may be the first time you ever felt trusting around food and your body. Many are raised with controlling caregivers or parents and, even with the best intentions, the result can often be an incredible insecurity and fear around eating and weight management. Imagine feeling peaceful, curious, knowledgeable and in control about your body and eating.

Misti Gueron, MS, RDN, Khalili Center

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