Diabetes and Mindful Eating

Mindful Eating Puts the "Self" in Diabetes Self-Management

Eat What You Love, Love What You Eat with Diabetes:
A Mindful Eating Program forThriving with Prediabetes or Diabetes

Book by Michelle May MD with Megrette Fletcher MEd RD CDE

After receiving a diagnosis of prediabetes or diabetes, it may seem that the days of "eating what you love" are over. Understanding dietary changes, blood glucose monitoring, and prevention of complications can feel scary and overwhelming. Eat What You Love, Love What You Eat with Diabetes builds on the principles in Dr. May's book Eat What You Love, Love What You Eat to help readers with prediabetes or diabetes reduce their anxiety about diabetes self-management. Even people with diabetes can eat what they love by learning how to use mindfulness--awareness and intention--to guide them. This book helps readers discover how eating and physical activity affect their blood sugar so that they can make decisions that support their good health without sacrificing delicious meals or dinner out with friends. This four-part system helps readers think, nourish, care, and live with diabetes - without restriction or guilt - to discover optimal health and the vibrant life they crave. Read more...

Availalble from your local bookstores, Amazon, and Barnes & Noble now!

Hyperglycemia (High Blood Sugar)

By Michelle May, MD and Megrette Fletcher, M.Ed., RD., CDE authors of Eat What You Love, Love What You Eat with Diabetes

Do you know what your blood sugar range should be? If you are not sure, ask your health care provider to establish a target range for your blood sugar. One size does not fit all, however the American Diabetes Association has established a target blood sugar of 70-130 mg/dL before meals and 180mg/dL or below after eating. As you know, having elevated blood-sugar levels increases your risk for kidney disease, retinopathy, and neuropathy, and plays a role in heart disease, delayed healing, and infection. It can also cause you to feel fatigued. 

How Mindful Eating can Help.

Be curious not critical if your blood sugar is above this target. The causes of high blood sugar can often be traced back to changes in eating, physical activity, and medication.  In addition, an injury, illness, infection, or stress can cause a sudden increase in blood sugar. More gradual changes may be from increasing insulin resistance, decreasing insulin production, and age-related changes.

 Changes in eating. When your blood sugar is too high, the mindful eating cycle provides clues to possible causes, as you learned in “Don’t Miss the Lesson” in chapter 17.

Over treatment of hypoglycemia. Hypoglycemia can be an unpleasant experience, so you might be tempted to over treat it by eating until you feel better. But overeating doesn’t raise your blood sugar faster than eating 15 grams of carbohydrates or taking four glucose tabs, and it can raise your blood sugar higher than it needs to go.

 Changes in physical activity. Less physical activity than normal can lead to a higher blood sugar than normal, as Mac discovered:

 "My blood sugar was high when I woke up this morning. Then I remembered that I’d skipped my walk after work because it was raining. I looked through my blood sugar log and realized what a difference exercise makes."

 Changes in medication. Another possible cause of high blood sugar to consider is a missed dose or other changes to your medication.

 Illness. Having a cold or flu is a stress on the body that can cause the blood sugar to rise. Additionally, being sick can change activity and eating patterns.

 Medication side effects. Some over-the-counter and prescribed medications are known to raise your blood sugar, including cough syrup, certain antidepressants, inhalers, steroids (such as those taken for a flare-up of asthma or injections in your joints), and others. Make sure that all of your health care providers (including your pharmacist) are aware that you have diabetes.

 Progression of diabetes. Diabetes is not a static disease; in other words, you can expect it to change over time. Keeping track of your blood sugar can help you notice these changes, giving you the information you need to make the necessary adjustments to your diabetes plan, so you can experience optimal health.

 

How to Manage Triggers for Overeating with Diabetes

By Michelle May MD, co-author of Eat What You Love, Love What You Eat with Diabetes

Our environment is loaded with triggers for eating when we're not really hungry and for continuing to eat past the point of satiety - wreaking havok on your blood sugar control! Learning to recognize these triggers and respond in an effective manner is one of the keys to managing diabetes effectively in our food abundant environment.

What is a trigger?

Think about the word trigger for a moment…

In behavioral terms, a trigger is anything that serves as a stimulus that initiates a reaction or series of reactions. This concept is analogous to a mechanical trigger, defined as a mechanism that activates a sequence.

Thinking about a trigger in mechanical terms is helpful because it takes the emotion out of it for a moment. More importantly, it reminds us that a trigger has no effect on its own and must be activated in some way. Similarly, your triggers for overeating are powerless over you—until you choose to act on them.

The following mindful eating concepts will help you break the automated response to your triggers. (From chapter 3 of Eat What You Love, Love What You Eat: How to Break Your Eat-Repent-Repeat Cycle):

Focus: Whenever you want to eat or continue to eat, that is your trigger to pause and ask, Am I hungry? or Am I still hungry? In essence, you are creating a new trigger for yourself - wanting to eat now triggers you to pause and check in. This pause creates a gap between the stimulus and response, allowing you to respond instead of react.

Explore: If you're not hungry, get curious! I wonder why I want to eat right now even though I'm not hungry. What was the trigger?

Accept: Don't judge yourself. You wouldn't judge a machine for having a switch! Instead, say, Hmmmm, isn't that interesting?

Strategize: Choose how you will respond. I could eat anyway if I want to. For now, I am not going to activate this particular sequence of events. Let's see...what else could I do until I'm hungry?

Take Action: Each time you choose not to pull the trigger, you weaken its connection. It's as if the wires rust and eventually break. Further, each time you choose a different action, you create new connections. With practice, you will hardwire these new pathways - like insulating the wiring.

Download a copy of our Fearless Blood Glucose Log and see what you can learn about the connections between what you eat, how you feel, and your blood sugars.

Related articles

Experimenting with Food and Blood Sugar

What Are the Most Common Triggers for Overeating?

You are NOT powerless over food!

Experimenting with Food and Blood Sugar

By Michelle May, MD and Megrette Fletcher, M.Ed., RD., CDE authors of Eat What You Love, Love What You Eat with Diabetes

The purpose of meal planning is to help lower your blood sugar after meals. To determine if your dietary changes are successful, consider conducting an experiment. The purpose of this experiment is to help you figure out how different types and amounts of food affect your blood sugar. For this experiment, you’ll need the following: food, your blood glucose monitor, and your blood glucose log. 

Experiment 1: What happens when you eat different amounts of carbohydrate? 

• Fill half your plate with non-starchy vegetables and a quarter of your plate with a serving of protein. For the upper-right section of your meal, select three to five servings of carbohydrate-containing foods, such as carbohydrate containing vegetables, grains or grain products, fruit, dairy, or some combination of these food groups. (See page 105 of Eat What You Love, Love What You Eat with Diabetes.  If you feel comfortable counting carbohydrates, aim for 45 or 60 grams if you’re a woman, or 60 or 75 grams if you’re a man. Write down your food choices so you’ll remember. 

• Next, write down your hunger and fullness level before you eat. 

• Then check your blood sugar before the meal. 

• Now enjoy your meal. Don't feel compelled to eat everything on your plate if you are not hungry. 

• Within thirty minutes after eating, jot down your fullness level. 

• Finally, recheck your blood sugar two hours after eating.

If you are physically comfortable after eating (not still hungry and not too full) and your blood sugar is in your target range—less than 180 mg/dL two hours after eating—then you’ll know that your body responds well to that amount of carbohydrate.

If your blood sugar is above target—over 180 mg/dL two hours after eating—conduct additional experiments. You can play around with noticing your changing sense of fullness while eating. For example, if you feel you need more volume but not more carbohydrate, you could add additional low carbohydrates foods, such as broth based soup, an extra serving of low carbohydrate vegetables, lean protein, or healthy fats.   

If your blood glucose was above target, notice what happens when you decrease the amount of carbohydrate you eat during your meal or snack. This can be done in a number of ways. You can reduce your portion sizes. For example, you might have a 1/2 cup of mashed potatoes instead of 1 cup. You could change the type of food you eat; for example, you could try a bread or pasta with more fiber (look for products with greater than 3 grams per serving). You could also decrease the number of carbohydrate-containing foods you eat. For example, instead of having cereal, milk. and fruit for breakfast, you could have cereal and milk and save your piece of fruit for a snack later.  

Don't Miss the Lesson

In Eat What You Love, Love What You Eat with Diabetes, we explain that we are always learning. Remaining curious is the key!  If you need help, check out the suggestions on in Chapter 17 and have fun learning about YOU! 

When Is the Best Time to Eat with Diabetes?

By Michelle May, MD and Megrette Fletcher, M.Ed., RD., CDE authors of Eat What You Love, Love What You Eat with Diabetes

If you have diabetes you may have heard that you need to eat on a rigid schedule. That may have been true 10, 20 or 30 years ago when medication options were limited. The great news is there are a lot of new diabetes medications and most don’t require you to eat at set times or eat when you’re not even hungry!

This significant advance in diabetes care is helpful if you are trying to be more mindful and use hunger as your guide for eating. Your hunger and fullness levels usually reflect the rise and fall of your blood glucose so you can use the Hunger and Fullness Scale (page 53 of Eat What You Love, Love What You Eat with Diabetes) to begin to fine-tune your eating patterns for optimal energy and glucose control. Starting in the middle, let’s work our way down the scale.

Level 5 or higher. If you’re at level 5 or above and want to eat or keep eating, you know that something other than hunger triggered this urge. This is an opportunity to learn more about yourself and how you respond to your environment and emotions.

Level 4. When your hunger level is at 4, you’re slightly hungry and starting to think about eating. You can begin to plan for it by making sure time and food will be available when you’re ready to eat. There will be times when you’ll want to eat even though you’re only slightly hungry, for example, at a mealtime or when you won’t have another opportunity to eat later. Just keep in mind that if you’re only a little hungry, you need only a little food.

Level 3 or 2. The ideal time to begin eating is when you reach level 3 or 2. At this point you’re significantly hungry, so food will be pleasurable and satisfying. Eating at this point also prevents a low blood glucose reaction if you’re on medications that put you at risk for hypoglycemia, as we’ll explore next. It’s important to plan meals ahead of time and to be prepared to respond to hunger even when it’s not a conventional mealtime. Keep nutritious foods on hand—in your office, purse, briefcase, car, gym bag, carry-on—to eat when you’re hungry.

Level 1. If you put off eating or don’t notice that you’re hungry until you’re famished or hypoglycemic, you may not think as clearly or make mindful decisions about what to eat. When you’re at level 1, you’re more likely to eat anything you can get your hands on and to eat too quickly to notice when you’ve had enough. That’s why you can easily go from starving to stuffed. If you are at risk for hypoglycemia, it’s especially important to monitor your hunger symptoms, blood glucose levels, or both so you can respond rapidly and appropriately.

Level 0. If you are at risk for hypoglycemia (low blood sugar) because of the medications you take, a “0” means that your blood sugar is too low (less than 70 mg/dL). Immediately stop what you are doing and treat the low blood glucose level with 15 grams of carbohydrates. Examples:

4 oz of juice

3-4 glucose tablets

6 saltine crackers

8 oz of skim milk  

Avoid choosing foods that are high in fat (like a chocolate bar or potato chips) because the fat will actually slow down the absorption of the carbohydrates.  

Wait 15 minutes and retest your blood sugar. If your blood sugar is still less than 70 mg/dL take another 15 grams of carbohydrates wait 15 minutes and retest, until your blood sugar is over 70 mg/dL.  Once it is above 70 mg/dL, decide whether you are going to eat a meal within 1 hour. If you’re not, have a larger fat and protein containing snack such as ½ sandwich, yogurt with nuts, or  peanut butter and crackers.

To learn more about how using your hunger to help with portion size, read chapter 5 of Eat What You Love, Love What You Eat with Diabetes, by Michelle May, MD with Megrette Fletcher M.Ed., RD, CDE

How Does Mindful Eating Help?

By Michelle May, MD and Megrette Fletcher, M.Ed., RD., CDE, authors of Eat What You Love, Love What You Eat with Diabetes

There is no simple formula for managing diabetes, but mindfulness can help you stop the downward spiral of overeating, inactivity, elevated blood sugars, fatigue, and worsening insulin resistance.

How? You can start by becoming more mindful. This is done by shifting your focus from “What do I do?” to “How do I feel?” For example, instead of focusing on calories, carbohydrates, and fat, become aware of why, when, what, how, and how much you eat. Let yourself see eating patterns, recognize triggers, and discover foods that are most satisfying to you.

Here’s how Lisa described it:

“When I was counting and measuring my food, I made sure to eat every last bite. I thought about diabetes and food all the time. This preoccupation only made things harder."  Sound familiar?

When Lisa finally had enough of dieting this is what happened:

"When I decided to shift my focus and really notice how I felt, things changed. The funny thing was, by doing this, I started to enjoy eating again and I stopped worrying. I wasn’t so determined to eat everything I was ‘allowed’ and I could focus on eating what I needed.”

Mindful eating can help you see food in a new way. When food is no longer the enemy, you can observe your thoughts, feelings, actions and results without judgment, guilt, or shame. That alone can help you feel lighter and more comfortable in your own body.

Now, shift your attention to your direct experience of eating. Notice as much as you can about each bite: taste, texture, aftertaste, thoughts, memories or other food associations. Allow your experience to guide your choices, replacing fear, anxiety, and doubt with curiosity, trust, and pleasure in each bite. By listening to what your body is saying, you have begun to create a different relationship with food and eating, opening the door to true understanding, wisdom, and health.

Don't Like Your Results? Change Your Mind

By Michelle May, MD, author of Eat What You Love, Love What You Eat with Diabetes

You become what you think. If you’re not getting the results you want, ask yourself what you were thinking first.

Whether you’re aware of it or not, you have a mental tape running constantly that affects your moods and ultimately, your behavior. When these thoughts are negative, outdated, or confining, they undermine the process of change. It stands to reason that without awareness of this mental chatter, you won’t really know why you do what you do.

Your thoughts are the primary creator of your emotions, which inspire your actions, and therefore lead to your results. This “thought > feeling > action > result” cycle is a “causal loop.” (In Eat What You Love, Love What You Eat with Diabetes we call this cycle “TFAR.”)

In other words, when you think a certain thought, it causes you to feel a certain way, which causes you to act in a certain way, which causes certain results, which then “proves” that your original thoughts were correct.

This “thought > feeling > action > result” cycle applies to all of your thoughts, not just those surrounding your diabetes self-management, eating, and physical activity. It applies to your thoughts about your relationships, your career, your finances, your habits, and your abilities—any area of your life within your sphere of influence.

These patterns of thinking become repetitive. Even when a thought pattern leads to poor results, you may stay locked in its trap because it feels familiar and comfortable. Thousands of repetitions of a particular experience create auto-pilot thoughts, feelings, and actions, and therefore, predictable results.

The first step to disrupting an undesirable cycle is to start monitoring your internal conversation and notice the results that it creates. If you recognize that your self-talk is inaccurate, ineffective, or limiting, you can choose to change it in order to change your outcome. Just as the repetition of negative mantras become ingrained, the repetition of new positive mantras will result in the rewiring of your brain.

Interestingly, you don’t even have to believe what you’re saying to yourself at first. There’s power in simply saying it. Your mind doesn’t tolerate incongruence; if your thoughts are saying something, your brain will find a way to make it true. In other words, “fake it until you make it.” When you act “as if” it were true, it often becomes true.

There are many thought patterns or self-talk that will keep you stuck in a rut. Let’s take a look at just one type of internal conversation that is common in people with diabetes, the Inner Critic. This self-talk is harsh and hypercritical and says things like:

“You will never learn to practice moderation when it comes to sweets.”

“You are too lazy to exercise.”

“You are too undisciplined to monitor your blood sugar they way you should.”

Although you may think you’re keeping yourself in line, criticism is a poor long term motivator—even when you’re the one doing the criticizing. Instead this hypercritical self-talk causes feelings of inadequacy and hopelessness. As a result, you won’t do your best or even try. The results only prove that the Inner Critic was right—and lead to more harsh criticism.

To change this pattern, begin to use an encouraging, gentle inner voice to motivate yourself toward the positive changes you want. For example:

“You've made other important changes in your life. It may take some practice but you can learn to eat moderately too!”

“You will feel so much better if you take even just a short walk. Everyone has to start somewhere.”

“You don't need to be perfect! You learn so much when you check your blood sugar even once a day.”

The next time you find yourself eating in a way that feels out of control, uncomfortable, or unsatisfying, ask yourself what you were thinking before you took the first bite of food. Remember that negative self-talk can lead to uncomfortable feelings and overeating. When you practice catching these negative thoughts before they lead to negative feelings and behaviors you can switch to a kinder, gentler, observing voice that coaches you toward the results you really want!

Related articles

Results Not Resolutions

When Is the Best Time to Eat with Diabetes?

By Michelle May, MD and Megrette Fletcher, M.Ed., RD., CDE authors of Eat What You Love, Love What You Eat with Diabetes

If you have diabetes you may have heard that you need to eat on a rigid schedule. That may have been true 10, 20 or 30 years ago when medication options were limited. The great news is there are a lot of new diabetes medications and most don’t require you to eat at set times or eat when you’re not even hungry!

This significant advance in diabetes care is helpful if you are trying to be more mindful and use hunger as your guide for eating. Your hunger and fullness levels usually reflect the rise and fall of your blood glucose so you can use the Hunger and Fullness Scale (page 53) to begin to fine-tune your eating patterns for optimal energy and glucose control. Starting in the middle, let’s work our way down the scale.

Level 5 or higher. If you’re at level 5 or above and want to eat or keep eating, you know that something other than hunger triggered this urge. This is an opportunity to learn more about yourself and how you respond to your environment and emotions.

Level 4. When your hunger level is at 4, you’re slightly hungry and starting to think about eating. You can begin to plan for it by making sure time and food will be available when you’re ready to eat. There will be times when you’ll want to eat even though you’re only slightly hungry, for example, at a mealtime or when you won’t have another opportunity to eat later. Just keep in mind that if you’re only a little hungry, you need only a little food.

Level 3 or 2. The ideal time to begin eating is when you reach level 3 or 2. At this point you’re significantly hungry, so food will be pleasurable and satisfying. Eating at this point also prevents a low blood glucose reaction if you’re on medications that put you at risk for hypoglycemia, as we’ll explore next. It’s important to plan meals ahead of time and to be prepared to respond to hunger even when it’s not a conventional mealtime. Keep nutritious foods on hand—in your office, purse, briefcase, car, gym bag, carry-on—to eat when you’re hungry.

Level 1. If you put off eating or don’t notice that you’re hungry until you’re famished or hypoglycemic, you may not think as clearly or make mindful decisions about what to eat. When you’re at level 1, you’re more likely to eat anything you can get your hands on and to eat too quickly to notice when you’ve had enough. That’s why you can easily go from starving to stuffed. If you are at risk for hypoglycemia, it’s especially important to monitor your hunger symptoms, blood glucose levels, or both so you can respond rapidly and appropriately.

Level 0. If you are at risk for hypoglycemia (low blood sugar) because of the medications you take, a “0” means that your blood sugar is too low (less than 70 mg/dL). Immediately stop what you are doing and treat the low blood glucose level with 15 grams of carbohydrates. Examples:

4 oz of juice

3-4 glucose tablets

6 saltine crackers

8 oz of skim milk  

Avoid choosing foods that are high in fat (like a chocolate bar or potato chips) because the fat will actually slow down the absorption of the carbohydrates.  

Wait 15 minutes and retest your blood sugar. If your blood sugar is still less than 70 mg/dL take another 15 grams of carbohydrates wait 15 minutes and retest, until your blood sugar is over 70 mg/dL.  Once it is above 70 mg/dL, decide whether you are going to eat a meal within 1 hour. If you’re not, have a larger fat and protein containing snack such as ½ sandwich, yogurt with nuts, or  peanut butter and crackers.

To learn more about how using your hunger to help with portion size, read chapter 5 of Eat What You Love, Love What You Eat with Diabetes, by Michelle May, MD with Megrette Fletcher M.Ed., RD, CDE

Results Not Resolutions

By Michelle May, M.D.
Co-author of Eat What You Love, Love What You Eat with Diabetes

On January 1st, millions of people resolved to lose weight. I hope you weren't one of them.

You may be thinking, “What?!!! Don’t resolve to lose weight? But it’s a tradition; I do it every year!”

Losing weight, like managing your blood sugar, is not a resolution, it is a RESULT. It is the result of making specific changes in the way you eat, move, and live. So this year, instead of setting a goal to lose an arbitrary number of pounds, inches, or clothing sizes, resolve to think differently about eating, physical activity, and living. Let me give you an example.

Leah said she just HAD to lose weight because she didn’t like the way she looked or felt. She admitted that she had tried many times in the past to lose weight but she always reverted back to her old habits as soon as her resolve wore thin.

She was a busy mom with two kids and a successful career. She typically skipped breakfast or grabbed whatever was in the break room at work. She was starving by lunch time so she'd pick up fast food to eat at her desk while doing paperwork. Dinner was either fast food again between her kids’ soccer practice and dance classes or a quick-to-fix meal like mac ‘n cheese before homework. After the kids were in bed and the house was finally picked up, she would snack until she went to bed.

It would have been easy to focus on what she should or shouldn’t be eating but she knew that her weight was really just a result of the choices she made at the many decision points throughout her busy days. Once she really understood what was really going on, she focused on what was most meaningful to her: spending time with her family and having the energy to be successful at her job. With this focus, she laid out a plan to make one change at a time.

First, she started getting up 10 minutes earlier for a bowl of cereal with skim milk and some quiet time before anyone else was up. She quickly found that she felt calmer and had more energy throughout the morning. Her next step was to start bringing her lunch at least several times a week and give herself at least 20 minutes to eat mindfully without working. She enjoyed her meals more and felt more recharged by taking a break.

With these positive experiences to fuel her along, she took her next step: walking for 10 minutes twice during her work day. She wasn’t perfect but it felt great so she did the best she could to be consistent. Next, she asked her husband to help their family plan ahead for dinner by throwing beans or chicken into the crock pot or having the ingredients on hand for a main dish salad. On the occasions they still went out for fast food, she tried to make healthier choices and stopped up-sizing her meal. Not only were they spending less money, but the kids were eating healthier too.

She then turned to her night time snack habit. She realized that most of the time she wasn’t hungry but was rewarding herself for getting through the day. She promised herself that she could eat her favorite foods without feeling guilty but she wanted to try rewarding herself in more nurturing ways. Her favorite "treats" became hot baths, reading, and scrap booking. She was feeling so much better that she started a dance class while her daughter was in ballet twice a week.

Looking back, Leah realized that if she had just started another diet or joined a gym like every other year, she might have had some quick but temporary results. This time she knew that gradual weight loss was only one of many great results she got from the small changes she made.

This year when you sit down with pen and paper to write your goals for 2013, focus on the small stuff that aligns with your priorities instead of arbitrary, monster goals. By making one sustainable change at a time, you can get the results you want from your resolutions too.

Understanding Insulin Resistance

By Megrette Fletcher M.Ed, R.D, CDE
Co-author of Eat What You Love, Love What You Eat with Diabetes
 

While the cause is not fully understood, Type  2 diabetes results from a series of problems. The first problem is insulin resistance. Just as it sounds, the fat, muscle and liver cells resist the effects of insulin.

Insulin’s job is to open up the cells, like a key opens a door, and let glucose enter. Insulin resistance is almost as if someone changed the locks and didn’t tell the body. The pancreas, the organ that makes insulin, initially compensates for insulin resistance by producing more insulin – making more keys – which results in high insulin levels or hyperinsulinemia. These high insulin levels promote fat storage and inhibit fat burning, which causes weight gain, making the insulin resistance worse. Eventually, the pancreas “burns out” and stops making enough insulin (keys) to keep up with demand. When this happens, blood glucose levels rise, which can create feelings of low energy and fatigue, prompting a person to be less active and thus driving the cycle of insulin resistance toward a diagnosis of diabetes. 

Many people don’t realize that insulin resistance may be present for five to ten years before they are diagnosed with diabetes. When blood sugars are above “normal,” but not quite at a level to be diagnosed as diabetes, you have prediabetes. Prediabetes occurs when the blood glucose levels are between 101-126 mg/dL before eating or 141-199 mg/dL within two hours of eating. 

If you have been diagnosed by your health care provider as having prediabetes, this means your pancreas has started to lose its ability to make insulin. If there are no changes in your activity or eating, the pancreas will continue to lose the ability to make insulin. When the pancreas looses about 50 percent of its ability to make insulin and blood sugar levels rise to greater than >126 mg/dL fasting or 200 mg/dL after eating your blood glucose levels are high enough to be diagnosed as “diabetic.” 

How mindful eating can help 

Study after study has shown that this decline in the body’s ability to make insulin can be changed by eating a balanced diet and engaging in consistent activity. Unfortunately, you may not be sure what a balanced diet looks like or whether you can be consistent with your activity. Adding to your uncertainty might be a past experience that felt unsuccessful. If this is the case, mindful eating could be the cure you are looking for. Yet to fully understand this idea, you have to resist the “quick fix” lure of the diet industry or a radical exercise program, which ultimately are a series of complex rules or restrictions that do not lead to lasting change. Instead, give yourself permission to explore your eating and food choices fully by asking yourself questions. Curiosity is at the heart of mindful eating. If you are not sure what questions to ask, Michelle May, M.D. created the Mindful Eating Cycle which is a series of six questions. They are described on page 11 of Eat What You Love, Love What You Eat with Diabetes. To learn more about the Mindful Eating Cycle, please visit DiabetesandMindfulEating.com.

Even if you just ask one question, “Why do I eat?”, you may find that this little dose of curiosity can offer a whole lot of answers.  The truth is that you eat for many different reasons! By asking questions instead of telling yourself what you can have (like a 1/2 cup of tuna fish with six crackers), you can begin to unravel your flavor passions and food pitfalls without guilt, blame or shame. Mindful eating isn’t a diet; it is a journey of discovering YOU – your hunger, your likes and how your blood sugar levels respond to your eating, physical activity, and other factors. You may be surprised how becoming curious can change far more than what you are eating; it can change your whole view of health!

Handling Holiday Head Hunger

By Michelle May, M.D.
Co-author of Eat What You Love, Love What You Eat with Diabetes

Notice how often food is at the center of your celebrations: traditional foods, family gatherings, tins of holiday goodies as gifts. Eating is a wonderful way to reminisce, nurture, and bond.

Emotional eating is normal, even healthy—unless it is the primary way you cope with or avoid your feelings. During the holidays, emotional eating becomes magnified. Not only is food everywhere, but you may feel more stressed, lonely, exhausted, overwhelmed, or even happier—all common triggers for emotional eating.

How Emotional Eating Leads to Overeating

1. Food is a quick, convenient, easy way to manage your feelings (for example, stuffing them or calming them down).
2. When you’re eating for emotional reasons, you’re more likely to reach for sweets, salty snacks, and comfort foods. In other words, why you are eating affects what you eat.
3. Emotional eating is often mindless, so you barely notice what you are putting in your mouth or how full you’re getting.
4. You can eat a lot of food when you’re eating for emotional reasons. If hunger doesn’t tell you to start eating, what tells you to stop?
5. Emotional eating only gives you temporary pleasure or distraction so you have to eat again when the effects fade.
6. Food alone can’t really make you happy or less stressed so your emotional triggers come back again and again.
7. Emotional eating can lead to shame and guilt—ironically two of the most powerful emotional triggers for more overeating.

The way to break out of this pattern is to create a self-care buffer zone to decrease emotional triggers. When it happens anyway (and it will), learn to identify and handle head hunger more effectively. When you do, you’ll feel better, for longer.

Prevent Emotional Eating with a Self-Care Buffer Zone

Recognize Head Hunger: Whenever you feel like eating, first ask yourself, “Am I hungry?” Look for physical signs that you need fuel. (Review chapter 5 of Eat What You Love, Love What You Eat with Diabetes)

Eat What You Love: Deprivation and guilt are powerful emotional triggers that can lead to overeating so choose foods that nourish your body and your soul.

Love What You Eat: Eating can be a satisfying emotional experience. Savor each bite mindfully, staying conscious of how your body feels as you eat.

Do what you love: What are your favorite holiday activities? Who do you want to spend time with? Which events are the most meaningful to you? Which ones could you do without this year?

Practice Self-Care: Give yourself the gift of adequate sleep, healthy meals, regular physical activity, and unscheduled time to decompress. These choices build an effective self-care buffer zone.