What is Mindful Eating?

By Cassie I. Story, RD

It wasn’t until the cat nudged my leg that I realized my plate was empty. I had been in a trance of sorts. I was watching while uploading a picture of my breakfast to Instagram, mindlessly devouring my plate of eggs.

Did I really just finish my meal without tasting one morsel?

Later that day, lunch was catered for a work meeting. Wilted, sad-looking lettuce, bowls of unidentifiable dressings, and what I only can assume was chicken disguised as cold, slimy cubes. Normally, I would have been prepared and brought food with me. However, the cat’s hair had stuck to my pants that morning like a magnet and took longer than normal to remove.

I reluctantly piled the flavorless food onto my plate and stat down. Hanger (hunger induced anger) had set in about an hour beforehand, so I didn’t have much choice. My manager began talking as I feverishly shoveled cold, flavorless food into my mouth. Within a few minutes the meal was over.

Did I really just eat that?

The only evidence I had that I actually ingested lunch was the glob of mystery dressing that accidentally fell onto my lap. Clearly, it wasn’t my day to be wearing pants!

As I got my daughters ready for bed that evening, a strange question came in mind. “Did I eat dinner?” Let me think. We went to soccer practice, then piano lessons, then came home… Oh yes! I had a handful of pistachios as I was rushing the girls off to take a bath and complete homework. Luckily, my pants did not endure any additional tragedies that day – except for the fact that they were starting to become difficult to button.

After the girls when to sleep and I began my normal adult duties – you know, laundry, dishes, and paying bills – I began to think about my tight-fitting pants. It is the first of the year, so it’s understandable that they are a little snug. Should I create a meal plan for myself? How about those nifty little “weekly meal prep” ideas I’d been seeing all the CrossFit people post about on Pinterest? Maybe I should do a cleanse?

As I was contemplating various strategies to help loosen said pants, I checked my email for the 203rd time that day (as I was nibbling on more pistachios). I came across an article titled “Mindful Eating: The Missing Piece to Your Health Goals.” One click later and I was transported back in time.

Once upon a time (before I had children), I used to enjoy eating. I would look down at my plate and taste with my eyes and nose before the food reached my mouth. I would set the table with fine linens, light a lavender-scented candle, put on soft, classical music and be completely present in the moment. Okay, okay – maybe I wasn’t that into enjoying my food, but I had definitely lit candles in the past during dinner, and I’d probably listened to soft music at some point in life.
I read the article with sustained curiosity. Could mindful eating really be the missing link to my waistline woes? I made a decision right then and there; during the next few weeks, I decided to conduct a small study, and by small, I mean a study of one – myself. I was going to dedicate my eating events to being mindful, to honor what I as hungry for and to savoring my food. It was time to shift my focus from what I was eating, to how I was eating.

What is Mindful Eating?

Principals of mindfulness:

• Deliberately paying attention to the present moment
• Being aware of your thoughts, feelings and physical sensations without judgment
• Paying attention to internal and external cues in the moment they are occurring
Mindful eating is:
• Eating food in a way that promotes respect to your body
• Being in the moment while eating, and acknowledging your personal likes and dislikes
• Becoming aware of physical hunger and satiety (fullness) cues to guide your eating choices
• Without judgment, selecting food that is satisfying to you and nourishing to your body
A person who eats mindfully:
• Savors each eating experience
• Is aware of how certain foods feel in their body and makes food choices that support their health and well-being
• Practices mindfulness to promote balance and acceptance of themselves as they are today
While I was preparing for my small study of one, I consulted my favorite scientific source, Google. Where was I going to start? Based on the various articles that I read regarding “mindful eating,” I kept seeing a few common strategies listed:
• Take five deep breaths prior to each meal
• Sit down while eating
• Place your food on an attractive plate or bowl
• Eat slowly and taste each bite
• Take small bites
• Honor your hunger cues, and do not fear hunger
• Pay attention to satiety cues
• Once you begin to feel satisfied, stop eating
• Eat without distraction
• Carry foods with you that you like and that support your health, in the event that you become hungry when you are out
• Sip warm tea or water prior to a meal to calm your body
Preparing for Mindful Eating
Before I started my new mindful eating adventure, I needed to go shopping. Not for new pants, but for food. If mindful eating was going to work, I needed to have my food environment stocked with foods that I enjoyed. I purposefully came to the store without a list. I wanted to focus on purchasing what looked good, instead of focusing on what I “could” or “couldn’t” have.
First stop, the produce section. The blueberries were mushy. The carrots lacked color. I was sick of apples. Then suddenly, I looked to my left and spotted this gorgeous emerald broccoli, glistening under florescent lights from the shower it just received. Yum! To the right, I noticed ruby red strawberries; I picked them up and used the smell test. Divine. Those would be delicious for breakfast.
As I continued to push my increasingly full cart around the store, I felt empowered. The foods I was choosing were not based on some latest diet craze. They were foods that I liked and made my body feel good. Then I came to the grain aisle and had to pause. I was faced with my first real dilemma. For years I’d been buying brown rice. Recently, I started to purchase quinoa, but you know what? I don’t really like quinoa. I know the deal, it’s a ‘superfood’ packed full of fiber, protein and B vitamins, but I just don’t like it.
If I was going to honor the rules of mindful eating, which included eating things I liked, what should I do in the situation? Then something caught my eye, something that hadn’t touched my shopping cart in over a decade – white rice. I remember white rice: sticky, slightly sweet and perfect with beef and broccoli. Could I, in good dietitian conscience, buy this?
I surveyed my cart. It was filled primarily with whole foods that I love. I guess adding white rice to it wouldn’t be the end of the world.

Putting it into Practice

That evening for dinner, I dimmed the lights in the kitchen, and turned off the TV. I sat down at the table and took five deep cleansing breaths. Then I looked down at my plate. Spicy stir fried beef with perfectly steamed broccoli sat on top of a small pile of mouth-wateringly sticky white rice. I took a few moments staring at my plate. No judgment, simply admiring this beautiful meal that I created. The first bite was divine. Soft and fluffy, I’d forgotten how much I loved white rice. I savored each and every bite.

My daughters looked at me like I’d gone crazy. Why was their mother making audible pleasure noises while eating? I didn’t care. I was reconnecting with something that had long been missing, eating not only for nourishment but also enjoyment. As I continued this tuned-in practice, I noticed after about 10 minutes that I was no longer hungry, and starting to feel a bit full. Not “Thanksgiving let me change into my sweatpants full,” but full-ish. I decided to stop eating and talk to the girls about various things that were going on in their lives. Which boy did my eight year old like this week? And was my six year old excited about her upcoming field trip to the science museum?

After a few minutes of talking, I looked back down at my plate. There was still some food on it, but it didn’t look as appealing as it had 15 minutes ago. Another mindful eating rule popped in my head: Stop eating when you are satisfied. Lately, I stopped eating when my plate was empty. I was at a mental crossroads. Do I keep eating or let the meal be over?

I stood up and took my plate to the kitchen, and came back to the table with my daughters while they finished their dinner. It was at that time that I noticed something – my daughters seemed to naturally eat mindfully. They ate when they were hungry. They stopped eating when they were satisfied and despite all my parenting efforts, they never ate quinoa. They were painstakingly slow eaters, and when they ate, they weren’t focused on all of the tasks that still had to complete that day, or what their friend was posting about on Facebook, or if their boss had emailed them. They just ate.


Throughout the next several weeks, I continued to focus on one mindful eating strategy at a time. I was not perfect, but that’s okay. I found that some ideas worked very well for me, like taking a few deep breaths before eating, and sitting down to eat. While others weren’t my favorite, like eating without distraction and placing my food on a pretty plate (not sure that placing a protein bar on a plate would really work for anyone).
I was slowly beginning to change my eating habits. I found that being present in the moment with eating allowed me to eat less, and enjoy my food more. And you know what else happened? My pants avoided further food-related causalities – the cat, however, just got shaved.
“Part of the secret of success in life is to eat what you like and let the food fight it out inside.” – Mark Twain
Additional Resources about Mindful Eating:
Intuitive Eating by Evelyn Tribole and Elyse Resch – A guide to healthy eating based on your personal food needs and your psychological relationship with food.
Am I Hungry? By Michelle May, MD – Helping people break the never ending diet cycle. Visit amihungry.com for free resources.
Eat, Drink, and be Mindful: How to End Your Struggle with Mindless Eating and Start Savoring Food with Intention and Joy – by Susan Albers, PsyD – A collection of more than 70 worksheets that the author uses with her clients to increase mindful eating.

Understanding Protein Powders

Suppose you went to the grocery store and asked for ground beef. The butcher gives you a package and says it’s a great buy at their new special pricing. Great deal right?

Only when you get home you find that the ground beef is only 25% meat and the rest is fat. Not much of bargain, right?

So how do you know when you purchase protein powder what you’re getting?

Let’s take a look at Whey Protein.

Not all Whey Protein is created equal. When you purchase whey protein you are either getting one of three forms. Whey is broken down into three main catagoies—whey protein concentrate (WPC), whey protein isolate (WPI), or whey protein hydrolysate (WPH).

Whey Protein Isolate contains almost all protein – usually at least 90% protein. Containing the highest percentage of pure protein it is pure enough to be virtually lactose free, carbohydrate free, fat free, and cholesterol free.

Whey Protein Concentrate is protein, lactose, and minerals. These ingredients can vary from 25% to 90%. The FDA only requires that Whey Protein Concentrate be a minimum of 25% protein. So, when it’s 25% protein, what’s the rest? It could be 60% lactose. When you get less protein, you get more lactose. So, what is lactose? We’ll talk about that in a moment.

Whey protein hydrolysate is the “predigested” form of whey protein—which has already undergone partial hydrolysis – a process necessary for the body to absorb protein. This form doesn’t require as much digestion as the other two forms of whey protein. In addition, it is commonly used in medical protein supplements and infant formulas because of it’s improved digestibility and reduced allergen potential.

So what is lactose? Lactose is milk sugar. Lactose sugars can cause problems for weight loss surgery patients. Lactose sugars can cause “dumping” and rob you of much needed protein we need for healing, overall health, weight loss and satiety. Not getting enough protein robs us of our health and undermines our hard-earned weight loss efforts.

Even though concentrate may be less money, they may not be our best option in the long run! You’re in charge of your health—which is the best option for you? Choose wisely. You have many moremiles to go!


Eating Out After Bariatric Surgery

One of the questions we’re often asked is whether you can eat out after bariatric surgery. The answer is, “Yes, but use caution.” Eating out can be a source of an extra hundred, or even thousand calories at each and every meal. This is often due to large portion sizes and the way the items are prepared (butter, oils, saturated fats etc.) Since most restaurants do not release their nutritional stats, you may not know what you’re actually consuming. These unknowns make it all the more important that you choose your restaurants, and your foods, carefully. By doing so, you can avoid derailing your diet and continue to enjoy all of the progress that you’ve made since surgery.

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Obesity Increases the Risk of Developing Breast Cancer

A recent Cornell University study published in Science Translational Medicine has shown a correlation between obesity and changes in breast tissue that can lead to a myriad of diseases, including cancer. The study also shows that the prognosis for obese women with breast cancer is worse than those who are not obese. The extracellular matrix, tissue that surrounds fat cells in the breast, can begin to stiffen as people gain weight. This stiffening is conducive to the development of cancerous cells. Typically, the stiffening of the extracellular matrix is limited to scar tissue formation from trauma, surgery or other damage. In obese women, however, this tissue seems to form without any discernible catalyst.

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Taming Your Wild Appetite

Did you think that weight loss surgery would help you solve your wild “appetite” issues for a life-time?

I bet it didn’t take long to realize that it didn’t. Sure, surgery may “tame” them for a while but soon they return, and sometimes with a vengeance. So, if weight loss surgery isn’t the answer, then what is?

Is there an answer to our overwhelming appetites?

The answer is YES. There most certainly is a solution. But in order to find it, we need to understand a little about how our appetites work, and how to tame them.

You may have discovered already, that our appetites don’t like to be ignored. The more we ignore them, the hungrier we become. And the hungrier we become, the more we eat. But the more we try to fill our appetites, the more they rage. Feeding our appetites with excess only leads to weight-gain, guilt, and shame. Realizing that over-indulgence doesn’t work,we conclude that we didn’t try hard enough, so we repeat the cycle. We try replacing our excess with total deprivation.

This is where we have gotten off-track. We have more than just physical appetites or a physical need for food. We have many other appetites. We also have emotional and spiritual needs. We have an appetite for sex, authority, power, pleasure, work, gaining wisdom, companionship, love, acceptance, to be wanted, needed, understood, cared for, appreciated, trusted, and to fellowship with God. WOW! Now, that’s a lot of appetites. No wonder we still find ourselves facing the wild side of our insatiable hungers.

Physical food can only satisfy physical hunger. In order to fully satisfy an emotional appetite, we must use the actual thing being desired to fill the need. When we try to fill our emotional needs with food, our real needs go unmet. Any appetite that goes unmet will grow stronger and our unfulfilled appetites scream all the louder to be fed.

The key is to discover what our real need is—whether physical, emotional or spiritual. Discovering our real need will allow us to fill our needs with what they’re really hungry for. For example, if it’s companionship we’re seeking, filling our needs with food doesn’t help. Actually our unmet need for companionship only grows worse. It’s starving. It cries out all the louder to be filled. Our appetite for companionship is not bad, it’s good, but it needs to be filled with healthy and fulfilling relationships, not food.

Are your many appetite needs being fulfilled or are they being starved? Remember, the trick is to discover what we are hungry for. Once we identify our appetite desire, we can work on filling it—one need at a time—achieving success in one area, then moving on to another.

For more on appetites and how to tame them, read my book, Out of Obesity and into the Promised Land.

PSB Performs the First Intragastric Balloon Procedure In Georgia

Toward the end of 2015 Dr. Duncan implanted the first ORBERATM Intragastric Balloon in Georgia. The patient, a working mom from Atlanta named Latonya, sees the intragastric balloon as an effective tool for fighting the excess weight that has been plaguing her since she had her children.

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What is the BMI?

We’ve seen it on TV, heard about it on the radio and read it online. Pretty much every diet and fitness medium references the Body Mass Index or BMI. The Body Mass Index has become the standard by which we measure obesity – by comparing height to weight ratios of the average person. But what purpose does it really serve? A BMI calculator, like the one you see on our website, is meant to give you a rough estimate as to whether you are underweight, overweight or obese and for our purposes, whether you may qualify for bariatric surgery.

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Why Eating More Fruits and Vegetables Won’t Make You Thin

Eating more fruits and vegetables is generally a good idea, but this alone is not likely to help you lose weight, a new review of studies suggests.
Researchers analyzed previous research on weight loss and increased fruit and vegetable intake, which included data on more than 1,200 people. The investigators found that eating more fruit and vegetables without also changing the amount of calories from other food sources, did not cause people to either lose or gain weight.
“Across the board, all studies we reviewed showed a near-zero effect on weight loss,” study author Kathryn Kaiser, an instructor at the University of Alabama at Birmingham School of Public Health, said in a statement.
Fruits and vegetables do have calories, and people who want to lose weight should reduce their overall energy intake, the researcher said.
“Fruits and vegetables have many benefits, and we encourage people to include them in their diets,” study author David Allison, associate dean of science in the UAB School of Public Health, told Live Science. “Eat all the vegetables and fruits you want, but you have to cut out more calories from other foods,” to lose weight, he said.
Public health authorities often fail to include the latter part of the message about the need to reduce the number of calories consumed, while recommending that people increase their intake of fruits and vegetables, Allen said.
However, the study did not show that the consumption of extra fruit and vegetables caused weight gain.
“It appears that an increase in servings does not increase weight, which is a good thing for getting more vitamins and fiber in one’s diet,” Kaiser said.
Laura Jeffers, a registered dietician at the Cleveland Clinic who was not involved with the study, said, “This is a good summary of research that has been done.”
Indeed, some of her clients are trying to lose weight and are adding fruits and vegetables to their diets without reducing their calorie intake, she said. If patients realized that this is no likely to work, they would be more successful in reaching their weight-loss goals, she said.
Fruits and vegetables include fiber and macronutrients that are important for health, she said. However, dieters should remember not to overeat, and they also may want to consider decreasing their overall food portions, she said.

A Beginner’s Guide to Meal Planning

When it comes to eating well, meal planning is one of the easiest things you can do to set yourself up for success. The beauty of it is there are no rules and, you can’t really mess it up. The key is just to start, and to set aside a little bit of time each week to do it. There are so many ways to approach meal planning that, after practicing just once or twice, you’ll begin to find what works for you and your family too.
To help you get started, we’ve broken down some of the basics. We’ve even included two practice exercises to help you map out your next week’s worth of healthy meals!

Part I: Assess Your Eating Situation

Our eating situations can vary greatly from week to week depending on work schedules, after school activities, evening commitments, travel plans–the list goes on. Here are some things to consider as you assess your eating situation.
• How Many Meals You Need To Plan For. Take a few moments to think about what you have going on next week. Taking a quick inventory of everyone’s plans will quickly give you a rough idea of how many meals you’ll need to get through the week, and how much mileage you can get from each recipe.
• What You Have Time For. If you have a crazy busy week coming up, make a mental note to be on the lookout for quick, slow cooker or make-ahead meals that can served up in a hurry. We’re big fans of the cook once, eat twice (or thrice) approach.
• Your Food Mood. Things like the weather, a change in seasons, and food cravings can impact what sounds good on any given day. Thinking about these things beforehand will make recipe selection process faster and meal times easier on everyone.
• Your Grocery Budget. If you want to eat better for less (and who doesn’t) think seasonal produce and sales. Check out these 6 ways to meal plan for savings.


1. Grab a pen and paper. Write the days of the week on the left side of the page and the meals you want to plan across the top.
2. Sketch out your weekly eats. Vague descriptions like quick dinner, leftovers, or packable lunch are fine for now. Don’t forget to plan for leftovers and make note of special dietary restrictions here as well.
3. Tally them up. Note how many meals you’ll need, grouping together similar ones. For example: 2 quick dinners, 3 packable lunches…

Money Saving Tip: Peruse grocery store savings for sales and specials. Jot down any ideas of interest as a reminder to select the recipes using those ingredients.

Part II: Collect and Calander Your Recipes

Now the fun part! Once you know how many meals you’ll need, it’s time to find some healthy recipes and fill in your calendar for the week. Here are some tips to help.
• Create a master recipe list. Having a list of go-to meals is one of the easiest ways to expedite the meal planning process. Consider trying one or two new recipes and use a few old favorites to fill in the gaps. • Every time you find a new meal you love, add it to the rotation!
• Find a few new dishes to try. Finding delicious, healthy recipes isn’t hard–you just need to know where to look. Health-conscious cookbooks and food magazines are great but the internet can literally provide millions of healthy recipes at your fingertips.
Some of our favorite websites for healthy recipes include:
• The MyFitnessPal Blog – in addition to being delicious the recipes are super easy to add to your food diary
• Cooking Light
• Food Network – Healthy
• Clean Eating
• Eating Well
• Healthy food blogs like Skinnytaste, Eating Bird Food, Kath Eats, Cook Smarts, and Fannetastic Food–just to name a few
• Save and organize your recipes
For online recipes:
• Add them directly to your MyFitnessPal recipe box, either on the web or within the app. Our new recipe tool will even calculate the nutrition facts for easy logging later.
• Create a healthy recipe Pinterest board. Check out ours for meal inspiration
• Check out Paprika, Plan to Eat or ChefTap, or more basic note clipping apps like Evernote
For paper recipes:
• A simple, three-holed binder with some plastic sleeve inserts are great for organizing recipe cards and meals pulled from magazines
• Use bright colored tabs to flag favorite cookbook recipes

Recipe Planning with a Purpose

Overlap ingredients. Selecting recipes with like ingredients will minimize how much you have to buy.
Keep your eyes on the nutrition facts. Choose recipes that will help you meet your goals for the day.
Look at serving information. Note how many servings a recipe yields – especially if you’re feeding a family or plan to use up leftovers.

Create your meal calendar Regardless of what format you prefer, the key here is to fill in your calendar with specific meals. Meal planning pro and Cook Smarts founder, Jess Dang, says, “Good meal planning is like putting together a puzzle. Try to avoid selecting different recipes that don’t fit together or else you’ll be buying a lot of different ingredients. Select one, look at the ingredient list and let that help you select recipe #2, and so on.”
Whether you use a simple notecard, a printable template or prefer a digital version, it’s a good idea to keep a paper copy of your calendar in plain view. “Making your meal plan visual may hold you more accountable for executing on the cooking. Plus, your family isn’t constantly asking you, “What’s for dinner?” They can just refer to the board, ” adds Jess. If you need some ideas, check out Pinterest for visual meal planning boards.
If you prefer digital, create a sub-calendar for your meal plan in Google, Outlook or your calendar application of choice and share it with family members or roommates so everyone knows the plan.
Write your grocery list Save yourself some time and write your grocery list while you fill out your calendar–and don’t forget to jot down quantities for each ingredient. Before you head to the store take a quick inventory of what you have on hand and cross off the ingredients you don’t need to purchase.

Meal Planning Practice: Collect and Calendar Your Recipes

1. Start a master recipe list. Digital versions (like a note on your smartphone) are handy, easy to update and usually within arm’s reach!
2. Fill in your calendar. Pick some favorites from your master list and 1 or 2 new recipes to try.
3. Write your grocery list. While doing that, jot down ingredients for each recipe. Then, take stock of what you already have on hand before heading to the store.
4. Pick a time to shop. Once your shopping is done, you’re ready to tackle food prep. Stay tuned for our how-to post coming up next week.

Overcoming and Preventing the Weight Loss Plateau

Have you had bariatric surgery?  Has your weight loss slowed or stopped?  Are you no longer seeing results, and don’t understand why? Well… you most likely need to learn how to stop weight-loss plateau. Weight loss, after bariatric surgery, is very significant early on; this typically occurs because the body is adapting to the lower calorie diet and is burning alternative energy sources. The body will first burn glycogen that is stored in the muscles and the liver (which causes a loss of water weight which is a significant amount of your overall weight loss), and the body then turns to fat and lean muscle mass. As your body burns muscle, your metabolism slows and this is typically what causes you to hit a plateau.  Before weight loss surgery, you still had quite a bit of muscle which is why it was so easy to lose weight shortly after your bariatric surgery. A person with lots of muscle mass will have a high metabolism, which means they will burn more calories throughout the day, even when just lying in bed, than a person with less muscle mass. As a lighter person, you no longer have as much muscle mass as you previously may have, so you may no longer be at a deficit with calories because of your lower metabolism.

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