Doctors often think of weight loss in terms of simple biology: “Calories in vs calories out”. And that’s not surprising because science is based on analyzing the human body through the lens of experimentation. For example, what happens when the caloric intake of these mice is restricted, compared to a control group of mice eating as much as they want?
The problem is that humans are infinitely more complicated than any experiments have the power to control or analyze, which is why the field of nutritional science is complicated and confusing. We have clarified a lot about the intricate processes of digestion and metabolism over the decades, but there is so much more to learn about the complex interaction of hormonal responses.
We’re constantly surrounded by unprecedented abundance, convenience and palatability
And beyond our basic biology, human behavior and psychology introduces yet another layer of complexity. What I mean is that while our ancestors may have been driven to eat by simple hunger or pleasure cues, today’s world presents a much more convoluted landscape. When it comes to food, we are constantly surrounded by unprecedented abundance, convenience and palatability, as well as myriad non-biological social cues for eating.
I share a few of my own stories below to illustrate the concept of social cues for eating, and my hope in doing so is to trigger you to become aware of your own stories and cues. The point is to recognize them for what they are: food habits. When we begin to see the results that are created by such habits, we get to choose whether to keep or discard them.
Food gifts
Every year in September before the Mid-Autumn (zhong1 qiu1) or Moon Festival, those of us living in Hong Kong engage in a ritual that seems just a little more bizarre to me each year. We exchange mooncakes in gift boxes that have become increasingly gorgeous and elaborate. It’s not that I don’t appreciate the sentiment behind observing cultural traditions, like exchanging gifts at Christmas or red envelopes at Chinese New Year. I’m mostly just mystified at the lack of imagination when it comes to the actual mooncakes themselves.
In Hong Kong, the currently popular varieties of mooncakes are egg custard or lotus paste +/- egg yolk, so other varieties are scarcely available at all. It would be like Americans collectively deciding that shortbread and ginger cookies were the trendiest Christmas cookies. And so all the best pastry shops and hotels would go all out to make and decorate the most elaborate versions possible. One could find Earl Grey or matcha flavoured shortbread, but few shops would consider carrying anything as outdated as chocolate chip cookies. And while mooncakes are not so impossible to find the rest of the year, we still press each other to eat them now because it’s that time of year.
It turns out that every culture has dozens, if not hundreds of social and cultural cues that pressure us to consume. Just consider our fondness for happy hours, or the British tradition of afternoon tea. We gather to connect, to celebrate and to reward ourselves. Food and drink are social lubricants that reduce awkwardness by providing a focus and promote a shared experience for all.
Food is love
I definitely grew up in a family where love was expressed as food. Love was served at every meal and gifted on special holidays. Snacks inevitably accompanied games like mahjong or activities like movies. Food was not to be wasted, and rejecting food was as unthinkable as shoving someone away when they are trying to hug you.
When I was maybe about five years old, I remember being punished by my mom for not finishing the food on my plate. I was made to sit at the kids table long after everyone else had left, staring down at this orangey baked meat dish that Nai Nai had made. I was normally obedient to a fault when it came to food, but somehow I was not willing to eat this orangey bean coating on the beef.
My mom considered it beyond rude to refuse any food made by Nai Nai, so she made me sit there all by myself, until I finally finished it. Afterwards we all piled into the car, with me sitting between the driver and shotgun. It didn’t take long on Hong Kong’s famous twisty hairpin roads before that orangey stuff all came back out, nastier than ever. Probably unnecessary to say that after that, I don’t ever remember having that orangey dish, nor even being forced to finish my food again.
Notwithstanding this unfortunate incident, my childhood memories involving food are almost overwhelmingly positive. Food inevitably accompanied holiday or family gathering, and snacks were offered as a kindness when life got rough. Food was my stalwart friend and refuge all through college and med school.
Unlearning food habits
Our food habits fall into four general categories, and they are often inextricably intertwined.
Thinking habits like thinking of food as comfort.
Feeling habits like wanting to eat chocolate when feeling sad or stressed.
Behaviour habits like finishing your plate.
Social habits like not being able to refuse a food pusher.
I clearly learned to clean my plate (or bowl) in childhood - my mom used to say that any rice left in my bowl would show up as blemishes on my face. Of course I know now that cleaning my plate (behaviour habit) can sometimes mean I’m overfull, so I get to choose whether or not to do so. And even though my adult brain knows that I won’t get in trouble for not finishing my plate, I still might sometimes do it. Maybe it’s when I’m busy and distracted, so it's literally just a force of habit situation. Or maybe I’m thinking that I shouldn’t waste food (thinking habit), inevitably leading to feelings of guilt or even shame (feeling habits) that were surely learned in childhood.
Food and drink are social lubricants that reduce awkwardness
Social habits are often even more complex, as they are usually linked to relationship dynamics. When we grow up learning that it’s rude and disrespectful to refuse food, eating becomes a performance we engage in to please others. Let’s say that Aunt May somehow remembers that you like her lemon meringue pie, so now she makes it for you every time. You may still love her pie so you’re glad to keep in the habit of enjoying the pie. But if you’ve outgrown your love of lemon meringue or just don’t want the pie, you’ll need to figure out how to let Aunt May know that you still love her, without eating the pie. Our thinking and feeling habits have us worried that Aunt May will feel disappointed, but it’s also possible that she will be relieved. What if she has been slaving away at making the pie because she’s worried about disappointing you all these years?
Rather than being stuck in a childhood pattern of thinking, feeling and behaviour habits, we get to decide what we want our new habits to be. Perhaps you get to offer to sit with Aunt May and spend some time talking or reminiscing with her, instead of sharing food. Remember that food and drink have always served as social lubricants, helping to connect people who might otherwise feel awkward. Choosing nonfood approaches to connecting is often a good alternative. Another way to connect may be to share photos on your phone - photos of your family, your pet, or maybe an artist you like.
Creatures of habit
Research has shown that up to 50% of our everyday behaviours are driven by habit. My hunch is that it’s probably more, because we aren’t even accounting for the automated behaviours that are pure muscle memory. For example, I may think that I am choosing to eat an apple for a snack, but actually if I have an apple most days then it’s more of a habit or routine. And how I go about eating my apple may not only be habitual, but actually automated - which means I don’t have to think about chewing and swallowing each bite of my apple.
Eating can become a performance we engage in to please others
Our human brains are very much programmed to try to automate as much as possible, to free up capacity for focusing and working on the things that actually require active brain power. Muscle memory helps us to do complex tasks like driving a car or riding a bicycle in an automated way. So we still have to decide when to stop and go and what direction to go in, but we automatically signal when making a turn. Habits help to free us up from day-to-day decisions like which side of the bed to sleep on, or what to take in our coffee.
Best-selling author James Clear makes the argument that our lives are the sum of our habits. Our habits to date have determined our current level of fitness, nutritional state and overall health.
My food habits are a product of my familial upbringing and socialization. So the good news is that I learned them and can choose to unlearn them. I get to choose whether or not I want to keep my habits of thinking, feeling and behaving around food. And if I’m choosing the identity of being someone who is healthy of mind and body at my 100th birthday party, I’ll want to be sure that my food habits are aligned accordingly.
Dr Em Coaching Tips
What top 5 food habits can you identify? Do you like them or would you want to change any?
Choose one habit that you’d like to change.
Clarify if it’s a habit of thinking/feeling/behaviour/social, or all of the above.
What specifically would you love to change about this habit?
When did you learn this habit?
What would happen if you changed this habit?
What’s the tiniest step that you could take to start shifting this habit?
