I AM WRITING THIS BOOK TO ADDRESS AN increasingly widespread and unnecessary form of suffering. Our struggles with food cause tremendous emotional distress, including guilt, shame, and depression. As a physician, I’ve also seen how our eating problems can lead to debilitating diseases and even to premature death.
According to the U.S. Department of Health, nearly two out of three American adults are overweight or obese. It’s also estimated that millions of Americans suffer from anorexia or bulimia. One could call this an epidemic of “eating disorders,” but I prefer to think of the problem as an increasingly unbalanced relationship to food. One of the primary causes of this imbalance is a lack of an essential human nutrient: mindfulness. Mindfulness is the act of paying full, nonjudgmental attention to our moment-to-moment experience. This book explores how we can use mindfulness to free ourselves from unhealthy eating habits and improve our overall quality of life.
Right now we’re in need of a fresh approach to our eating problems, because the conventional methods aren’t working. Research shows that no matter what diet people undertake, no matter what kinds of food they stop or start eating, they lose an average of only eight to eleven pounds and then gain it back in about a year. Only a few individuals are successful in losing a significant amount of weight and not regaining it. Dieting in teenage years also significantly increases the risk of future eating disorders. We can see that dieting is not the answer.
We’ve also tried to solve our weight problems by altering the food we eat in the hope that we could continue to eat in an unbalanced way without any ill effects. We have removed the calories, the fat, the sugar, and the salt. We have added protein, vitamins, fiber, artificial fat, and chemical sweeteners. This war on food has meant increased revenues for companies that create processed food, but it has not altered our expanding waistlines or brought us back to a wholesome way of eating.
Another approach has been to wage war on the fat in our bodies through starvation diets, compulsive exercise, or liposuction. Fat cells are actually trying their best to help us. Their job is to keep us warm and to provide emergency fuel for lean times. We can remove fat cells through surgery, but if we continue to consume extra calories, new fat cells will grow in a dutiful attempt to fulfill their role as energy storage containers.
We’ve tried attacking the body in other ways as well. Most large hospitals have opened departments of bariatric medicine to provide weight loss surgery and the aftercare it necessitates. These operations reduce the size of the stomach or bypass parts of the gut to produce malabsorption. With a smaller stomach, people experience pain, nausea, vomiting, and other kinds of discomfort if they eat more than one-half to one cup of food at a time. Following malabsorption surgery people may suffer chronic diarrhea and have to take many supplements to avoid becoming malnourished. There is no question that surgery helps people lose weight and reverse side effects such as diabetes. However, it appears that several years after undergoing surgery, many patients regain weight, with only one in ten stabilizing at their target weight. Hundreds of thousands of people each year are undergoing this surgery, which is expensive (about $25,000) and not without risk (as of this writing one in a few hundred patients die, and 20 to 50 percent have complications, often requiring further surgery). The cost of this treatment alone makes it unavailable to most people.
After undergoing bariatric surgery, people are forced to change their eating habits. They must eat mindfully or suffer acute discomfort. However, many patients eventually learn to “eat around” the restrictions imposed by altered intestinal anatomy, and they gain weight again. It appears that a significant number of patients develop “transfer addictions” after surgery, substituting alcohol, compulsive gambling, shopping, or sex for food.
If dieting or surgery are not practical treatments for adults, they certainly will not work for the 30 percent of American children who are now overweight or obese. Until about fifteen years ago, we pediatricians seldom saw overweight children in our clinics. Now they are common, as are serious complications including diabetes. Some researchers are predicting that this generation will live shorter life spans than their parents because of disordered relationships to food and eating. We do not want to push young children into neurosis about diet and obsession with weight. We need a new approach.
Similar challenges arise in trying to treat those whose weight becomes dangerously low due to anorexia or bulimia. Medical treatment, including hospitalization, intravenous nutrition, and dripping liquid nutrition into feeding tubes, often results in weight gain that is only temporary.
The situation is clear. The developed countries are in the midst of a serious epidemic of disordered relationships to food and eating, and this epidemic is spreading rapidly to less developed countries.
We are in urgent need of a treatment that will work equally well for children and their parents. We are in urgent need of a treatment that is inexpensive or free and can be used by anyone. It should at least be without negative side effects. Ideally it would have positive side effects.
The best treatment would be one that could be started with initial guidance and education by professionals but would be easy and interesting enough to be continued long-term by people on their own. The treatment should be accessible to people of all ages and social conditions, including children. It should have an immunizing effect, preventing children from developing full-blown eating problems. It should provide strong support to those who are undergoing medical treatment or surgery. Ideally this treatment would cause long-lasting changes and result in a permanent cure.
Mindfulness is the only treatment that I know of that fits this description. Mindfulness addresses our disorder at its source. The problem is not in our food.1 Food is just food. It is neither good nor bad. The problem is not in our fat cells, which are just trying to do their job of storing extra calories as insurance against times of famine—famine which never arrives. The problem is not our stomach or small intestine. They are just trying to take care of us by digesting food and absorbing nutrients. The long-term solution is not to eat food that has been stripped of nutrition or to mutilate healthy organs or to deliberately produce a second serious disease, malabsorption.
The source of the problem lies in the thinking mind and the feeling heart. Mindfulness is the perfect tool for the delicate operation of laying open the inner workings of these two most essential organs. Mindfulness is the perfect catalyst for setting into motion the course of their complete healing.
This book was inspired by the enthusiasm generated by the mindful eating retreats we give at the Zen monastery where I live and teach. Of our many workshops and retreats this one seems to generate the highest level of excitement and appreciation for the power of mindfulness to shed light upon a most vital aspect of life, even in people with little experience with meditation. Professionals who take the trainings say, “We are tired of handing out diet sheets to patients, when we know and they know that they won’t follow them. It’s an exercise in futility. Mindful eating is the missing piece!”
When mindful eating is ignored, it causes pervasive and unnecessary suffering. When mindfulness is applied to eating, a world of discovery and delight opens. This is a world that has been hidden, quite literally, beneath our noses.
It is my sincere wish that this book will help you to open yourself to the joy and delight, the richness and splendor, of the simple acts of eating and drinking, so that you can find true, deep, and lasting satisfaction with food and enjoy eating throughout your life.