Our table in the hotel dining room gave me the view of a quite large woman sitting quietly, watching her female friend eat through several servings from the breakfast buffet. What made this woman’s behavior somewhat strange was that the seemingly endless offerings of the breakfast buffet caused most people to eat several courses, ranging from mundane cereal, fruit or yogurt to elaborate quiches, salads, smoked fishes, custom-made omelets and pastries. The gorging companion was demolishing several plates of food (she was not exactly thin) while the non-eater nodded, but remained with her mouth forcefully closed as though if once she opened it, maybe she would start eating.
I wondered, “Had she just had bariatric surgery so she could eat only tiny portions?” My reason for thinking this resulted from a conversation with my nephew, who had bariatric surgery a year-and-a-half earlier. He told me how difficult it was to dine with others because his marshmallow-size stomach severely limited the amount of food he could eat. He had to pretend to eat and drink normally when he took clients to dinner, but sometimes he felt socially isolated because of the restriction on his food intake.
Losing weight is an obstacle course with the dieter confronting endless situations that may cause the more healthful eating plan to be discarded, or only partially followed. Dieters need willpower, mindfulness, willingness to take on new and almost ritualistic behaviors. Now eating small portions, exercising daily, and not eating when they are not hungry? It’s a new adjustment which can be very hard when dining with others who pay little attention to how much they eat, or whether they are eating out of hunger or simply because food is presented to them…the way the post-op bariatric patient must function.
Recently I was on a daylong tour that included a visit to a multi-cultural community center. As our group entered the building after a long bus ride, we were offered a variety of ethnic foods along with coffee, pastries and fruit. “Don’t worry about the small amount of food,” our guide told us, “this is only a snack. Lunch will be served later.” The group lined up to sample the foods. “Is anyone hungry?” he asked. I doubted it, but the group ate eagerly (well almost everyone ate while I took pictures because I wasn’t hungry…). As the day progressed, an enormous buffet lunch was served and gorged upon, and late in the afternoon different ethnic pastries and cold juices were served.
If someone in our group were dieting, or simply refraining from gaining weight, it would have been hard to resist the many opportunities to eat. And not eating when everyone else did may have been a lonely, alienating experience.
Residential weight-loss programs such as Canyon Ranch work in part because the dieters are part of a community. A participant eats the same low-calorie food, often at a communal table, participates in group exercise, and hears lectures about mindful eating, relaxation, and avoiding food based ‘temptations.’ But when the residential stay ends, the idyllic bubble of group weight loss is broken. Suddenly dieters no longer have the companionship of others who share in their caloric restriction, but must attempt to hold onto these constrained behaviors in the midst of others eating whatever they wish.
The difficulty of doing this may be under-appreciated, except by the dieters themselves. Not only must they be continually sensitive to their food intake as well as the need to exercise frequently; they are often assaulted by the urging of others to ‘break their diet, just this once, because, “It’s a special occasion!”’ Sometimes, perhaps too often, they are berated for making others look bad because their self-discipline contrasts strongly with the heedless eating of those around them. This is perhaps why I noticed the solitary non-eater in the dining room. Her lack of eating contrasted dramatically with the seemingly endless food intake of her companion.
Obesity experts talk about accepting and following a new, healthy life style if the dieter wants to lose weight and maintain that loss. Another way of putting it is that the dieter must ‘convert’ to a new way of eating. Changing drastically one’s eating behavior, i.e. converting to a different eating ideology, is something quite common these days. People become vegetarian, or vegan, gluten-free, Paleolithic, raw food enthusiasts, juicers, or members of a religious group with stringent eating rules. Once committed (or converted) to the new eating ideology, the convert follows the rules: vegetarians do not go to steak restaurants, and Muslims do not eat during daylight hours for the month of Ramadan. In fact, surveys now show that dating relationships flourish or flounder in regard to a potential partner’s eating ideology, because a vegan and meat eater may be incompatible for long-term relationships.
Conversion to a healthy, weight-maintaining or weight-losing lifestyle should ideally give the dieter access to a community that follows a similar lifestyle. If dieters can find others who understand and support them in adhering to an eating and exercise lifestyle that will maintain a healthy weight, they may succeed in doing so themselves. The problem is that unlike vegans, raw food adherents or gluten-free eaters, individuals who follow a healthy eating and exercise pattern are effectively anonymous excepting people who write blogs on the subject or offer professional help. And even though a vegan or someone who keeps kosher will reject offered foods by invoking an eating belief system, I have never heard a ‘healthy eater’ invoke a healthy eating belief system and say, “Sorry, but this food has too much sugar/fat/calories, and so I cannot eat it.”