Abstract
Introduction
P
Before surgery, many patients do not have a well-defined appetite regulation system. As such, patients report a return to preoperative psychological hunger/cravings after 6–18 months. Patients will often report eating for reasons other than hunger, and overeating when no physical hunger is felt. They return to chaotic eating habits of the past.
Mindful eating teaches patients to become particularly sensitive to often internal and external cues of hunger, thirst, and satiety, as well as to identify and rate the intensity of each emotional craving. Cravings may be triggered by boredom, insecurity, unexpressed anger, and other emotions. Mindfulness is a lifelong approach to living; mindful eating encourages the connection between the body and the mind. The goal is that we take the time to breathe and appreciate each moment, one meal at a time.
Methods
A literature review in December 2013 reveals that the number of books targeted to bariatric mindful eating is unfortunately quite small. Search terms included mindful eating, bariatric meals, bariatric meal planning, bariatric recovery, and mindfulness and diabetes.
It is my experience that the publications featured have resonated with both patients and practitioners. It is not intended to be an exhaustive review of the literature, but suggested readings to promote a focused and mindful approach to eating all phases of life. The reviews included with each entry are my own.
Mindful eating literature
Albers S. Eat, Drink and Be Mindful: How to End Your Struggle with Mindless Eating and Start Savoring Food with Intention. Oakland, CA: New Harbinger Publications, 2009.
Review: An excellent workbook that advocates mindful eating and living. Provides concise exercises to deal with emotional eating, which can interfere with a lifelong recovery.
Alexander CL. The Emotional First Aid Kit: A Practical Guide to Life After Bariatric Surgery, second ed. West Chester, PA: Matrix Medical Communications, 2008.
Review: Superbly written and very patient friendly. Covers all aspects of a patient's journey, with an emphasis on the skills needed for recovery.
Bays JC. Mindful Eating: A Guide to Rediscovering a Healthy and Joyful Relationship with Food. Boston, MA: Shambhala, 2009.
Review: Discusses the seven forms of hunger—eye, nose, mouth, stomach, cellular, mind, and heart—and how to accept, befriend, and influence each one.
Craighead LW. The Appetite Awareness Workbook: How to Listen to Your Body and Overcome Bingeing, Overeating and Obsession with Food. Oakland, CA: New Harbinger, 2006.
Review: Based on Dr. Craighead's extensive research. Teaches skills to help people rely on internal hunger and satiety cues to determine when and how much to eat.
Furtado M, Ewing J. The Complete Idiot's Guide to Eating Well After Weight Loss Surgery. New York: Alpha Books, 2009.
Review: Rich in information, including a mindful eating exercise. Also contains nutritional information and a description of gut hormone changes after metabolic surgery.
Gerard, D. One Bowl: A Guide to Eating for Body and Spirit. New York: Marlowe & Company, 2001.
Review: Brief, but nonetheless provides the opportunity for a personal evolution. Every detail of a meal is identified and exquisitely explained. Advocates learning to eat alone first as the “key to hearing your own food symphony.”
Glovsky ER. Wellness, not Weight: Health at Every Size and Motivational Interviewing, first ed. San Diego, CA: Cognella Academic, 2013.
Review: Includes chapters by experts in mindful eating, motivational interviewing, and the idea of “health at every size.” Chapters focus on health, food choices, and empowering people to make healthy changes in their lives.
Latimer JE. Beyond the Food Game: A Spiritual and Psychological Approach to Healing Emotional Eating. Denver, CO: LivingQuest, 1993.
Review: A powerful book that examines a person's emotional boundaries focusing on his/her relationship to binge eating. Discusses the separation of self-criticism and the powers of the physical body. Also focuses on how to overcome emotions that may be related to childhood experiences.
May M. Eat What You Love, Love What You Eat: How to Break Your Eat-Repent-Repeat Cycle. Austin, TX: Greenleaf Book Group Press, 2011.
Review: A potent, down-to-earth combination of mindfulness and its practical applications. Includes a detailed description of the mindful eating cycle and a process to deal with relapse. Also discussed are methods to approach and gently rework exercise resistance. Includes menus and recipes.
Siegel RD. The Mindfulness Solution: Everyday Practices for Everyday Problems. New York: Guilford Press, 2009.
Review: An excellent examination of mindful meals from one raisin to a full buffet. Used by many therapists as a meditation guide.
Tribole E, Resch E. Intuitive Eating, third ed. New York: St. Martin's Press, 2012.
Review: A classic book that supports people's abilities to detach themselves from allowing emotions to influence their relationship with food. Includes thoughtful explanations of our bodies' true hunger/fullness cues.
Conclusion
I am confident that each of these publications would be beneficial to the weight loss surgery patient. They address the eating experience and can provide paths to resolution of food and weight issues. Mindfulness strengthens our capacity to integrate brain and body, identity physiological needs versus emotional wants, and identify positive ways to handle life's stressors. Potentially it can lead to improved life choices and radical self-acceptance. Diet fads will come and go, but the wisdom of eating each bite of food while awake, aware, and alive can nourish us for a lifetime.
Disclosure Statement
No competing financial interests exist.