Family Meals Focus
The Ellyn Satter Institute Newsletter
A taste of eating competence for clients struggling with eating
by Keira Oseroff, MSW, LCSW, and Jennifer Harris, RDN, LD, CEDRD
Your anguish and frustration from struggling unsuccessfully with your eating and weight can’t be addressed with another, “better” diet. Instead of trying still again to lose weight, consider learning to eat normally, as defined by the Satter Eating Competence Model. To become tuned in, orderly, relaxed, and positive with your eating, take good care of yourself with food. Feed yourself faithfully, and give yourself permission to eat.
Eating disorders clinicians see typical patterns
Keira Oseroff and Jennifer Harris are Ellyn Satter Institute (ESI) faculty members who are expert in the treatment of eating disorders. They depend clinically on the Satter Eating Competence Model and the Satter Feeding Dynamics Model for symptom management of distorted eating/feeding attitudes and behaviors. This article was originally published in the Eating Disorders Catalogue.
An all-too-typical first meeting with a new client struggling with disordered eating and with her relationship with food goes something like this: “I have food issues and I’m so hoping you can help me. I’ve been trying to lose weight on and off for as long as I can remember, and I just can’t seem to get anywhere anymore. I used to be able to at least lose weight and maintain it for a while, but now, I can’t even put together one day of good eating. I try to stay positive, thinking, ‘Tomorrow is a new day. I’ll do better tomorrow.’ But tomorrow never comes.” Despite the feminine pronoun, men fall victim to this process, as well, though the underlying issues fueling it may be different.
What are the choices for the client?
In essence, this client wants desperately for something to change, but has no idea what change would look like. As a consequence, her only option is to return to the same destructive cycle: food deprivation followed by a loss of control with food. This is commonly referred to as yo-yo dieting. After exploring the client’s history of eating and weight, we can safely label her a Dieting Casualty—a term coined by Ellyn Satter, MS, RD, MSSW, a well-recognized authority on nutrition, eating, and feeding. The term describes someone who has been on the dieting roller coaster, characterized by highs and lows of restraint and disinhibition. She is no longer able to sustain caloric restriction or to trust her internal compass for hunger and fullness – or even be aware of those sensations. As a result, her eating is chaotic and her weight is unstable. Yet still, food remains the focus of attention as if the answer can be found there.
Messages are everywhere that reinforce the diet/binge cycle. That roller coaster does the opposite of building trust in our abilities to eat competently, and it erodes self-efficacy—our belief in our own ability to navigate our way through the world. Just look at magazine covers in the checkout line—pictures of decadent food next to headlines of how to lose weight are commonplace.
Becoming eating competent is critical
When we focus on how we feed ourselves, the what follows naturally within the trust-based eating competence model.
Understanding how one arrives at eating competence, Satter’s term used to describe normal eating based on the Satter Eating Competence Model, is a personal journey. For some, it’s a logical progression that occurs without much difficulty. For others, it is more challenging, and the reasons for that are varied. When people find themselves struggling with food, it is best for them to work with a professional trained to help identify the factors that have eroded their ability to be Competent Eaters.
Eating competence is about normal eating
Eating competence provides a framework for understanding what normal eating is for each of us. Eating competence is not about controlling our weight; it is about learning to trust our ability to take care of ourselves with food. Interestingly, the focus remains with “how” we feed ourselves, and the “what” follows more naturally within this trust-based model. Eating competence comprises four distinct areas.
- Positive attitudes and beliefs about food and about eating. Competent eaters are relaxed about food and eating. They look forward to eating and enjoy their food. They aren’t anxious about it, they aren’t preoccupied by it, and they don’t obsess after they have eaten it. They eat and then they move on.
- Food acceptance skills. Competent eaters like a variety of food and enjoy trying new foods and learning to like them…or not. They can “make do” in situations that call for it, eating food they don’t much care for because not every meal has to be the most exciting.
- Internal regulation skills. Competent eaters tune in to their bodies when they eat. They know when they are hungry and when they are not. They trust those hunger and fullness cues enough to decide to keep eating or to stop because they are truly satisfied.
- Context management skills. Competent eaters plan for feeding themselves. They are reliable and can depend on themselves to have regular meals and snacks in between if they want/need them.
Developing eating competence is a process
The areas of competency are not something one masters in isolation. Further understanding of the process is offered by Satter’s Hierarchy of Food Needs. This hierarchy is a review of eating progression that leads to eating competence. From that framework, the four competencies can be achieved. Think of it as a parallel to Maslow’s Hierarchy of Needs. Before moving up in the hierarchy, one must master the skills within each tier, beginning at the base. To bring ourselves along in that process of building greater trust and competency, we must first understand where we are from within each of the four areas.
Identify your level of eating competence
To get started in identifying your level of eating competence, use Satter’s assessment tool, ecSI 2.0. From there, you can use Satter’s Hierarchy of Food Needs to bring yourself along, or work with a qualified professional to begin identifying what steps to take to achieve greater competence with eating. The Satter Eating Competence Model offers a path to emotional and physical wellness.
Keira Oseroff, MSW, LCSW
Jennifer Harris, RDN, LD, CEDRD
To read about applying sDOR-consistent nutrition education with children, read Appendix H, “Nutrition education in the schools,” in Ellyn Satter’s Secrets of Feeding a Healthy Family.
More about eating competence
- Eating competence
- Eating competence: Context-management skills
- ecSI 2.0
- Evidence for ecSatter
- How to eat
- The joy of eating: Being a competent eater