Review part 2 of Secrets of Feeding a Healthy Family: Virtue and restraint.

(Part 1 here)

So there's a couple of turns of phrase in Ellyn Satter's Secrets of Feeding a Healthy Family that sets off red lights and sirens for the likes of me.

The first one is "Shun Virtue."  Yes, you heard that right:  shun virtue.  It even appears in the index:  "Virtue, shunning, 20."

The second one is "Restraint is profoundly unrealistic."  "The research is clear that restrained eating profoundly disrupts eating attitudes and behaviors" (okay, that's circular) "as well as destabilizes body weight."

Let me first give you an idea of the grain of salt you need to tuck into your cheek here.  Note that she does not say that the research is clear that restrained eating causes, or even is associated with bad outcomes -- only that it's associated with weight instability, which in turn is associated with bad outcomes.  And although the heading "Restrained Eating" in the appendix (pp. 240-241) is followed by a column and a half of text with citations, only a couple of these are actually about so-called "restrained eaters."  Just one of those looks well-supported to me, and I'll write more about that one further down.

But more to the point, how can we take anyone seriously who says "shun virtue" and "restraint is unrealistic?"  I'm automatically suspicious of the "restraint is unrealistic" line, because in my experience it's often the backbone of an entire philosophy of existence, life, and education -- a philosophy which I utterly reject.   It comes too often with advice to "do what feels good", justified by the assertion that self-control is inherently damaging, and that our pent-up frustration will find an outlet in psychological problems or some kind of binge.  We Catholics are certainly familiar with analogous philosophies in sexual matters, no?
 
I'm not saying that Satter espouses a "do what feels good" philosophy, or even that she's incorrect in suggesting that "restrained eaters" really do tend to binge as a reaction to their restraint (more on that later -- I think the evidence is that some of them do).  I'm just saying that the twin phrases "shun virtue" and "restraint is unrealistic" make me instantly skeptical.

But maybe the problem is one of defining one's terms.  Obviously Satter's not setting out to write a book about virtue and vice.  She's not, then, using the term "virtue" and "restraint" in the same way that we are -- they aren't theological jargon, but some jargon of her own.  So what does she mean?

A quote:

When I helped Wesley learn to feed himself in a more positive and nurturing way, I encouraged him to have regular meals.  This brought us right up against his well-developed pattern of freaking himself out with the food rules, and together we apprehended him again and again when he went chasing off after the food rules and neglected to provide himself with foods he enjoyed.  When his eating became chaotic, we traced it to his out-of-control virtue.  You understand the dilemma of the overdeveloped conscience if you order broiled fish when you really want it fried, and then give in to cheesecake when the dessert tray comes around.  If you truly enjoy broiled fish, you will have to come up with some other example of out-of-control virtue, but the point stands:  If you can't give yourself permission to eat the foods you enjoy, you will have to rely on impulse to get them.

She's using the word "virtue" to mean something it never means in ordinary usage:  something bad.  Can real virtue get "out of control" and become bad?  I think not, although we can misunderstand what behaviors are required for the practice of virtue (and become prudish when we intended to be modest, for example).  So -- this is an error on her part, and it sounds to me like she's unfamiliar with the language of virtue -- or else she would choose a different word.   (Note too the reference to an "overdeveloped conscience."  No such thing.  You can have a perverted conscience, though, which is what she really means:  a conscience that tells you good things are bad.)

What Satter means for the reader to shun is food scrupulosity:  excessive rule-following coupled to self-judging with respect to the rules.  She calls this "virtue." I hope it does not reflect upon her opinions about people who really do try to be virtuous in the correct sense!

That takes care of "virtue."  Now, how about "restraint?"  What does she mean by a "restrained eater" or an "unrestrained eater?"

Helpfully, she includes a side box with a definition of "restrained eating."

As originally defined, restrained eating is trying to get yourself to eat less food or less-desirable food than you really want in pursuit of thinness [or health]."

• Imposing absolute limits:  so many calories, so many helpings.  Going by portion sizes or a food pattern. 
• Making yourself hurdle:  "I have to eat this before I can eat that."
• Avoiding certain foods...
• Limiting your menus to drab, uninspiring foods
• Trying to fill up on low-fat, low-calorie, "healthy" food
• Trying to eat only low-carb...
• Substituting low-calorie butter, margarine, or salad dressing for the real thing in order to save calories.
• Asking yourself "Do I really need that?"

This is what she means whenever she talks about "restraint."  She clearly doesn't mean all kinds of self-control, because (while she recommends "self-trusting" eating) she does make recommendations that require self-control or self-discipline, and even an imposed outside structure.  For example:

•  She advocates eating as part of regular meals and snacks -- not grazing.
• She offers techniques for learning to like new foods through controlled exposure.  (Some of us find it hard to believe you might need self-discipline to get yourself to eat more of something, but indeed you do.)
• She advocates "tuning in" and "staying in touch with your feelings of hunger and eagerness to eat" while eating -- mindful eating.  She even advises, "That takes effort."  In other words, she advocates slowing down and paying attention.  
• She even gives an excruciatingly detailed technique for learning to notice hunger and satiety signals, right down to how long to chew a mouthful of food.  If that isn't controlled, I don't know what is!

 
It's pretty clear that she thinks *her* messages are all about trust and not control or restraint, but I'm not buying that the distinction is all that clear.  (Similarly, she writes lots of stuff about how children need to be free to take as much or as little of a food as they want -- but when you get right down to it, even she says that children should only be given one helping of bread lest they fill up on it!  And she even advocates making "rules" -- her word, not mine -- about Halloween candy.  Gasp!  Rules!)

So.  What does her "unrestrained eating" have to do with gluttony?  When she says "get rid of restraint," is she inviting us to be gluttons?

What's usually cited as Aquinas's "definition" of gluttony is really more of a classification of gluttonies (too much, too soon, too eagerly, too pickily, too expensively).  I made a stab at defining gluttony here:  gluttony abhors the restraints on food that are necessary according to our state in life.  Restraints are placed on us by a number of different requirements:  charity, obedience, resources, physical health, religious or ethical duties, and manners, among other things.  If you can't stand to make your food intake conform to these requirements, you might be a glutton.

It's really clear from reading Satter that with her term "restrained eating" she doesn't mean to condemn any of the restraints I mention above -- except those we perceive we need for physical health and especially thinness.  For example, she strongly emphasizes table manners, and demonstrates sensitivity to food budgets or cultural differences in food traditions.  

As far as I can tell, though, she completely ignores a distinction between our real physical constraints and our perceived ones, and condemns as dangerous "restrained eating" any self-control in pursuit of help.  

Can she really mean this?  I assume, for instance, that she wouldn't advocate ignoring the restraints placed upon people by allergies, autoimmune diseases, or endocrine diseases like diabetes -- even though these involve eating "less" or "less-desirable" food "than you really want" in the pursuit of "health."   A diabetic simply cannot eat as much as he or she wants of whatever he or she wants.  And conditions like diabetes really do exist on a spectrum from healthy to pre-metabolic syndrome to metabolic syndrome to pre-diabetes to full-blown diabetes, itself on a continuum of severity.  So somewhere along the line, a person has to be aware that food choices affect health, and a little bit of "restraint" won't kill you.  But by ignoring the constraints placed on people by real physical disorders, she loses the opportunity to clarify when restraint is appropriate.

So I mentioned above that there was one thing about the dangers of restraint that made sense to me.  Here's the one thing she writes that looks plausible to me based on the citations, and that I'm willing to believe on her authority, given that she works with people who suffer from eating disorders:

Rather than overeating per se in response to stressors, restrained eaters suspend restraint:  They stop undereating.  Then, because restraint has been violated, rather than simply eating enough to satisfy hunger, they go on to overeat.

That sounds really familiar.  The term she uses for this pattern is "restraint and disinhibition."  And I think what it comes down to is this:  Following rules won't cure gluttony all by itself.  The tendency is still there.

And she may be right about this.  On the other hand, the problem may also be that the rules are poorly designed.  I tend to think that she doesn't really think all rules are bad; she just won't call the good rules "rules."  More on this another time.

Comments

[Becca Balmes]

I haven't read the book, but from this synopsis I believe I can say I won't ever read the book.

I'm currently doing a very similar weight loss process to that you outline going through in your blog archives. I'm a recovering glutton, have had very little self-restraint with food or material pleasures for most of my life. I'm learning, VERY slowly, how to follow rules and train my impulses to conform to a longer-range goal than simply feeling good in the moment.

It's an incredible feeling to be succeeding at this, and when I hear "experts" tell me that what I'm doing is unhealthy or impossible, I automatically discount the rest of their advice.

[bearing]

OK, this wasn't at all a "synopsis" of the book! Only a highlight of one of its problems. I actually think there is some good stuff in the book, Becca, so don't discount it yet. I will be writing more about it. There are some useful principles for thinking about what she calls "eating competence," some good ideas for feeding children, and even some recipes.

She and I definitely wouldn't be in agreement about how to "treat" gluttony, but I would chalk a lot of that up to different philosophy (and there's nothing wrong with that -- I don't think eating problems have a one-size-fits-all solution, and her approach is probably the right approach for some people.) Personally, I'd want to see some numbers about how successful are the clinics or practices who use her philosophy before making up my mind for sure.

The book is simply not *about* morality. It's not part of her worldview that she's throwing out there. It needs a supplement.

I have a suspicion, too, that her work has given her a bit of blinders about it. I think she works with enough people with serious, serious eating disorders and sensory issues and other clinical diagnoses, that the problem of simple lack of restraint is maybe wayyyyyy under her radar -- all the folks who won't ever seek eating-disorder treatment because they don't have *that* kind of a problem, but still are unhappy with their difficulty exercising self-control.

edited to add: Oh, and the techniques for mindful eating ("tuning in," "finding your stopping place") are in there, which are real tools to learning to deal with gluttony. Of course, you have to be able to control yourself to practice them. So you have to be willing to take a non-gluttonous step to begin -- you have to exercise "restraint" to learn her method that she calls "unrestrained."

(Man, I just can't get over how much I dislike those vocabulary choices. But the term "restrained eating" is apparently already-established technical term in the field of eating disorders, so we can't blame her for that. LMK when "out of control virtue" enters the DSM-IV.)