All-Inclusive Resorts and Dietary Self-Regulation (Part 3)

Old-Kitchen-Scale-Hunger-Artist

7: Rendering your limits irrelevant

In this series so far, we’ve used the all-inclusive vacation model to illuminate recovery from a restrictive eating disorder: from adhering to a blanket rule of “as little as possible” to incentivizing “more than necessary.”

We’ve reviewed evidence suggesting that “dietary restraint” is counterproductive, atrophying the skill of eating without top-down rules, and often resulting in the opposite of what’s intended (eating lots once any eat-less rule has been broken).

I’ve suggested that the difference between applying rigid rules and “self-regulating” amounts to whether the feedback is meaningfully incorporated into the decision-making system: whether our actions adjust in response to other relevant stuff that’s happening in ourselves or our environments. In this penultimate part, I offer some pointers for how to tell whether you’re operating with meaningful feedback or not and how to start if you’re not.

In a way, the “self” prefix in self-regulation is a misnomer. There is no little homunculus me sitting in my skull, pulling the strings. “Me” includes innumerable inbuilt signaling mechanisms that evolved to guide human eating and movement, plus all kinds of evolutionarily newer factors like social conformity cues stretching far beyond the individual organism.

And, of course, there’s no hard line at the cellular level between these implicit “rules” and the explicit numerical ones we might also cognitively generate—it’s all just stuff arising from the activity of our neurons and all our other cells.

Someone with anorexia knows better than most people—someone in recovery from anorexia, all the more so—just how automatized the “top-down” rules can get, how seamlessly integrated into the self they can become. They come to pass themselves off ever-so-nearly convincingly as “what I really feel like,” e.g., I’m not hungry, I don’t even like ice cream, I feel better this way, ugh, bacon fat is so disgusting. 

Operationally, though, there is that key difference between the rules that work and those that don’t: the former incorporate feedback, the latter don’t. And if that structural difference is hard to spot (because we’re all experts at self-deception), there’s a simple difference you can glean from the outcomes.

If you’re in the ambiguous not-very-ill-but-probably-not-entirely-fine zone (aka quasi-recovery) and want to tell which method you’re operating by, the million-dollar question to ask is: Do I ever eat “too much” or exercise “too little?” More precisely: Do you ever get to the point where all the signals are straightforwardly saying “I don’t want to eat anymore” or “I really want to move just for the sake of it” because you’ve ignored a subset of the signals that were saying you ought to stop eating or start exercising much earlier on?

If the answer is yes and you feel fine when that happens, great, you probably don’t have a problem. If the answer is no, or yes, and you feel awful when it happens, you probably do.

In the dietary restraint experiment described in Part 2, this simplicity is presumably the point the high-restraint (“dieter”) participants got to at the end when they were genuinely full of ice cream. Or maybe they just stopped because their rule-breaking was freaking them out enough that it felt better to stop than carry on. Or maybe some of them actually got to the end of the tub and would have kept eating if they hadn’t.

If these people started making a consistent habit of eating “too much,” that would be a route for them to switch high dietary restraint for low. Contravening the signals that constituted the blanket priority of high restraint would allow them to start letting other measurements take up the slack. 

How do you actually make a habit of rule-breaking, though? When the rules are as pathologically powerful as anorexia’s, you need serious encouragement to transgress. There are plenty of encouragement types, but the simplest and best is often to change the explicit “do not transgress” threshold.

Do the thought experiment: If you have anorexia and you tell yourself, “OK, I now have no limits, I can eat as much ice cream as I like,” what happens? Possibly, you buy yourself a carton, pick up a spoon, and never look back. Probably, you do nothing.

Having no limit is meaningless because you have no idea how to operate without a limitation to butt up against, with hunger, desire, and the self-satisfied sense of being superior to all those people who eat when they’re hungry and stop when they’re not. Your number is how you know how to stop eating, and it is therefore what gives you the confidence to start.

Given this is how your eating operates—given you know exactly what to do with upper limits—it’s far more sensible to make your first step towards losing all the limits by just upping the limit. That, you can work with. 

However acutely or semi-recovered you’re using numerical limits, you can do worse than just increase your current ones by some non-negligible margin and see what happens. (Or the opposite with an exercise compulsion: gradually reduce the minimum per day or per session.)

What happens when you’re patient and determined, is that in the end, you’ll reach the point where you’ve raised the limit high enough that you can’t actually get there (or, with exercise, where it’s reduced to zero)—in other words, all the other ways of deciding when to stop (or start) have taken over.

In other words, you’ve booked yourself an all-inclusive vacation with limitless food and drink and no need to do anything much. All the other mechanisms that show you how to stop and start have been allowed to start doing their job again because the “300 calorie max.” or “30 minutes min.” (or whatever other) rules have been stopped from pre-empting all of them. 

An alternative or complementary strategy is to turn your maximum (for food) into a minimum or your minimum (for exercise) into a maximum. This gives you an additional explicit imperative to act differently and a different route to weakening the previous rule by ignoring it.

Finally, here’s another way of defining the difference between self-regulating with feedback or not: Do I have only one method for deciding when to start/stop eating (or exercising), or do I have many? The more methods you have, the less you’re probably aware of “having” any at all because they’re all kicking in as and when appropriate: hunger/satiety, the appeal of this specific food, social context, today and tomorrow’s activity levels, how much time you have, what happens to be in the fridge, etc. 

If you try out any of these structural encouragements to develop self-regulation, remember that you cannot set too high a numerical open-loop rule for yourself because all you need to do is stop operating by such rules.

You won’t get “unnecessarily” fat by upping your limit too high because “too high” is the structural prerequisite for the rule’s irrelevance—which is where you can really start living. 

Source: Abas Gemini via Wikimedia Commons, CC BY-SA 4.0

8: Beyond eating disorders

In this series, we’ve strayed quite a long way from the Playa del Carmen resort we started at, via milkshakes and open-loop versus closed-loop systems. In the penultimate part we circled right back to it: back to how raising numerical limits lets you rediscover what it’s like to self-regulate in a way that works and feels great. Here are the key takeaways from this series on “self-regulation”, or your body knowing what it’s doing:

  • Self-regulation can’t happen without feedback. The system has to be closed-loop, not open-loop.
  • Self-regulation can’t happen in the presence of a strong external regulator that overrides feedback (e.g., a rigid, exception-free rule) and makes the system open-loop.
  • Open-loop regulation in eating disorders is not only ineffective by all meaningful metrics (health, happiness, etc.), it also misses out on even the benefit of not needing to measure, because measurement is going on all the time, just not of anything useful, and not leading to meaningful adjustments.
  • An external open-loop regulator (a rigid rule), once habitual, can’t typically be removed just by declaring it no longer exists or applies.
  • Instead, we need to devise a process that makes the external regulator unable to operate. For instance, if its job is to impose a numerical limit (e.g., on calorie consumption), we up the limit so high that it becomes meaningless. Alternatively, if you’re so rule-bound that quantifiably increasing your freedom of movement results in no new movement, you can force the change by converting an upper limit into a lower one.
  • Once the limit is high or low enough that other regulators (recalibrated satiety, fatigue, or any of the other richly complex signals that constitute “(not) feeling like it”) can kick back in, the external one will be rendered superfluous—or rather, its historical superfluity will be exposed.

This is the core of the story this series tells about eating disorders. Then, there are some interesting wider speculations that these structural principles around dietary restraint and self-regulation could lead us to. They take us out into eating and exercise habits, weight control, and health and happiness beyond the clinical realm.

It’s easy to argue that the evolved systems for hunger/satiety and bodyweight regulation that used to serve humans well no longer do. The familiar argument is that because there’s now so much more readily available fat and sugar on offer and so little need for most people in post-industrial societies to do anything physical to survive, we need new ways of keeping ourselves regulated. The increasing prevalence of obesity (and metabolic syndrome more generally) is typically cited in support of this argument.

The argument that we need new regulation methods for energy intake/expenditure is the standard justification for introducing more and more open-loop regulators into the spheres of eating and exercise. More of these are imposed into our attentional spheres every year, via governmental and medical guidance on calorie intake and weekly minutes of exercise (such as the CDC’s recommended 150 moderate minutes per week or the NHS’s ridiculously arbitrary “5 a day”), supported by all the conspicuous numerical indicators intended to help people apply these rules: nutritional information and traffic lights on food packaging, calorie counts on menus, calories-burned estimates on treadmills and fitness trackers, etc. The demonstrable failure of all these initiatives to make any significant change of the type intended (see Piwek et al., 2016Jo et al., 2019) seems to lead only to yet louder calls for more of the same. 

On the logic proposed in this series, however, if external open-loop regulators are the problem, not the solution, one would expect that the more widely they’re promoted, the worse the situation will become. On a population level, their spread will increase the prevalence of poor bodyweight management thanks to actively encouraged over-reliance on open-loop regulators that (as the dietary restraint literature cited earlier in this series suggests) don’t work. Given that this appears to be what we’re seeing, despite few significant changes in food production or availability in post-industrial nations over the past decades, there seems to be some evidence in support of this counter-hypothesis. 

If there’s any truth in it, this shifts the causal burden for increasing the prevalence of obesity from modern changes in diet/exercise incentives to the misguided responses to these changes at the level of standard public health initiatives, as well as individual recourse to diets and tracking technologies. In this story, the rise of the extraneous regulators—a great surge of them, ignited by the popularization of fat-reduced diets from around the 1980s onwards, and catalyzed by the tech explosion on which all forms of (self-)quantification easily piggyback—is what has made and will continue to make people fatter in the long run (Jakicic et al., 2016), not what is valiantly keeping a lid on the “obesity epidemic.”

If this alternative story has any merit, even as a hypothetical, then what we need to do is switch the public health focus away from all the numerical distractions that prevent people from self-regulating effectively (see this New York Times piece for a recent overview), and towards encouragements to optimize closed-loop, self-regulation. This might involve training in fundamentals like interoceptive awareness, eating speed (Troscianko and Leon, 2020), power/skill-oriented movement, and many other easily unlearned instincts. Who knows, maybe treating ourselves, and being treated by our governments, a little more like competent adults might reveal that we were all along?

One final meta-point to wrap up: I love how intellectually generative the two weeks in the Mexican sun turned out to be for me. This series is just one of the things that came out of it, along with a post on reasons to dine out alone, plus lots of ideas for course design that I spent fun time scribbling about on my balcony or by the pool or ocean. These things happened precisely because there was no pressure on any of it (if I’d aimed to write two long blog posts and create outlines for a writing support program and a mind/body course, that would have been a great way to wreck the vacation), and because the everyday “shallow work” had been removed to make space for things that weren’t urgent but were meaningful. 

Deep work can happen when all the usual shallow demands are lifted and idleness is embraced, just as real eating and movement can happen when all the numbers are lifted. The good stuff takes energy, and the energy comes from fuel and from rest—of the kind you get only when you know your body well enough to give it what it needs.


References

Jakicic, J. M., Davis, K. K., Rogers, R. J., King, W. C., Marcus, M. D., Helsel, D., … & Belle, S. H. (2016). Effect of wearable technology combined with a lifestyle intervention on long-term weight loss: The IDEA randomized clinical trial. JAMA316(11), 1161-1171. Open-access full text here.

Jo, A., Coronel, B. D., Coakes, C. E., & Mainous III, A. G. (2019). Is there a benefit to patients using wearable devices such as Fitbit or health apps on mobiles? A systematic review. The American Journal of Medicine132(12), 1394-1400. Paywall-protected journal record here.

Piwek, L., Ellis, D. A., Andrews, S., & Joinson, A. (2016). The rise of consumer health wearables: Promises and barriers. PLoS Medicine13(2), e1001953. Open-access full text here.

Troscianko, E. T., & Leon, M. (2020). Treating eating: A dynamical systems model of eating disorders. Frontiers in Psychology11, 1801. Open-access full text here.

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