A Taste of Eating Competence
by Keira Oseroff, MSW, LCSW & Jennifer Harris, RDN, LD, CEDRD
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 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…tomorrow never comes.”
In essence, this client wants desperately for something to change, but has no idea what that would look like. The only option this individual knows is to return to the cycle of deprivation followed by a loss of control, what 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, LCSW, BCD, a well-recognized authority on nutrition, eating and feeding, used to describe someone who has been on the dieting roller coaster, characterized by highs and lows of restraint and disinhibition. No longer able to sustain caloric restriction, or to trust her internal compass for hunger and fullness, her eating is chaotic and her weight 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.
While using the feminine pronoun, her, for the purposes of this article, it is important to note that men fall victim to this process, as well, though the underlying issues fueling it may be different. We typically see these images on women’s magazines, but they are creeping into the male market, too. Exposure is becoming universal.
Understanding how one arrives at Eating Competence, Satter’s term used to describe normal eating, 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 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. 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.
To get started in identifying your level of eating competence, use Satter’s assessment tool, ecSI 2.0. From there, you can use the 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. You can learn more about the Satter Eating Competence Model by visiting ellynsatterinstitute.org.
About the authors –
Keira Oseroff, MSW, LCSW
Keira Oseroff is a Licensed Clinical Social Worker and a member of the Ellyn Satter Institute Faculty. She received her Bachelor’s degree from The George Washington University and her Master’s degree in Social Work from the University of Georgia. Since 1999, Keira has worked in a variety of clinical settings including residential treatment and private practice. Working with individuals, couples, families and groups, she specializes in the treatment of those struggling with disordered eating (Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder), including childhood feeding issues and dual diagnosis. Since being introduced to the Satter Feeding Dynamics and Eating Competence Models in 2002, she has utilized them in the assessment and treatment of the individuals and families with whom she has worked. Keira serves on the Board of Directors of IAEDP (International Association of Eating Disorder Professionals) Atlanta Chapter, and is a Clinical Supervisor for the Atlanta staff at Hope Homes Recovery. She is passionate about the important distinction between treating people, not disorders, and guiding people of all ages toward a healthy relationship with food.
Jennifer Harris RDN LD CEDRD
Jennifer is a registered and licensed dietitian nutritionist. She is a member of the Ellyn Satter Institute Faculty. She has a varied work background which includes working at a WIC clinic, in an acute care hospital setting as a clinical dietitian, and as part of a student health service/wellness promotions clinic at an all-female college. For over 24 years Jennifer has worked at CentraCare Health in St. Cloud, MN and specializes in the treatment of eating disorders including: anorexia nervosa, bulimia nervosa, binge eating disorder and feeding and eating disorders not otherwise specified. She understands that in order to help those who struggle with disorders, treatment providers need to have a solid foundation in effective and functional eating and feeding. Her work in the area of eating disorders led her to the conclusion that the Satter eating competence and feeding dynamics models are protective for children when considering prevention and treatment modalities for childhood feeding and eating issues; including dysfunctional and disordered eating and weight divergence. Since her first exposure to the Satter feeding dynamics model in 1996, she has incorporated it into her practice to support patients and family members during treatment. Learn more at: http://ellynsatterinstitute.org/other/faculty.php#sthash.DybnTy5X.dpuf