Awareness defies any direct definition: we cannot define awareness in the same way we define an object or measurable material element. Rather than saying what it is, its effects can be measured. You can recognize it, live it, be it. You can draw on it, like on a raw material, to forge something authentically ours. It could be said that awareness is the raw material of the human being, the substance it has in order to shape itself. But if we have to define it anyway, it can be said that awareness is the ability to be aware of what is perceived and of one’s behavioral responses. It is a cognitive process distinct from sensation and perception. Among all the tools that human being has to live, awareness is certainly one of the most important. So, can we use awareness to follow a diet, improve our eating lifestyle and lose weight? Who wants to lose weight is very often aware and knows that being overweight is an important risk factor for various diseases such as diabetes, metabolic diseases, stroke, etc. and frequently it says to itself: “From tomorrow I will go on a diet and go to the gym”, aware that in most cases being overweight is caused by incorrect lifestyles and food choices. Can all these aspects be modified to regain psycho-physical health? Answer: yes, they can. The first fundamental step is to contact a nutritionist recognizing that “do it yourself” diets can be ineffective, if not even harmful to health. However, these people, despite all the good intentions, the correct dietary indications and even the sporting efforts, did not reach their goal and found themselves once again abandoning diet and good intentions.
Why Can’t I Follow the Diet?
People who are unable to lose weight, despite wanting it, often ask themselves: “Why can’t I follow the diet?” and so, they experiment with different diets, change nutritionist, dietician and sport activity in the hope of finding a solution that is more suitable for them. There is who believes diet is wrong, who attributes the causes of failure to life rhythms and too many commitments that prevent it from following the prescribed diet, who thinks they are not helped enough by family, friends and partner. The justifications are the most diverse and at first glance they also seem to make some sense, but the real reasons of diet interruption must be sought elsewhere. The cause of these failures may not be the type of diet, the life rhythm, the absence of family help but may be the mental approach to food and diet and everything that revolves around it. Diets are abandoned primarily due to a sabotaging mental attitude that pushes to seek easy and external solutions that will always and only give partial results, if they are not supported by a real change in the way of psychologically approaching food. There is a fundamental element for a successful diet, in addition to a correct nutrition and healthy sport activity: our mind. Psychological support can be a “goad” for a stimulus to change. The nutritionist’s skills together with the psychologist can, in fact, help the person to change the failed mental approach in interfacing with food and nutrition. The psychologist can help the patient to increase its awareness but in addition to awareness, psychological tools are needed to achieve this goal. Several strategies are reported in the literature: let’s describe some of them.
Mindfulness technique such as “decentralization” (the ability to consider multiple aspects of a situation) can help modulate behavioral responsiveness to thought processes. These effects combined with a mental strategy of awareness and acceptance instilled through the mindfulness approach, reduce the likelihood of involvement in maladaptive food-related behaviors (such as acting on food cravings) in response to both environmental and emotional cues. For example, imagine that you have just come home from a long day at work, sitting on the sofa and watching TV. If we frequently eat chips in such a situation, this may trigger simulations of consumption, for example consisting of the taste of chips, grabbing them and the hedonic pleasure of eating them. This process can then induce all kinds of reactivity, such as eating thoughts and cravings to eat chips. Being immersed in these experiences and continuing to process them, such as the potentially good feeling of eating chips, further increases this reactivity, such that we may find ourselves wandering around the kitchen looking for a bag of chips. Conversely, when we adopt a decentralization perspective towards these experiences, we observe them as non-permanent mental events, making them less vivid and compelling. Therefore, any thoughts such as the taste and texture of food, the pleasure of eating and the gratifying feeling of satiety are observed as mere transient mental events. As a result, processing and immersion are not accelerated and simulations of consumption and reward become less convincing. In this way, decentralization can work to prevent cravings, avoid consumption of unhealthy and high-calorie foods, or eat at all hours. Recent research provides important evidence that decentralization reduces responsiveness through less immersion and processing, from food and eating behavior. This technique has also proved useful for quitting smoking.
Mindfulness is a process that cultivates the ability to bring attention to the present moment, awareness and acceptance of the present moment [1,2]. The constituent elements of mindfulness, which emerge from the definitions above (awareness and attention), highlight what is the purpose of mindfulness practice, and thus its ethical tension: the goal is to eliminate unnecessary suffering by cultivating an understanding and deep acceptance of whatever happens through active work on one’s mental states. According to the original tradition, mindfulness practice should allow to move from a state of imbalance and suffering to one of greater subjective perception of well-being due to a deep knowledge of mental states and processes. This technique allows you to recognize and tolerate your internal states without reacting immediately, thus reducing the need to shift your attention to food. At the same time, these practices can facilitate awareness of the thoughts and feelings that trigger emotional eating. This technique has proven very useful in women who gain a lot of weight during pregnancy [3-5].
Reinforcement or Associative Learning
We must remember that from an evolutionary point of view everything concerning food sources is adaptive: when, where and how to get them. To do this, we rely on one of the best characterized learning processes: reinforcement or associative learning (i.e. operant conditioning). This includes both positive and negative reinforcement: receiving a reward or removing a noxious stimulus, respectively, which increases the likelihood of repeating a behavior in the future. Behaviors learned through positive and negative reinforcements are reinforced by their consequences (rewards). Once our brain grasps the connection between a behavior and a reward, we create a powerful emotional memory that increases the likelihood of performing reward-producing behaviors in the future. Simply put, if we eat a highly palatable food, we feel good about it and establish a memory that helps us remember under what circumstances we ate it, where we got it, what we liked about it, and so on. This memory reminds us to perform the same behavior the next time we are in a similar situation (positive reinforcement). Similarly, if we eat something to reduce our sadness or anxiety, we can create a memory to eat certain foods in order to reduce particular affective states (negative reinforcement). Even restricted eating can be governed, in part or in full, by reinforcement or associative learning. The first step to change towards a healthy lifestyle is certainly to improve the approach to food consumption [6,7]. This approach passes through an important and decisive phase for our goal, the awareness of wanting to lose weight. A step that is not easy but requires courage and determination. All this is not enough, we need a goad, a psychological support which helps us, providing us with useful tools to achieve this goal I would also define a challenge with ourselves. Psychology provides us with various techniques, which will be evaluated by the professional depending on our personality, our experience and our ability to put them into practice.
- Petra Hanson, Emma Shuttlewood, Louise Halder, Neha Shah, F T Lam, et al. (2019) Application of Mindfulness in a Tier 3 Obesity Service Improves Eating Behavior and Facilitates Successful Weight Loss. J Clin Endocrinol Metab 104(3): 793–800.
- Mike Keesman, Henk Aarts, Michael Häfner, Esther K Papies (2017) Mindfulness Reduces Reactivity to Food Cues: Underlying Mechanisms and Applications in Daily Life. Curr Addict Rep 4(2): 151–157.
- Chen J, Papies EK, Barsalou LW (2016) A core eating network and its modulations underlie diverse eating phenomena. Brain Cogn 110: 20–42.
- Judson A Brewer, Andrea Ruf, Ariel L Beccia, Gloria I Essien, Leonard M Finn, et al. (2018) Can Mindfulness Address Maladaptive Eating Behaviors? Why Traditional Diet Plans Fail and How New Mechanistic Insights May Lead to Novel Interventions. Front Psychol 9: 1418.
- Petra Hanson, Emma Shuttlewood, Louise Halder, Neha Shah, F T Lam (2019) Application of Mindfulness in a Tier 3 Obesity Service Improves Eating Behavior and Facilitates Successful Weight Loss. J Clin Endocrinol Metab 104(3): 793–800.
- Westbrook C, Creswell JD, Tabibnia G, Julson E, Kober H, et al. (2013) Mindful attention reduces neural and self-reported cue-induced craving in smokers. Soc Cogn Affect Neurosci 8(1): 73–84.
- Cassandra Vieten, Barbara A Laraia, Jean Kristeller, Nancy Adler, Kimberly Coleman-Phox, et al. (2018) The mindful moms training: development of a mindfulness-based intervention to reduce stress and overeating during pregnancy. BMC Pregnancy Childbirth 18(1): 201.