Scott: Yes!  This is right up my alley. The “Clean plate” club. All of our life we have been trained. As an 8-year-old, we are told that if you want dessert or want some candy (which is extra food and sugar) you have to finish your potatoes.  So, the kid says: “I’m full” And we say: “No you’re not!”  There is more room for more food.  And, if you eat it, your reward is sugar on the top.  And we train these kids to ignore that message (“I’m full”) –because we associated that message as an excuse for “I want to go play!”  So, we the parents (I have an 8-year-old son). I’m guilty of this daily. “No finish your macaroni and cheese. And if you finish your macaroni and cheese, you will get a cookie.  And we are training my son full time to not listen to that part of his body that says satiation has been reached. We don’t need to worry about my son being in a choleric death. He is going to be fine. There will be food for him tomorrow.  We still train these kids to store up –and the “clean plate club” or whatever it is, we are training them to eat more.

There are drinks at Starbucks and Dairy Queen that contain 1,600 calories.  So, you say you are getting a drink at 1,600 calories and you have been trained to finish all of your food even when you aren’t hungry anymore.  So, you crush down a dessert. We are absolutely conditioning these people to be what they are.

Bill B: So, you are saying that I have been getting that message about stopping all of my life, but I learned to ignore it as a child. I was thin, so my mother said that I needed to eat more.  So, in some sense, now in my 80s I am finally saying “Screw this”. I am going to listen to my body.  So, are we saying that you, as physicians, are in the role of educator. You should help to encourage people to listen to their bodies.

Scott: The number one thing I have done to help people lose weight (I am by no means an expert in this area and usually refer out for it). But with the people that I have worked with, one of the first things I ask is: when did you stop listening to your body?  And all of the people talk about learning to stop listening to their body at an early age.

Jeremy: One of the challenges—to go back to Bill G. start—is that the use of BMI further externalizes daily weight which fluctuates greatly. So, people begin to attach their sense of wellbeing to a daily number that goes up and down. So, their mood goes up and down.  The whole hyper focus on weight tends to be very discouraging to people. So, they eat more because they’re stressed. There is no focus on how they are feeling.  Do I feel “fit’.  Do I even know what that means to feel energized. Should I go for a walk. So, I think there is an over-emphasis on the numbers. It is a further contributor to that cycle.  One thing I will add is that there is a loss of elasticity as we age.  So, our stomach being a very elastic organ gets stiffer, just as is the case with our bladder—so we have to pee more often.  We feel full earlier because our stomach’s walls get tense. There is sort of a natural thinning that takes place in our 70s, as our metabolism slows down. However, in our 50s this slowing of metabolism means that we have to be careful about our weight and digestion of food – or we get a bigger mid-section.  Then our stomach shrinks so that hopefully we can make it into our 70s and 80s.  I don’t think we consider that to be “body wisdom”. Also, you are no longer eating primary for stress reasons. You’re eating because you are hungry.  You are not so time- conscious (“ I am going to work right now, so I need to stuff this down”) I think the retirement era is an opportunity for health and for some wisdom counselling.  This counselling would be helpful and I think people are missing out on this counselling.