The Satter approach to eating

The Satter approach to eating

by Ellyn Satter

I created the Satter Eating Competence Model because I was determined to help without harming. After years of trying, failing, and trying again, I have discovered that eating is about the joy of life, and that the joy in eating is about wellness. 

The weight loss dream

As a young dietitian in my outpatient practice, I knew the data: 5% of people can lose weight and keep it off. But it would be different for me! I had my nifty diets and I could motivate and do follow-up. So I and my unfortunate patients struggled with weight: The man who lost 100 pounds and gained it right back; The many who stopped coming and blamed themselves for failing; The ones for whom I had nothing more to offer who became dependent on me for weight management; The two (2) who lost weight and kept it off. The last two were both virgin dieters who started out inactive and eating a lot. Clinicians in professional journals reported producing weight loss, why couldn’t I? I must have to do more, harder! I realized too late that the literature lies: by cherry picking results, presenting distorted statistics, giving short-term results.

The behavioral weight control fiasco

So I did more, harder, and it was a doozy. I trained with a then-leading expert in the then-popular behavioral weight method, and I was transformed. I was charismatic as for 20 weeks I inspired a group of dedicated and tolerant people who deserved far better than they got. Those lovely folks did everything I asked: recorded eating times, feelings, circumstances, counted calories, put their forks down between bites, ate only sitting down, in a certain place, with no associated activates, exercised vigorously and, of course, recorded and graphed it all. There was more, but memory  (mercifully) fails me. They lost weight in gobs.

Creating dietary cripples

Thank goodness for follow-up. One month – one month – after the end of the 20-week group, everyone came back heavier. My star couple. My man who was an obsessive dieter who lost weight for the first time in years. His helpful and supportive wife. Everyone. And they were so ashamed. I was young, I was shocked. I was speechless. I so wish I had said to them, “What have I done to you?” Following that debacle, I saw others who had become dietary cripples at my hands: the patients with diabetics, the folks with heart disease, those with ulcers and high blood pressure. But I drew the line at children, and that was part of my redemption. 

Learning to ask questions

In disarray, I went back to graduate school to become a psychotherapist, where I learned not to give answers but to ask the questions I should have asked all along: How do you see that you get fed? How do you feel about eating that way? How were you fed when you were a child? What would you like to be different? It was scary at first to stop telling people what and how much to eat and simply do a bit of tweaking. We all feared that they would go out of control. But they didn’t. Unlike the folks on diets, their eating developed order and reliability. Gradually, the components of eating competence became apparent to me: positive attitude, interest in food, ability to internally regulate, relaxed, confident, practical, and structured food management.

Testing the Satter Eating Competence Model

Without weight loss as an outcome indicator, I needed a test to measure eating-that-is-going-well. So I wrote it, tried it out with my patients, rewrote, and finally arrived at a test that worked great. Enter professor and researcher Barbara Lohse, who asked, “does this instrument stand up to testing?” She meant real, research-based testing. I don’t know, I said, but I am game to see. We designed and she coordinated the research trial for what she named the Satter Eating Competence Inventory (ecSI), and after five years we had our answers. Whew. The test works. People who score high on the test do better. Our original work with ecSatter and ecSI was published in a 2007 supplement to the Journal of Nutrition Education and Behavior.

This brings us to you

This last part of the story is about you. My colleagues and I have worked hard on this website. We hope you will use it to expose yourself to the discovering the joy of eating – and feeding –  following the Satter models. 

•  Poke around on the ESI website and see what you see. Read my books. Watch the videos. Get on our mailing list. 
• Join our Facebook pages for the public and for professionals. Ask questions. Share your experience. Learn and grow.
• Consider whether you want to learn how to help without harming. Get in touch with us and share your ideas for how you could help reach out to other parents and professionals.
• Send money. ESI does a lot on a slender shoestring. We could do more if we had the money. Your donation is so important in all ways – and it is tax-deductible.  

Click to read the story of the Satter approach to feeding