The Eater's Digest

With their sharply delineated goal of changing how people act--and never mind why--the behaviorists have chalked up a number of successes with juvenile delinquency, sexual problems, chain-smoking and a variety of phobias. Now, at a handful of diet clinics, behavioral theories are being applied to overeating as well.

According to Henry Jordan and Leonard Levitz, co-founders of the University of Pennsylvania Hospital Diet Clinic, most popular diets are only temporarily effective in changing one's pattern of eating. The menu may turn out to be less important than how and where one eats. Outpatients at the Jordan-Levitz diet clinic can have peanut butter sandwiches or lemon meringue pie if they like, but for 20 weeks they must keep a food-intake chart, a sort of eater's digest of the circumstances of each meal or snack.

Patients are asked to record the length of time they spend eating, the time of eating, the place (the living room, kitchen or den), what else they are doing (talking, cooking, reading, watching TV), whom they are with and whether they are sitting, standing or lying down. The degree of hunger is also noted--none to mild, mild to extreme--and their mood: neutral, tense, fatigued or rushed. "By using the charts we help the patients identify what particular constellations of behavior lead to an increase in caloric intake," says Levitz. "Once those are isolated, we can suggest techniques for dealing with them." One technique is to make eating an event. "Even if a person is just eating a carrot, he should put it on a plate, cut it up and enjoy it."

Almost Hysterical. Until she began keeping charts for the Jordan-Levitz clinic, Esther Rich, a 29-year-old Philadelphia housewife, never realized that she ate a little something, usually candy, every two hours. As a remedy, Levitz suggested that she stretch the time between snacks little by little. "The first time I tried it I was almost hysterical," Rich confesses. "I was only able to wait 20 minutes. The second time I distracted myself by calling someone on the telephone." After-dinner snacking in the kitchen was a particular problem. Now Rich washes her dinner dishes in the morning. To make each meal last longer, she sets her fork down between bites, and sometimes even interrupts her meal to do the laundry.

Another housewife who found that she gobbled calories at home between 4 p.m. and 6 p.m. now leaves the house and does her errands in the late afternoon. A college student who used to eat Danish pastries on the way to school has changed her route to give wide berth to the bakery. She has also moved her desk out of the kitchen. According to Jordan and Levitz, eating habits are often determined by such environmental cues as the amount of food on a plate or a TV set in the kitchen rather than by internal triggers like hunger.

In the past 18 months the clinic's 56 patients have shed an average of 24 lbs. each. For their 20 hour-and-a-half sessions, at which they discuss their eating habits, patients pay a hefty fee of $500, no doubt part of the reason the clinic has had only five dropouts. Despite the dues (which go to the University of Pennsylvania Hospital for obesity research), Jordan and Levitz are booked solid until September and are now planning to train successful patients as lay consultants.

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