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Search results for: 'child of mine'
Feeding with Love and Good Sense: 12 through 18 years PKG 25$137.50
Webinar by Ellyn Satter: Resolving the adult weight dilemma$35.00
ESI Affiliate Program Application$50.00
Starting Solid Foods: Spoon-feeding your 4 to 7 month old$10.00
Starting Solid Foods: Learning to eat at the family table, 8 to 11 month old$10.00
Starting Solid Foods: Becoming eating competent, your 12 month old$10.00
Trusting the Trust Model: Foundations for Feeding Well$25.00
Making Meals Happen: A Core Tool for Success with the Satter Models$25.00
Continuing Education Exam Retake Child of Mine$75.00
Continuing Education Exam Retake YCW Part I Primary Care Applications$75.00
Continuing Education Exam Retake YCW Part II Assessment & Treatment of Trevor$75.00
Webinar by Ellyn Satter: The Satter Eating Competence Model in context$35.00
That's too much ketchup!
We've had quite a few questions about how to navigate children serving themselves condiments such as ketchup, sugar, maple syrup and honey. Here are some of the questions and our answers:
My daughter (5yo) loves condiments like salad dressing and ketchup. She consumes way too much of them in order to eat carrots or hamburgers. We let her take some and some days, it is a reasonable amount and other days not. Should this be restricted?
We do family style meals and let her serve herself, but she often takes too much and leaves it and it is then wasted. Anything we can do here?
We are assuming that you are following the division of responsibility in feeding, where you do the what, when, and where of structured meals and snacks and let your daughter do the how much and whether of eating. Is the concern that she is eating too much salad dressing or ketchup? Then it is better leave her alone to determine how much condiment to use. Being a child, all food represents new learning, and she is using familiar condiments to allow the food to taste more familiar and enjoyable. Over time, the amount of condiments she eats will moderate. Or is the concern truly waste? Truly? We press this point because concern that a child is eating too much frequently gets disguised as concern about food waste. Keep in mind that with feeding kids, waste is inevitable. Consider serving the condiment in a way that makes it easier for your child to manage quantities, such as in a small squeeze bottle or dish with a spoon. Reassure her she can always go back for more.
Okay, what about this. Say, when having oatmeal or pancakes, should children be responsible for choosing how much sugar or syrup goes on top? Is it better to provide the serving container and let them choose, or should parents take the approach of dessert and serve them a limited portion with the meal for the child to use as they wish?
We encourage being brave and letting them put on as much sugar or other topping that they want. They are learning to enjoy the flavor of the cereal or pancakes by toning it down a bit with the topping. Over time, they are likely to eat less topping. Or not. Kids who have been exposed regularly enough to sweets to take the specialness out of them are relaxed about sweet toppings, as well. Being relaxed about sweets means they will eat fewer when their energy needs are low, more when their energy needs are high. We must confess, however, with expensive maple syrup we encourage them to put some in a small bowl so they can add it as needed.
The other day I let my toddler put as much chocolate sauce in his milk as he wanted. He put in a half inch and exclaimed it wasn't milk anymore, it was chocolate! Then he just wasn't able to finish it because it was so rich. The next day he wanted to do it again, but I said he could just have the regular chocolate milk that I usually make. No big fuss cuz I had prevented it from becoming a "forbidden food" the day before.
We love it! It so demonstrates children's amazing ability to figure things out for themselves.
My daughter will frequently request ketchup for her bread, then eat only ketchup sandwiches and ignore the rest of the meal. It seems like allowing ketchup every time there is bread is turning into an "alternate meal" for her, and her palate and food variety is shrinking. Perhaps it is over-concern on our part, perhaps it is something we should let run its course and see if she moves past it?
Kids, kids. To her it is just food. As your daughter eats her ketchup sandwiches, she is learning to eat unfamiliar foods by simply seeing you eat and enjoy them. Restricting ketchup would amount to pressure, which would decrease her food variety. We recommend your following your own hunch: Be matter-of-fact about it and let it run its course. Keep yourself in control of the menu by putting the ketchup on the table every meal, not having her ask for it and you having to decide yes or no.
Breastfeeding in the second year and beyond-2
Family Meals Focus
The Ellyn Satter Institute Newsletter
Breastfeeding in the second year and beyond
by Ellyn Satter, Dietitian and Family Therapist
Click here for a PDF of this newsletter
A dietitian writes: I am helping a mom address extended breastfeeding in the context of the division of responsibility in feeding (sDOR) for a toddler who is a picky eater. He fills up on breastmilk and then is not interested in family meals. I am not comfortable asking the parent to wean the child.
Satter writes: It isn't necessary to wean the child to address this issue. Instead, work toward offering any nipple-fed (or cup-fed) breastmilk or formula as a structured, sit-down snack. At mealtime, offer breastmilk or formula in a cup. Wait to introduce whole milk until the child eats two or three ounces of family food at a meal. The food dilutes the pasteurized milk and keeps it from forming a tough and indigestible curd in the child's stomach.
What is the basis for the recommendations?
Let us begin by digressing: The World Health Organization (WHO) and the American Academy of Pediatrics (AAP) are prominent in establishing breastfeeding policy.
- WHO and AAP: Breastfeed exclusively for the first 6 months.
- WHO and AAP: Introduce complementary (solid) foods at 6 months.
- WHO: Continue frequent, on-demand breastfeeding until 2 years of age or beyond.
- AAP: Continue breastfeeding beyond the first year as long as mutually desired.
Consider the child's step-by-step process of growing up to join in with family meals
Now to fill in the developmental blanks. From the perspective of growing up with eating, rather than going by the hard-and-fast "start solids at six months" rule, consider this: "Go by what you baby can do, not how old s/he is." Some babies are truly ready for solid food by 4 or 5 months: They are sitting up, opening up for the spoon, and swallowing. Others aren't ready until months later; Developmentally delayed children often aren't ready until sometime in the second year.
During early infancy (roughly the first six months), exclusive breastfeeding or formula feeding on demand fits the children's developmental needs and lets them accomplish homeostasis (becoming calm and organized) and attachment (falling in love with their parents). After that, they continue to master homeostasis and attachment and start to work on separation-individuation (discovering they are separate from others around them). To manage breastfeeding (or formula feeding by bottle) after introducing solid foods, the same principle applies:
From the perspective of growing up with eating, rather than going by age-related guidelines, consider this: "Go by what you baby can do, not how old s/he is."
Observe what your child does. He will develop the ability to control the position of food in his mouth and mash it with his jaw before swallowing, close his lips around the rim of a cup, and pick up food and put it in his mouth. You support his learning by offering increasingly thick and lumpy food and finally by letting him join in with family meals and finger-feed himself soft, easy-to-chew food. Nipple feeding varies accordingly: The child who loves semi-solid from the spoon will fill up and not be too interested. The child who doesn't want to be bothered with solids will continue to depend primarily on breast- or formula-feeding. The one who is somewhere in between takes some food by nipple, some solids.
Making the transition to family meals
At some point children who show all three patterns (and others too numerous to mention) develop the interest and hand/mouth skills to eat soft family food with their fingers. Making that transition is often abrupt and enthusiastic. Early separation individuation takes the form of their caring deeply about doing it themselves: They bat away the spoon and try to grab it and prefer food they can eat by themselves.
If all has gone well during this progression, routine has evolved. To be interested in mealtime food, your child has to arrive hungry but not starved. To help him with that, at first you are likely to stave off nipple feeding a little and adjust mealtime a little. You offer snacks every two or three hours partly on demand and partly on a schedule that you determine. At the almost-toddler stage, you continue to support the transition from demand feeding to structure by offering your child sit-down snacks roughly every two or three hours between meals. Once you have your routine, you are set to follow the path that is right for you and your child. You can continue the process of weaning by introducing sit-down snacks with finger food and beverages from the cup. Alternatively, you can make those sit-down snacks breastfeeding or formula from the bottle. Extended breastfeeding is different for each family, but a common breastfeeding routine is early morning, before nap, and before bed.
The take-home message
The moral of the story? There is no right or wrong way to do this. Pay attention to your child, and feed in the way that is right for him.
Feeding with Love and Good Sense: The First Two Years 2020 Gives a brief and clear road map in words and pictures for navigating your child's early months. Sections about child development and temperament and step-by-step guidance on how and what to feed help you understand your child and guide feeding based on information coming from them. Newly introduced sections give guidance to parents on managing family meals: family-friendly meals, being considerate without catering with food selection, and using "forbidden" food.
To see what good feeding looks like as well as to read about it, see Ellyn Satter's Feeding with Love and Good Sense DVD II. For the home use version, click here.
Birth to 3 months: Feeding your newborn
- 2 to 6 months: Feeding your infant
- 7 to 15 months: Feeding your almost-toddler
- 5 to 9 months: Feeding your older baby
- 11 to 36 months: Feeding your toddler
Is it okay to breastfeed on demand into the second year?
Some say yes: Breastfeeding any time and at any age is nature's way and therefore best. Others say no: When a child is between one and two years of age, we feed them on schedule, not on demand, and that includes breastfeeding.
This is a developmental issue
Ellyn Satter says to consider the issue from the child's point of view: "To me this is a developmental issue. The typically developing child approaching the end of the first year and into the second year is ready to experience the narcissistic resolution: To find out that s/he is no longer the center of the universe (where others drop everything and immediately address their needs), and joins the larger social group of the family (where they have to wait a bit for gratification).
"During early infancy (roughly the first six months), exclusive breastfeeding or formula feeding on demand fits the children's developmental needs and lets them accomplish homeostasis and attachment. As children move through the "older baby" then "almost-toddler" stages, moving toward structure is a better fit because it supports separation-individuation developmental stage. To know where s/he leaves off and others start, they need structure in all things, including feeding. To make the transition from the demand feeding of infancy to the meals-plus-snacks routine of family meals, they (and parents as well) experience a necessary loss: Giving up the intimate one-on-one relationship of nipple feeding in order to gain the reward of being part of the family."
Get started with sit-down snacks
Here is what it says on the ESI website, under How to feed/ages and stages/feeding your almost-toddler. During the older baby stage, in response to your child's increased regularity with feeding, you offered snacks partly on demand and partly on a schedule that you determined. At the almost-toddler stage, you continue to support the transition from demand feeding to structure by offering your child sit-down snacks roughly every two or three hours between meals. That lets him arrive at mealtime hungry (but not starved) and therefore able to behave nicely: He is interested in eating the food there. While he is likely to love drinking and eating on the go, he won't learn to eat the food you eat because his special food, delivered in his special way, is more to his liking. Offer any nipple-feedings (breastmilk or formula) as a structured, sit-down snack. Don't offer anything else between times except water. You are establishing the meals-plus-snacks routine of the division of responsibility for older children: Parents do the what, when and where of feeding, children do the how much and whether of eating.
Understand child development and feeding
Feeding with Love and Good Sense: The first two years addresses nutrition, child development, understanding and responding to child feeding behavior, and feeding relationships with respect to breast feeding, formula-feeding, beginning solid foods, and learning to eat grownup food.
Eve Reed APD and Ellyn Satter Institute Faculty Member
Feeding Children with ADHD
Parents whose children who are being treated with medication for ADHD have particular feeding challenges. The medication spoils children's appetites, children eat poorly, and parents worry that their child's growth will be stunted. Often, parents and their children with ADHD have fights when parents try to get children to eat more than they are hungry for. Those very fights spoil the feeding relationship, take away children's good feelings about eating, and undermine their ability to know how much they need to eat.
It could well be true that children with ADHD are more likely to be overweight, obese, and have an eating disorder. But it need not be so. The problem is the food fights, not the ADHD itself. The division of responsibility in feeding (sDOR) and being family friendly with feeding works for children with ADHD, the same as for every other child. Even more than other children, children with ADHD are helped to focus and attend to eating when parents faithfully do the what, when, and where of feeding, and scrupulously trust children to do the how much and whether of eating. Children can be trusted to make up for their food needs. In the evening, when the meds wear off, they are likely to be hungry and eat a lot. They do the same any time they are off the medication, even if it is weeks or months later.
Through your child's ups and downs with eating, stick with sDOR and don't panic. sDOR helps stabilize all children, and it particularly helps stabilize children who may have difficulty focusing. Your child's body remembers how much it needs. Given her generally poor appetite, she will benefit from reminders to consider eating, which is where the regularly scheduled meals and snacks come in. You might provide the meals, or you might remind her to provide them for herself when she is on her own. When you follow sDOR, even with all the ups and downs in eating, your child will likely eat what she needs and maintain steady growth – or correct back to her normal growth curve after the medical issue is addressed.
Making parents anxious
Just when you start to relax, now comes word that you have to be careful not to overfeed your baby! Always ready to pack for a guilt trip, having grownup children doesn't save us from second-guessing what we did back then! Not to worry! Relaxing and having good times with feeding your baby is the way to go. But let's lay the issue to rest.
Prescription vs Consideration
This message comes from the well-publicized (but ineffective) obesity prevention INSIGHT study, conducted by researchers at Pennsylvania State. The core intervention: Use food for hunger only and not for soothing, reward, or punishment. Go through a routine, says the study protocol, to make sure your baby really wants to eat: change the diaper first and then try other techniques, such as swaddle, change position, shush, etc. INSIGHT teaches that babies cry up to 3 1/2 hours per day. It also addresses feeding solid foods: increase vegetable intake, control portion size.
Knowing what your baby wants
Three-year-olds who were in the study had the same BMI as those who weren't. But what of parents who spent the three years worried that their child was eating too much? I doubt if researchers intended this, but it is, understandably, easy to worry parents. Consider the careful and reassuring way Ellyn Satter addresses the same issue in the Child of Mine breastfeeding and formula-feeding chapters (pg 167 and 216): "You might want to get in the habit of sorting out what he wants, rather than feeding him first thing. Part of the problem with fussy, irregular babies is that they haven't learned yet to maintain a quiet alert state. They work themselves up and benefit from some help getting calmed down and staying calm. Review the soothing techniques discussed on page 131 of chapter 4, and go through the routine with him. Keep in mind that you are not trying to stave him off and get him to eat less or less often. You are only going through a process of trial and error to figure out what he does want. If, however, you go through the routine and he seems to be hungry, go ahead and feed him. You are not trying to deprive him of food with these tactics; you are simply giving him a chance to settle down."
Self control vs autonomy
These days, it's common for researchers to conclude that "deficits" in children are what cause obesity. That is, there is something wrong with the child that leads to obesity. Self-control, generally defined as the ability to delay gratification, is a case in point. Self-control is also defined as the ability to control temper, respect others' property, accept the ideas of peers' and handle peer pressure.
According to some researchers, children who are low in self-control at the time they start school are said to be at risk for an unhealthy increase in BMI as they approach adolescence. These children who lack self-control eat fewer fruits and vegetables, drink more sugar sweetened beverages (SSB), and are less active. The logic behind these conclusions? That an unhealthy diet and activity behaviors provide more immediate gratification than healthy behaviors.
Giving children autonomy
In contrast, the Satter Feeding Dynamics Model emphasizes the importance of giving children autonomy in order for them to develop their "self-control" capabilities. These self-control capabilities are the ability to regulate food intake, grow predictably, and over time, learn to eat the variety of food to which they are regularly exposed in their every-day lives. Their parents give them autonomy, from birth, by following the division of responsibility in feeding and letting them determine how much they will eat from what parents offer. As they get older, parents give autonomy, by doing the what, when, and where of feeding, then letting children do the how much and whether of eating. This is positive self-control, growing out of inner capability and self-trust. This is in contrast to the usual definition of self-control, which is restraint and avoidance.
Developing trust
Toward the end of the first year, this positive self-control gradually becomes the ability to delay gratification. To gain the rewards of joining in with family meals and snacks, children have to wait to eat. After that brief wait, their needs are gratified: they get enough to eat of food they enjoy. As they grow up, they continue to behave autonomously: they eat "healthy" food and engage in "healthy" activity, not because someone else makes them or because they "should," but because they enjoy it. They become ho-hum about sugar sweetened beverages and other high-sugar, high-fat foods from regular neutral exposure and therefore don't consume them to excess. For example, children who are fed according to the division of responsibility learn that they will have the opportunity to eat treat foods every now and then and that they are offered at some meals together with other foods. They are then free to pick and choose from the treat and other foods as they wish. I have seen young children alternate between bites of a lamb cutlet in one hand and licks of an ice cream in the other. This is not self-control but knowing that their parents trust them to make those decisions, Read about feeding your child so that they grow to have the body they are meant to have: Your Child's Weight: Helping without Harming
Trust your child's appetite
Recently, I was doing an assessment in my clinical practice and reviewed a video of a family meal – Mum, Dad and their four-year-old daughter. The meal lasted 58 minutes! How could a four-year-old sit at the table for that long, I hear you ask. Well, she did a pretty good job of it. It was her mum who became frustrated, angry and sick of being there for so long.
Stress at mealtimes
The fact is that the child eats all she is hungry for in the first 10 minutes. However her parents don't trust her appetite and think she hasn't eaten 'enough'. The remainder of the meal is spent with the parents bribing, cajoling and pressuring her to eat. They use every trick in the book to get their daughter to eat more. These kind of meals are unpleasant for everyone, don't achieve what parents want and certainly don't help the child to become a competent eater. In fact, the child may end up eating less rather than more because of this. Stress can lead to anxiety around mealtimes. Anxiety is known to decrease appetite. A child may be anxious even before she gets to the table if mealtimes are often stressful.
How much is enough?
I am always intrigued when parents feel that their child hasn't eaten 'enough'. How can someone know how much is 'enough' for someone else? I certainly can't. Appetite varies from meal to meal and from day to day. If a child is growing well, then they are eating enough for their unique needs.
The trust model
We need to trust our children's appetite, knowing that when there is food available, children will eat enough. An infant who is breastfed knows how much milk to take without anyone else knowing the exact quantity they are taking. We feed when the baby is hungry and stop when they show us they have had enough. At every age, it is up to the child to decide how much to eat from the food that is offered. When we don't let the child do their job of deciding how much to eat, we are interfering with their natural hunger and satiety cues. We are giving them the message that we don't trust their appetite. Unfortunately, this lack of trust can result in children overeating or under eating and not having the body they were meant to have.
I am reminded of children's variable appetite when I take my three year-old granddaughter to have sushi for lunch. Each time she chooses the packet of baby tuna sushi. There are six pieces of sushi in the packet. Some days she eats all six pieces and some of mine as well. Other weeks she stops after three pieces and other times she may have less or more. I have no idea how much she is going to eat before the meal starts.
Letting your child eat according to his/her own individual appetite is one of the best things you can do for her/him to become a competent eater – a competent eater enjoys eating, comes to the table when called for mealtimes, learns to like the foods his/her parents like eating, and regulates the amount of food eaten based on hunger and satiety.
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- User Content
- User Content Generally. Certain features of the Service may permit users to upload content to the Service, including, reviews, text, and other types of works ("User Content") and to publish User Content on the Service. You retain any copyright and other proprietary rights that you may hold in the User Content that you post to the Service.
- Limited License Grant to Ellyn Satter Institute. By providing User Content to or via the Service, you grant Ellyn Satter Institute a worldwide, non-exclusive, royalty-free, fully paid right and license (with the right to sublicense) to host, store, transfer, display, perform, reproduce, modify for the purpose of formatting for display, and distribute your User Content, in whole or in part, in any media formats and through any media channels now known or hereafter developed.
- Limited License Grant to Other Users. By providing User Content to or via the Service, you grant other users of the Service a non-exclusive license to access and use that User Content as permitted by these Terms and the functionality of the Service.
- User Content Representations and Warranties. Ellyn Satter Institute disclaims any and all liability in connection with User Content. You are solely responsible for your User Content and the consequences of providing User Content via the Service. By providing User Content via the Service, you affirm, represent, and warrant that:
- you are the creator and owner of the User Content, or have the necessary licenses, rights, consents, and permissions to authorize Ellyn Satter Institute and users of the Service to use and distribute your User Content as necessary to exercise the licenses granted by you in this Section, in the manner contemplated by Ellyn Satter Institute, the Service, and these Terms;
- your User Content, and the use of your User Content as contemplated by these Terms, does not and will not: (a) infringe, violate, or misappropriate any third party right, including any copyright, trademark, patent, trade secret, moral right, privacy right, right of publicity, or any other intellectual property or proprietary right; (b) slander, defame, libel, or invade the right of privacy, publicity or other property rights of any other person; or (c) cause Ellyn Satter Institute to violate any law or regulation; and
- your User Content could not be deemed by a reasonable person to be objectionable, profane, indecent, pornographic, harassing, threatening, embarrassing, hateful, or otherwise inappropriate.
- User Content Disclaimer. We are under no obligation to edit or control User Content that you or other users post or publish, and will not be in any way responsible or liable for User Content. Ellyn Satter Institute may, however, at any time and without prior notice, screen, remove, edit, or block any User Content that in our sole judgment violates these Terms or is otherwise objectionable. You understand that when using the Service you may be exposed to User Content from a variety of sources and acknowledge that User Content may be inaccurate, offensive, indecent, or objectionable. You agree to waive, and do waive, any legal or equitable right or remedy you have or may have against Ellyn Satter Institute with respect to User Content. If notified by a user or content owner that User Content allegedly does not conform to these Terms, we may investigate the allegation and determine in our sole discretion whether to remove the User Content, which we reserve the right to do at any time and without notice. For clarity, Ellyn Satter Institute does not permit copyright-infringing activities on the Service.
- Monitoring Content. Ellyn Satter Institute does not control and does not have any obligation to monitor User Content or the use of the Service by its users. You acknowledge and agree that Ellyn Satter Institute reserves the right to, and may from time to time, monitor any and all information transmitted or received through the Service for operational and other purposes. If at any time Ellyn Satter Institute chooses to monitor the content, Ellyn Satter Institute still assumes no responsibility or liability for content or any loss or damage incurred as a result of the use of content. During monitoring, information may be examined, recorded, copied, and used in accordance with the Ellyn Satter Institute Website Privacy Policy.
- Digital Millennium Copyright Act
- DMCA Notification. We comply with the provisions of the Digital Millennium Copyright Act applicable to Internet service providers (17 U.S.C. §512, as amended). If you have an intellectual property rights-related complaint about material posted on the Service, you may contact our Designated Agent at the following address: Ellyn Satter Institute; ATTN: DMCA; 1510 W. Main Street, Suite 100, PO Box 220; Sun Prairie, Wisconsin 53590; Email: [email protected] Any notice alleging that materials hosted by or distributed through the Service infringe intellectual property rights must include the following information:
- an electronic or physical signature of the person authorized to act on behalf of the owner of the copyright or other right being infringed;
- a description of the copyrighted work or other intellectual property that you claim has been infringed;
- a description of the material that you claim is infringing and where it is located on the Service;
- your address, telephone number, and email address;
- a statement by you that you have a good faith belief that the use of the materials on the Service of which you are complaining is not authorized by the copyright owner, its agent, or the law; and
- a statement by you that the above information in your notice is accurate and that, under penalty of perjury, you are the copyright or intellectual property owner or authorized to act on the copyright or intellectual property owner's behalf.
- Repeat Infringers. Ellyn Satter Institute will promptly terminate the accounts of users that are determined by Ellyn Satter Institute to be repeat infringers.
- DMCA Notification. We comply with the provisions of the Digital Millennium Copyright Act applicable to Internet service providers (17 U.S.C. §512, as amended). If you have an intellectual property rights-related complaint about material posted on the Service, you may contact our Designated Agent at the following address: Ellyn Satter Institute; ATTN: DMCA; 1510 W. Main Street, Suite 100, PO Box 220; Sun Prairie, Wisconsin 53590; Email: [email protected] Any notice alleging that materials hosted by or distributed through the Service infringe intellectual property rights must include the following information:
- Prohibited Conduct. BY USING THE SERVICE YOU AGREE NOT TO:
- use the Service for any illegal purpose or in violation of any local, state, national, or international law;
- violate, or encourage others to violate, any right of a third party, including by infringing or misappropriating any third party intellectual property right;
- interfere with security-related features of the Service, including by: (i) disabling or circumventing features that prevent or limit use or copying of any content; or (ii) reverse engineering or otherwise attempting to discover the source code of any portion of the Service except to the extent that the activity is expressly permitted by applicable law;
- interfere with the operation of the Service or any user's enjoyment of the Service, including by: (i) modifying or altering the Service; (ii)uploading or otherwise disseminating any virus, adware, spyware, worm, or other malicious code; (iii) making any unsolicited offer or advertisement to another user of the Service; (iv) collecting personal information about another user or third party without consent; or (v) interfering with or disrupting any network, equipment, or server connected to or used to provide the Service;
- perform any fraudulent activity, including impersonating any person or entity, claiming a false affiliation, accessing any other Service account without permission, or falsifying your age or date of birth;
- sell or otherwise transfer the access granted under these Terms, any Materials (as defined in Section 7), or any right or ability to view, access, or use any Materials except as expressly set forth in these Terms; or
- attempt to do any of the acts described in this Section 9 or assist or permit any person in engaging in any of the acts described in this Section 9.
- Modification of these Terms. We reserve the right to change these Terms on a going-forward basis at any time. Please check these Terms periodically for changes. If a change to these Terms modifies your rights or obligations, you may be required to accept the modified Terms in order to continue to use the Service. Otherwise, modifications are effective upon publication. Your continued use of the Service after receiving notice, including via the Site, of modifications to these Terms constitutes acceptance of the modified Terms. Except as expressly permitted in this Section 12, these Terms may be amended only by a written agreement signed by authorized representatives of the parties to these Terms. Disputes arising under these Terms will be resolved in accordance with the version of these Terms that was in effect at the time the dispute arose.
- Term, Termination and Modification of the Service
- Term. These Terms are effective beginning when you accept the Terms or first access or use the Service, and ending when terminated as described below.
- Termination. If you violate any provision of these Terms, your authorization to access the Service and these Terms automatically terminate. In addition, Ellyn Satter Institute may, at its sole discretion, terminate these Terms or your account on the Service, or suspend or terminate your access to the Service, at any time for any reason or no reason, with or without notice. You may terminate your account and these Terms at any time by contacting customer service at [email protected]
- Effect of Termination. Upon termination of these Terms: (a) your access rights will terminate and you must immediately cease all use of the Service; (b) you will no longer be authorized to access your account or the Service; (c) you must pay Ellyn Satter Institute any unpaid amount that was due prior to termination; and (d) all payment obligations accrued prior to termination and Sections 4, 3, 14, 15, 16, 17 and 18 will survive.
- Modification of the Service. Ellyn Satter Institute reserves the right to modify or discontinue the Service at any time (including by limiting or discontinuing certain features of the Service), temporarily or permanently, without notice to you. Ellyn Satter Institute will have no liability for any change to the Service or any suspension or termination of your access to or use of the Service.
- Indemnity. You are responsible for your use of the Service, and you will defend and indemnify Ellyn Satter Institute and its officers, directors, employees, volunteers, consultants, affiliates, subsidiaries and agents (together, the "Ellyn Satter Institute Entities") from and against every claim brought by a third party, and any related liability, damage, loss, and expense, including reasonable attorneys' fees and costs, arising out of or connected with: (a) your use of, or misuse of, the Service; (b) your violation of any portion of these Terms, any representation, warranty, or agreement referenced in these Terms, or any applicable law or regulation; (c) your violation of any third party right, including any intellectual property right or publicity, confidentiality, other property, or privacy right; or (d) any dispute or issue between you and any third party. We reserve the right, at our own expense, to assume the exclusive defense and control of any matter otherwise subject to indemnification by you (without limiting your indemnification obligations with respect to that matter), and in that case, you agree to cooperate with our defense of those claims.
- Disclaimers; No Warranties
EXCEPT AS PROVIDED IN SECTION 17.4(iii) AND TO THE FULLEST EXTENT PERMITTED BY LAW, THE AGGREGATE LIABILITY OF THE ELLYN SATTER INSTITUTE ENTITIES TO YOU FOR ALL CLAIMS ARISING OUT OF OR RELATING TO THE USE OF OR ANY INABILITY TO USE ANY PORTION OF THE SERVICE OR OTHERWISE UNDER THESE TERMS, WHETHER IN CONTRACT, TORT, OR OTHERWISE, IS LIMITED TO THE GREATER OF: (A) THE AMOUNT YOU HAVE PAID TO ELLYN SATTER INSTITUTE FOR ACCESS TO AND USE OF THE SERVICE IN THE 12 MONTHS PRIOR TO THE EVENT OR CIRCUMSTANCE GIVING RISE TO CLAIM; OR (B) $100.
- Dispute Resolution and Arbitration
- Generally. In the interest of resolving disputes between you and Ellyn Satter Institute in the most expedient and cost effective manner, and except as described in Section 2, you and Ellyn Satter Institute agree that every dispute arising in connection with these Terms will be resolved by binding arbitration. Arbitration is less formal than a lawsuit in court. Arbitration uses a neutral arbitrator instead of a judge or jury, may allow for more limited discovery than in court, and can be subject to very limited review by courts. Arbitrators can award the same damages and relief that a court can award. This agreement to arbitrate disputes includes all claims arising out of or relating to any aspect of these Terms, whether based in contract, tort, statute, fraud, misrepresentation, or any other legal theory, and regardless of whether a claim arises during or after the termination of these Terms. YOU UNDERSTAND AND AGREE THAT, BY ENTERING INTO THESE TERMS, YOU AND ELLYN SATTER INSTITUTE ARE EACH WAIVING THE RIGHT TO A TRIAL BY JURY OR TO PARTICIPATE IN A CLASS ACTION.
- Exceptions. Despite the provisions of Section 1, nothing in these Terms will be deemed to waive, preclude, or otherwise limit the right of either party to: (a) bring an individual action in small claims court; (b) pursue an enforcement action through the applicable federal, state, or local agency if that action is available; (c) seek injunctive relief in a court of law in aid of arbitration; or (d) to file suit in a court of law to address an intellectual property infringement claim.
- Arbitrator. Any arbitration between you and Ellyn Satter Institute will be settled under the Federal Arbitration Act and administered by the American Arbitration Association ("AAA") under its Consumer Arbitration Rules (collectively, "AAA Rules") as modified by these Terms. The AAA Rules and filing forms are available online at adr.org, by calling the AAA at 1-800-778-7879, or by contacting Ellyn Satter Institute. The arbitrator has exclusive authority to resolve any dispute relating to the interpretation, applicability, or enforceability of this binding arbitration agreement.
- Notice of Arbitration; Process. A party who intends to seek arbitration must first send a written notice of the dispute to the other party by certified U.S. Mail or by Federal Express (signature required) or, only if that other party has not provided a current physical address, then by electronic mail ("Notice of Arbitration"). Ellyn Satter Institute's address for Notice of Arbitration is: Ellyn Satter Institute, 1510 W. Main Street, Suite 100, PO Box 220, Sun Prairie, Wisconsin, 53590. The Notice of Arbitration must: (a) describe the nature and basis of the claim or dispute; and (b) set forth the specific relief sought ("Demand"). The parties will make good faith efforts to resolve the claim directly, but if the parties do not reach an agreement to do so within 30 days after the Notice of Arbitration is received, you or Ellyn Satter Institute may commence an arbitration proceeding. During the arbitration, the amount of any settlement offer made by you or Ellyn Satter Institute must not be disclosed to the arbitrator until after the arbitrator makes a final decision and award, if any. If the dispute is finally resolved through arbitration in your favor, Ellyn Satter Institute will pay you the highest of the following: (i) the amount awarded by the arbitrator, if any; (ii) the last written settlement amount offered by Ellyn Satter Institute in settlement of the dispute prior to the arbitrator's award; or (iii) $10,000.
- Fees. If you commence arbitration in accordance with these Terms, Ellyn Satter Institute will reimburse you for your payment of the filing fee, unless your claim is for more than $10,000, in which case the payment of any fees will be decided by the AAA Rules. Any arbitration hearing will take place at a location to be agreed upon in Dane County, Wisconsin, but if the claim is for $10,000 or less, you may choose whether the arbitration will be conducted: (a) solely on the basis of documents submitted to the arbitrator; (b) through a non-appearance based telephone hearing; or (c) by an in-person hearing as established by the AAA Rules in the county (or parish) of your billing address. If the arbitrator finds that either the substance of your claim or the relief sought in the Demand is frivolous or brought for an improper purpose (as measured by the standards set forth in Federal Rule of Civil Procedure 11(b)), then the payment of all fees will be governed by the AAA Rules. In that case, you agree to reimburse Ellyn Satter Institute for all monies previously disbursed by it that are otherwise your obligation to pay under the AAA Rules. Regardless of the manner in which the arbitration is conducted, the arbitrator must issue a reasoned written decision sufficient to explain the essential findings and conclusions on which the decision and award, if any, are based. The arbitrator may make rulings and resolve disputes as to the payment and reimbursement of fees or expenses at any time during the proceeding and upon request from either party made within 14 days of the arbitrator's ruling on the merits.
- No Class Actions. YOU AND ELLYN SATTER INSTITUTE AGREE THAT EACH MAY BRING CLAIMS AGAINST THE OTHER ONLY IN YOUR OR ITS INDIVIDUAL CAPACITY AND NOT AS A PLAINTIFF OR CLASS MEMBER IN ANY PURPORTED CLASS OR REPRESENTATIVE PROCEEDING. Further, unless both you and Ellyn Satter Institute agree otherwise, the arbitrator may not consolidate more than one person's claims, and may not otherwise preside over any form of a representative or class proceeding.
- Modifications to this Arbitration Provision. If Ellyn Satter Institute makes any future change to this arbitration provision, other than a change to Ellyn Satter Institute's address for Notice of Arbitration, you may reject the change by sending us written notice within 30 days of the change to Ellyn Satter Institute's address for Notice of Arbitration, in which case your account with Ellyn Satter Institute will be immediately terminated and this arbitration provision, as in effect immediately prior to the changes you rejected will survive.
- Enforceability. If Section 6 is found to be unenforceable or if the entirety of this Section 17 is found to be unenforceable, then the entirety of this Section 17 will be null and void and, in that case, the parties agree that the exclusive jurisdiction and venue described in Section 18.1 will govern any action arising out of or related to these Terms.
- General Terms. These Terms, together with the Ellyn Satter Institute Website Privacy Policy and any other agreements expressly incorporated by reference into these Terms, are the entire and exclusive understanding and agreement between you and Ellyn Satter Institute regarding your use of the Service. You may not assign or transfer these Terms or your rights under these Terms, in whole or in part, by operation of law or otherwise, without our prior written consent. We may assign these Terms at any time without notice or consent. The failure to require performance of any provision will not affect our right to require performance at any other time after that, nor will a waiver by us of any breach or default of these Terms, or any provision of these Terms, be a waiver of any subsequent breach or default or a waiver of the provision itself. Use of section headers in these Terms is for convenience only and will not have any impact on the interpretation of any provision. Throughout these Terms the use of the word "including" means "including but not limited to". If any part of these Terms is held to be invalid or unenforceable, the unenforceable part will be given effect to the greatest extent possible, and the remaining parts will remain in full force and effect.
- Governing Law. These Terms are governed by the laws of the State of Wisconsin without regard to conflict of law principles. You and Ellyn Satter Institute submit to the personal and exclusive jurisdiction of the state courts and federal courts located within Dane County, Wisconsin for resolution of any lawsuit or court proceeding permitted under these Terms. We operate the Service from our offices in Wisconsin, and we make no representation that Materials included in the Service are appropriate or available for use in other locations.
- Privacy Policy. Please read the Ellyn Satter Institute Website Privacy Policy below carefully for information relating to our collection, use, storage, disclosure of the personal information you provide while accessing and using the Service. The Ellyn Satter Institute Website Privacy Policy is incorporated by this reference into, and made a part of, these Terms.
- Additional Terms. Your use of the Service is subject to all additional terms, policies, rules, or guidelines applicable to the Service or certain features of the Service that we may post on or link to from the Service (the "Additional Terms"). All Additional Terms are incorporated by this reference into, and made a part of, these Terms.
- Consent to Electronic Communications. By using the Service, you consent to receiving certain electronic communications from us as further described in the Ellyn Satter Institute Website Privacy Policy. Please read the Ellyn Satter Institute Website Privacy Policy to learn more about our electronic communications practices. You agree that any notices, agreements, disclosures, or other communications that we send to you electronically will satisfy any legal communication requirements, including that those communications be in writing.
- Contact Information. The Service is offered by Ellyn Satter Institute, located at 1510 W. Main Street, Suite 100, PO Box 220, Sun Prairie, Wisconsin 53590. You may contact us by sending correspondence to that address or by emailing us at [email protected].
- Notice to California Residents. If you are a California resident, under California Civil Code Section 1789.3, you may contact the Complaint Assistance Unit of the Division of Consumer Services of the California Department of Consumer Affairs in writing at 1625 N. Market Blvd., Suite S-202, Sacramento, California 95834, or by telephone at (800) 952-5210 in order to resolve a complaint regarding the Service or to receive further information regarding use of the Service.
- No Support. We are under no obligation to provide support for the Service. In instances where we may offer support, the support will be subject to published policies.
- International Use. The Service is intended for visitors located within the United States. We make no representation that the Service is appropriate or available for use outside of the United States. Access to the Service from countries or territories or by individuals where such access is illegal is prohibited.
Ellyn Satter Institute Privacy Policy
Effective 9/14/2017
This Privacy Policy ("Policy") describes the manner in which Ellyn Satter Institute ("Ellyn Satter Institute", "we," "us," or "our") and our website at www.ellynsatterinstitute.org (the "Site"), as well as all related websites, networks, applications, and other services provided by us and on which a link to this Policy is displayed (collectively, together with the Site, our "Service") use and collect data from individuals. This Policy, which is incorporated into and is subject to the Ellyn Satter Institute Terms of Service, describes the information that we gather from you on the Service, how we use and disclose such information, and the steps we take to protect such information.
Any information provided by you or collected by us, in connection with our provision of any coaching or mentoring services to you, will be governed by a separate privacy policy that you will be required to agree to prior to receiving such services.
Information We Collect on the Service:
- User-provided Information. When you use the Service, we may collect information about you, including your name, email address, mailing address, mobile phone number, your date of birth, geographic area, or preferences and we may link this information with other information about you. You may provide us with information in various ways on the Service. For example, you provide us with information when you register for an account, use the Service, make a purchase on the Service, or send us customer service-related requests.
- Cookies and Automatically Collected Information. When you use the Service, we may send one or more cookies – small text files containing a string of alphanumeric characters – to your device. We may use both session cookies and persistent cookies. A session cookie disappears after you close your browser. A persistent cookie remains after you close your browser and may be used by your browser on subsequent visits to the Service. Please review your web browser "Help" file to learn the proper way to modify your cookie settings. Please note that if you delete, or choose not to accept cookies from the Service, you may not be able to utilize the features of the Service to their fullest potential. We may use third party cookies on our Service as well. For instance, we use Google Analytics to collect and process certain analytics data. Google provides some additional privacy options described at google.com/policies/privacy/partners/ regarding Google Analytics cookies. Ellyn Satter Institute does not process or respond to web browsers' "do not track" signals or other similar transmissions that indicate a request to disable online tracking of users who visit our Site or who use our Service.
We may also automatically record certain information from your device by using various types of technology, including "clear gifs" or "web beacons." This automatically collected information may include your IP address or other device address or ID, web browser and/or device type, the web pages or sites that you visit just before or just after you use the Service, the pages or other content you view or otherwise interact with on the Service, and the dates and times that you visit, access, or use the Service. We also may use these technologies to collect information regarding your interaction with email messages, such as whether you opened, clicked on, or forwarded a message. This information is gathered from all users, and may be connected with other information about you.
- Location Information. We may obtain information about your physical location, such as by use of GPS and other geolocation features in your device, or by inference from other information we collect (for example, your IP address indicates the general geographic region from which you are connecting to the Internet).
- Third Party Web Beacons and Third Party Buttons. We may display third-party content on the Service, including third-party advertising. Third-party content may use cookies, web beacons, or other mechanisms for obtaining data in connection with your viewing of the third party content on the Service. Additionally, we may implement third party buttons (such as Facebook "like" or "share" buttons) that may function as web beacons even when you do not interact with the button. Information collected through third-party web beacons and buttons is collected directly by these third parties, not by Ellyn Satter Institute. Information collected by a third party in this manner is subject to that third party's own data collection, use, and disclosure policies.
- Information from Other Sources. We may obtain information from third parties and sources other than the Service, such as our partners and advertisers.
How We Use the Information We Collect
We use information we collect on the Service in a variety of ways in providing the Service and operating our business, including the following:
- We use the information that we collect on the Service to operate, maintain, enhance and provide all features of the Service, to provide services and information that you request, to respond to comments and questions and otherwise to provide support to users, and to process and deliver entries and rewards in connection with promotions that may be offered from time to time on the Service.
- We use the information that we collect on the Service to understand and analyze the usage trends and preferences of our users, to improve the Service, and to develop new products, services, features, and functionality.
- We may use your email address or other information we collect to contact you for administrative purposes such as customer service or to send communications, including updates on promotions and events, relating to products and services offered by us and by third parties.
- We may use cookies and automatically collected information to: (i) personalize our Service, such as remembering information about you so that you will not have to re-enter it during your visit or the next time you visit the Service; (ii) provide customized advertisements, content, and information; (iii) monitor and analyze the effectiveness of the Service and third-party marketing activities; (iv) monitor aggregate site usage metrics such as total number of visitors and pages viewed; and (v) track your entries, submissions, and status in any promotions or other activities on the Service.
When We Disclose Information
Except as described in this Policy, we will not disclose information about you that we collect on the Service to third parties without your consent. We may disclose information to third parties if you consent to us doing so, as well as in the following circumstances:
- Any information that you voluntarily choose to include in a publicly accessible area of the Service will be available to anyone who has access to that content, including other users.
- We work with third party service providers to provide website, application development, hosting, maintenance, payment processing and other services for us, including PayPal and Authorize.Net. These third parties may have access to or process information about you as part of providing those services for us. Generally, we limit the information provided to these service providers to that which is reasonably necessary for them to perform their functions, and we require them to agree to maintain the confidentiality of such information.
- We may disclose information about you if required to do so by law or in the good-faith belief that such action is necessary to comply with state and federal laws, in response to a court order, judicial or other government subpoena or warrant, or to otherwise cooperate with law enforcement or other governmental agencies.
- We also reserve the right to disclose information about you that we believe, in good faith, is appropriate or necessary to: (i) take precautions against liability; (ii) protect ourselves or others from fraudulent, abusive, or unlawful uses or activity; (iii) investigate and defend ourselves against any third-party claims or allegations; (iv) protect the security or integrity of the Service and any facilities or equipment used to make the Service available; or (v) protect our property or other legal rights (including, but not limited to, enforcement of our agreements), or the rights, property, or safety of others.
- Information about our users may be disclosed and otherwise transferred to an acquirer, successor, or assignee as part of any merger, acquisition, debt financing, sale of assets, or similar transaction, or in the event of an insolvency, bankruptcy, or receivership in which information is transferred to one or more third parties as one of our business assets.
- We may make certain aggregated, automatically-collected, or otherwise non-personal information available to third parties for various purposes, including: (i) compliance with various reporting obligations; (ii) for business or marketing purposes; or (iii) to assist such parties in understanding our users' interests, habits, and usage patterns for certain programs, content, services, advertisements, promotions, and/or functionality available through the Service
Your Choices
- You may, of course, decline to share certain information with us, in which case we may not be able to provide to you some of the features and functionality of the Service. You may update, correct, or delete your account information and preferences at any time by accessing your account preferences page on the Service. If you wish to access or amend any other personal information we hold about you, you may contact us at [email protected] Please note that while any changes you make will be reflected in active user databases within a reasonable period of time, we may retain all information you submit for backups, archiving, prevention of fraud and abuse, analytics, satisfaction of legal obligations, or where we otherwise reasonably believe that we have a legitimate reason to do so.
- If you receive commercial email from us, you may unsubscribe at any time by following the instructions contained within the email. We may allow you to view and modify settings relating to the nature and frequency of promotional communications that you receive from us in user account functionality on the Service.
- Please be aware that if you opt out of receiving commercial email from us or otherwise modify the nature or frequency of promotional communications you receive from us, it may take up to ten business days for us to process your request, and you may continue receiving promotional communications from us during that period. Additionally, even after you opt out from receiving commercial messages from us, you will continue to receive administrative messages from us regarding the Service.
Third-Party Services
The Service may contain features or links to websites and services provided by third parties. Any information you provide on third-party sites or services is provided directly to the operators of such services and is subject to those operators' policies, if any, governing privacy and security, even if accessed through the Service. We are not responsible for the content or privacy and security practices and policies of third-party sites or services to which links or access are provided through the Service. We encourage you to learn about third parties' privacy and security policies before providing them with information.
If you make payments through the Service, we will ask you to provide your payment information, such as your credit card number, so our service providers can process your payments.
Children's Privacy
Protecting the privacy of young children is especially important. Our Site is a general audience site not directed to children under the age of 13, and we do not knowingly collect personal information from children under the age of 13 without obtaining parental consent.
Data Security
We use certain physical, managerial, and technical safeguards that are designed to improve the integrity and security of information that we collect and maintain. Please be aware that no security measures are perfect or impenetrable. We cannot and do not guarantee that information about you will not be accessed, viewed, disclosed, altered, or destroyed by breach of any of our physical, technical, or managerial safeguards.
International Visitors
The Service is hosted in the United States and is intended for visitors located within the United States. If you choose to use the Service from the European Union or other regions of the world with laws governing data collection and use that may differ from U.S. law, then please note that you are transferring your personal information outside of those regions to the United States for storage and processing. Also, we may transfer your data from the U.S. to other countries or regions in connection with storage and processing of data, fulfilling your requests, and operating the Service. By providing any information, including personal information, on or to the Service, you consent to such transfer, storage, and processing.
Changes and Updates to this Policy
Please revisit this page periodically to stay aware of any changes to this Policy, which we may update from time to time. If we modify this Policy, we will make it available through the Service, and indicate the date of the latest revision. In the event that the modifications materially alter your rights or obligations hereunder, we will make reasonable efforts to notify you of the change. For example, we may send a message to your email address, if we have one on file, or generate a pop-up or similar notification when you access the Service for the first time after such material changes are made. Your continued use of the Service after the revised Policy has become effective indicates that you have read, understood and agreed to the current version of this Policy.
Your California Privacy Rights
Residents of California have the right to request a disclosure describing what types of personal information we have shared with third parties for their direct marketing purposes and with whom we have shared it, during the preceding calendar year. You may request a copy of that disclosure by contacting us at [email protected]
How to Contact Us
Please contact us with any questions or comments about this Policy, information we have collected or otherwise obtained about you, our use and disclosure practices, or your consent choices by email at [email protected]
Mailing Address
Ellyn Satter Institute
1510 W. Main Street, Suite 100, PO Box 220
Sun Prairie, Wisconsin 53590
Self-StudyPracticing with the Satter Feeding Dynamics model (fdSatter) and Satter Eating Competence model (ecSatter) will amaze you and give you joy! You don't have to advocate avoidance and restriction and tell others what to eat, how much to eat, and what to weigh. Instead, you can trust others to act on their own behalf and join with them in finding ways to eat and feed wisely and well.
Professional workshop: Feeding with Love and Good Sense VISION WorkshopDescription: Feeding with Love and Good Sense VISION Workshop This in-depth workshop shows health professionals how to do secondary intervention with feeding. The over 700 dietitians, nurses, doctors, OTs, SLPs, and mental health professionals who have taken this workshop give it the highest markets for praticality and empowerment. Satter's division of responsibility in feeding is the gold standard of feeding. This workshop shows professionals how to accurately apply sDOR in correcting distortions in parenting around feeding. February 6, 7, 8, 2017, Madison, WI USA
Project consulting
Family Meals Focus ~ Special edition prairie
Family Meals Focus
The Ellyn Satter Institute Newsletter
Prairie as a life metaphor
by Ellyn Satter, Registered Dietitian and Family Therapist
This month, we have a change of pace in honor of August - vacation month, last gasp before the push back to school. This issue of Family Meals Focus is for and about young mothers who are finding their way with home and career. Many of today's young fathers identify with this story, as well, and you have my blessings. We are all in this together.
Weaving together all the threads
One of my friends, now in her 40s, recently got a job that allows her to weave together the threads of everything she has ever done. After getting her education and working a while, she took time out to raise her family. I have seen many other women and a few men do this, and I did it too. I consider it a great privilege, and I wouldn't trade it for anything. At the same time, it was hard. I still don't fully understand why staying home with children is so hard. I have seen others experience the same ennui that I did, and beyond offering my encouragement, I haven't been able to explain what those feelings are all about. I suspect that it has something to do with lack of creativity. It seems so irreverent to say that being with children 24/7 is not creative, but there it is!
During those stay-at-home years, to challenge myself, I worked part-part time, did volunteer work, read and thought, taught and took the occasional workshop and University course, and puttered away at writing Child of Mine. When I was 41 years old, my youngest child was 11 years old, I was published, I got my master's degree in clinical social work, and I hung out my shingle as a family therapist specializing in eating and feeding. At that point, I discovered that those child-raising years had been tremendously productive for me. To tell you why, let me share a metaphor that grows out of my native gardening hobby.
It's all about trust in yourself and your life circumstances.
We remember the pre-settlement prairie
I love the prairie, and here in Wisconsin we enthusiastically preserve prairie remnants and restore native prairie. In pre-settlement times, grasses and flowers dominated the plains from the Appalachians to the Rockies. Prairies grew "as tall as a man on horseback" and were broken only by the occasional small grove of huge old oak trees. Periodically, fires swept the prairies and reduced them to ash. The fires were started by lightening or by Indians who had observed that grazing animals preferred the tender grass that grew back through the ashes. The old oaks survived the fires because they had very thick bark. In contrast, the young oaks that sprouted from the acorns were burned to the ground.
When the settlers came, they plowed the prairies to plant their crops, and that stopped the fires. And the young oaks grew like weeds. The settlers got the impression that the oak was a very fast-growing tree, when in reality, it grows very slowly. But those young oaks had root systems which were decades - centuries - millennia old. When the fires stopped, they got their chance, and grew and grew.
You are developing your roots
You are like the young oaks. Over the years, as you raise your family and live your life, you develop your root systems - your skills and resources. When the time is right, you too will grow rapidly. I was born in 1942, and I think I got a lot accomplished in the last 35 years. The same can hold true for you. Trust yourself, trust life to give you opportunities to grow, do it at your own pace, and know that you will find the path that is right for you. What does this have to do with eating competence and feeding dynamics? It's all about trust - trust in yourself and your life circumstances.
Family Meals Focus ~ No. 11 update
Eating management as a part of medical nutrition therapy for children with cystic fibrosis
Eating management to prevent and treat child overweight
Eating management as a part of medical nutrition therapy for adults with diabetes and impaired glucose tolerance
The Satter Feeding Dynamics Model
Children eat and grow well when parents feed according to a developmentally appropriate Satter Division of Responsibility in feeding (sDOR).1-3 The Satter Feeding Dynamics Model (fdSatter) illustrates that when parents follow sDOR, children grow up to become eating competent:4 They are sensible and joyful eaters. sDOR encourages parents to take leadership with the what, when, and where of feeding and let children determine how much and whether they will eat of what adults provide.1
What can eating competent children do?
- Feel good about eating and have the drive to eat.5
- Naturally eat the amount they need6-10 and grow in the way that is right for them.11-15
- Follow a predictable trajectory of development that guides feeding practice.16-18
- Apply their drive to grow up to learning to eat the food their parents eat.5,19-22
- Enjoy family meals and learn to behave well at mealtime.
Agencies recognize the division of responsibility in feeding as best practice
- The Academy of Nutrition and Dietetics.23-25
- The American Academy of Pediatrics.26,27
- Expert Committee on Child Obesity.28
- Head Start.29
- WIC: The Special Supplemental Nutrition Program for Women, Infants, and Children.30
- USDA Food and Nutrition Service.31
sDOR can soon be directly tested by sDOR.2-6yTM
An instrument for directly testing sDOR, the Satter Feeding Dynamics Inventory, sDOR.2-6yTM, has been developed based on cognitive interviewing.32 It has also been validated using videotaped parent-child interactions around feeding as well as comparison with other tools and nutritiional analysis. The validation work will soon be published. After that, it will be made available for use in research and clinical practice.
- Satter EM. The feeding relationship. J Am Diet Assoc. 1986;86:352-356.
- Satter EM. The feeding relationship: problems and interventions. The Journal of pediatrics. 1990;117:S181-S189.
- Satter EM. Feeding dynamics: Helping children to eat well. J Pediatr Health Car. 1995;9:178-184.
- Satter EM. Eating Competence: definition and evidence for the Satter Eating Competence Model. J Nutr Educ Behav. 2007;39:S142-S153.
- Davis CM. Self selection of diet by newly weaned infants: an experimental study. Am J Dis Child. 1928;36:651-679.
- Gesell SB. Feeding Behavior of Infants. Philadelphia: J.B. Lippincott; 1937.
- Fomon SJ, Thomas LN, Filer LJ, Ziegler EE, Leonard MT. Food consumption and growth of normal infants fed milk-based formulas. Acta Pædiatrica. 1971;60:1-36.
- Fomon SJ, Filer LJ, Jr., Thomas LN, Anderson TA, Nelson SE. Influence of formula concentration on caloric intake and growth of normal infants. Acta Paediatr Scand. 1975;64(2):172-181.
- NRC. National Research Council Recommended Dietary Allowances, 10th ed. Washington, DC: National Academy Press; 1989.
- Fomon SJ. Recommendations for feeding normal infants. In: Fomon SJ, ed. Nutrition of Normal Infants. St. Louis, MO: Mosby-Year Book, Inc.; 1993:455-458.
- Garn SM, Clark DC. Trends in fatness and the origins of obesity. Pediatrics. 1976;57:443-456.
- Hamill PV, Drizd TA, Johnson CL, Reed RB, Roche AF, Moore WM. Physical growth: National Center for Health Statistics percentiles. Am J Clin Nutr. 1979;32(3):607-629.
- Zack PM, Harlan WR, Leaverton PE, Cornoni-Huntley J. A longitudinal study of body fatness in childhood and adolescence. The Journal of pediatrics. 1979;95(1):126-130.
- Satter EM. Internal regulation and the evolution of normal growth as the basis for prevention of obesity in childhood. J Am Diet Assoc. 1996;96:860-864.
- Pietilainen KH, Kaprio J, Rasanen M, Winter T, Rissanen A, Rose RJ. Tracking of body size from birth to late adolescence: contributions of birth length, birth weight, duration of gestation, parents' body size, and twinship. Am J Epidemiol. 2001;154(1):21-29.
- Greenspan SI. Fostering emotional and social development in infants with disabilities. Zero to Three: National Center for Clinical Infant Programs; 1988:8-18.
- Erikson EH. Eight ages of man. Childhood and Society, 2nd Edition. New York: W.W.Norton; 1993:242-274.
- Morris SE, Klein MD. Pre-feeding Skills--A Comprehensive Resource for Mealtime Development. San Antonio, Texas: The Psychological Corporation/Therapy Skill Builders; 2000.
- Birch LL, Marlin DW. I don't like it; I never tried it: Effects of exposure on two-year-old children's food preferences. Appetite. 1982;3:353-360.
- Birch LL. Children's food preferences: Developmental patterns and environmental influences. In: Whitehurst G, Vesta Re, eds. Annals of Development. Greenwich, CT: JAI Press; 1987:171-208.
- Hendy HM. Effectiveness of trained peer models to encourage food acceptance in preschool children. Appetite. 2002;39(3):217-225.
- Addessi E, Galloway AT, Visalberghi E, Birch LL. Specific social influences on the acceptance of novel foods in 2-5-year-old children. Appetite. 2005;45(3):264-271.
- Butte N, Cobb K, Dwyer J, Graney L, Heird W, Rickard K. The Start Healthy Feeding Guidelines for Infants and Toddlers. J Am Diet Assoc. 2004;104(3):442-454.
- Nicklas TA, Hayes D. Position of the American Dietetic Association: Nutrition guidance for healthy children ages 2 to 11 years. J Am Diet Assoc. 2008;108(6):1038-1047.
- Ogata BN, Hayes D. Position of the academy of nutrition and dietetics: nutrition guidance for healthy children ages 2 to 11 years. Journal of the Academy of Nutrition and Dietetics. 2014;114(8):1257-1276.
- Krebs NF, Jacobson MS, American Academy of Pediatrics Committee on N. Prevention of pediatric overweight and obesity. Pediatrics. 2003/2007;112(2):424-430.
- Hagan JF, Shaw JS, Duncan PM. Bright Futures Nutrition, Guidelines for Health Supervision in Infants, Children, and Adolescents, 3rd ed. Elk Grove Village, IL,: American Academy of Pediatrics; 2008.
- Barlow SE, the Expert C. Expert Committee Recommendations Regarding the Prevention, Assessment, and Treatment of Child and Adolescent Overweight and Obesity: Summary Report. Pediatrics. 2007;120(Supplement_4):S164-192.
- HHS.Gov. Introducing the New Head Start Program Perfomance Standards 2016; http://www.acf.hhs.gov/ohs/policy. Accessed September 15, 2016.
- Stallings V. Institute of Medicine Dietary Risk Assessment in the WIC Program. Washington, DC2002.
- USDA, FNS. Maximizing the message: Helping moms and kids make healthier food choices. FNS-409. 2012; http://www.fns.usda.gov/core-nutrition/maximizing-message. Accessed May 8, 2015.
Lohse B, Satter E, Arnold K. Development of a tool to assess adherence to a model of the division of responsibility in feeding young children: using response mapping to capacitate validation measures. Child Obes. 2014;10:153-168.
The joy of eating
To be a competent eater, be relaxed, self-trusting, and joyful about eating, and take good care of yourself with food. Read more.
Feed yourself with love and good sense
Your eating can be joyful and positive. Learn how to make your eating one of life's great pleasures. Read more.
History of the models
Webinar: A conversation with Ellyn Satter
Ellyn Satter fields questions from callers about applying Feeding Dynamics, Division of Responsibility, Eating Competence, and more. Watch the webinar.
The Division of Responsibility in Feeding
The division of responsibility in feeding (sDOR) encourages parents to take leadership with the what, when, and where of feeding and give children autonomy with the how much and whether of eating. The division of responsibility in feeding applies at every stage in the child's development, from infancy through the early years through adolescence.
The parent is responsible for what children are offered to eat. The child is responsible for how much and whether to eat of the foods offered by the parent. sDOR says to feed infants on demand, letting them determine the timing and tempo of feeding. As the child develops and becomes more regular in his eating patterns, the parent gradually takes on responsibility for when and where the child is fed.
Most children are ready to join in with the meals-plus-snacks routine of family meals by the end of the first year or the beginning of the second year. After that, parents need to maintain the structure of family meals and sit-down snacks throughout the growing-up years.
When parents do their jobs with feeding, children do their jobs with eating.
sDOR encourages parents to take responsibility for feeding . . .
- Choose and prepare food.
- Provide regular meals and snacks.
- Make eating times pleasant.
- Step-by-step, show children by example how to behave at family mealtime.
- Be considerate of children's lack of food experience without catering to likes and dislikes.
- Not let children have food or beverages (except for water) between meal and snack times.
- Let children grow into the bodies that are right for them.
An essential part of sDOR is for parents to trust their child to be capable with eating.
- Eat the amount they need.
- Learn to eat the food their parents eat.
- Grow predictably in the way that is right for them.
- Learn to behave well at mealtime.
For a PDF of Ellyn Satter's division of responsibility in feeding, click here. For a PDF of Ellyn Satter's división de la responsabilidad al alimentar (sDOR in Spanish), click here.
This book by Ellyn Satter breaks the spell of negativity and fear that permeates our eating.
Resources & links for professionals
Family Meals Focus ~ No. 85We are fortunate to have the National School Lunch Program (NSLP), even though lunches aren't as good tasting and filling nowadays dues to low-fat, low-sodium, and yes, low-calorie policies. However, NSLP sees to it that children get fed, and provides breakfasts and even evening meals in some cases. More children than ever before qualify for free or reduced-price school menus. In spite of its shortcomings, we need NSLP and it does a lot of good, so let's consider what we each can do in order to nurture our children with school meals.
Family Meals Focus ~ No. 93
How to feed
On this page
- Raise a healthy child who is a joy to feed
- Trust your child to grow in the best way
- Don't panic about child overweight and obesity
- Keep your nerve with your small or slowly growing child
- Follow sDOR when your child has medical issues
- sDOR works for feeding children with special needs
- Troubleshoot when sDOR doesn't seem to work
- Get help when you are stuck
Evidence for sDOR and the Satter Feeding Dynamics Model
Children learn to eat new food
- The division of responsibility in feeding
- Be considerate without catering with meal planning
- Your child will grow up to get the right body
Raise a healthy child who is a joy to feed
Step by step, throughout the growing-up years, your child learns to eat the food you eat and feel about eating the way you do. Starting with breast- or formula-feeding, learning to eat grown-up food, and joining in with family meals, your child becomes a part of the family with eating. Trying to get children to eat certain foods in certain amounts and grow in certain ways spoils family meals and makes everyone miserable. Parents who set aside the struggles are amazed at how much better they and their child feel and do, not only at mealtime, but all the time.
Do your jobs with feeding and let your child do his jobs with eating
Follow the division of responsibility in feeding. You do the what, when and where of feeding and let your child do the how much and whether of eating.
- Trust your child to grow in the way that is right for him.
- Understand your child's development. Feed—and parent—in the way that is right for each stage.
- Solve feeding problems by applying the division of responsibility in feeding.
A good eater is a competent eater
Competent eating is about how your child feels and behaves around food, not about what and how much she eats. Your child wants to please you. When you follow the division of responsibility in feeding and give her the time she needs to learn and grow, she will eat the food you eat and behave nicely around food.
- She enjoys family meals—and you do, too.
- She eats as much or as little as she needs: Only she knows how much. Trusting her lets her be healthy and energetic and grow up to have the body that nature intended for her.
- She eats what you eat with only minor tweaking. She is okay with being offered food she has never seen before. She can sneak up on new food and learn to like it.
- She behaves nicely at mealtime: She picks and chooses from what you provide for the meal. She says "yes, please," and "no, thank you." She does not make a fuss.
Children come in all sizes
- Children know how much they need to eat
- Your child will grow up to get the right body
Trust your child to grow in the best way
- Your child has a natural way of growing that is right for her.
- Her natural growth is in balance with her eating and moving.
- Maintain the division of responsibility in feeding and in activity.
- Trust her to do her part with eating, moving, and growing.
It's mostly about genes
Your child's body shape and size are mostly inherited. The amounts she needs to eat are also inherited, and support her growing and moving in her own unique way. Even if her height and weight plot at the extreme upper or lower ends of the growth charts, she is growing normally as long as she grows consistently. Growth is only a problem if accelerates or falters: if it goes rapidly up or down from the usual growth curve.
Protect yourself and your child from interference
Don't let anyone make an issue of your child's size, shape or weight, and beware of hidden messages. Children who are encouraged to eat or move in a certain way to be "healthy" get the message that there is something wrong with their body. For a child, having a flawed body means she is is flawed in every way: not smart, not physically capable, and not worthy.
It ain't over 'til it's over
You won't know how your child's body will turn out until toward the end of her teen years and even later for boys. Trying to control or change your child's body will likely create the very outcome you are trying to avoid! As long as you keep your nerve and maintain the division of responsibility with feeding and with activity, your child's growth may surprise you. The fat baby is likely to slim down. The small, ill, or growth-delayed child is likely to continue to do catch-up growth well into her teen years and has a good chance of being bigger than you may expect.
Your child will grow up to get the right body
Don't panic about child overweight and obesity
Child overweight and obesity are terms generally used to mean that children are too fat. They really mean children are too big - the designators - BMI - don't distinguish between bigness and fatness. Often, children are classified as being "at risk" of overweight and obesity if parents are big. Your child might be big, but he is not too big provided he follows consistently along his growth curve, even it if is above the 95th or 97th percentile that many use to classify a child as obese. From the feeding dynamics perspective, a child's weight is a problem only if it accelerates rapidly off his usual growth curve. Some kids are just big, and that is the way they are. Some parents are big, and that is the way they are. If you and your child are big and even fat, don't panic and try to slim him down. To address real, imagined, or anticipated weight problems, follow the division of responsibility in feeding from birth. Let your child's weight find its own level. Trying to get him to be thinner will make him fatter than he otherwise would be. Think about it: Did someone try to slim you down when you were little? Is it possible that, as a result, you are fatter than you would have been otherwise?
Be wary of the label
Don't call your child overweight or obese, and don't let anyone else do it either. Don't even think it! Misery enters when weight becomes an issue. Kids who get the idea they are overweight feel bad in all ways: not smart, not physically capable, and not worthy. Studies show that children gain more weight, not less, when parents believe them to be fat. Parents do what they think is right and try to slim children down. That makes children afraid of going without, continually begging for food, and inclined to eat more than they even want when they can get it. Give yourself and your child a break! Do your jobs with feeding, let your child do his jobs with eating, and let nature take its course.
Some children are naturally small
Keep your nerve with your small or slowly growing child
The way to allow your small, slowly growing child to grow in the best way for her is to follow the division of responsibility in feeding from birth. The way to address growth faltering is to restore the division of responsibility in feeding and let your child's weight find its own level.
Your child may have been labeled too small or "failure to thrive" of her growth is below the third or even the fifth percentile. That is a scary term that means there is something wrong. Actually, if she grows consistently, nothing at all may be wrong with your child's growth. But even without such labeling, parents worry when their child's growth is extremely low or extremely high. But don't let your worry make you put pressure on your child to eat. She will eat even less and grow even more slowly. Trying to change your child's natural growth pattern will make everyone miserable and is unlikely to succeed.
Follow the division of responsibility in feeding
- Webinar: sDOR and child diabetes
- Cystic fibrosis
- Medication and sDOR
Follow sDOR when your child has medical issues
You don't need to abandon the division of responsibility feeding in order to address your child's medical issues. For your child with diabetes, maintain the structure and predictability of the division of responsibility in feeding, depend on him to maintain his own energy balance, and adjust his insulin to cover what he eats. For your child with food allergies or sensitivities, focus on providing acceptable food rather than avoiding problematic food, and gradually teach your child to take responsibility for staying away from what makes him sick. For your child with cystic fibrosis, give him digestive enzymes, then trust him to eat enough to cover for his malabsorption.
Children want to learn to eat
- sDOR works with special needs
- Adoptive and foster child feeding problems
- Picky eating: Born or made?
- Webinar: Raising special needs children to be competent eaters
sDOR works for feeding children with special needs
The division of responsibility in feeding works for children with special needs, even children learning to eat after being tube-fed. When you follow the division of responsibility and get help attending to any medical, nutritional, and oral-motor issues, even children with special needs push themselves along to learn to eat. But fragile children scare everyone, even experienced health professionals, and scared people pressure children to eat. That makes children behave like they don't want to eat: uninterested in food, suspicious of unfamiliar food, upset about being offered anything new.
Let your child manage his own caution
Some children are naturally slow to warm up to tastes and textures. Children who have had painful medical procedures that involved their mouths, or negative early experiences around eating, are naturally cautious about new foods and new eating experiences. Children who have been tube-fed early on have missed out on early eating experience, and eating is all new to them. But even your slow-to-warm-up child wants to eat. After all, you eat, and she wants to grow up to be just like you!
Correctly apply the division of responsibility in feeding
- Do you have to starve children to make them eat?
- Do children lose the ability to self-regulate?
- Birth through adolescence
- How to get your child to eat
- Moves and counter-moves in feeding
- Trouble-shooting
Troubleshoot when sDOR doesn't seem to work
Every child is unusual in some way. The division of responsibility applies to all children and applies to children of all ages, birth through adolescence. The problem is that some children's characteristics and behaviors make it seem that they can't be trusted to do their part with eating. They can. With some children more than others, sticking to the division of responsibility demands steady nerves and a leap of faith. If a child continues to be negative, upset, and anxious about eating, either structure is eroding or pressure and/or restriction is creeping in.
When you first start following the division of responsibility in feeding, it takes a while to institute structure and let go of being controlling with what and how much your child eats. Once you get feeding organized, your child will have to test for a while to be sure you really will stick to structure and really will let him determine what and how much to eat from what you provide. But if you hang in there with doing your jobs and letting him do his jobs, your child will settle down. He will become relaxed and comfortable with eating and begin eating in his own normally quirky and erratic ways. Typically, once you get feeding in place, infants take a day or two to become relaxed and comfortable with feeding, toddlers a week, preschoolers 2 or 3 weeks, and school age children a month to six weeks.
However, keep in mind that that your child may not suddenly - or ever - eat the food you want him to eat or grow the way you want him to grow. The division of responsibility lets him be relaxed and comfortable with eating so he can eat and grow in the way that is right for him. Stow your agenda, do your jobs with feeding, enjoy pleasant family mealtimes, and trust your child to do his jobs with eating.
ESI can help you
Get help when you are stuck
Resolving feeding issues is important enough to merit an investment in time and money. You don't have to spend years struggling with your child around feeding. You and your child both deserve to have a relationship around food that is relaxed and joyful. What can you do to find help?
- Look for a feeding dynamics professional. An Ellyn Satter Institute Faculty member or Associate may live near you. Alternatively, ask around. You may be able to find a professional who has been trained in feeding dynamics education and intervention by studying with Ellyn Satter Institute faculty members and/or demonstrated their expertise by taking ESI continuing education exams.
- Grow your own. Look for someone who understands how children grow and develop - in eating and in all ways - and is willing to learn right along with you. Together, you can Identify the causes of your child's food refusal, make a feeding relationship plan, and help each other to be consistent and brave as you carry it out.
- Consider online coaching from ESI faculty members. Via Skype, telephone, and email, ESI faculty members do assessment, create a treatment plan just for you, and work with you as you institute that plan over several weeks.
How to eat
On this page
- Your eating can be joyful and positive
- Raising eating competent children
- Eating competence and weight
- Eating competence and wellness
- Eating competence and mental health
- Eating competence and eating disorders
- Get help when you are stuck
Evidence for the Satter Eating Competence Model
Your eating can be joyful and positive
At the heart of a positive relationship with food is the principle of eating competence. The evidence for ecSatter shows that we can trust and gratify our natural desires rather than struggling against them.
- We all long to eat as much as we want of food we enjoy . . .without feeling guilty and worrying that our weight will go out of control.
- We long to enjoy delicious food with other people . . .without feeling we are eating too much of the wrong food.
- We long to nurture our children and delight in family meals . . . without continually second-guessing ourselves and feeling like the food police.
ecSatter shows how to make your eating one of life's great pleasures
- Stop worrying about food and trying to go without. Instead, give yourself permission to eat.
- Have rewarding, regular, and reliable meals
- Pay attention while you eat
- Then eat what and how much you want.
Your eating will become orderly and reliable
You may fear that throwing away the food shoulds and oughts will send your eating and weight out of control. But the way eating competence works is quite the opposite.
- Foods you no longer have to eat become enjoyable foods that you can eat for pleasure.
- Foods that are no longer forbidden became ordinary foods that you can eat matter-of-factly and moderately.
- Large portion sizes won't dictate how much you eat: You can eat it all if you are hungry enough, not if you aren't.
Experience the rewards of being a competent eater
- Eat what you like and be healthy!
- ecSI 2.0
- Evidence for ecSatter
- Feed yourself with love and good sense
- Joy of Eating
Ellyn Satter's Secrets of Feeding a Healthy Family tells you how to eat as much as you want of foods you enjoy and be healthy!
Raising eating competent children
To rear a competent eater, be eating competent yourself. Verto, cogo eros vel gravis letatio proprius. Gemino, commodo magna, acsi regula metuo autem, secundum fatua paulatim similis, sino letatio at. In capio torqueo exerci, blandit olim quod duis. Eros torqueo hendrerit vereor ventosus euismod singularis comis paratus sudo. In eros praesent demoveo velit nunc commodo in sed interdico ut. Iriure, pagus utinam ludus sit vereor blandit ad eum dolor huic si in. Vulpes magna suscipere jugis eum quae, nunc utinam brevitas vicis in laoreet modo. Ymo hos tation proprius refoveo consequat probo utinam virtus pecus suscipit huic.
History of the models
Eating competence and weight
The eating competence model says nothing at all about what and how much to eat or how much to weigh. Isn't that a little dangerous? Won't you eat like there is no tomorrow and gain a lot of weight? No, you won't. Research shows that folks who are eating competent weigh the same or less than others. Being eating competent lets you trust your feelings of hunger and fullness and accept the weight that is right for you. Granted, that weight might not be one that the charts or the fashionistas dictate, but consider the alternative. You could spend the rest of your life struggling with your eating and weight, take the joy out of eating, and end up weighing same or even more. Less that 5% of people succeed at sustained weight loss. Instead of keeping the weight-loss hope alive, why not hope for a rich and valuable life and being all you can be . . . at this weight?
Address weight wisely and well
- Adult eating and weight
- Are you tired of feeling bad about your eating?
- Eat what you like and be healthy!
- Eating competence
- Feed yourself with love and good sense
- Stop being hysterical about "obesity!"
Eating competence and wellness
You don't need a special diet to address your health. Instead, develop eating competence. Consider the research: eating competent people have better blood lipids, lower blood pressures, and weigh the same or less than other people. The structure, predictability, and energy balance of eating competence is a natural fit for your diabetic regimen. Staying in tune with your body's natural processes and focusing on providing food rather than avoiding it and give ease and practicality to coping with food allergies and intolerances. Pregnancy isn't a medical issue, but what a fine time to become eating competent! Maintaining the joy and predictability of eating competence allows you to nourish yourself and your baby, lay the foundation for feeding your family, and gain the weight that is right for you.
ecSatter and health
- Associations between eating competence and cardiovascular disease biomarkers
- Diet quality is related to eating competence in cross-sectional sample of low-income females surveyed in Pennsylvania
- Eating competence and adult diabetes
- Eating competence of elderly Spanish adults is associated with a healthy diet and a favorable cardiovascular disease risk profile
- Eat, sleep, work, play: Associations of weight status and health-related behaviors among young adult college students
Eating competence and mental health
The evidence shows that eating competent people do better, socially and emotionally. They are more trusting and accepting of themselves and other people. They are aware of how they think and feel and are effective in guide their lives with that self-awareness. Why should positive eating attitudes and behaviors act as a measure for mental health? Because eating goes well when it is based on tuning in on and respecting our inner experience of hunger, appetite, and satisfaction as well as being accepting and nurturing with our ourselves and our bodies. This self-awareness and self-respect originate in earliest life, with parents who follow the division of responsibility in feeding.
ecSatter and psychosocial wellness
- Eat, sleep, work, play: Associations of weight status and health-related behaviors among young adult college students
- Weight attitudes predict eating competence among college students
- Measuring eating competence: psychometric properties and validity of the ecSatter Inventory
Eating competence and eating disorders
Eating disorder attitudes and behavior are the antithesis of eating competence
- Do people with eating disorders celebrate eating? Hardly. To feel good about eating means it could go out of control!
- Do they enjoy food and trust appetite? Not at all! Since they are trying not to eat, they experience appetite as unbearably compelling and never satisfied.
- Do they eat enjoyable food? No, such food is particularly hazardous because it can undermine rigid control.
- Do they eat as much as they want? Horrors! The goal of the person with anorexia or bulimia is to not eat very much.
- Do they feed themselves regularly and reliably? Not likely! They experience eating as being so negative that they would forget about it if they could.
- Is there a secondary benefit to all this misery? By all means! Eating becomes so engrossing that it distracts from the underlying life misery that they regard, likely unconsciously, as being even worse.
ecSatter and eating disorders
- Are we teaching our children conflict and anxiety about food?
- ARFID: What is it? What does it have to do with feeding dynamics and eating competence?
- Child on psychotropic medication
- Court-ordered placement for child obesity: what can you do to help?
- Emotional eating
- Versions of internally regulated eating
- What does eating competence research say about eating disorders
Get help when you are stuck
Resolving eating issues is important enough to merit an investment in time and money. You don't have to spend years struggling with your eating and weight. You deserve to have a relationship around food that is relaxed and joyful. What can you do to find help?
- Look for an eating competence professional. An Ellyn Satter Institute Faculty member or Associate may live near you. Alternatively, ask around. You may be able to find a professional who has been trained in eating competence intervention by studying with Ellyn Satter Institute faculty members and/or demonstrated their expertise by taking ESI continuing education exams.
- Grow your own. Look for someone who has studied the eating competence model and is willing to learn right along with you.
- Consider online coaching from ESI faculty members. Via Skype, telephone, and email, ESI faculty members do assessment, create a treatment plan just for you, and work with you as you institute that plan over several weeks.
Are you in a muddle about eating?
- You worry about eating almost continuously – doing it, avoiding it.
- You feel you know what to do with respect to eating, but can't do it.
- You feel bad if you eat and bad if you don't.
- You can't remember when you have felt good about your eating or weight.
ESI can help you
The Satter approach to feeding: Ellyn's story
The Satter approach to eating: Ellyn's story
Adult eating and weight
On this page
- How to become eating competent
- A taste of eating competence
- Eat as much as you want
- Resolve the weight dilemma
- You can learn to enjoy vegetables
- What is normal eating?
- The adult picky eater
- Eating during pregnancy: provide, don't deprive
Secrets tells you how to be relaxed and positive about eating.
Click for details and purchase.
Click here for the handout, "The Joy of Eating"
How to become eating competent
Eating competence is sensible, sustainable, and good for you. Have rewarding, regular, and reliable meals, pay attention while you eat, and eat what and how much you want. You will enjoy eating, do better nutritionally, and be healthier.
When the joy goes out of eating, nutrition suffers
- Roughly half of today's consumers who know about "official" dietary guides say they ''don't really follow the rules.''
- Fewer and fewer people say they enjoy eating.
- If they follow the rules they later reward themselves with "forbidden" food.
- Only 20% of consumers get their five-a-day of fruits and vegetables, and overweight is a major concern.
Consider the evidence-based Satter Eating Competence Model (ecSatter)
- Feel positive about your eating.
- Be reliable about feeding yourself.
- Eat food you enjoy.
- Eat as much as you are hungry for.
Respect and trust your body's wisdom
- Your hunger and your drive to survive.
- Your appetite and natural need for pleasure.
- Your enjoyment from sharing good food with others.
- Your tendency to maintain your own best weight.
Your eating will fall into place
- Being able to eat the foods you enjoy in satisfying amounts gives your eating order and reliability.
- Foods you no longer have to eat become enjoyable foods that you can eat for pleasure.
- Foods that are no longer forbidden became ordinary foods that you eat moderately.
- Large portion sizes won't make you overeat. You can eat it all if you are hungry enough, not if you aren't.
Secrets tells you how to eat what you enjoy and be healthy! Click for details and purchase.
Click here for the handout, "The Joy of Eating"
A taste of eating competence
Research with the Satter Eating Competence Model shows that people do better when they feel good about their eating, eat enough, and eat what they enjoy at regular meals and snacks. They are healthier in all ways, eat what they need, and eat as much as they need.
We are entitled to enjoy eating and eat the food we enjoy
- To feel good about our eating, rather the guilty or anxious.
- To put together a meal with food we really have a taste for.
- To eat as much of that food as we want.
- To get up from an enjoyable meal knowing another on is coming that will be just as good.
Provide; don't deprive
- Go to meals hungry, have food you enjoy, tune in while you eat, and eat as much as you want. Then stop, knowing another meal or snack is coming soon and you can do it all over again!
- Have rewarding, regular, and reliable meals
- Pay attention while you eat
- Then eat what and how much you want.
What is it like to be eating competent?
- Going by your body rather than the rules for what and how much to eat.
- Taking good care of yourself. Planning for feeding yourself and paying attention while you eat.
- Having regular meals with food you enjoy. Sitting down for snacks between times if you need them.
- Feeling good about your eating and about your food, and feeling good about feeling good.
- Thinking about what you want to eat and letting yourself eat it without feeling guilty.
- Letting yourself eat as much as you are hungry for.
- Trusting your body to weigh what it needs to.
Secrets teaches you to trust your body to know how much to eat. Click for details and purchase.
Click here for the handout, "The Joy of Eating"
Eat as much as you want
Your body knows how much you need to eat. To be able to trust your body to help you with what and how much you eat, you must help it. You must have structure. Whether there are one or ten people in your family, have meals with food you enjoy, and have sit-down snacks between times if you need them.
- Feed yourself at more-or-less set times.
- Go to some trouble to make food taste good.
- Eat often enough so you can go to the table hungry but not starved.
- Take the time to tune in and enjoy your food.
You won't be able trust your body if you . . .
- Don't take feeding yourself seriously.
- Grab food when you happen to think about it or when hunger drives you to it.
- Snack and nibble instead of taking time to feed yourself.
- Try not to eat as much as you are hungry for.
Secrets helps you develop loyalty and respect for your body. Click for detail and purchase.
Click here for the handout, "The Joy of Eating"
Resolve the weight dilemma
We are told to lose weight and keep it off. Nobody can do it. That makes trying to lose weight the impossible dream - and hard on your body, besides.
How can so many be so wrong?
- Health policy makers and most health professionals insist - repeatedly and with a great deal of judgment and urgency - that any degree of overweight is medically dangerous.
- However, high body weight is a serious health risk only for people who are very, very heavy (more studies).
- Somehow the many, many studies don't sink in: There is no successful method for reducing and maintaining a lowered body weight.
- In fact, weight loss attempts backfire: Almost all people regain lost weight; many gain to a higher level with each loss-regain cycle (more studies).
- Weight instability as a result of dieting is associated with health impairment (studies).
The weight dilemma is worse for people of size
- Body composition is, for the most part, genetically determined, but people of size feel guilty about their weight and therefore ashamed of their eating.
- They have accepted society's judgment that they overeat and that they are digging their graves with their knives and forks.
- In reality, most relatively fat people eat no more or no differently from thin people. They just pay the price.
- People of size at times eat chaotically. However, that chaotic eating, rather than being a cause of high body weight, is far more likely to be a consequence of the weight-reduction dieting.
Define the problem in the way it can be solved
- Whatever your size, to keep from being caught in the weight dilemma, work with your body rather than against it.
- Eat well and joyfully, and trust your internal regulators to guide you in what and how much to eat.
- Move your body in ways that you enjoy and can sustain.
- Let your body weigh what it will in response to your positive and consistent eating and activity.
- Develop loyalty and respect for your body.
- Stop postponing living until you get thin.
Secrets says to eat vegetables because you enjoy them, not because you have to. Click for details and purchase.
Click here for the handout, "The Joy of Eating"
You can learn to enjoy vegetables
In our culture, fruits and vegetables especially are considered both critically important and difficult to eat. Generations of parents force themselves to eat vegetables and are convinced that children will only eat them under pressure. It doesn't have to be that way.
Vegetables and fruits can be challenging
- They have a variety of textures and flavors, some of them strong, sharp, or biting.
- You or your child may be a supertaster, which means you are sensitive to strong flavors.
- Some people are sensitive to textures.
- However, even supertasters and people who are sensitive to textures learn to enjoy vegetables and fruits.
Learning to enjoy: Time, many chances to learn, and no pressure
- Plan to eat fruits and vegetables because you enjoy them, not because you feel obligated.
- Tone down strong vegetable flavors with salt, fat, sauces, bread crumbs, herbs, and spices.
- Tone down fruit textures by making sauces, desserts, using canned rather than fresh.
- Sneak up on the new: Look at it, prepare it, watch others eat it, put it in your mouth and take it out again. Don't swallow until you are ready.
- Take your time, and be persistent. It may take dozens of the sneaking-up bit before you enjoy eating it.
Secrets says normal eating is joyful eating! Click for details and purchase.
Click here for a PDF of "What is Normal Eating?"
What is normal eating?
Written in 1983 by Ellyn Satter
- Normal eating is eating competence. It is going to the table hungry and eating until you are satisfied.
- It is being able to choose food you enjoy and eat it and truly get enough of it - not just stop eating because you think you should.
- Normal eating is being able to give some thought to your food selection so you get nutritious food, but not being so wary and restrictive that you miss out on enjoyable food.
- Normal eating is giving yourself permission to eat sometimes because you are happy, sad or bored, or just because it feels good.
- Normal eating is mostly three meals a day, or four or five, or it can be choosing to munch along the way.
- It is leaving some cookies on the plate because you know you can have some again tomorrow, or it is eating more now because they taste so wonderful.
- Normal eating is overeating at times, feeling stuffed and uncomfortable. And it can be undereating at times and wishing you had more.
- Normal eating is trusting your body to make up for your mistakes in eating. Normal eating takes up some of your time and attention, but keeps its place as only one important area of your life.
- In short, normal eating is flexible. It varies in response to your hunger, your schedule, your proximity to food and your feelings.
Secrets takes the misery out of eating and puts the joy in. Click for details and purchase.
The adult picky eater
No one eats everything. That only is a problem when you eat such a short list of food it's hard to get the nutrients you need. It is even more of a problem when you feel singled out, shamed, and criticized. You are probably a picky eater because of the way you were raised with food: Too much pressure or too little exposure to unfamiliar food. As a child, you may have been especially sensitive to taste and texture. However, you could still have learned to eat a variety of food with lots of chances and no pressure.
Begin by addressing your attitudes about eating
- You are entitled to eat what you eat and to feel good about it.
- Say to yourself, "It is all right to eat this. I just have to sit down and enjoy it."
- Once you learn to be kind to yourself about eating, work on protecting yourself from food pressure.
- Be matter-of-fact and unapologetic about saying ''yes, please,'' and ''no thank you.'' Don't complain and don't explain.
Develop positive mealtime behavior
- Pick and choose from what is on the table.
- Politely and firmly decline to be served.
- Eat only one or two foods, if that's all that appeals.
- Leave unwanted food on your plate.
- Take more of one food before you have finished another.
Avoid negative mealtime behavior
- Drawing attention to your food refusal.
- Requesting food that is not on the menu.
- Wasting a lot of food.
- Discussing what you eat and don't eat.
- Expecting others to cater to your food preferences.
After you learn to say no, learn to say yes
- Begin ever-so-gradually sneaking up on new food and learning to eat it.
- Provide yourself with regular, repeated, and unpressured opportunities to learn to eat new food.
- Always give yourself an out: Pair familiar food with unfamiliar, foods you eat with those you don't yet eat.
- Don't force yourself to eat if anything you don't want to eat.
Secrets says to feed yourself enjoyably and dependably! Click for details and purchase.
Eating during pregnancy: provide, don't deprive
Pregnancy in general and eating during pregnancy in particular give you a marvelous opportunity to gain respect for your body and for the miracle of giving birth. Trust yourself. Eating competently will allow you to do well nutritionally and gain weight in a way that is right for you. Your hunger, appetite, and weight gain will be different from that of other women and will vary month to month and among your first, second and third trimesters. Don't spoil your pregnancy by dieting or by worrying about your weight!
Goals for feeding yourself well during pregnancy
- Nourish yourself and your baby.
- Lay the foundation for feeding your family.
- Gain the amount of weight that is right for you, in your own distinct pattern.
To achieve those goals, be nurturing and trusting with yourself
- Feed yourself enjoyably and dependably. Be positive and reliable about taking care of yourself with food.
- Give yourself permission to eat food you enjoy. Provide, don't deprive. Seek food rather than avoid it.
- Emphasize three meals a day and as many snacks as you need to feel comfortable and energetic.
- Start where you are: Eat what you are eating now, just have it at regular and structured times.
- Get the meal habit by choosing food you enjoy. For you to maintain the meal habit, your food has to taste good!
- Once you have the meal habit, sneak up on menu planning.
- Go to meals hungry but not famished, savor your food, and stop only when your hunger and appetite are satisfied.
The bottom line: Trust your body!
Intervening with pediatric feeding disorders
Childhood feeding problems
Children's eating and growthChildren know how much they need to eat and how to grow. Your child may eat a lot or a little, be big or small. Trust him tot know what he is doing.
Child weight issues
On this page
- Address your child's weight with the division of responsibility in feeding
- Make an informed choice: sDOR or conventional treatment?
Address your child's weight with the division of responsibility in feeding
The Ellyn Satter Institute position is that the terms overweight and obesity (BMIs in excess of the 85th and 95th percentiles, respectively) are not useful when applied to individual children. Many children grow naturally and consistently at or above those percentiles and are perfectly healthy. A child's weight only becomes a concern when it accelerates: Weight abruptly goes up across a number of growth percentiles.
Support your naturally large child's growth, from birth, by following Satter's division of responsibility (sDOR) in feeding: You do the what, when, and where of feeding and let your child do the how much and whether of eating. Address weight acceleration by following sDOR and letting your child's natural ability with food regulation restore eating and growth that is right for her.
On the surface, the intervention is simple enough – so simple, in fact, that you may feel you are doing nothing at all. In reality, you do a tremendous amount when you follow sDOR and thereby do good parenting with feeding. You keep up the day-in-day-out of family meals and structured snacks throughout your child's growing-up years. Then you keep your nerve and trust your child to eat as much or little as she needs and grow in the way that is right for her.
Because following sDOR is rewarding and supports the quality of your family life, you will be able to keep up the considerable effort of maintaining pleasant and rewarding family meals and sit-down snacks. Then you can forget about strategies for getting your child to lose weight:
- You don't have to try to control what and how much your eats . . . and you don't have to try to get her to control it, either.
- You don't have to try to get her to eat more "healthy" foods such as fruits and vegetables, whole grains, and other low-fat foods.
- You don't have to be the food police with so-called "unhealthy" foods – the high-fat, high-sugar stuff.
- You don't have to give up Friday night pizza nights or movie popcorn or hide tempting foods so your child doesn't get them.
Child overweight: Helping without harming
Feeding dynamics and eating competence based prevention and intervention
By Ellyn Satter
Child overweight: Helping without harming
Feeding dynamics and eating competence based prevention and intervention
By Ellyn Satter
ESI's expert advisors can help you, step-by-step, properly apply sDOR as well as remain consistent and firm while your child's eating attitudes and behaviors ever-so-gradually improve.
Related issues of Family Meals Focus
Child overweight: are current guidelines helpful? Do they do harm?
- Counterfeit permission
Learn to follow the division of responsibility in feeding
On the right are resources to help you learn how to feed based on the division of responsibility. Read Your Child's Weight: Helping without Harming and watch the feeding videos to get a clear understanding of good feeding based on the division of responsibility. Observe how children naturally behave with eating, Be considerate without catering in your meal-planning. Each meal needs high- and low-calorie foods as well as one or two foods your child generally eats. Then adjust your expectations of your child. When you apply sDOR, your goal is not to limit him to a certain amount or type of food, but for him to feel good about eating and show evidence that he knows how much to eat. And be prepared for the long haul. He will only feel good about eating, eat the amount he needs, and grow consistently when you accurately apply sDOR and continue to follow it.
Evidence that your child eats the amount she needs
If you have been restricting your child, it will take him a while to recover his trust that you will let him eat as much as he wants. It will also take him a while to become sensitive to his own feelings of hunger and fullness. At first, he is likely to eat a lot, especially of foods you haven't let him eat before. But after a few weeks or months, depending on his age, he will begin to show evidence of his ability to regulate her food intake. He will:
- Feel good about eating
- Come willingly to meals and snacks and behave appropriately there
- Do most of his eating at regular meal-and snack-times
- Be relaxed about getting enough to eat
- Be relaxed about eating all kinds of food
- Come to meals and snacks hungry and eat until he is satisfied
- Manage how much he eats without worrying whether it is too much or too little
- Grow at a consistent percentile or shift gradually up or down
Your Child's Weight: Helping Without Harming
To discover the joy and reward of following the division of responsibility in feeding and letting your child grow up to get the body that is right for him, read Ellyn Satter's Your Child's Weight: Helping Without Harming .
Feeding with Love and Good Sense
To see what feeding looks like when parents follow the division of responsibility - and when they don't (and to find out that feeding your child is not all that much different), see Ellyn Satter's Feeding with Love and Good Sense DVD II. For home use version, click here.
Make an informed choice: sDOR or conventional treatment?
You are likely to be advised to follow some sort of restrictive diet with your child to try to get her weight down. Your adviser may tell you to follow the division of responsibility in feeding along with the other methods listed below, but that is just wrong. You can not both follow sDOR and try to get your child to eat certain amounts and/or types of food. sDOR means letting your child determine for him/herself what and how much to eat from what you offer. Trying both follow sDOR and restrict will hopelessly confuse you and your child. However, the choice is yours.
People who advise restricting children's eating to slim them down seem to think that children who get "too fat" simply eat too much of the wrong food or move too little. For them, the solution is simple: get the child to eat less or move more. Those folks are unimpressed by the many studies demonstrating that child weight loss programs, in the home or at school, simply do not work.
Below are common conventional methods of child weight management. Even if such a method is called non-diet, or non-restrictive, or a point system, it is still a diet.
- Having a target or cutoff point for the child's BMI (Body Mass Index): Defining the child as overweight if BMI is above the 85th percentile, obese if BMI is above the 95th, and trying to get the child's weight to level off or go down.
- Emphasizing what and/orhow much the child should eat: Trying to get the child to eat more low-calorie foods such as vegetables, fruits, skim milk, and whole grains, and fewer high-calorie foods such as sweets and fried food. Imposing portion sizes.
- Emphasizing what and/or how much the child shouldn't eat: Trying to get the child to eat fewer high-fat, high-sugar foods.
- Emphasizing exercise for the purpose of slimming. Giving the child guidelines or activities that emphasize how much to move.
- Targeting interventions toward the child: Giving the child (rather than the parents) instruction in food selection or prescriptions for activity. (Child-focused weight reduction interventions are particularly ineffective.)
- Miscellaneous: Giving calorie prescriptions, limiting eating out, particularly at fast-food restaurants, encouraging eating breakfast, all for the purposes of weight management.
- Avoid restriction
- Children know how much they need to eat
- Follow Satter's Division of Responsibility in Feeding (sDOR)
- Raise a healthy child who is a joy to feed
- The "overweight" child
Family Meals Focus ~ No. 99
Family Meals Focus ~ No. 90
Child feeding ages and stagesUnderstand your child's development, and feed in the way that is right for her. Your baby needs to be fed on demand, but older children need structure. .
Family Meals Focus ~ No. 15
Family Meals Focus
The Ellyn Satter Institute Newsletter
Pregnancy weight gain
by Ellyn Satter, Registered Dietitian and Family Therapist
In Secrets of Feeding a Healthy Family, I observed that ''Until we recover eating as one of life's great pleasures, it simply is not going to turn out well.'' Nowhere is that more apparent than when we consider current pressure to restrict food intake and limit weight gain during pregnancy. Such pressure does far more harm than good.
We have restricted pregnancy weight gain in the past
Back in the sixties, when I started my dietetics career in an private outpatient medical group practice, obstetricians were vehement about combating what they viewed as excessive weight gain during pregnancy. Their rigid guidelines allowed women whose weights were judged to be normal to gain 15 lb; those judged overweight were told to gain none. Doctors were absolutely convinced of the rightness of these guidelines, based on their clinical impressions (contradicted by numerous research studies then available) that excessive weight gain caused preeclampsia and difficult delivery. Women were shamed and scolded, and one of doctors even threatened not to deliver his patients if they gained too much weight. Women worried constantly about eating and weight and dreaded their prenatal appointments. Most tried to go hungry all month and many stopped eating and even drinking on the day prior to weigh-in. In short, many perfectly happy pregnancies were spoiled by obsession with eating and weight gain.
Weight gain guidelines were liberalized in the 1970s
That all changed with the 1970 National Research Council statement,1 which encouraged, and supported with persuasive clinical outcome data, letting women eat as much as they were hungry for and gaining weight accordingly during pregnancy. The monograph predicted a weight gain of 20 to 25 lb and correlated this natural weight gain with the best outcome for both mother and child. In response to that report, we began encouraging our patients to eat in accordance with their hunger, appetite and satiety. Women gained more weight than before, and we supported it (with the exception of one nurse who persisted in sucking in her breath when patients gained and praising them when they failed to).
Research from a medical practice
The theme of this series is ''don't try to outsmart Mother Nature.'' Supporting mothers in eating as much as they need and accepting their weight gain has the best chance of producing a healthy baby.
Three years later, our clinical research showed that our patients before 1970 gained, on the average, eight pounds less than those after 1970, 15.9 versus 24.2 pounds. Babies born to mothers who gained more weight were heavier by 159 grams - over five ounces. There were six mothers before 1970 who gained less than ten pounds, and their babies weighed over 11 ounces less than the average babies.2 The five-ounce weight difference between the pre-1970 and post-1970 babies doesn't sound like much, and neither group had low birth weights. To understand the practical significance of this difference, consider that infants born after the extremely short rations of the WWII Rotterdam blockade were 300 g. (10 oz) smaller than average.3 Infants of our advantaged mothers showed half the weight deficit of infants of starved Rotterdam mothers!
Maternal weight gain doesn't predict birth size
The moral of the story is not, however, that low weight gain will produce a small baby, high gain a big baby. While the trends existed in our population and in other studies, we can't predict for individuals. According to the Institute of Medicine, which published the current recommendations on nutrition during pregnancy, ''The low birth weight of an infant born to a mother who gained only 11 lb. cannot be a confidently attributed to her low gestational weight gain, nor can the high birth weight of a baby whose mother gained 55 lb be attributed to high gestational weight gain.''4
The bad old days are coming back
Unfortunately, those bad-old-days attitudes about restricting weight gain during pregnancy are coming back. Now health and nutrition policy, medical practice, and societal vehemence about weight exert the very pressures on weight gain during pregnancy that came from those pre-1970 norms in obstetrical practice. Current concern is focused around high obstetrical weight gains, particularly those of women considered to be overweight, delivering a large baby - one who by definition weighs 9.9 lb or more, or increasing post-pregnancy weight retention in the mother and the fetus.5
Don't try to outsmart Mother Nature
The next four newsletters will address the dilemmas. negative consequences, and erosion of nutritional behavior that weight restriction create for pregnant women, and proposes a sensible and non-harmful prenatal eating management. The series wraps up by addressing infant birth weight and lifetime health patterns. The theme of this series is ''don't try to outsmart Mother Nature.'' Supporting mothers in eating as much as they need and accepting their weight gain has the best chance of producing a healthy baby.
1. Committee on Maternal Nutrition F&NB. Maternal Nutrition and the Course of Pregnancy. Washington, DC: National Research Council; 1970.
2. Gormican A, Satter EM, Valentine J. Relationships of maternal weight gain, pre-pregnancy weight, and infant birth-weight. J Am Diet Assoc. 1980;77:662-667.
3. Stein Z, Susser M. The Dutch famine, 1944-1945, and the reproductive process. II. Interrelations of caloric rations and six indices at birth. Pediatr Res. 1975;9:76-83.
4. Food and Nutrition Board IoM. Nutrition During Pregnancy. Washington, D.C.: National Academy Press; 1990.
5. Abrams B, Altman SL, Pickett KE. Pregnancy weight gain: still controversial. Am J Clin Nutr. 2000;71:1233S-41S.
Ellyn Satter's Secrets of Feeding a Healthy Family tells you how to eat as much as you want of foods you enjoy and be healthy!
Read the series on weight gain in pregnancy!
- Pregnancy: 1 Weight gain
- Pregnancy: 2 The weight dilemma
- Pregnancy: 3 Weight restriction, harming without helping
- Pregnancy: 4 The joy of eating
- Pregnancy: 5 Weight gain won't make your baby fat
Stay in touch
Family Meals Focus ~ No. 29
Family Meals Focus ~ No. 14
Family Meals Focus ~ No. 12To prevent child overweight and obesity, follow the division of responsibility in feeding from birth and throughout the growing up years. To address child overweight, restore the division of responsibility in feeding and in activity and let your child recover his competence with eating and growth. In short, attend to the how, not the what of feeding.
Family Meals Focus ~ No. 13
Webinar: A Conversation with Ellyn Satter
A Conversation with Ellyn Satter
Ellyn Satter fields questions from callers about applying Feeding Dynamics, Division of Responsibility, Eating Competence, and more.
Ellyn Satter, MS, RD, LCSW, BCD, is a therapist, author and lecturer. She is a registered dietitian, and a holder of the Diplomat in Clinical Social Work. Her best-selling books, including Child of Mine: Feeding With Love and Good Sense and Your Child's Weight: Helping without Harming, as well as journal and magazine articles, teaching materials, seminars and media interviews have made her well-known to parents and professionals as an authority on nutrition and feeding of infants and children.
Family Meals Focus ~ No. 68
Family Meals Focus ~ No. 67
Family Meals Focus ~ No. 63
Family Meals Focus ~ No. 81Following the division of responsibility in feeding (sDOR) takes steady nerves and a leap of faith. It seems simple: you do the what, when, and where of feeding, your child does the how much and whether of eating. But sDOR only works when all the parts are in place. You must be both faithful about doing your feeding jobs and scrupulous about letting your child do her eating jobs. That is a big change. We are used to being casual about structure and controlling with what and how much we and our children eat.
Family Meals Focus ~ No. 46
Family Meals Focus ~ No. 44
Family Meals Focus ~ No. 97 ecSatter and eating disorders
Family Meals Focus
The Ellyn Satter Institute Newsletter
What does Satter Eating Competence Model research say about eating disorders?
by Ellyn Satter, Nutritionist and Family Therapist
Click here for a PDF of this newsletter
To the extent that we urge, persuade, and guilt-trip ourselves and others to eat certain amounts and types of food and force our bodies to turn out a certain way, we all contribute to distortion, conflict, and anxiety with respect to eating. This is not to say that we cause eating disorders. Distorted eating attitudes and behaviors are symptoms of underlying psychosocial distortion, with each exacerbating the other. As Hilde Bruch observed, an eating disorder is "the misuse of eating in an attempt to solve or camouflage problems of daily living that seem otherwise insoluble."1
Eating disorder attitudes and behavior are the antithesis of eating competence
- Do people with eating disorders celebrate eating? Hardly. To feel good about eating means it could go out of control!
- Do they enjoy food and trust appetite? Not at all! Since they are trying not to eat, they experience appetite as unbearably compelling and never satisfied.
- Do they eat enjoyable food? No, such food is particularly hazardous because it can undermine rigid control.
- Do they eat as much as they want? Horrors! The goal of the person with anorexia or bulimia is to not eat very much.
- Do they feed themselves regularly and reliably? Not likely! They experience eating as being so negative that they would forget about it if they could.
- Is there a secondary benefit to all this misery? By all means! Eating becomes so engrossing that it distracts from the underlying life misery that they regard, likely unconsciously, as being even worse.
Subjects with high eating competence subjects score low on TFEQ
Two well-known validated tests addressing eating attitudes and behavior were among the instruments used to validate both the original2 and the updated3 ecSI 2.0TM : Stunkard's Three Factor Eating Questionnaire (TFEQ)4 and Garner's Eating Disorders Inventory (EDI).5,6 From the perspective that achieving a particular body weight requires ignoring and overruling internal regulators, TFEQ tests for cognitive restraint with eating, disinhibition of restraint, and coping with hunger. EC subjects score in the "free eater" range for all three. EC subjects trust their internal regulators of hunger, appetite and satiety and tolerate between-meal hunger, not from willpower, but from a pleasant anticipation of the next satisfying meal or snack.
Subjects with high eating competence score low on EDI
Validation with EDI-26 and EDI-35 allow direct comparison of ecSI 2.0TM scores with eating disorder indicators. EDI-26 and EDI-35 are two-prong eating disorder inventories measuring eating and body image attitudes and behaviors as well as underlying psychosocial distortion.
A person who scores in the lowest tertile of ecSI 2.0TM (16 or below) may exhibit eating, body image, and psychosocial attitudes and behaviors associated with eating disorders.
The higher subjects score on both the original2 and updated3 ecSI 2.0TM, the lower they score on EDI-defined indicators of both eating/weight distortion and psychosocial limitations associated with eating disorders. Subjects who score in the lowest ecSI 2.0TM tertile (16 or below)3 score within typical EDI-2 and EDI-3 clinical ranges for these indicators:
- Bulimia
- Body dissatisfaction
- Low self-esteem
- Personal alienation (emotional emptiness and aloneness)
- Interpersonal insecurity (difficulties expressing thoughts and feelings)
- Interpersonal alienation (lack of trust in relationships)
- Maturity fears (desire to retreat to childhood)
The eating competence interview study
Cognitive interviews with low-income women7 reveal striking attitudinal differences between low-income women who score high and those who score low on ecSI. Women who score high relate their eating to energy, excitement, enjoyment, happiness, and relaxation. Those who score low report eating-disorder-typical eating attitudes and behaviors:
- Negative thoughts and feelings about eating
- Making weight management primary
- Emphasizing restricting and avoiding food
- Disorganized, inattentive eating
- Distress about failure to adhere to food management rules
Hypothesis: ecSI 2.0TM helps detect eating disorders
A person who scores in the lowest tertile of ecSI 2.0TM (16 or below)3 may exhibit eating, body image, and psychosocial attitudes and behaviors associated with eating disorders. Identifying ecSI 2.0TM cutoffs that warrant exploration of eating disorder diagnosis requires further study.
- Use EDI5 or the validated but uncopyrighted EAT-268 along with ecSI 2.0TM.
- As with any other paper-and-pencil test, cautiously interpret low ecSI 2.0TM scores, even when used in conjunction with EDI and/or EAT-26, as indicating an eating disorder. Only clinical examination can determine whether the person truly has an eating disorder.
- Until the scoring norms are established by further research, accumulate your own body of knowledge about typical ecSI 2.0TM scores you observe in people with eating disorders.
- Because ecSI 2.0 has been demonstrated to have test/retest reliability,9 you may administer ecSI 2.0TM before, during, and after intervention to support evidence-based clinical practice.
- Bruch H. Eating Disorders: Obesity, Anorexia Nervosa and the Person Within. New York: Basic Books; 1973.
- Lohse B, Satter E, Horacek T, Gebreselassie T, Oakland MJ. Measuring eating competence: psychometric properties and validity of the ecSatter Inventory. J Nutr Educ Behav. 2007;39:S154-166.
- Krall JS, Lohse B. Validation of a measure of the Satter eating competence model with low-income females. Int J Behav Nutr Phys Act. 2011;8:26-36.
- Stunkard AJ, Messick S. The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger. Journal of Psychosomatic Research. 1985;29(1):71-83.
- Garner DM. Eating Disorders Inventory 3. Odessa, FL: Psychological Assessment Resources, Inc.; 2000.
- Garner DM. Eating Disorders Inventory 2. Odessa, FL: Psychological Assessment Resources, Inc.; 1991.
- Krall JS, Lohse B. Cognitive testing with female nutrition and education assistance program participants informs validity of the Satter eating competence inventory. J Nutr Educ Behav. 2010;42(4):277-283.
- Garner DM, Olmsted MP, Bohr Y, Garfinkel PE. The eating attitudes test: psychometric features and clinical correlates. Psychol Med. 1982;12(4):871-878.
- Stotts JL, Lohse B. Reliability of the ecSatter Inventory as a tool to measure eating competence. J Nutr Educ Behav. 2007;39:S167-170.
Ellyn Satter's Secrets of Feeding a Healthy Family tells you how to eat as much as you want of foods you enjoy and be healthy!
ecSatter and eating disorders
- Are we teaching our children conflict and anxiety about food?
- ARFID: What is it? What does it have to do with feeding dynamics and eating competence?
- Child on psychotropic medication
- Court-ordered placement for child obesity: what can you do to help?
- Emotional eating
- Versions of internally regulated eating
- What does eating competence research say about eating disorders
More about eating competence
- Counseling with the Satter Eating Competence Model
- Eating competence
- Eating competence: Context-management skills
- Evidence for ecSatter
- How to eat
- The joy of eating: Being a competent eater
- Using ecSI 2.0TM
Stay in touch
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- Say thanks for this great information by making a donation to ESI!
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Family Meals Focus ~ No. 20Your child's food refusal is not your fault. All children are skeptical of unfamiliar food and take time to learn to enjoy it. However, some children are especially skeptical, are slow to warm up, react negatively to unfamiliar food, take longer to learn, and have more to learn.
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Family Meals Focus ~ No. 78To work your way through the continual changes of introducing solid foods in a "baby-led" fashion, go by what your baby can do, She will gradually learn to eat grownup food from toward the middle of the first year until she joins you at family meals and finger feeds herself soft table food.
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Professional workshop: The feeding relationship, an introduction to the possibilities in your settingWorkshop: Helps health and nutrition professionals begin to address the how, not the what of feeding and eating. Case examples addressing common child nutritional problems allow audience to identify underlying feeding dynamics and eating competence issues.
Affiliate programthe ESI Affiliate program offers professional development and certification for those working with eating and feeding based on the Eating Competence and Feeding Dynamics models.
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Professional workshop: Helping children to eat and grow well in child careWorkshop for child care providers and Head Start and preschool teachers teaches effective feeding practice. Learn to feed so children eat well, solve feeding problems, and diplomatically give parents good feeding guidance.
Webinar: Child Overweight: Helping Without HarmingThis webinar shows how child overweight can be prevented from birth with appropriate feeding. Growth acceleration can be treated by examining and correcting feeding distortions and letting the child's own capability with energy and growth regulation resolve the problem.
Webinar: School-age children and preadolescents: Setting up assessment and treatment of eating/weight issuesWorking in the context of the Satter Eating Competence Model and the Satter Feeding Dynamics Model, we will address assessment: What information do you need to get and why? We will also touch on treatment: Should children be in or out of the room with parents?
Webinar: Preventing Child Overweight and Obesity: Raising Children to be Competent EatersWebinar: Prevent child overweight, birth through teens by doing a good job with feeding based based on Satter's division of responsibility with feeding. Treat child weight acceleration by correcting feeding problems and restoring optimum feeding.
Webinar: Raising special needs children to be competent eatersWebinar: Learn to feed well, then trust the special needs child to push himself along to learn to eat. Case examples show how feeding can be approached with confidence, practicality, and joy.
Webinar: A County-wide Webinar: Obesity Prevention Strategy: Speaking with One Voice
WebinarsWebinars on preventing feeding and eating problems and understanding, assessing, and intervening with child and adult weight, special needs, and disease.
Eating management as a part of medical nutrition therapy for children with diabetes and impaired glucose tolerance
About Ellyn Satter
About Ellyn Satter
Ellyn Satter is a Registered Dietitian, Family Therapist, and internationally recognized authority on eating and feeding. In her presentations, books, videos, teaching materials, articles, and social media, Satter shares the wisdom of her 50 years' experience and research in helping with eating and feeding.
Ellyn pioneered the Satter Eating Competence Model (ecSatter) and the Satter Feeding Dynamics Model (fdSatter) and created the Division of Responsibility in Feeding (sDOR), which is the gold standard for feeding children. In her transformative, practical, theoretically sound, and evidence-based conceptualizations of eating and feeding, Satter emphasizes competency rather than deficiency, providing rather than depriving, and trust rather than control.
During her earlier professional years, Ellyn specialized in psychodynamic psychotherapy, in the symptom management of eating disorders, and ran Ellyn Satter Associates, which provided resources for professionals and the public in the area of eating and feeding. These days, she is a senior faculty member and programming consultant for the Ellyn Satter Institute.
Ellyn continues to publish and consult, dedicating herself to mentoring both parents and professionals. Practical, warm and empowering, she helps nutrition, health, and mental health professionals to identify and correct eating and feeding distortions and allow the people they advise to gain eating competence. She helps non-professionals by crafting and publishing accessible and authoritative printed materials and videos and by making herself available for conversations on FaceBook.
A sampling of Satter's books and teaching materials
- Secrets of Feeding a Healthy Family: How to Eat, How to Raise Good Eaters, How to Cook.
- Your Child's Weight: Helping Without Harming (Birth through Adolescence
- Child of Mine: Feeding with Love and Good Sense.
- How to Get Your Kid To Eat...But Not Too Much.
- Feeding with Love and Good Sense: The First Two Years
- Feeding with Love and Good Sense: 18 months through six years
- Ellyn Satter's Feeding with Love and Good Sense II DVD
- Ellyn Satter's Feeding with Love and Good Sense II: Parent Teaching Package
- Ellyn Satter's Feeding in Primary Care Pregnancy Through Preschool: Easy-to-Read Reproducible Masters
- Ellyn Satter's Nutrition and Feeding for Infants and Children: Handout Masters
- Satter Eating Competence Model Webcast Series on CD
Webinar: Early Weight Gain, Childhood Obesity, and Adult Disease RiskWebinar gives the evidence that rapid weight gain in early infancy isn't a problem, but there is a huge problem with sounding the alarm about it. It interferes with appropriate feeding.
Raise a healthy child who is a joy to feedYour child wants to eat, and he wants to learn to eat the food you eat. You don't have to get him to eat. Instead, he needs time and lots of chances to learn. Focus on how you feed and how your child feels and behaves at mealtime and around food in general, not on what or how much your child eats.
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Resources and links for organizations and policy-makers
Resources and links for the public
EducationLearn about the Satter feeding and eating models so you can correctly and creatively apply them at home and at work. We sponsor live presentations, contract with sponsors, offer the Affiliates program, self-study, do webinars, mentoring, and consulting. Join us on Facebook and Clinical Facebook.
The division of responsibility in feeding
ContactDo you have feeding or eating problems? Are you looking for a consultant or mentor? Contact us!
Who we areThe non-profit Ellyn Satter Institute is named for Ellyn Satter, who created the Satter Feeding Dynamics Model and the Satter Eating Competence. ESI faculty members and associates direct programming that carries on the legacy of Satter's work. ESI is recognized internationally for evidence based resources and guidance on sensible, enjoyable, wellness-based, and effective eating and feeding.
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Family Meals Focus ~ No. 66Children who are very large or very small can't be accurately tracked on the standard growth charts. To understand and assess their growth, their weight needs to be converted to z scores. Plotting their z scores against their age gives an accurate picture of their weight patterns.
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