Several conversations converged this weekend. First came a question from my friend Nazalee to a community of my colleagues: “Oh wise ones…why sooo hungry after Thxgiving? Does stomach stretch or what? Is it a hormone?” One reply: “Perhaps expl is longer than 140 words. Salad Wine turkey ham pumpkn pie not horrible food.”

Then, just two days later, a friend was telling me about his experience studying Talmud in Jerusalem last summer. While studying a different subject entirely, the rabbi made an aside that indulging drives makes them stronger. My friend’s ears perked up at that, and he saved that little pearl to think about at a later time

His comment returned my thoughts to Dr Mike Roizen’s and Dr Oz’s oft-stated opinions (in contrast to my own) that dietary changes must be made on an all-or-nothing basis. Hook, line, and sinker. Like AA. Might this truly be the best strategy for someone with a food addiction? It is certainly in line with the rabbi’s comment. The rabbi’s observation may also have a hormonal basis, as Nazalee conjectures above. Dr Richard Bernstein, from the Nutrition & Metabolism Society, taught me once that stomach stretching initiates a cascade of hormone release that raises blood sugars, which is why eating a whole cabbage will raise your blood sugar even if it is the only thing you eat.

In contrast to the all-or-nothing strategy, on the other hand, I have always been of the opinion that the most sustainable changes are the small ones. When a patient came to see me, I would identify the worst, most egregious, problem and try to work on that issue first. When a patient asks my opinion on a reasonable rate of weight loss, I joke that one-quarter pound a month for the rest of their life would be just about right! I feel that there must be accommodation for our humanness, our fallibility. We aren’t computers to be set at a particular setting. This seems right to me, both for myself and for my patients. The last thing I want to do is to increase stress-related eating. But maybe it’s exactly the wrong advice for someone whose overeating pattern is more in line with an addiction.

I, too, ate a lot more food than usual this weekend. Maybe it’s the change in routine, the distractions, the food itself: its availability, quality, flavor, or the love with which it is made. Whatever the reasons, tomorrow is another day, and I am sure my appetite will be back to normal within a day or two.

Michael and Mary Eades, of Protein Power, talk about coming upon “the honey tree.” This is their descriptor for the experience of taking a major detour from one’s usual way of eating, particularly eating more sweets than usual. Nazalee, it appears that you (and most Americans, probably) came upon the honey tree this week. Other than that, I don’t have an answer for you. It’s not the 140-space limit. I just don’t know. But I have faith and I believe, therefore, that with time you will figure it out.