External Controls

The concept of external control is in comparison to that of self-control. Often external control is used in the context of the equation: (Internal) Self-Control + External Control = Weight Control.

People with an inability to self-regulate an action such as smoking, consuming alcohol, or overeating often turn to external controls for assistance. An external control is something that is out of the person's control that directly affects their particular action. For example, a family member throwing away cigarettes is an external control for smoking. An external control for over-eating may be having access to a limited amount of food. Several popular weight-loss programs use just such an external control.

An early example of external controls can be found in a group of Portuguese monks of the Middle Ages who consciously built a kitchen door narrow enough to keep out all but the slender monks.

A chief external control for youths is a parent figure dictating how much food the child will consume. Some data hints that people whose portions were decided by parents, i.e., children who grew up being told to “finish their plates,” have more trouble aligning adult food intake with hunger than people who were allowed to determine their food doses as youths.

Imposing external controls requires determination. Some people move to metropolitan locations that force them to walk more, rather than dwell in suburbs. Others take activity-focused vacations. Recruiting family members and spouses to help limit temptations and access to food has repeatedly been shown to aid people in reducing their over-eating. Individuals who are supported in their endeavors to control their eating are less likely to feel depressed about their actions and also less likely to relapse into overeating.

With recent interest in overeating, obesity, and dieting, the desire for a solution to overeating has inspired entrepreneurs. For example, it is commonly known that the body takes fifteen to twenty minutes to recognize a state of satiety; in 1987 a patent was filed for a device that is effectively a microphone to amplify sounds made in the gastrointestinal tract when enough food has been consumed, to warn the eater before the standard physiological fifteen to twenty minutes. Another device filed under the same patent was to be internally embedded and would send a radio [Page 252]signal to an external processor once enough nutrients have been consumed. These two devices would act as an external control to alert the eater when enough food has been eaten, thus avoiding over-eating.

External controls can range from subtle to extreme. For example, limiting the stress in one's life might relax the need to find solace in food. Extreme cases of imposing external controls include wiring one's teeth shut or undergoing gastric bypass surgery, colloquially known as “stomach stapling”.

Gastric bypass surgery shunts food from a smaller-sized stomach to further down the small intestine than normal (the shunt joins the jejunum). In this way, the stomach is much smaller and therefore fills up more easily (an individual who has undergone gastric bypass surgery can consume about the amount of food that would fit in a shot glass). Additionally, the first part of the small intestine (duodenum) is circumvented, limiting caloric absorption. Downsides to this surgery include extreme pain and nausea if too much food has been consumed, and possible under-absorption of vital nutrients such as iron and vitamin B-12. Deficiency in vitamin B-12 is particularly frequent in individuals with gastric bypass because a gastric secretion is necessary for absorption of this vitamin. Therefore, not only smaller portions of food must be eaten, but specific foods and supplements must be consumed in order to obtain proper nutrition.

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