Intuitive eating where to start

This post was written by Brittany Swygart, RDN, CD, Parkview Health.

When I see people in an outpatient setting for nutrition education and counseling, it’s not uncommon for these individuals to have experimented with different diets in the past. Whether it be point-based eating, pre-portioned delivered meals, keto, intermittent fasting, calorie counting, or any of the number of trends out there today, they’ve tried a variety of methods. Often by the time someone decides to see a registered dietitian for weight management or healthy eating, they have already tried losing weight on their own.

The truth about diets

It’s common for people to lose weight following (insert diet of choice here), and then gain it back. This can become a cycle of new diet, weight loss, weight gain, new diet, weight loss, weight gain, and so on. By the time they make an appointment to see me, patients are often discouraged and frustrated.

The diet market is close to a $70-billion-dollar industry. Weight loss sells! Who wouldn’t want a quick fix program to lose weight? It’s also an industry that profits off of knowing that diets seldom work and that they often lead to an unhealthy merry-go-round. When one diet eventually fails, you start looking for another.

There are many individuals who like the rules, control and structure of diets. Unfortunately, the research shows that 95% of people who diet will end up regaining the weight they lost within 3-5 years. What’s more, a large percentage of these people will actually gain back more weight than the amount they initially lost. This yo-yo pattern with weight loss and regain is known as weight cycling. Research shows that one’s health is actually worse off through this weight cycling than if they would have stayed the same weight. Data supports that weight loss is a predictor of subsequent weight gain rather than sustained weight loss.

Intuitive eating

As a professional, why would I recommend something that only has a 5% success rate? Another approach that takes the focus off of weight loss (which isn’t a behavior in and of itself) and instead focuses on healthy behaviors and your long-term relationship with food is called intuitive eating. This approach is based off of a book by the same name, written in 1995 by two registered dietitians, Evelyn Tribole and Elyse Resch. It has since been updated and revised with the latest nutrition research. Dozens of research studies over the past 25 years have supported the intuitive eating concept.

So, what is intuitive eating? The intuitive eating method to eating is a non-diet approach that focuses on internal cues versus external diet rules. The focus is on health-promoting behaviors versus just the number on the scale.

10 principles of intuitive eating
  1. Reject the diet mentality.  Stop focusing on short-term results. Diets are not sustainable. Yes, you will lose weight short-term, but then the restrict/binge and yo-yo dieting cycle begins again. Intuitive eating is a process, but the end results are well worth it to stop the endless diet-restrict-regain weight cycle.
     
  2. Honor your hunger.  So many diets focus on deprivation, which inevitably leads to not being able to follow the diet long-term. Dieting can actually be a form of starvation. Our bodies need a certain amount of energy to function. When you’re dieting, the body will drastically lower your metabolism and hold onto fat. When you are eating too few calories, your body thinks it’s starving so it decreases your metabolism and increases fat storage. This makes it even more difficult to lose weight. Your body is holding onto all the food it can. Our bodies are designed to protect us against starvation, so it’s going to do everything it can to adapt and compensate.
     
  3. Make peace with food.  Personally, this is my favorite of all the 10 principles, and is often the one people struggle with the most. Making peace with food means giving yourself permission to eat all foods. I use this example: I personally love chocolate; I have a sweet tooth. If I tried to “be good” and not have chocolate for a period of time (say a week), I am going to be thinking about chocolate and craving it nonstop! However, giving myself permission to eat chocolate, and knowing that I can have it again tomorrow, takes the chocolate off the pedestal. I don’t have to go crazy with chocolate because it’s not a rare treat or “indulgence”. I’m usually satisfied after eating less knowing that it’s not this “bad” food and I can eat it again tomorrow if I want. There’s even research that shows individuals with higher dietary restraint have a hyper-responsive reaction of reward regions in their brain to food. The evidence shows that individuals with high dietary restraint show elevated weight more than those who show low dietary restraint.
     
  4. Challenge the “food police”.  This principle goes hand-in-hand with making peace with food. While making peace with food is giving yourself the physical permission to eat all foods, challenging the food police is giving yourself the emotional permission to eat all foods. The food police monitor the unreasonable rules that dieting has formed in your mind. You are not “good” for eating a salad and you are not “bad” for eating a chocolate chip cookie. Yes, foods have nutritional differences, but all foods can have a place. Continually avoiding certain foods or social situations to avoid food that isn’t allowed on your diet is not emotionally or mentally healthy in the long run. Food has no moral value. It’s just food. The only food you should ever feel guilty for eating is stolen food!
     
  5. Respect your fullness.  Just like it’s important to honor your hunger and eat when you’re hungry, it’s also important to notice when you are comfortably full. Are you eating just because there is food still left on your plate?
     
  6. Discover the satisfaction factor.  It’s possible to feel physically full, but not satisfied. For example, if you’re craving something sweet (dessert) and decide to have fruit, you could experience this. While the fruit might make you full, you might really be wanting chocolate. Oftentimes, you may actually end up eating more because you keep looking for something else to satisfy that craving. Eat the chocolate, enjoy it, and move on.

    Another example is if you’re at a restaurant and are really craving a burger, but instead order the salad to “be good” and follow your diet. You leave feeling unsatisfied and end up snacking on other foods to try to fill that craving. You don’t want to constantly be preoccupied with food throughout the day.
     
  7. Honor your feelings without using food.  It’s normal to eat for reasons other than physical hunger sometimes, and that’s not necessarily always bad. Think of birthday cake, the homemade treats or donuts your coworker brought into the office, etc. However, the problem is when you consistently use food to cope with emotions (stress, depression, boredom, etc.). Food may make you feel slightly better in the short-term, but long-term it’s not a helpful coping mechanism. I encourage you to discover the why behind what you eat and how much. Discovering your emotional relationship to food can be messy, as it often causes someone to think about these negative feelings. But digging down to the root issues is ultimately worth it, opposed to covering something up with a short-term solution.
     
  8. Respect your body.  An analogy in the “Intuitive Eating” book is that just as a person with a size 8 shoe size would not expect to realistically squeeze into a size six, it is futile (and uncomfortable) to have the same expectation with body size. It’s difficult to reject the diet mentality if you are unrealistic and overly critical of your body. Your weight is one of many indicators of your health, not the only one.
     
  9. Exercise – feel the difference.  Find movement that you enjoy so it’s more sustainable long-term. Another personal example: I hate gyms. I don’t like anything about them. Some people thrive in that environment, which is great for them. I personally prefer exercising outside. Walking my dog, biking, and hiking are some activities I regularly do that don’t even feel like exercise to me. Intuitive exercise is focused on feeling your best—not used as punishment strictly for weight loss.
     
  10. Honor your health.  And last but not least, the final principle focuses on nutrition. Make food choices that honor your health and taste buds, while making you feel well. For example, you probably logically know that eating fast food for every meal or an entire pizza in one sitting will not make you feel your best.


This is also the principle where medical nutrition therapy comes into play. For example, if an individual has diabetes, it would be honoring his or her health to learn how to eat a consistent amount of carbohydrates throughout the day. If someone has heart failure and needs to monitor their sodium or fluid intake, they should learn how to consume foods to align with those restrictions and minimize risk. The authors of “Intuitive Eating” remind us that you won’t suddenly develop a nutrient deficiency from one snack, meal or even entire day of eating. It’s what you eat consistently over time that matters, and you should focus on progress over having “the perfect diet”.

Interestingly, research shows that intuitive eaters are actually less likely to be overweight, and spend less time thinking about food. Dieters (a.k.a. controlled eaters who are listening to external rules regarding what and how much they should eat versus internal cues) are actually more likely to be overweight and spend much more time preoccupied with food. However, the focus of intuitive eating is not on weight. Rather, it’s about a healthy long-term relationship with food and your body and focuses on honoring your overall health.

If you’re interested in learning more, the book “Intuitive Eating” by Evelyn Tribole and Ellyse Resch is extremely helpful, practical and thorough. They also have a website that includes more on the research and science behind intuitive eating. This short Ted Talk is also helpful in understanding the concept.

 

Sources

Bacon, L., & Aphramor, L. (2011). Weight science: evaluating the evidence for a paradigm shift. Nutrition journal10, 9.

Burger, K. S., & Stice, E. (2011). Relation of dietary restraint scores to activation of reward-related brain regions in response to food intake, anticipated intake, and food pictures. NeuroImage55(1), 233–239.

Field, A.E., Manson, J.E., Taylor, C.B., Willett, W.C., Colditz, G.A. (2004). Association of weight change, weight control practices, and weight cycling among women in the Nurses’ Health Study II. Int J Obes Relat Metab Disord. 2004 Sep;28(9):1134-42.

Fletcher, S. W., Buring, J. E., Goodman, S. N., Goodridge, A. G., Guthrie, H. A., Hagan, D. W., ... Williams, O. D. (1992). Methods for voluntary weight loss and control. Annals of Internal Medicine116(11), 942-949.

Mann, T., Tomiyama, A. J., Westling, E., Lew, A.-M., Samuels, B., & Chatman, J. (2007). Medicare's search for effective obesity treatments: Diets are not the answer. American Psychologist, 62(3), 220-233.

Stice, E., Cameron, R. P., Killen, J. D., Hayward, C., & Taylor, C. B. (1999). Naturalistic weight-reduction efforts prospectively predict growth in relative weight and onset of obesity among female adolescents. Journal of Consulting and Clinical Psychology, 67(6), 967-974.

Tribole, E., & Resch, E. (2012). Intuitive eating: A revolutionary program that works (3rd ed.). New York: St. Martins Griffin.

 

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