Friends, I am particularly excited writing this blog.
Elizabeth Freyre, registered dietitian and my sister, will be talking about nutrition and health coaching based on the intuitive eating model - originally published in 1995 by Evelyn Tribole and Elyse Resch (Full reference below).
As a doctor, learning about intuitive eating is exciting and interesting to help people with various patterns of disordered eating, difficulty losing weight, serial dieting and anxiety around food. For DECADES, we have been touting: “eat right and exercise” and the “calories in/calories out” equation. For most people, it really just isn’t that easy. There are so many factors that go into our body size and weight, and what we eat and when and why (including stress, see my previous blog on chronic stress: This Painful Life: Part 2)
I cannot tell you how many times I’ve sat with a woman in an exam room talking about weight. It’s sensitive and painful. Wrapped up in our weight is a major value judgement on ourselves as a people. It’s not fair, but it’s there.
When I have ruled out medical causes for weight gain or difficulty losing weight and we have reviewed a food and exercise diary and still there is no change, we both slump a little in our chairs. I hate not having something helpful to offer.
I believe intuitive eating is a way of getting in touch with our bodies to directly address anxiety around food and emotional eating. When the goal is physical and mental well-being, the success is far greater. There is research data to support the intuitive eating model. In a 2014 literature review in Australia, Intuitive Eating, defined, for study purposes, as: eating when hungry, stopping when no longer hungry or being full, and no limitations on types of foods except for medical reasons, was associated with lower BMI, better markers of psychological health (including body image, optimism, positivity, lower depression rates) and possibly increased physical health indicators (lower cholesterol, lower inflammatory markers). More research is needed and is being done, but from the perspective of “body wisdom” it simply makes a whole lot of sense.
Below is a beautiful summary that Elizabeth wrote on intuitive eating. For me, reading it makes me feel inspired and relieved; there is no magic formula or diet, my body knows the right answer, I just need to remind myself to be quiet and listen to it.
What is intuitive eating?
Intuitive Eating is the process of you becoming the expert of your own body.
It’s about rejecting the diet mentality. Avoiding programs, diets, plans that promise quick weight loss, because let’s face it, they don’t work! Sadly, they make you feel as if you were the failure, when really, the diet is the failure.
Intuitive eating is about honoring your hunger. Learning how to honor this first biological signal is so important for rebuilding trust with yourself and with food.
It’s about making peace with food. Giving yourself unconditional permission to eat whatever you want. When we forbid ourselves from certain foods it can cause intense feelings of deprivation, which can lead to obsessing and often overeating or bingeing, causing you to feel guilty. Many are afraid to do this because they fear they will uncontrollably eat ‘bad’ foods and gain weight, but case studies show quite the contrary.
Intuitive Eating is about challenging the food police. The food police monitor the unreasonable rules that dieting has created and they live deep in our psyche: ‘I’m bad because I ate too many carbs today’, ‘I’m good because I only ate 1000 calories’. Scream ‘NO, NO, NO!’ to these officers, as this is critical for rediscovering the intuitive eater in you.
It’s about feeling your fullness. Learning to listen to your body’s signals that tell you ‘I’ve had
enough.’ Learn to pause and check-in with yourself mid-meal or mid-snack to ask ‘how does this taste?’, ‘What is my fullness level?’ You’ll find that when you honor your hunger, it’s easier to feel your fullness.
Intuitive Eating is about discovering the satisfaction factor. In the United States especially, we eat for health or to lose weight and we tend to overlook a beautiful gift of existence - the
pleasure and satisfaction that can be found in the eating experience. When you actually enjoy your food (without guilt or judgement from yourself or others), you’ll find that you’ll be satisfied with less.
It’s about learning to cope with your emotions without using food. We all experience
uncomfortable emotions throughout our life, but food won’t fix these feelings in the long-run.
Learn the triggers of these emotions and different ways to nurture, comfort, and resolve these issues without using food.
Intuitive eating is about respecting your body. Learning to be less critical of your body shape,
and accept the body that you were given. When you feel better about yourself, it is easier reject the diet mentality.
It’s also about feeling the difference with exercise. When you shift your focus from ‘how many calories am I burning’, to ‘how it feels’ to move your body, it can make such a big difference.
And finally, intuitive eating is about honoring your health with gentle nutrition. Near the end of
the intuitive eating process, you will be much more in tune with your body and its signals, that you will be making food choices that honor your taste buds, while still honoring your health by giving you energy and making you feel good.
Finally, a few questions came up during our discussion on this topic. She assures me that these are frequently asked questions regarding intuitive eating and took a moment to address them for me. This is a little of our Q&A session:
Stepping onto a scale is a major source of anxiety for many people. With intuitive eating, you don’t recommend weighing yourself regularly and you don’t take weights at visits. Can you discuss why that is?
Yes, scale anxiety is real and little wonder! Many patients have been scolded by practitioners regarding their weight, yet are not given any suggestions to get to a healthy weight other than an ‘eat less, exercise more’ talk, or some other form of diet that doesn’t work long-term and will ultimately slow your metabolism, causing the weight gain trend. Intuitive Eating therapy avoids the scale because when we see that number, whether it’s ‘good’ or ‘bad’ it affects our thought process. We judge ourselves, we restrict, we congratulate with over-eating, we do anything but listen to our body’s needs. It interrupts the ability to honor your hunger and respect your fullness.
What about people who have diabetes or other health conditions that might affect when/how/what they eat or people who have been given special diets by their doctor?
Intuitive Eating is very experiential. When you become more in-tune with your body’s signals, the various foods (or amounts) that negatively affect you (possibly because of your condition or disease) will no longer be appealing because of the way they make you feel. In the case of diabetes, if you’re eating in a way that keeps your blood sugars at a normal level, rather than high, you’re going to feel a lot better: more energy, better focus. Part of learning to become an intuitive eater is being aware enough to notice these effects on your entire body and learning from these experiences. Anyone with a medical condition should always be followed by their physician and take their medications as prescribed but the intuitive eating model is generally still a very safe approach.
With the rise of overweight and obesity in children and the excessive marketing of junk foods and treats to children, fostering healthy eating behaviors in kids is critical. You told me, “kids are the most intuitive eaters.” Can you speak to some of the best ways to help our kids be and stay intuitive eaters?
Yes, the younger we are, the more we listen to our body’s hunger/fullness cues, simply because we’ve had less outside influence, which is outrageously abundant in so many forms these days. In order to help our kids be/stay intuitive eaters, one of the best things you can do is to trust your child’s innate abilities. Offer a variety of healthful foods but let them oversee how much they eat. It’s also great to share the power of nutrition early on (such as ‘these foods help you grow’, or’ these foods will keep you from getting sick’) but avoid talking about foods as ‘good’ or ‘bad’ or ‘junk’. Calling food ‘junk’ implies they have no purpose and children will then feel guilty for wanting to eat them. Evelyn and Elyse call this ‘play food’ and overly restricting play food will make it extra appealing for kids when they are exposed to it at friends' homes, etc. Children are more likely to rebel and overeat when we act as the ones in charge of their body. For more detailed steps for protecting and reinforcing your child’s intuitive eating experience, see chapter 15 of: Intuitive Eating by Evelyn Tribole, MS, RD, and Elyse Resch, MS, RD, FADA, CEDRD
Finally, Elizabeth can you speak a little to what nutrition/health coaching visits might look like when learning and practicing intuitive eating and how long does it take?
Since this is such a personal and unique journey for each person there won’t be an exact template for counseling sessions. However, at the beginning, we will uncover what kind of eater you might be and see how far from Intuitive Eating you are. This will help us establish a path for your experiential journey. We will introduce all the intuitive eating principles (not necessarily in order 1-10) and provide you with real scientific information/case studies/research that will help elicit change. The time frame will be different for everyone. If you’ve been chronically dieting on/off for many years, you may need more therapy sessions to get back in tune with your eating.
References:
Van Dyke N, Drinkwater EJ. Relationships between intuitive eating and health indicators: a literature review. Public Health Nutr. 2014 Aug;17(8):1757-66. doi: 10.1017/S1368980013002139. Epub 2013 Aug 21.
Tribole, Evelyn, Resch, Elyse. Intuitive Eating, A Revolutionary Program That Works. New York, New York. St Martin’s Press 2012
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