Dietitian Dish: Intuitive Eating (June 2021)

Howdy Mountaineers!

It’s good to be back with another Dietitian Dish post and have a chance to connect with Mountaineer family members that might be joining us from locations around the world this summer. When thinking about what I wanted to share with my Mountaineers entering the summer season (depending on where you're located, that is) I wanted to be intentional about the topic I shared. I know I’m not alone when I say that right now, so much of what I see and hear on social media, the news and discussions among families is related to monitoring food consumption for that “summer body." I want to first acknowledge that thinking about vacations, new summer clothes and fun outings can be drenched in privilege, and while many do not have the option to do so, my hope is that this post can speak to everyone!

I’d like to talk about Intuitive Eating (IE). What it is (and what it isn’t). And how this framework is for everyone, because IE is a non-diet. I’d also like to say that any body currently experiencing summer...is a summer body! So, enjoy that vacation, wear that thing, visit that friend and nourish your body along the way. If you are considering any type of diet or substitute to eating in order to do all the fun summer things, I hope this information challenges you, as well as offers an alternative.

Let's talk IE shall we? There is a lot of confusion around IE and for good reason. If you search Instagram for the phrase "Intuitive Eating," more than a million posts pop up! If you google the phrase, more than 20 million! Now, If every post or site followed the same principles and contained the same information, OBVIOUSLY there wouldn’t be 20 million options of information to choose from right!? So, I’m here to set the record straight (drum roll please!).

If you’ve read any of my blog posts before (and if you haven’t, here is your sign to do so), you know that I like to share information that is from evidenced-based research. When it comes to our mental and physical health, I think it’s important to share recommendations and information that are supported through sound and unbiased evidence. I preface this to give my Mountaineer readers a forewarning for what’s to come (references galore!). I’d like to get into some pretty recent research that looks at the benefits of IE, but let’s first start with a definition.

Intuitive Eating is an evidenced-based, self-care eating framework (Tribole & Resch, 2020). There are 10 principles within this weight neutral model. More than 150 studies have been conducted looking at the benefits of IE (Tribole & Resch, 2020). The IE framework is rooted in respect for all bodies (body diversity) and focuses on the following characteristics: reliance on internal hunger and satiety cues, unconditional permission to eat (a.k.a. attunement), and food-body choice congruence (Tribole & Resch, 2020). There is a lot to unpack here so let’s start with the 10 principles of IE and break down each one to better understand these main characteristics.

Principle 1

Reject the diet mentality. Whoa, this is a hard one. What this means is to turn your back on all the diets that promised quick solutions, weight loss, self-esteem boosts and to solve all your problems! But wait! What about that one diet that worked for you for a couple of months? The fact is, 95% of people who lose weight when dieting gain the weight back in five years. Furthermore, about ⅔ of these folks will gain back even more weight than when they initially started the diet (Mann, et al., 2007). So, by “working,” we are talking about short-term weight loss that ultimately increases cravings, guilt, restriction, deprivation and weight in the long-term. What this first principle is asking, is to reject any mental and physical action that is harmful and has no long-term success. We are talking about a peace movement here (both in our mind and body), and the first step is acknowledging that all those diet books and magazines share lies that weight loss is the key to happiness.

Principle 2

Honor your hunger. Yes, you read that right! To honor our hunger means to not restrict. So, when you're hungry, honor it. When we meet our body’s biological needs for energy (and yes that includes carbohydrates), then we begin to rebuild body trust. If you can’t trust you, then who can?

Principle 3

Make peace with food. By giving yourself unconditional permission to eat (without any food rules) you ultimately stop obsessive food thoughts. Have you ever thought about consuming a food and then tell yourself you have to be “good” by not eating the food? Then, you find yourself two days later, binging on that said food? If so, you aren’t alone. Food rules and restriction can actually increase cravings and binges (Meule, 2020).

Principle 4

Challenge the Food Police. If you have ever had thoughts after eating a food that said you were “bad” for eating it, guilt or shame were likely to follow. While the media gives the message that if you avoid eating the “bad” foods, your health will improve, research doesn’t support this. What we know is, adopting IE will increase overall well-being, optimism, body trust and self-control (Linardon, et al., 2021). So, by giving yourself unconditional permission to eat, you will be taking one giant leap towards improving your health!

Principle 5

Discover the ‘Satisfaction Factor.’ By allowing yourself the pleasure to eat the foods that are yummy to you, it is easier to honor your body’s signals of hunger and satiety. By doing so, evidence shows that individuals decrease their triglycerides, increase their HDL (the good cholesterol) and improve their glycemic control (Tribole & Resch, 2020).

Principle 6

Feel your fullness. By honoring your fullness, and assessing hunger levels, evidence supports that increasing body trust takes place (Tribole & Resch, 2020; Linardon, et al., 2021).

Principle 7

Cope with your emotions with kindness. This principle suggests that finding ways to cope with extreme emotions that support positive self-care is important. It is likely that using food as a coping strategy to combat negative emotions will ultimately not soothe those emotions long-term and will only provide short-term relief. By practicing IE, evidence shows that individuals have greater emotional functioning and proactive coping, as well as a more positive body image (Bruce & Ricciardelli, 2016).

Principle 8

Respect your body. Everyone is unique, right? Bodies come in all different heights, shapes and sizes. Accepting the body you are in allows you to honor and respect yourself. If you wore a size 8 shoe but continued to become upset that you couldn’t fit your foot into a six 6, that would be pretty silly right? Applying this analogy to one’s body size shouldn’t be any different! Body size and weight are impacted by a plethora of factors, including: biological and genetic factors; ethnicity; culture and social influences; trauma; stress; activity; food consumption; age and environmental factors (Institute of Medicine, 2004). Weight is not as simple as the number of calories you take in and the amount of physical activity you carry out. Being flexible with body image is connected with decreasing disordered eating risk and increased emotional regulation (Cardoso, et al., 2020).

Principle 9

Focus on how movement makes you feel. What do you define as physical activity? Is it what burns the most calories? Is it the traditional modes of activity such as lifting weights, playing a sport or endurance training? What if you instead shifted your mindset on what movement looked like? Weight-focused or calorie focused physical activity is associated with decreased motivation in consuming quality foods (Carraca, et al., 2019). Intuitive eating increases physical activity motivation! Focusing on movement as it relates to how it makes you feel versus how many calories you burn while doing it is key.

Principle 10

Honor your health through gentle nutrition. We need a ton of different vitamins and minerals, as well as macronutrients and food variety. Certain foods have higher amounts of vitamins and minerals and are more energy dense compared to others. Striving for progress, consistency and balance is the key to gentle nutrition. By exploring how foods make you feel and practicing internal awareness of food and body sensations, you can meet all of your body’s nutrient needs and make informed decisions about eating. This is what we mean by the phrase “food-body choice congruence.”

And there you have it. The principles of IE. So, is IE the key to happiness? Arguably, there are many ways in which we can achieve happiness, fulfillment and contentment, but there’s not any ONE right way to do so. But, IE is connected to increased body trust, improved wellbeing, optimism and self-control, proactive coping, interoceptive awareness, and decreased disordered eating. And with the statistics showing that almost 29 million Americans will have an eating disorder in their lifetime, adopting IE can be one way to combat that statistic and improve well-being (Sonneville & Lipson, 2018).

Diets and Eating Disorders

We discussed the IE framework and outcomes that are associated with this model: increased body appreciation, increased body trust, increased body cue awareness, increased food variety and fruit/vegetable consumption, etc. (Howard, et al., 2021). Let’s pause here. If you’re wondering if honoring your hunger cues and eating foods that you enjoy is part of what we are talking about here — you are absolutely right! What isn’t associated with all of these positive and health promoting outcomes is the need to change your body in any way!

On the flip side of the IE framework is eating disorder statistics. Remember: this discussion is for educational purposes only and is not a substitute for medical/professional advice. What we know about risk factors for eating disorders is that there are complex biological, psychological and sociocultural factors that impact these diagnoses (NEDA, 2021). Because these complex factors are beyond the scope of this post, let’s just take a look at the connections. If you're interested in eating disorders as a topic for a future post, give me a shout! The following considerations are connected to an increased risk of developing an eating disorder: perfectionism; body image dissatisfaction; anxiety disorder; behavioral inflexibility; weight stigma; bullying; appearance ideal internalization; history of dieting and more (NEDA, 2021). Wow, associations between IE and eating disorders are shocking! By NOT following a diet, restricting food intake and honoring hunger cues, our health improves.

The misconception about IE is that it provides a “pass” for individuals to eat whatever they want, when they want. IE isn’t “giving up” and just eating whatever you want! It is a set of principles to support honoring your body, hunger and fullness, and your mental and physical health.

And with that, another blog post has concluded. Until next time, fellow Mountaineers!

References:

1. Bruce, L.J., & Ricciardelli, A.L. (2016). A systematic review of the psychosocial correlates of intuitive eating among adult women. Appetite, 96(1), 454-472.
2. Cardoso, A., Oilveira, S., & Ferreira, C. (2020). Negative and positive affect and disordered eating: the adaptive role of intuitive eating and body image flexibility. Clinical Psychologist, 24:176–185.
3. Carraca, E.V., Leong, S.L., & Horwath, C.C. (2019). Weight-focused physical activity is associated with poorer eating motivation quality and lower intuitive eating in women. Journal of the Academy of Nutrition and Dietetics, 119(5), 750-759.
4. Hazzard, V.M., Telke, S.E., Simone, M., Anderson, L.M., Larson, N.I., & Neumark-Sztainer D. (2021). Intuitive eating longitudinally predicts better psychological health and lower use of disordered eating behaviors: findings from EAT 2010-2018. Eat Weight Disord, 26(1), 287-294.
5. Institute of Medicine. (2004). Factors that influence body weight. US Subcommittee on Military Weight Management. Washington (DC): National Academies Press.
6. Linardon J., Tylka, T., and Fuller-Tyszkiewicz M. (2021). Intuitive eating and its psychological correlates: a meta-analysis. International Journal of Eating Disorders, 1-26.
7. Mann, T., Tomiyama, A.J., Westling, E., Lew, A.-M., Samuels, D., & Chatman, J. (2007). Medicare’s search for effective obesity treatments: Diets are not the answer. American Psychologist, 62(3), 220-233.
8. Meule, A. (2020). The psychology of food cravings: the role of food deprivation. Curr Nutr Rep, 9, 251-257.
9. National Eating Disorder Association (2021). Risk Factors. Retrieved from https://www.nationaleatingdisorders.org/risk-factors
10. Tribole & Resch (2020). Intuitive Eating, 4th ed., St. Martin’s Press.
11. Tylka, T.L. (2013). Journal of Counseling Psychology, 60(1), 137.
12. Tylka, T.L., & Kroon Van Diest, A.M. (2013). The Intuitive Eating Scale-2: item refinement and psychometric evaluation with college women and men. Journal of Counseling Psychology, 60(1), 137-53.