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What is “Intuitive Eating”

A brief history

The philosophy of Intuitive Eating posits that humans are born with the ability (an “intuition”) to self-regulate appetite and make dietary choices based on internal hunger and fullness cues, but external messaging about food and body size undermines this ability and causes distress and disorder around food and weight. Intuitive Eating is then characterized by being in-tune with internal bodily cues, and flexible thinking and behavior concerning food.

Intuitive Eating was developed in an effort to promote health independent of weight, in direct response to concerns about the efficacy and ethical implications of the weight-centric standard of care. Though the term “intuitive eating” was coined by dieticians Evelyn Tribole and Elyse Resch in 1995, its concept and development began in the 1960s with feminist activists opposed to weight-centric cultural norms.

Feminists in the 1960s began advocating for people in all body sizes to receive non-discriminatory healthcare. In 1968, journalist and feminist advocate Susanna McBee, who was described as having a slim body size, wrote an exposé that popularized the movement for size inclusivity and the opposition to weight loss diets; McBee documented visits to 10 different doctors where she expressed dissatisfaction with her body size and a desire to lose weight, and on each visit was prescribed medications to aid in weight loss including amphetamines

In the 1970s, this movement gained the attention of dieticians and psychologists.  In 1973 the first known dietetic program built on the principle that weight loss diets were ineffective and often unethical was developed by dietician, Thelma Wayler. In 1978, famed psychologist and eating disorder specialist Susie Orbach published her book, Fat is a Feminist Issue, which brought the feminist movement’s opposition to weight-centric healthcare to popular consciousness. Orbach wrote about Western prejudice against people with larger bodies, the rise in disordered eating behavior and normative bodily discontent among women, and advocated for women to listen to their body’s internal hunger and fullness cues. Orbach’s work was monumental in the development of Intuitive Eating, as she was one of the first healthcare professionals to publicly oppose weight-centric standards of care.

Throughout the late 1970s and 1980s, activists and scholars increasingly pushed for systemic changes and questioned the thin ideal.  In the 1980s, research supporting these movements emerged, suggesting that restrictive eating may contribute to weight cycling, decreased resting metabolism, increased fat storage potential, and increased risk of eating disorders and low self-esteem. Prior to the 1980s, opposition to weight-centric norms was purely theoretical and advocacy-based. However, the emergence of scientific evidence supporting theory and advocacy work further legitimized the movement and allowed for the semination of this information to medical professionals.

In the late 1980s and early 1990s, this research began examining the eating behavior of people who did not comply with weight-centric standards.  In studies examining participants with unrestrained eating behavior who did not overeat, it was found that these individuals maintained “healthy weights” among other positive health measures.  Thus, researchers began questioning weight-centric standards of care, leading to the emergence of what we now call Intuitive Eating. 

Theory

The foundation Intuitive Eating is described by Tribole and Resch as a “dynamic interplay of instinct, emotion, and thought”, embracing physiological instincts and signals, logical decision-making and thought about food choices, and the emotional and cultural meanings these choices hold.  At the core of these choices, however, is attention to internal bodily cues.

While eating as an infant and toddler is mostly based on instinct, the theory of Intuitive Eating suggests that as we develop greater ability to attend to emotion and thought, our food choices intuitively follow.  With the development of food choices with age, the theory of Intuitive Eating proposes that interoceptive awareness becomes increasingly important.  Interoceptive awareness refers to the ability to perceive physical sensations that arise within one’s body like hunger, a full bladder, or an itch.  The ability to perceive these sensations must not only be present, but also sensitive enough to accurately predict needs, and adequately inform behavior – an ability known as interoceptive sensitivity.  Finally, interoceptive responsiveness is thought to play a role in the ability to eat intuitively, which refers to our behavioral responses to the physical cues we perceive.  Therefore, if physical sensations about hunger, fullness and food selection can be accurately perceived, the basis of Intuitive Eating then is the practice of honoring and respecting one’s body by listening and responding to those sensations.

Research has demonstrated that external messaging about food and body size can undermine this instinct.  For example, parent feeding practices including restriction, pressure to eat, and excessive monitoring, are linked to higher rates of eating disturbances in children as young as 2-years-old!  Likewise, in a study of long-term effects of parental monitoring and restriction, young adults and their parents were asked to retrospectively respond to questionnaires about childhood feeding practices and current eating patterns.  In this study, higher levels of parental monitoring or restriction during childhood predicted lower interoceptive sensitivity, and higher levels of emotional eating.  These effects have similarly been observed in studies of immigrants moving from under-developed into industrialized nations.  In one such study, as acculturation increased for a group of immigrants, rates of disordered eating increased.

Principles of Intuitive Eating

To begin practicing Intuitive Eating, it is important for us to understand the cultural and historical significance of this approach.  Intuitive Eating is, at its core, a radical movement focused on challenging societal ideals of how we “should” eat, and empowering individuals to make informed choices about their health and bodies.

This is why the first principle of Intuitive Eating is Reject the Diet Mentality.  Rather than feeling dissatisfied with our bodies and our eating, Intuitive Eating encourages us to question the source of this dissatisfaction.  We begin Intuitive Eating by rejecting the notion that we ought to maintain a diet or body size that is unsustainable for us.

The second principle of Intuitive Eating is Honor Your Hunger.  This goes hand-in-hand with the first principle, which encourages us to question external messaging about how we should eat.  Simply put, this principle is about giving yourself permission to eat when your body says it wants to.

Once we begin to allow ourselves to honor our hunger, we become free to Make Peace With Food, the third principle of Intuitive Eating.  Often, when we begin to honor our hunger after trying to ignore or suppress it for a period, we end up eating much more than we ever previously allowed.  This, as registered dietician and intuitive eating counselor Christy Harrison puts it, is the pendulum of restriction – when we do not listen to our hunger, we pull the pendulum back, only for it to inevitably swing in the other direction. Just like a pendulum cannot just stop in the middle once it has been pulled, your body cannot regulate its hunger and fullness cues without first making peace with food by addressing restrictive mindsets and behaviors.

The fourth principle of Intuitive Eating, then, is Challenge the Food Police.  This means that we begin to question the voice in our heads (and the voices of others who comment on our bodies, the messages on our televisions, social media feeds, etc.) that labels foods and bodies in black-and-white terms.  In eating disorder treatment, we often call this voice “Ed” or the voice of the eating disorder.  This allows us to continue to address restrictive mindsets around eating so we can begin distinguishing between external and internal messages.

Once we can adequately distinguish between external and internal messages about food, we will be better equipped to tune into what our body is telling us.  At this stage, we can begin to Discover the Satisfaction Factor.  Now that the noise of the food police (or Ed) has been dialed down, we can hear our intuition’s voice with greater clarity. 

With this newfound clarity, we can finally hear what our body is telling us.  If we have been eating past our fullness point up until this stage, that is normal.  In the sixth step of Intuitive Eating, you are able to Feel Your Fullness.  In order to feel our fullness, our bodies need to trust that they will be fed consistently.  Our bodies do not know the difference between a diet and a famine, they just know that food is not being given consistently.  So, when food becomes available our bodies respond by trying to stock up before the next famine begins.  Only once restrictive mindsets and behaviors are resolved, can we finally eat when we are hungry and stop when full.

Once our physical relationship with food has begun to heal, we can address the emotional relationship.  The seventh principle of intuitive eating, Cope with Your Emotions with Kindness, helps us to distinguish between our physical and emotional hunger and fullness cues.  Keeping in mind that food can serve many purposes – physical, social, emotional, and cultural – this principle helps us to become more aware of when the way we are eating is not serving us.  Some of us eat to soothe emotions, and this principle aims to help us develop additional emotion regulation skills without damning the role that food may play. 

The next principle, Respect Your Body, aims to address concerns we may have about our body shape and size.  While most people report feeling dissatisfied with the way their bodies look, efforts to change our bodies are more likely to yield distress than increased satisfaction.  Respecting our bodies means that, while we may not always like how our bodies look, we still need adequate nourishment and care.

Respecting our bodies may include Movement – Feel the Difference, in the ninth stage of Intuitive Eating.  Exercise does not have to be punitive or for the purpose of changing our body shape or size.  This principle of Intuitive Eating is centered around exploring how to feel good in our bodies through movement. 

The tenth and final principle of Intuitive Eating, is Honor Your Health – Gentle Nutrition.  We continue to explore how to feel good in our bodies without trying to change them in this stage by feeding ourselves nourishing foods.

If you think you might benefit from Intuitive Eating, click here to learn more about working with me on your journey toward a healthier relationship with food.  To learn more about Intuitive Eating, here are some places I recommend starting:

Podcasts
FoodPsych, Christy Harrison
Rethinking Wellness, Christy Harrison
Maintenance Phase, Michael Hobbes & Aubrey Gordon

Books
– Intuitive Eating – 4th Edition, Elyse Resch & Evelyn Tribole
– Health at Every Size, Lindo Bacon
– Anti-Diet, Christy Harrison
– The Eating Instinct, Virginia Sole-Smith
– The F*ck it Diet, Caroline Dooner

Websites
www.intuitiveeating.org
christyharrison.com

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