Intuitive Eating is not a Perfect Paradigm.
There is no perfect.
I have used and still use Intuitive Eating in my practice, thus why I became a Certified Intuitive Eating Counselor in 2017. I even co-taught a course at Boston College in the Spring of 2022 that was designed loosely around the 10 Principles of Intuitive Eating.
That being said, Intuitive Eating has its problems. Just like everything else.
In this article, I will outline some ways IE comes up short. (There are others.) Maybe this will resonate with you, maybe not.
My goal is to debunk the myth that Intuitive Eating is for everyone.
What is Intuitive Eating?
As described on the official website, Intuitive Eating (IE) is a self-care eating framework that integrates instinct, emotion and rational thought. It was created by two dietitians, Evelyn Tribole and Elyse Resch, in 1995. It has a validated assessment scale, the IES-2, which you can get in a German or English version. Intuitive eating is supported by over 100 studies. As I stated above, I have used IE throughout my career and the IES-2 to measure outcomes in the class I co-taught Spring 2022.
In IE, the idea is to ditch (restrictive) diet culture, cultivate attunement and let go of expectations around food, body and movement.
There are 10 Principles of Intuitive Eating. You can read about those here.
How does IE help people?
Intuitive Eating was a complete paradigm shift when it was published in the 90s. The idea that you could eat anything, at any time, in amounts that felt okay to you was radical. (In the US, this was the time of the Snackwells cookie and low fat everything!) And, in some ways, that still is very much the case.
It was also a huge change for me as a dietitian. In my dietetic internship, I did not learn about Intuitive Eating. I learned about how to portion food, count calories, and do calculations for tube feeding (among many other things).
Since I had gotten to study nutrition and food through a love of food- the tastes, textures, temperatures, colors, meaning, culture, fun and experience of eating - Intuitive Eating made sense to me.
And, it still does. I find that it helps people to:
Learn how to tune in to themselves, both emotionally and physically
Reject diet culture and let go of the expectations others have around body/food
Give themselves permission to eat and move in ways that work for them
Be curious and non-judgemental
Research also shows that Intuitive Eating is helpful. There is a list of studies up until 2022 on the IE website. More recently, a 2023 study found that practicing IE is associated with lower odds of high depression symptoms, low self esteem, restriction of food, binge eating and more.
It is clear that IE can be helpful. Yet, there are some challenges with Intuitive Eating.
Problem 1: Privilege and Trauma
Food is a basic need. The unfortunate reality is that many people do not have adequate access to food. And, others face trauma that makes it very difficult to have a calm nervous system that can then have space to practice IE principles.
I am going to refer to two articles that outline the assumptions that IE makes when it comes to food access and trauma.
The first is by Liz Brinkman, a dietitian, who points out in her wonderful article critiquing IE that IE assumes people have adequate food access and have worked on their trauma to a degree that allows them access to their internal world.
The second article is by dietitian Anjali Prasertong, who writes about how IE does not take into account the cultural and racial aspects of food, body and eating.
These two authors write in a way that beautifully addresses the impact of privilege and trauma on ability to ‘do’ IE. I highly suggest reading their articles.
Additionally, while IE promotes equity among bodies and promotion of reducing weight stigma, IE has been taken up as an approach mainly of white, cis-gendered, able-bodied, and smaller bodied dietitians (including myself, full disclosure). What I end up seeing is messaging and marketing that does not mean to, but ends up sending the message that IE is actually not for everyone and that IE is a promise of finally achieving that perfect relationship with food.
Problem 2: Being an Athlete can make IE impossible
Although the days of training 2-3 hours a day in the pool and gym are behind me, I still remember them as if they were yesterday. The long practices, achy muscles and pain mixed with exhilaration while my body slogged away in the pool, swimming up and down that black line.
I also remember the time when my college coach pulled me into her office, asking if I was eating enough. I had already run through my entire meal plan half-way through the semester. I was eating everything in sight, at least I felt like I was, yet not doing so well.
It was really hard to eat enough food with a packed schedule and limited cooking skills. I’d also be anxious before meets, and not eat. I’d be exhausted after practice, and not fuel right away.
For athletes, the nervousness and anxiety mixed with any financial and logistical constraints and the fact that when they training, endorphins increase and make it hard to check in with hunger and fullness make it difficult to fully practice IE.
Plus the IE principle ‘Exercise: Feel the Difference’ can fall flat- is my body saying, with its burning calves and difficulty breathing, to stop pushing so hard in practice? Yes! But, as athletes we often have to keep going to push towards personal bests.
As I tell my athlete clients, you can rely on hunger (when you’re hungry- eat!) AND you need to eat when you’re not hungry. This means snacking significantly between meals, having carbs during workouts and eating more on rest days.
Athletes and intuitive eating are not a perfect match. Athletes need a different approach.
Problem 3: IE requires cooking, grocery shopping, wanting to experience food and more
What if you hate cooking? What if you don’t have many cooking skills? What if the grocery store is a million miles away or is a huge hassle?
Cooking is a skill. It is not something we are born knowing how to do.
So, what if you haven’t been exposed to certain foods or ways of making meals. How will you know what you want to eat? How will you know how to make it?
IE assumes you have this wide range of foods and skills to utilize, when that is not the case for most people.
Problem 4: Digestive Distress makes IE very hard
There are many reasons why this is the case.
If we’re constipated and bloated, you are not going to feel hunger at all or in the same way as if you were not constipated and bloated. If you have stomach pain every time after you eat, you can get so attuned to your body and this pain, that eating becomes a fear.
IE is very difficult to do when we are experiencing gut issues that are impacting our mental health, ability to check in with ourselves and literally, our hunger/fullness signals.
Problem #5: Having OCD or black/white thinking
I will never forget one of my clients who came into my office with a list of the 10 IE principles and underneath each, an explanation on how she was doing them perfectly. That session, we took what she had written and ripped them up!
IE is not meant to be a ‘diet’ or rules repackaged, yet it can end up feeling like that for clients, especially clients with obessive compulsive disorder.
As with treatment that is manualized, there is often hope that it will work ‘just so’ and that maybe, just maybe, one day I will ‘master’ the art of knowing my hunger/fullness, of making peace with every food, of being aware of my desires for food versus my emotional needs, etc.
But, eating and food are not like this.
Sometimes, we eat because we are emotional. Sometimes, we eat X or Y because that is all we have to eat. Sometimes, we are not sure if we’re hungry or full. Sometimes, we eat for many other reasons besides hunger.
Intuitive Eating is gray. Just like everything else.
IE can be a wonderful way to find peace with food and let go of expectations around food/body. I have seen it help people dramatically rediscover themselves and food, determine what they like to eat and be more confident about their food and movement choices. It has changed lives!
And, I’ve seen it create confusion and not be a great fit for every client.
I hope this was helpful in thinking about IE and your own relationship with food.