Eating Disorders Recovery Today

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Winter 2009

How do you honor your health whenyou have permission to eat anything?How can rench ries or a candy bar,or example, be considered adequatechoices? These questions are a sourceo conusion or many o my patients,their amilies, and even practitioners.My message to them is that healthy eat-ing includes having a positive relation-ship with ood o all kinds. This meansthat meals are not a moral dilemmaresulting in eelings o guilt and shame,but rather a place to practice tuning intoone’s inner needs and ullling thoseneeds in a healthy, nurturing way. Inmy work, I call this practice,

intuitiveeating

.While there are many ways o incor-porating this process, there are threecore characteristics:

Intuitive Eating: Can You Be Healthy

and

Eat Anything?

Evelyn Tribole, MS, RD

•

Unconditional permission to eat.

•

Reliance on internal hunger andsatiety cues.

•

Eating or physical, rather thanemotional reasons.Although most chronic dieters anddisordered eaters have lost touch withthese skills, the good news is that theycan be relearned through

attunement

—aprocess o listening

and

responding toyour body cues, rather than ocusingon rigid ood rules. This means makingdecisions about eating based on whatyour body is

experiencing

. For example,upon experiencing a grumbling stom-ach (one o many hunger cues), youmight respond by eating a snack, ratherthan withholding ood because o arigid rule stating, “It’s not okay to eatbetween meals.”Being able to eat intuitively takespractice. How long depends on manyactors, such the length o time youhave been at war with ood and yourbody, and your motivation to change.Ultimately, recovery rom an eatingdisorder means learning how to eatnormally, which includes the ability toeat a variety o oods, including “earoods,” which are perceived as atten-ing and/or unhealthy. It’s importantto work with your treatment team todetermine when and how to implementintuitive eating.

Intuitive Eating Research

Many people ear that intuitive eat-ing is synonymous with a junk ooddiet and poor health. On the contrary,

Eating Disorders Recovery Today

•

Winter 2009

studies show that trusting and satisyingone’s physical hunger causes an increasein well-being, both physically andmentally. For example, Brigham YoungUniversity researchers looked at therelationship between intuitive eatingand the quality o the diet in 343 col-lege students. Their results did not in-dicate poor nutritional choices. Rather,these stu-dents hada greaterdiversityin eating,more sat-isaction,and health-ier bodyweights.In 2006, a larger study on nearly1,300 college women by Tracy Tylkarom Ohio State University, demon-strated similar ndings. Intuitive eat-ers were ound to be more optimistic,had better sel-esteem, a lower bodymass index (BMI), and were less likelyto internalize our culture’s unrealisticthin ideal.While these results may seem surpris-ing, it is something that the Frenchare well known or—they regularlyconsume oods considered “attening”or “unhealthy” by American standards.Ironically, the French also have someo the lowest rates o obesity and heartdisease.In 1999, Paul Rozin rom the Uni-versity o Pennsylvania explored howood unctions in the minds and lives o people rom our countries: USA, Japan,Belgium, and France (Japan was chosenbecause the Japanese have the longestlie expectancy). Rozin ound thatAmericans have the greatest concernabout health and the most dissatisac-tion with eating. They worry the mostabout attening eects o ood and asso-ciate it most with health and least withpleasure. But the French were ound tobe the most pleasure-oriented and leasthealth-oriented (hence the popularterm French Paradox). These attitudesmay be an important, yet overlookedcontributor to overall happiness.Rozin concluded that worries andobsessions regarding diet might becounterproductive. Several studieshave also demonstrated that anxietyincreases stress chemicals in the blood,which has a wide-range o negative e-ects on the body, rom infammationto depression.

Applying Intuitive Eating to Your Life

So, how do you balance creating apositive re-lationshipwith ood,while alsoconsider-ing nutri-tion? Sev-eral actorscome tomind:

•

Getting in touch with your in-ternal satiety cues o hunger andullness.

•

Discovering satisaction in eat-ing.

•

Using nutrition inormation with-out judgment.Many times, “healthy eating” or“better nutrition” is code or dieting.Consequently, i you ocus solely onthese actors, without considering yourinternal body cues o what would bestsatisy hunger, you can easily eel de-prived. This in turn may increase crav-ings and thoughts o ood, overeating,dieting, and heighten anxiety aroundsnacks and meals. Try to answer thesequestions when considering what toeat: I I eat this ood or meal now, willit satisy and sustain me? Is my bodymeal-hungry or snack-hungry? Howdo I want to eel physically aterwards?What have my past experiences shownme?Answers to these questions will guideyou on making the best ood choicesbased on your body’s needs. Whateveryou decide to eat, take note i it metyour expectations, which helps to cre-ate a meaningul learning experience.For example, i you were meal-hungryand choose to drink a smoothie—didit sustain you until your next meal?Given the same circumstances and whatyou learned, would you make a similarchoice? Paying attention to these ex-periences will also help you build trustwith your body.When you are attuned to your body,as well as armed with the knowledgethat you can truly give it what it needs,you will possess the clarity to make e-ective choices. You will be able to askyoursel: I I am meal-hungry, wouldbags o potato chips truly satisy andeel good physically? I I am ravenous,would

only

a salad meet my body’sneeds? I I have a sweet tooth, wouldraspberries really curb my craving?When you can enjoy ood with uncon-ditional permission, the process o eatingbecomes emotionally neutral—and youdo not eel good or bad based on whatyou eat. You also understand that onemeal will not make or break your health,or your weight. All too oten, there isa negative perception regarding eatingcertain oods, resulting in guilt. Butwhen judgment (and guilt) is removed,i you’ve eaten the wrong thing or toomuch, it is not a catastrophe rom whichto recover and/or perorm nutritionalpenance. You are no longer caught up inthese thoughts. Ultimately, intuitive eat-ing eels good, which is sel-reinorcing.Remember, when you can truly eat in-tuitively, it doesn’t take much chocolateto satisy a sweet tooth.

Sources:

Hawks, ST et al. The relationship betweenintuitive eating and health indicatorsamong college women. Am. J. HealthEduc. 2006;26:322-324.Rozin, P. et al. Attitudes to Food and therole o ood in the lie in the USA, Japan,Flemish Belgium and France: PossibleImplications or the Diet-Health debate.Appetite, 1999 (33):163-180.Tylka, TL. Development and psychomet-ric evaluation o a measure o intui-tive eating. J Counseling Psych, 2006;53(2):226.

Evelyn Tribole, MS, RD,

is co-author of

Intuitive Eating 2

(2003) and the newaudio companion with added material andguided practices:

Intuitive Eating: A Practical Guide,

released in January 2009.

Intuitive eaters were more optimistic,had better self-esteem, and were lesslikely to internalize our culture’sunrealistic thin ideal.