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Evelyn Tribole, MS, RD
How do you honor your health when you have permission to eat anything? How can french fries or a candy bar, for example, be considered adequate choices? These questions are a source of confusion for many of my patients, their families, and even practitioners. My message to them is that healthy eating includes having a positive relationship with food of all kinds. This means that meals are not a moral dilemma resulting in feelings of guilt and shame, but rather a place to practice tuning into one’s inner needs and fulfilling those needs in a healthy, nurturing way. In my work, I call this practice, intuitive eating. While there are many ways of incorporating this process, there are three core characteristics: • Unconditional permission to eat. • Reliance on internal hunger and satiety cues. • Eating for physical, rather than emotional reasons. Although most chronic dieters and disordered eaters have lost touch with these skills, the good news is that they can be relearned through attunement—a process of listening and responding to your body cues, rather than focusing on rigid food rules. This means making decisions about eating based on what your body is experiencing. For example, upon experiencing a grumbling stomach (one of many hunger cues), you might respond by eating a snack, rather than withholding food because of a rigid rule stating, “It’s not okay to eat between meals.” Being able to eat intuitively takes practice. How long depends on many factors, such the length of time you have been at war with food and your body, and your motivation to change. Ultimately, recovery from an eating disorder means learning how to eat normally, which includes the ability to eat a variety of foods, including “fear foods,” which are perceived as fattening and/or unhealthy. It’s important to work with your treatment team to determine when and how to implement intuitive eating.
Intuitive Eating Research
Many people fear that intuitive eating is synonymous with a junk food diet and poor health. On the contrary,
Eating Disorders Recovery Today
studies show that trusting and satisfying have also demonstrated that anxiety one’s physical hunger causes an increase increases stress chemicals in the blood, in well-being, both physically and which has a wide-range of negative efmentally. For example, Brigham Young fects on the body, from inflammation University researchers looked at the to depression. relationship between intuitive eating and the quality of the diet in 343 col- Applying Intuitive Eating to Your Life lege students. Their results did not inSo, how do you balance creating a dicate poor nutritional choices. Rather, positive rethese stulationship dents had with food, a greater Intuitive eaters were more optimistic, while also diversity had better self-esteem, and were less considerin eating, likely to internalize our culture’s ing nutrimore satunrealistic thin ideal. tion? Sevisfaction, eral factors and healthcome to ier body mind: weights. In 2006, a larger study on nearly • Getting in touch with your in1,300 college women by Tracy Tylka ternal satiety cues of hunger and from Ohio State University, demonfullness. strated similar findings. Intuitive eaters were found to be more optimistic, • Discovering satisfaction in eathad better self-esteem, a lower body ing. mass index (BMI), and were less likely • Using nutrition information withto internalize our culture’s unrealistic out judgment. thin ideal. While these results may seem surprisMany times, “healthy eating” or ing, it is something that the French “better nutrition” is code for dieting. are well known for—they regularly Consequently, if you focus solely on consume foods considered “fattening” these factors, without considering your or “unhealthy” by American standards. internal body cues of what would best Ironically, the French also have some satisfy hunger, you can easily feel deof the lowest rates of obesity and heart prived. This in turn may increase cravdisease. ings and thoughts of food, overeating, In 1999, Paul Rozin from the Uni- dieting, and heighten anxiety around versity of Pennsylvania explored how snacks and meals. Try to answer these food functions in the minds and lives of questions when considering what to people from four countries: USA, Japan, eat: If I eat this food or meal now, will Belgium, and France (Japan was chosen it satisfy and sustain me? Is my body because the Japanese have the longest meal-hungry or snack-hungry? How life expectancy). Rozin found that do I want to feel physically afterwards? Americans have the greatest concern What have my past experiences shown about health and the most dissatisfac- me? tion with eating. They worry the most Answers to these questions will guide about fattening effects of food and asso- you on making the best food choices ciate it most with health and least with based on your body’s needs. Whatever pleasure. But the French were found to you decide to eat, take note if it met be the most pleasure-oriented and least your expectations, which helps to crehealth-oriented (hence the popular ate a meaningful learning experience. term French Paradox). These attitudes For example, if you were meal-hungry may be an important, yet overlooked and choose to drink a smoothie—did contributor to overall happiness. it sustain you until your next meal? Rozin concluded that worries and Given the same circumstances and what obsessions regarding diet might be you learned, would you make a similar counterproductive. Several studies choice? Paying attention to these exEating Disorders Recovery Today
periences will also help you build trust with your body. When you are attuned to your body, as well as armed with the knowledge that you can truly give it what it needs, you will possess the clarity to make effective choices. You will be able to ask yourself: If I am meal-hungry, would bags of potato chips truly satisfy and feel good physically? If I am ravenous, would only a salad meet my body’s needs? If I have a sweet tooth, would raspberries really curb my craving? When you can enjoy food with unconditional permission, the process of eating becomes emotionally neutral—and you do not feel good or bad based on what you eat. You also understand that one meal will not make or break your health, or your weight. All too often, there is a negative perception regarding eating certain foods, resulting in guilt. But when judgment (and guilt) is removed, if you’ve eaten the wrong thing or too much, it is not a catastrophe from which to recover and/or perform nutritional penance. You are no longer caught up in these thoughts. Ultimately, intuitive eating feels good, which is self-reinforcing. Remember, when you can truly eat intuitively, it doesn’t take much chocolate to satisfy a sweet tooth.
Hawks, ST et al. The relationship between intuitive eating and health indicators among college women. Am. J. Health Educ. 2006;26:322-324. Rozin, P. et al. Attitudes to Food and the role of food in the life in the USA, Japan, Flemish Belgium and France: Possible Implications for the Diet-Health debate. Appetite, 1999 (33):163-180. Tylka, TL. Development and psychometric evaluation of a measure of intuitive eating. J Counseling Psych, 2006; 53(2):226.
Evelyn Tribole, MS, RD, is co-author of Intuitive Eating 2nd ed (2003) and the new audio companion with added material and guided practices: Intuitive Eating: A Practical Guide, released in January 2009.
Women with a history of eating disorders are at higher risk of major adverse perinatal outcomes. A study at King’s College London that compared adjusted birth weight, preterm delivery, and miscarriage history has concluded that individuals with bulimia nervosa had significantly higher rates of past miscarriages and individuals with anorexia nervosa delivered babies of significantly lower birth weight than the general population.
according to a study in Sweden that was reported in the journal Nature. Fat cells can only change in size, not in number. Obese people who underwent weight loss surgery had as many fat cells two years after surgery as before it.
“You gain strength, courage, and confidence by
every experience in which you really stop to look fear in the face. You must do the thing which you think you cannot do.” — Eleanor Roosevelt
Teen Boys at Growing Risk
Eating Disorders rose significantly among American boys between 1995 and 2005, according to a study that examined weight control behaviors among high schoolers. The increased weight control behavior noted in males suggests growing social pressure for males to achieve unrealistic body expectations, thus increasing the risk of body dissatisfaction and eating disorders, the study authors said. —International Journal of Eating Disorders
In a New York Times article, dated March 25, 2008, the author reports that women who Fat Cells Die and Are Replaced describe themselves as feminists are more It does not matter if you are fat or thin or have forgiving than other women when assessing gained or lost weight, 10 percent of your fat the attractiveness of women who are either cells die and are replaced with new fat cells, very underweight or very heavy. This finding added evidence to the argument that these women also might be less likely to be taken in by the idea that the most important thing for women is to be thin. His conclusions were based on a 2008 study led by Viren Swami of the University of Westminster in London. The author of the article, Eric Nigourney, asserts, “If beauty is in the eye of the “If you hold for a minute, the doctor will beholder, then try carefully choose the best diet for you.” to be beheld by a feminist.”
Nibbles, by Hunter
Barbie’s won a TOADY!
On the eve of the world’s most famous doll’s fiftieth birthday, the Campaign for a Commercial-Free Childhood announced that Mattel’s Barbie Dallas Cowboy Cheerleader Doll won its inaugural TOADY (Toys Oppressive and Destructive to Young Children) Award for the worst toy of the year. In an online vote by more than 6,000 members, Barbie handily beat four other nominees. For more information on why these toys were nominated, visit www.commercialfreechildhood.org.
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