Professional Documents
Culture Documents
Evelyn Tribole, MS, RD
Coauthor Intuitive Eating
August 7, 2009
www.EvelynTribole.com
Objectives
When & how to Implement
Overcoming Barriers
Identifying Readiness
New Intuitive Eating research
Attunement
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Attunement
Internal External
http://www.gse.buffalo.edu/cap/satsanga/healthyself.asp
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MisAttunement
Internal
•Unfilled Appetites
•Eating Struggles
•ExternalBased
http://www.gse.buffalo.edu/cap/satsanga/healthyself.asp
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External Overvalued
Extreme Makeover
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Disconnect
Problem
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“Interoception is the
perception of sensations from inside the body
and includes the perception of physical
sensations related to internal organ function,
such as heart beat, respiration, satiety, and
autonomic nervous system activity related to
emotions. ”
Mehling WE et al. 2009 Body Awareness: Construct and Self-Report Measures. PLoS ONE 4(5):
e5614. doi:10.1371/journal.pone.0005614
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Walter H. Kaye et al . New insights into symptoms and neurocircuit function of anorexia nervosa
Nature Reviews Neuroscience. published online 15 July 2009; doi:10.1038/nrn2682.
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Walter H. Kaye et al . New insights into symptoms and neurocircuit function of anorexia nervosa.
Nature Reviews Neuroscience. published online 15 July 2009; doi:10.1038/nrn2682.
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What the Research Shows
Intuitive Eating Scale:
l Unconditional Permission to Eat
l Eating for Physical Not Emotional
l Reliance on Internal Hunger/Satiety
Tylka, TL. J. Counseling Psychology 2006;53:226240.
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What the Research Shows
2008 BED Study
5
3
8 Weeks
2
Binge Frequency
Intuitive Eating Intervention
1
P r e - t r e a t m e n t O u t c o m e F o l l o w - U p
Smitham, L. Evaluating an Intuitive Eating Program for Binge Eating Disorder: A Benchmarking Study
(Dissertation).University of Notre Dame. 26 November 2008
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What the Research Shows
What the Research Shows
Intuitive Eater Characteristics
BMI
Wellbeing
HDL
Triglycerides
Self esteem
Thin idealization
*Tylka, TL. J Counseling Psychology. 53(2):226, 2006. Smith TS & Hawks, SR. Am J Health Edu. 2006;37(3):130.
www.IntuitiveEating.org
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Intuitive Eating
Principles
1. Reject Diet Mentality 6. Discover Satisfaction
l Honor Your Hunger 7. Cope without Food
l Make Peace w/Food 8. Respect Your Body
l Challenge Food Police 9. ExerciseEnjoyable Feel
l Feel Your Fullness 10. Honor Your Health Gentle Nutrition
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Our “Story” & Influences
LL Birch
Hirschmann & Munter
Geneen Roth
Ellyn Satter
Habituation
Restraint Theory
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Brief History
• 1995 Intuitive Eating, first ed.
• 2003 Intuitive Eating, 2nd ed.
• 2005 Linda Bacon JADA
• 2005 Stephen Hawks
• 2006 Tracy Tylka
• 2006 Wikipedia
• 2006 People Magazine
• 2008 Univ. Notre Dame
• 2009 JADA (in press)
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Attunement Barriers
In Eating Disorders
• Primal Hunger Issues
“Hunger Meter Broken”
“Satiety Meter Broken”
• Rigid External Rules & Beliefs
Food
Nutrition
Body
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Attunement Barriers
In Eating Disorders
• ExerciseExternal Based
Calories burned vs intention
“Satiety Meter Broken”
• Trust Issues
Self
Body
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Getting Basic Needs Met?
• Selfcare
• Sleep
• Transition Time
• Friendships
• Boundaries
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Patient Expertise
Thoughts
Feelings
Experiences
Missing Factors
Trust
Empowerment
Acceptance
Mindfulness
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Readiness for Intuitive
Eating
• Biological Restoration
• Balance
• RecognitionED not
about weight or food
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Readiness for Intuitive
Eating
Ability & Willingness:
• Deal with Feelings
• ID Wants and Needs
• Take Risks
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What’s Your Thermostat?
Pleasant?
Unpleasant?
Neutral?
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Intuitive Eating Principles
1. Reject Diet Mentality 6. Discover Satisfaction
l Honor Your Hunger 7. Cope without Food
l Make Peace w/Food 8. Respect Your Body
l Challenge Food Police 9. ExerciseEnjoyable Feel
l Feel Your Fullness 10. Honor Your HealthGentle Nutrition
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PRINCIPLE 1:
REJECT DIET MENTALITY
• Primal Hunger
• Biology
• Psychology
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PRINCIPLE 2:
HONOR YOUR HUNGER
Primal Hunger
• Regular Meals
• Biological Balance
• Timing
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“I can’t be hungry…”
Reframe Context
• “Meal Hungry”
• Exercise
• Last Meal/snack
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Guided Activity
HUNGER AWARENESS
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PRINCIPLE 5:
FEEL YOUR FULLNESS
• Rate 110
• Not Sure?
• Pain vs. Comfort
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Fullness Nuances Comfortable & Nourished
“Gap”
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Satiety Cues Exceptions
• Stress
• Illness
• Mood Disorder
• Eating Disorder
• Intense Exercise
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PRINCIPLE 3:
MAKE PEACE with FOOD
MAKE PEACE with FOOD
• Take Risks
• Add New Foods
• When Ready
• ID Vulnerability
• Baby Steps
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Food Habituation Studies
Exposure
Response
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Habituation & Dieters
• No Habituation Experience
• Instead, Food is:
Exciting & Scary
Must be controlled
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What To Expect
• Excitement
• Every meal
• Every day
• Normal
• Wanes
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PRINCIPLE 4:
CHALLENGE FOOD POLICE
Remove:
✔ Morality
✔ Judgment
✔ Shame
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“I feel guilty because I ate…”
Lunaea Weatherstone
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PRINCIPLE 9:
JOYFUL EXERCISE
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When Does Nutrition Fit In?
Readiness
Free From:
• Morality in Eating
• Dichotomous Thinking
• OneBiteAway
Disaster
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PRINCIPLE 10:
GENTLE NUTRITION
• Not Rigid Rules
• Not Knowledge Issue
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Resources
Intuitive Eating Practices Audio CD
Intuitive Eating Pro Skills Training
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