Is Intuitive Eating for Everyone?

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I want to say “yes!” because I’m an advocate, I see so much value in it, and have been using Intuitive Eating in nutrition counselling for many years. However, it is not a simple answer.

Intuitive Eating is not a weight loss method but a nutrition philosophy that is actually an anti-diet approach to reconnecting with your body and healing your relationship with food. Intuitive Eating has many excellent principles that are of value to everyone including: rejecting the dieting mentality, coping with emotions, respecting your body, etc. (for more information see www.intuitiveeating.org)

What I don’t see discussed very often are situations and factors that may make Intuitive Eating challenging for some people. I want to touch on one possible limitation of Intuitive Eating and that is the presence of having trustable internal cues or identifiable hunger/fullness cues. This may be temporary because many people can regain their internal cues or learn to identify and trust them but we have no evidence that everyone can. For some people these cues are not even present and for others they are not reliable for a variety of reasons (short or long-term).

Here are some factors to take into consideration that may make internal cues less reliable: 

  1. Sleep deprivation: When you are sleep deprived the hormones ghrelin and leptin are affected. Ghrelin (stimulates appetite) levels increase and leptin (suppresses appetite) levels decrease.
  1. Chronic stress: Initially short-term stress may cause appetite to decrease but prolonged or chronic stress can increase the hormone cortisol that may increase appetite.
  1. Medications: (a few examples that can affect appetite)
  • Corticosteroids ie. prednisone, dexamethasone
  • Insulin, sulfonylureas (for diabetes)
  • Vyvanse (for ADHD)
  • Some antidepressants: ie. Fluoxetine (Prozac)
  • Morphine
  • Levothyroxine (Synthroid) for hypothyroidism
  1. Intense training/exercise: Prolonged intense endurance training is known to suppress appetite.Therefore these athletes may need to eat beyond their hunger cues to adequately fuel themselves and for optimal recovery.
  1. Illness: When we become sick (for example the flu), we often lose our appetite. There is a physiological reason for this as cytokine production is increased when we become ill. Cytokines can reduce appetite by acting directly on neurons that regulate appetite in our brains.    
  1. Eating disorders: People struggling with eating disorders always have very individual needs, challenges, and different journeys to recovery. There are so many factors both physical and psychological that can affect their hunger and fullness cues (or lack of). For example, for someone working on increasing their food intake after prolonged restriction they may experience early satiety (because of gastroparesis). Or someone who binges may not experience or recognize fullness cues because they have been eating well beyond them for years. A person affected by an eating disorder may need to be nourished, achieve medical stability and have psychological supports and counselling first. Even then it may take a great deal of time before they are ready to trust and identify their internal cues. In my experience if the concept is introduced too early it can cause unnecessary “mental noise”, confusion, or anxiety.  

My on-going learning:

With all the hype of Intuitive Eating in recent years, I have seen and heard amazing stories of how it has changed people’s lives and relationship with food. On the other end, I have seen people struggle with some of the principles and application of it. Or they never could rely on their internal cues for various reasons.

In my professional opinion, all aspects of Intuitive Eating are not for everyone but there are Intuitive Eating principles that can be helpful for anyone.  Intuitive eating is a journey of learning and timing is important. As a Dietitian I need to be prepared, willing and open to supporting people in a variety of ways, always individualizing care. There is never going to be one single approach that works for everyone.

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