Research on eating behaviour has traditionally been focused on describing, explaining, and predicting disordered eating, with little emphasis on identifying and promoting more positive eating behaviours and attitudes.
Knowing what approach to eating is healthy or adaptive would be extremely valuable for not only improving the quality of life and wellbeing of many people, but it may have the potential to prevent a whole host of disordered eating behaviours.
For these reasons, a great deal of recent research has begun to study the various potentially adaptive eating styles, with intuitive eating gaining the most amount of research, clinical, media, and public health attention.
What is intuitive eating?
The definition of intuitive eating can be quite complex. Let’s break it down a bit.
It is generally agreed that intuitive eating can be described as an adaptive style of eating characterized by a strong connection with internal physiological hunger and satiety cues1 Tylka, T. L. (2006). Development and psychometric evaluation of a measure of intuitive eating. Journal of Counseling Psychology, 53(2), 226. .
However, while this definition seems quite simple, there are a whole host of principles that underpin intuitive eating. We can usefully categorise all these principles into 4 domains2 Tylka, T. L., & Kroon Van Diest, A. M. (2013). The Intuitive Eating Scale–2: Item refinement and psychometric evaluation with college women and men. Journal of Counseling Psychology, 60(1), 137. :
- An unconditional permission to eat: this domain refers to a persons’ willingness to eat when hungry and a refusal to classify foods as “good” or “bad”. Eating in such a way is said to prevent overindulgence, loss of control eating, and shame associated with eating.
- Eating for physical rather than emotional reasons: this domain reflects a persons’ tendency to eat when physically hungry (and stop when feeling full) rather than to cope with emotional distress.
- Reliance on hunger and satiety cues: this domain reflects a persons’ trust in their internal hunger and satiety cues, and for these cues to guide their eating behaviour. This domain stands in direct contrast to dietary restraint, which is a style of eating behaviour that is governed by external cues (e.g., self-imposed rules that dictate what, when, and how much one can eat, irrespective of what one feels like).
- Body-food choice congruence: this domain reflects a persons’ ability to recognise that all foods serve a variety of important functions (e.g., taste, stamina) that are dependent on the context and situation at hand.
Is intuitive eating beneficial?
The short answer – yes.
A wealth of research has examined the possible impacts of intuitive eating on a variety of physical, psychological, and social health outcomes.
A recent systematic review synthesised these research findings, and unequivocally found support for the potential health benefits of intuitive eating3 Bruce, L. J., & Ricciardelli, L. A. (2016). A systematic review of the psychosocial correlates of intuitive eating among adult women. Appetite, 96, 454-472. .
For example, across all ethnicities, genders, weight classes, ages, and socioeconomic statuses, intuitive eating was consistently connected to a whole host of positive health outcomes, some of which include:
- Body image acceptance
- Lower binge eating
- Lower perfectionism
- Lower dietary restraint
- Fewer unhealthy weight control behaviours (e.g., skipping meals, fasting, smoking, diet pills, laxative use)
- Body satisfaction
- Motivation to exercise for enjoyment and health-related reasons
- Lower levels of anxiety and depression
- Self-compassion and self-esteem
- Lower levels of thin-ideal internalisation
- Less food preoccupation
- Greater life satisfaction
- Lower levels of body shame
- Lower Body Mass Index
Can I learn Intuitive Eating?
There is a large body of evidence demonstrating that intuitive eating can indeed be learnt.
Multiple randomized controlled trials have been conducted on interventions designed to promote intuitive eating, and the outcomes have been promising.
Not only do these interventions result in increases in intuitive eating behaviour, but they have also been consistently shown to produce clinically and statistically significant improvements in physiological (e.g., blood pressure, blood lipids), psychological (e.g., depressive and anxiety symptoms, body satisfaction, self-esteem etc.), and behavioural (e.g., less restrictive and binge eating) outcomes4 Bacon, L., & Aphramor, L. (2011). Weight science: evaluating the evidence for a paradigm shift. Nutrition journal, 10(1), 9 .
Importantly, these findings have been shown to persist one year after the intervention ends, demonstrating that it may have a durable impact on people5 Bacon, L., Stern, J. S., Van Loan, M. D., & Keim, N. L. (2005). Size acceptance and intuitive eating improve health for obese, female chronic dieters. Journal of the American Dietetic Association, 105(6), 929-936. .
How to eat intuitively?
It can be very hard for someone to learn to trust their internal hunger and satiety cues. After all, if you’ve been dieting for most of your life, it might seem impossible at first.
Don’t despair. It is certainly possible to learn to eat intuitively. Indeed, one study found that overweight/obese females who dieted nearly all their life were able to effectively learn to eat intuitively after a brief intervention 6 Bacon, L., Stern, J. S., Van Loan, M. D., & Keim, N. L. (2005). Size acceptance and intuitive eating improve health for obese, female chronic dieters. Journal of the American Dietetic Association, 105(6), 929-936 . It just takes practice, patience, and perseverance.
Here are some useful tips for learning how to eat intuitively:
1. Ditch the diet
In order to learn to eat intuitively, you must decide to quit any form of dieting. Intuitive eating and dieting cannot go together, by definition. One good way to commit to ditching the diet is to remember the success rates of diets. Less than 20% of people can maintain the weight lost through a diet, and most people who lose weight through a diet regain almost all of it back a few years later. Remember, too, that dieting is also associated with a range of negative psychological outcomes. Therefore, there are a few good reasons for adopting a diet.
2. No more forbidden foods
Learn to incorporate a broad range of foods into your diet. Ensure that you have no “forbidden foods”, as these types of food can increase your cravings for them, can cause you considerable anxiety, and can be a major trigger for binge eating. Remember that no food in isolation causes weight gain. To eliminate your “forbidden food” list, you’ll need to slowly reintroduce these food types back into your diet, in small amounts, and until your feelings of apprehension disappear. This is your typical exposure therapy – an empirically supported treatment approach for a range of mental health issues.
3. Use a hunger-fullness scale
If you’ve been dieting for so long, it is likely that you’ve forgotten what it’s like to recognise true hunger and fullness.
To redevelop these feelings you’ll need to start paying attention to the body.
Create a short hunger-fullness scale that ranges from 0-10, where 0 = absolutely empty, 2 = getting empty, 5 = full, 8 = overfull, and 10= stuffed full.
Before each meal, ask yourself where you fall on this scale right at that moment. You would want to ideally be between 2-3.
During your meal, pause for 10 seconds and check in again.
Towards the end of your meal, check in one last time. You want to end up at around the 5-6.
Practicing this task for a few weeks will allow you to appropriately recognise your internal body cues. This recognition will then guide your eating behaviour and choices.
4. What do I want to eat?
Before you intend on eating, ask yourself what you feel like.
As your body learns to trust that it can have a broad range of foods, cravings for, and overeating on, so-called “junk foods” will diminish and eventually disappear. Instead, you’ll start to make food-related decisions that are appropriate for your situation.
5. Be mindful
Mindful eating involves being present and aware of what you’re eating, why you’re eating, and how you are eating.
Try the following when you’re eating: Sit down. Turn the TV off. Put the phone away. Really focus on each mouthful. Chew a lot. After 3 mouthfuls, put the fork down for 20 seconds. Take in the site, taste, smell, and texture of the food.
Eating in this manner will help you better identify your internal hunger and satiety cues.
Caveats to learning intuitive eating
I will emphasise that, although the health benefits of intuitive eating are well-known, I don’t think that this style of eating is for everyone, and it, in some cases, may actually be detrimental.
Specifically, if you’ve had a history of chaotic binge eating and purging behaviour, then I would advise against learning to eat intuitively until you’ve gained some sort of control back.
To gain this control, my recommendation would be to engage in a pattern of regular, structured eating, where you eat 3 meals and 3 snacks per day, no longer than 3 hours apart.
But, for others, I would highly recommend learning intuitive eating. This is because the evidence for the benefits of this style of eating is unequivocal!
|↑1||Tylka, T. L. (2006). Development and psychometric evaluation of a measure of intuitive eating. Journal of Counseling Psychology, 53(2), 226.|
|↑2||Tylka, T. L., & Kroon Van Diest, A. M. (2013). The Intuitive Eating Scale–2: Item refinement and psychometric evaluation with college women and men. Journal of Counseling Psychology, 60(1), 137.|
|↑3||Bruce, L. J., & Ricciardelli, L. A. (2016). A systematic review of the psychosocial correlates of intuitive eating among adult women. Appetite, 96, 454-472.|
|↑4||Bacon, L., & Aphramor, L. (2011). Weight science: evaluating the evidence for a paradigm shift. Nutrition journal, 10(1), 9|
|↑5||Bacon, L., Stern, J. S., Van Loan, M. D., & Keim, N. L. (2005). Size acceptance and intuitive eating improve health for obese, female chronic dieters. Journal of the American Dietetic Association, 105(6), 929-936.|
|↑6||Bacon, L., Stern, J. S., Van Loan, M. D., & Keim, N. L. (2005). Size acceptance and intuitive eating improve health for obese, female chronic dieters. Journal of the American Dietetic Association, 105(6), 929-936|
Hi Dr Linardon, I am a clinical psychologist who has been attempting to treat an obese client who is bedridden due to obesity for the past 2 years. They weigh 270kg and cannot walk as their knees give out on them. I have been treating them for PTSD and they have had NDIS support for the eating disorder. But NDIS has ceased funding for physio, dietician and pre-prepared meals. They cannot fit into a car.
I am desperately looking for advice or an inpatient clinic that could treat PTSD & eating disorder – obesity
I welcome any comment.
Dr Jake Linardon
This sounds like a complex case. Unfortunately I am not aware of any clinics that specialize in both eating disorders and PTSD. There might be many that specialize in one of these, however. I suggest that it might be worth targeting the crux of the issue and tailor your treatment plan accordingly. It might also be worth getting a team of experts involved in this case.
Apologies if this isn’t much help.