Years of research demonstrate that for most people, rigid dietary patterns do not lead to sustained weight loss or improved psychological well-being. Many of us have firsthand experience of the difficulties of dieting, and it’s no surprise that we might be looking for alternatives. A practice known as intuitive eating—with a focus on becoming in tune with your body’s hunger and fullness signals and combating black-and-white thinking around food choices—is a potential option.
Intuitive eating is a frequent buzzword and has become increasingly popular in recent years, but confusion exists around what this approach is all about. This article will dive deeper into what intuitive eating is, clarify related terms, and explain what the research says about intuitive eating’s effect on health outcomes.
What is intuitive eating?
Intuitive eating was created by two registered dietitians, Evelyn Tribole and Elyse Resch, and first published in a book of the same name in 1995. As noted by the creators, intuitive eating is a “self-care eating framework rooted in science and supported by clinical experience.” It’s based on ten principles, quoted below:
- Reject the diet mentality;
- Honor your hunger;
- Make peace with food;
- Challenge the food police;
- Respect your fullness;
- Discover the satisfaction factor;
- Honor your feelings;
- Respect your body;
- Movement—feel the difference; and
- Honor your health with gentle nutrition
While intuitive eating does not operate by rules per se, its principles are meant to guide you toward a healthier relationship with food and your body. Intuitive eating works in two primary ways: (1) it helps you get back in tune with your body’s signals for hunger, fullness and satisfaction (also known as interoceptive awareness); and (2) it removes obstacles that might prevent you from listening to your body (these obstacles typically are externally motivated food rules and rigid thoughts about eating).
It’s important to note that advocates for intuitive eating assert that intentionally pursuing weight loss does not allow you to eat intuitively, as doing so inhibits you from listening to your body’s signals. This does not mean that it’s impossible to lose weight while eating intuitively; however, weight loss is not the main goal of the practice.
What else do I need to know?
Intuitive eating fits into the Health at Every Size® (HAES®) paradigm, which is a weight-inclusive (also called weight-neutral) approach to health as opposed to an approach that places emphasis on body weight.
Essentially, weight-inclusive or weight-neutral means that body size will not be the main parameter for assessing someone’s health status. Intuitive eating, HAES®, and weight-inclusive are all terms that are often bucketed under “the non-diet approach.” While we are focusing on the research on intuitive eating, it’s helpful to understand the larger context into which this eating framework fits.
The research on intuitive eating
While intuitive eating is still relatively new, to date there have been about 200 studies evaluating its impact on a myriad of health outcomes. Most often, intuitive eating is assessed in relation to eating pathology (as an antidote to chronic dieting or disordered eating), weight (in comparison with weight-normative approaches), psychological well-being, and attending to hunger and fullness cues.
This 2014 literature review on the relationships between intuitive eating and health indicators included 26 articles; 17 were cross-sectional survey studies and nine were clinical studies, eight of which were randomized controlled trials. Because the principles of intuitive eating can be challenging to assess, the review defined intuitive eating as: (i) eating when hungry; (ii) stopping eating when no longer hungry or when full; and (iii) there being no restrictions on types of food eaten with the exception of restrictions for medical reasons.
The review’s results note: “The cross-sectional surveys indicate that intuitive eating is negatively associated with BMI, positively associated with various psychological health indicators, and possibly positively associated with improved dietary intake and/or eating behaviors, but not associated with higher levels of physical activity. From the clinical studies, we conclude that the implementation of intuitive eating results in weight maintenance but perhaps not weight loss, improved psychological health, possibly improved physical health indicators other than BMI (e.g. blood pressure; cholesterol levels) and dietary intake and/or eating behaviors, but probably not higher levels of physical activity.”
This 2017 study sought to examine the relationship between rigid control (inflexible dietary rules dictating what, when and how much one should eat), flexible control (a graded approach to eating, defined by behaviors such as taking smaller servings of food to regulate weight, eating a variety of foods in limited quantities and compensating at subsequent meals if “unhealthy” foods were consumed earlier) and intuitive eating on various indicators of disordered eating and body image concerns. The authors collected data online from 372 normal-weight (based on BMI ranges) men and women (mean age of 25) and found that, in contrast to rigid dietary control intuitive eating uniquely and consistently predicted lower levels of disordered eating and body image concerns. The authors note: “This intuitive eating-disordered eating relationship was mediated by low levels of dichotomous thinking and the intuitive eating-body image relationship was mediated by high levels of body appreciation.”
Furthermore, this 2018 study assessed eating-related and psychological outcomes of a HAES® intervention. For this study, 216 weight-preoccupied (i.e. seeking help for “weight issues/concerns”) women who participated in the HAES® intervention were compared with 110 weight-preoccupied women who did not receive an intervention. The two groups were of similar BMI. The HAES® intervention, which focused on healthy lifestyle, self-acceptance, and intuitive eating, entailed 14 weekly meetings provided by health professionals. Eating behaviors and psychological correlates (e.g., body esteem, self-esteem, and depression) were assessed using validated questionnaires first when the study began, then immediately following the intervention period, and finally one year after the intervention. The evaluation of this HAES® intervention in a real-life context showed its effectiveness in improving eating-, weight-, and psychologically related variables among women struggling with weight and body image. The eating-related changes observed in this study are consistent with findings from other research on HAES and intuitive eating.
Limitations, summary, and future discussions
The research on intuitive eating is promising, and its effects on psychological well-being, weight, improved body image, and eating in response to internal cues is becoming more well-documented. However, further studies are needed on more diverse populations. Moreover, the limited sample sizes of most of the studies cited warrants further research and discussion. Still, intuitive eating can be an option for those interested in shifting away from strict dieting rules in favor of a different approach. As always, there are many factors involved when it comes to improving your health, and we always recommend working with your individual healthcare provider or registered dietitian.
This article includes contributions from Kris Sollid, Rd.