Intuitive Eating Part 2: Addressing the Skeptics

Written by: Emily Russo, MS, RD, CDN

Intuitive Eating and social movements books

Part 2 in this series takes a deep dive into the critiques of intuitive eating and why it is often linked to other social movements. And don’t forget to scroll down for additional resources!

“There is a lot more to health than what you eat.”

This quote, taken from Intuitive Eating, underscores the belief that a person’s worth or value is not a reflection of their dietary choices. The concept is revolutionary, considering its juxtaposition with the ever referenced “you are what you eat” by French lawyer Brillat-Savarin in 1826. The latter now seems to me more like a mantra for diet culture than an insightful call to action.

The Social Determinants of Health
What we choose to eat doesn’t make us a good or bad person. It also doesn’t exclusively determine our health status. Compared to other variables, diet is actually a very small piece of what determines our health outcomes.

According to the World Health Organization (WHO), the Social Determinants of Health (SDOH) – education, economic stability, access to health care, environment, and social circumstances – in addition to genetics, account for the majority of health outcomes. 

From the World Health Organization (WHO) website: “The context of people’s lives determine their health, and so blaming individuals for having poor health or crediting them for good health is inappropriate. Individuals are unlikely to be able to directly control many of the determinants of health.”

Have you ever thought to yourself that people should be able to lose weight if they try hard enough? I’ve had this thought, but have since realized it’s not accurate.

Keep in mind that about 10% of Americans live in poverty and about the same percentage are uninsured. It may seem helpful to teach nutrition information concerning which foods are healthier than others, but how relevant is it to know which kind of meat has two less grams saturated fat than another if you don’t even have access to medical care?

SDOH and Nutrition
It is true that diet impacts health, but access to food and food choice is too intertwined with SDOH for diet to make as big of an impact as we think. Also, diet doesn’t only refer to the nutrients we eat, but also how we eat. Stress over eating and choosing certain foods contributes negatively to health, even if ultimately the more “nutritious” food is chosen.

Gentle Nutrition (principle 10 in Intuitive Eating) provides some nutrient-specific guidance but it doesn’t live in a vacuum. It goes hand in hand with letting go of the stress over binary attitudes and behaviors towards food and body.

Addressing the skeptical FAQs about intuitive eating (I’ve even asked myself!):

1. So you just want me to eat whatever I want?
In the beginning it may feel that way because it takes practice to let go of food rules we have always relied on. This doesn’t mean we don’t care about what we eat or that we are reckless around food. It means we change our relationship from fearing food to incorporating it into our lives without judgment.

The good news is that habituation tends to win out – food freedom and unconditional allowances strip away the thrill of foods. We develop collaboration or balance between brain and taste buds.

2. I’ve read so many articles on how weight loss will improve my health and that being fat is harmful to my health – how can you possibly disagree with this?
It is true that larger bodies are associated with chronic health conditions. But it doesn’t translate to body size causes chronic illness. It also doesn’t mean that intentional weight loss will prevent chronic illness.

Studies do not account for things such as mental health, weight stigma, access to health care, and genetics, that may provide more information to this correlation. Losing weight in short term is possible and even probable with dieting. This may also make an impact on health markers in the short term. But long-term health impacts are more in-line with behavior changes.

Weight change is more of a byproduct, not an impact factor.

3. Isn’t this just another diet?
This is not a new or unique way to lose weight. In intuitive eating, weight is placed on the back burner. It’s the behavior change that matters and weight change (higher or lower) can be a byproduct of these changes.

Intuitive eating is an approach to re-building healthy relationships with food. It’s not rules-based and goes hand-in-hand with guidance, support, and counseling.

4. I feel like everyone who follows IE has a history of eating disorders. I don’t have an eating disorder, so is this even appropriate for me?
Intuitive eating was not developed to treat eating disorders. But normalizing food has become a validated way of healing damaged relationships with food.

Hunger and fullness cues, as well as other interoceptive awareness – meaning the ability to process and respond to our own internal signals – is damaged during an active eating disorder and in early recovery. This is why if intuitive eating is introduced to this population, it’s typically in the latter stages of treatment once those connections have been re-established.

Critiques of Intuitive Eating (I also grapple with these!)

1. This is for privileged people only
Agreed. Unfortunately, most health interventions – diets, health care, exercise programs, surgeries, mental health you name it – are for the privileged in this country. Taking time and money to reflect on any health intervention is privileged at the core.

The authors of Intuitive Eating self-admittedly have thin white privilege, and do not represent or speak for marginalized voices. 

2. There is not enough research behind Intuitive Eating and health outcomes
Agreed. Intuitive eating is relatively new. There have only been about a hundred published studies so far. Overall, they have shown how beneficial intuitive eating is for our health.

While many do account for the SDOH, study participants are often women on college campuses, and not generalizable to the population as a whole. We would benefit from more research, especially focused on diverse populations and controlling for factors like weight stigma, fatphobia, and diet culture.

3. Isn’t this just another money-making scheme like other diets?
I can see that angle, and certainly anyone’s job relates to making money by definition. However, the goal of intuitive eating is to maintain a healthy relationship with food for life. We won’t need to buy more pills, memberships, blenders, or other products, now or later, to do this.

4. I’m happy with how I eat – why would I need to practice intuitive eating, or change my mindset to have a healthier relationship with food?
Intuitive eating is not for everyone, and that’s OK. And if you are in a happy, safe place with food, that’s fantastic.

5. How can kids be intuitive eaters?
Kids are born intuitive eaters. Our job as caregivers is to make sure we keep that instinct strong! This is certainly a tricky task because kids need boundaries as they develop, including food boundaries. If curious how to balance this, I highly recommended How to Raise an Intuitive Eater (also noted in resources below).

With anything we teach our children, it all begins with parents as role models. We need to make sure our relationship with food is healthy if we want our kids to feel the same way.

Intuitive Eating (IE) & Social Movements
Embracing all different kinds of food cultures and body shapes align intuitive eating with other social movements. This is why intuitive eating-focused social media accounts, blogs, or podcasts tend to overlap with some of these topics as well:

  • LGBTQIAA+ Advocacy – IE embraces the fact that there is not one ideal body type or sexual orientation that is better or intrinsically healthier than another.
  • Racial Justice – Diet culture promotes the thin white ideal and perpetuates a fear of larger bodies, specifically non-European body types. This can be traced to the 18th century, when white European males established racial ”hierarchies” based on body size and skin color. This was before any medical advice about “obesity” had been established. It was racially and ethnically motivated at the core and meant to keep one group at the top and other groups at the bottom. IE is anti-diet and doesn’t perpetuate the belief that larger bodies have to shrink to be healthy.
  • Gender Equality – In today’s society, it is often accepted –consciously or subconsciously – that men can eat in certain ways (like ordering a messy cheeseburger) but women should practice more restraint. In IE, women are NOT expected to look a certain way or restrain themselves from eating certain foods. 
  • Self Care – This may include meditation, self-love (it’s not so taboo anymore!) mindfulness, and openness to dialogue about the body. IE embraces these tools to develop a healthier relationship with our bodies and to be more in tune with our body signals.
  • Health at Every Size (HAES) – This framework of care advocates for everyone to have the right to pursue health and wellbeing without focusing on body shape or weight. It’s intended to address weight stigma, most specifically in health care situations. IE is a nutrition approach which tends to align with HAES.

For more information, and deeper diving into the subject, here are a few books (out of many!) I’ve read and recommend. This just scratches the surface, so please contact me if you are looking for more!

Key Takeaway
There is a lot more to health than the nutrients we eat. SDOH have the biggest impact on health outcomes. Intuitive eating is aligned with social movements such as LGBTQIAA+ advocacy, racial justice, and gender equality because of the underlying belief that there is not one body size, shape or color that is inherently better than another.

I welcome your comments and questions. I always love hearing from you!

 

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