Intuitive Eating (2024)

Intuitive Eating (1)

What Is It?

Intuitive eating (IE) is not so much a diet plan as an approach to eating based on one’s internal needs, whether physical, emotional, or other influencers. When these needs are recognized, they may determine one’s food choices. Because the method is based on an individual’s needs at one moment in time, it does not focus on specific foods, a calorie level to reach, or even eating at certain times. It has been used as an approach to lose weight as well as a treatment strategy for those with disordered eating patterns. The term “intuitive eating” was introduced in 1995 as the title of a book authored by registered dietitians Evelyn Tribole and Elyse Resch. However, the concept of eating from an emotional response was described by researchers prior to that date. [1]

How It Works

IE is the antithesis of restrained eating that demands rigid control. Many commercial diets follow a restrained eating model, with meal plans that include specific foods and/or measured portions. In contrast, IE focuses on body cues such as hunger and fullness, which may be physical hunger and fullness from an empty or filled stomach, or cues caused by emotional or external triggers. IE is flexible, with no restrictions on types of foods to eat, amounts, or specific mealtimes.

IE is sometimes described as this basic concept: learning to eat when hungry and stopping when full. Yet, in our society physical hunger is not the only reason we eat. Our appetites and cravings are continuously stimulated by visual cues (cooking shows, food advertisem*nts), emotional cues (feeling sad, lonely, stressed, bored), olfactory cues (smelling freshly baked bread), or social cues (Sunday family dinners, sharing a restaurant meal with friends). IE seeks to identify the specific cause of the “hunger,” and to respond with awareness and intention. Eating in response to triggers other than from physiological cues may cause a feeling of lack of self-control, guilt, or self-condemnation. Practicing IE concepts may help to prevent these negative feelings. Intuitive eating encourages self-care and a positive body image.

Weight loss is not a focus of IE. However, eating excess calories can occur from emotional cues, so if one learns to respond appropriately to emotional eating cues, weight loss may follow naturally.

Signs of physical hunger:

  • Fatigue, lightheadedness
  • Irritability
  • Headache
  • Stomach is grumbling
  • Hunger gradually intensifies
  • No specific cravings; any type of food will satisfy

Signs of emotional hunger:

  • Stomach is quiet
  • Desire for food occurs suddenly (e.g., because of an emotion such as anger or stress, or from external cues such as viewing a television commercial or other food advertising)
  • Cravings are for a specific food or flavor, whether salty, sweet, crunchy, creamy, etc.
  • Guilt is associated with eating

Examples of intuitive eating strategies:

  • Acknowledge hunger. Recognize physical hunger cues and respond to them. These cues will not always occur at consistent times, as true hunger can be influenced by changes in physical activity, lack of sleep, etc. Therefore, eating meals and snacks at the same time every day may not be appropriate according to IE principles, if you are not hungry.
  • Recognize and respond to fullness. As you identify true hunger, you will also learn to identify a comfortable degree of fullness after eating, and respond by stopping eating. This may require periodic check-ins while eating, noting if you are enjoying the food and reaching a point of having enough.
  • Don’t fear negative feelings. Accept that negative emotions like stress, anger, and boredom will come and go. Learn to cope with these feelings without using food: talk to a friend, go for a walk, take a shower, pray, or meditate.
  • Honor and respect your body regardless of size and ability. A negative self-image can lead to self-destructive behaviors, whereas nurturing a positive self-image may lead to healthful behaviors.

How is intuitive eating different from mindful eating?

Often used interchangeably, many intuitive eating and mindful eating concepts overlap but there are some key differences. Mindful eating stems from the broader practice of mindfulness, a centuries-old philosophy used in many religions. Mindful eating focuses on the present eating experience with heightened awareness beyond the self, and without judgment. [2] The following are some areas of focus:

  • Considering the wider spectrum of the meal which informs what and how much one eats: where the food came from, what elements were needed from nature that enabled the food to grow and thrive, the individuals involved in getting the food from the farm to grocery stores or restaurants, how the food was prepared, who prepared it.
  • Noticing how the food looks, tastes, smells, and feels in our bodies as we eat.
  • How the body feels after eating the meal.
  • Expressing gratitude for the meal before and/or after eating
  • May use deep breathing or meditation before the meal to transition your busy mind to focus on the meal in front of you.
  • How our food choices affect our local and global environment.

Including these considerations when eating can help to increase appreciation, enjoyment, and understanding of the food.

Intuitive eating often integrates concepts of mindful eating but also considers eating specifically in response to hunger and satiety cues, nurturing a positive body image, addressing non-physiological reasons for hunger, and physical activity. It usually does not involve meditation nor gratitude.

Learn more about mindful eating

The Research So Far

There is a growing body of research on IE. Small, short-term controlled trials or cross-sectional studies using IE concepts have consistently shown benefits for psychological wellbeing (e.g., reduced depression and anxiety; increased body satisfaction, self-acceptance, and quality of life). [3,4] IE interventions have also shown a decrease in certain behaviors such as binge eating and restrained eating/dieting. A limited number of studies have shown improvements in blood pressure and cholesterol. [5] Randomized trials show conflicting results of IE interventions and weight loss or decreased body mass index; some show no weight changes while others show modest weight reductions.

Diet quality
  • A cross-sectional study of 5,238 Swiss men and women were evaluated with self-administered questionnaires assessing intuitive eating behaviors and diet quality. [3] The study found that scoring higher with “unconditional permission to eat” was associated with poorer diet quality (increased sugar sweetened beverages, salty snacks, sweets, meat, and fried foods; lower intake of fruits, vegetables, and whole grains).
  • Another cross-sectional study of 41,536 men and women found that scoring higher with “unconditional permission to eat” or no food rules/restrictions was associated with more unhealthful food choices and a higher total calorie intake. High scorers tended to eat less fruits, vegetables, and whole grains, while eating more fast food and sweetened and fatty foods. [6] Those who scored higher on “physical rather than emotional reasons to eat” had a lower calorie intake and ate less sweet and fatty foods.
Body mass index
  • In a randomized-controlled trial, 40 women each (ages 30-45 years) were randomized to a weight loss program or to a weight neutral program. [7] Both programs emphasized healthy gradual lifestyle changes, but the weight loss program focused on a prescribed calorie restriction, while the weight neutral program focused on an intuitive eating approach with internal physical cues of hunger and satiety. Size acceptance was emphasized in the weight neutral group, as opposed to meeting weight loss goals in the other group.
    • Reductions in weight and BMI occurred in the weight loss group but not the weight neutral group. However, the weight neutral group showed greater reductions in LDL cholesterol. Both groups showed an increase in healthy lifestyle behaviors (increased physical activity and fruit/vegetable intake), improved quality of life and self-esteem, and decreased total and LDL cholesterol, all of which were maintained at the 2-year follow-up.
  • A meta-analysis of 10 randomized controlled trials looked at conventional weight loss programs (via calorie restriction) versus mindful/intuitive eating strategies for weight loss. It found that mindful/intuitive eating strategies were effective for weight loss compared with no intervention, but there was no difference in weight reduction compared with conventional weight loss programs. [8]
Eating behaviors
  • A literature review of 68 publications looked at the role of mindful eating and intuitive eating in changing eating behaviors. The number of studies specific to intuitive eating was limited but found that it had positive associations with identifying hunger cues, increased freedom to eat, greater pleasure associated with food, and greater awareness of how their bodies were feeling. [9]

Potential Pitfalls

  • May not cause weight loss. The IE model is not intended to cause weight loss, but to promote a positive self-image and healthy lifestyle changes. People who are seeking a plan that causes weight loss may not prefer this approach, because there are no specific amounts or types of foods recommended and body weight is not measured. However, a decrease in behaviors like restrained eating and emotional eating may naturally lead to weight loss for some. If a person has been advised to lose weight by their physician to improve medical conditions (e.g., prediabetes, high blood pressure, fatty liver), an IE approach may be used in conjunction with a weight-reducing eating plan. Guidance on this type of plan from a registered dietitian or licensed health coach can help to encourage a healthy body image and realistic lifestyle goals.
  • Fear of weight gain. A concern with individuals is letting go of diet rules and “forbidden” foods. They may fear a lack of control around these foods that are now permitted without restrictions. In certain cases, less boundaries may lead some people to overeat or choose low-nutrient-dense foods (e.g., processed high-sugar beverages or foods). Consulting with a registered dietitian who is experienced with IE concepts can help one to identify the body’s signals on what and how much to eat, ideally choosing foods and amounts that support their wellbeing and health.
  • May not improve health outcomes related to weight gain or chronic disease. IE concepts encourage self-care and a positive response to food, which may or may not cause a change towards healthful eating patterns (consuming more fruits and vegetables, less sweetened beverages and foods, less fried foods, not skipping meals, etc.). An individual has the freedom to choose fast food and soda if desired, so IE will not necessarily lead to a disease-preventive eating pattern or to a reversal of weight gain.
  • Does not address the concept of food addiction from “hyper-palatable” foods, which can lead to food cravings. Cravings for food may stem from a neurobiological source that is neither caused by physical or emotional hunger. The notion of a food addiction is controversial, but research shows that the brain can activate reward regions of the brain in response to flavors like fat, salt, and sugar when they are eaten in excess and on a regular basis. [10-14] Researchers have compared this effect to that of addictive drugs like cocaine and alcohol. These foods tend to be highly processed, calorie-dense, and low in nutrients. People may develop strong cravings for these foods because of the reward-related neural changes that occur after consumption (a calming or pleasurable feeling with the release of dopamine). In this case, relying on intuition about what to eat may backfire if one has developed an “addiction” to these types of foods.

Unanswered Questions

  • Can IE concepts prevent the onset or progression of chronic diseases including obesity by promoting healthier lifestyle behaviors?
  • Are there certain types of people in which the IE approach would work best (e.g., chronic dieters, those experiencing disordered eating)?

Bottom Line

Intuitive eating is an alternative approach that was developed in response to the negative mental and physical health effects caused by traditional diets for weight loss, which involve the deliberate long-term restriction of food. IE allows internal cues to guide one’s eating choices and patterns rather than a meal plan or designated rules.

Research has shown that IE can lead to greater psychological wellbeing, increased pleasure when eating, and body satisfaction. However research also shows that permission to eat all foods with no “food rules” can sometimes lead to unhealthful food choices with more high-calorie palatable foods. Therefore a certain level of restraint and nutrition knowledge may be beneficial when starting an IE plan (if the desired result is to improve overall health and wellness). Still, in the long run, continued dietary restraint increases the risk of ignoring natural physiological signals to eat. Therefore a combination of IE practices with basic nutrition knowledge may lead to more positive outcomes than either approach alone.

It may also be beneficial to use IE strategies to heighten one’s awareness of internal cues of not just feeling “full” versus “hungry” but to also note how the body feels after eating healthful foods of fruits and vegetables versus highly processed high-calorie snack foods, which may lead to eating patterns that promote wellbeing. [3]

Related

References
  1. Gast J, Hawks SR. Weight loss education: the challenge of a new paradigm. Health education & behavior. 1998 Aug;25(4):464-73.
  2. Fung TT, Long MW, Hung P, Cheung LW. An expanded model for mindful eating for health promotion and sustainability: issues and challenges for dietetics practice. Journal of the Academy of Nutrition and Dietetics. 2016;116(7):1081-6.
  3. Horwath C, Hagmann D, Hartmann C. Intuitive eating and food intake in men and women: Results from the Swiss food panel study. Appetite. 2019 Apr 1;135:61-71.
  4. Bruce LJ, Ricciardelli LA. A systematic review of the psychosocial correlates of intuitive eating among adult women. Appetite. 2016 Jan 1;96:454-72.
  5. Van Dyke N, Drinkwater EJ. Review article relationships between intuitive eating and health indicators: literature review. Public health nutrition. 2014 Aug;17(8):1757-66.
  6. Camilleri GM, Méjean C, Bellisle F, Andreeva VA, Kesse-Guyot E, Hercberg S, Péneau S. Intuitive eating dimensions were differently associated with food intake in the general population–based NutriNet-Santé study. The Journal of nutrition. 2017 Jan 1;147(1):61-9.
  7. Mensinger JL, Calogero RM, Stranges S, Tylka TL. A weight-neutral versus weight-loss approach for health promotion in women with high BMI: A randomized-controlled trial. Appetite. 2016 Oct 1;105:364-74.
  8. Fuentes Artiles R, Staub K, Aldakak L, Eppenberger P, Rühli F, Bender N. Mindful eating and common diet programs lower body weight similarly: Systematic review and meta‐analysis. Obesity reviews. 2019 Nov;20(11):1619-27.
  9. Warren JM, Smith N, Ashwell M. A structured literature review on the role of mindfulness, mindful eating and intuitive eating in changing eating behaviours: effectiveness and associated potential mechanisms. Nutrition research reviews. 2017 Dec;30(2):272-83.
  10. N Gearhardt A, Davis C, Kuschner R, D Brownell K. The addiction potential of hyperpalatable foods. Current drug abuse reviews. 2011 Sep 1;4(3):140-5.
  11. Leigh SJ, Morris MJ. The role of reward circuitry and food addiction in the obesity epidemic: An update. Biological psychology. 2018 Jan 1;131:31-42.
  12. Hebebrand J, Albayrak Ö, Adan R, Antel J, Dieguez C, De Jong J, Leng G, Menzies J, Mercer JG, Murphy M, Van Der Plasse G. “Eating addiction”, rather than “food addiction”, better captures addictive-like eating behavior. Neuroscience & Biobehavioral Reviews. 2014 Nov 1;47:295-306.
  13. Schulte EM, Avena NM, Gearhardt AN. Which foods may be addictive? The roles of processing, fat content, and glycemic load. PloS one. 2015 Feb 18;10(2):e0117959.
  14. Lennerz BS, Alsop DC, Holsen LM, Stern E, Rojas R, Ebbeling CB, Goldstein JM, Ludwig DS. Effects of dietary glycemic index on brain regions related to reward and craving in men. The American journal of clinical nutrition. 2013 Sep 1;98(3):641-7.

Last reviewed November 2023

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Intuitive Eating (2024)
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