Intuitive Eating, Diet Culture, and Health

Embracing the basic truth that one size does not fit all, January is no longer “diet season” for all. Sure, you can find folks promoting everything from healthy dietary patterns like the Mediterranean diet to diets aimed more directly at weight loss, like intermittent fasting. But now, non-diet diets are sharing the spotlight, too. Intuitive eating started as a radical challenge to diet culture and has now slipped into the mainstream, says Michelle Ruiz in the New York Times. She calls it “the cornerstone of the modern anti-diet movement.”

Clearly, this is a concept that resonates. People are fed up with restrictive, polarized, and stigmatizing ideas about food. But the question remains, how helpful is intuitive eating for our physical and psychological health?

A Potential Plus for Psychological Health

Scanning the scientific literature for research on the effectiveness of intuitive eating strategies does not yield a wealth of rigorous studies. But you can find support for the possibility that these strategies can help with psychological health.

Vivienne Hazzard collaborated with researchers from the University of Minnesota School of Public Health to analyze eight years of data on psychological health and disordered eating behaviors. This, of course, is observational data. So these findings point to associations (not necessarily causal relationships) of better psychological health with skills for intuitive eating.

Hazzard et al conclude:

“These results indicate that IE longitudinally predicts better psychological and behavioral health across a range of outcomes and suggest that IE may be a valuable intervention target for improving psychological health and reducing disordered eating behaviors, particularly binge eating.”

Fuzzier Answers for Physical Health

Though some ardent fans of intuitive eating have tried, it’s hard to come up with persuasive evidence that intuitive eating will yield better physical health.

Hannah Grider, Steve Douglas, and Hollie Raynor published a recent systematic review of mindful and intuitive eating interventions and found “little evidence” for a benefit to dietary health with respect to either energy intake or diet quality. They point to the need for research using study designs of greater rigor in the future.

Not the Whole Story

So in the end, we agree with Harvard’s Fatima Cody Stanford, who told Ruiz that she endorses having patients think about what their bodies are telling them. But, she says, that’s not enough by itself. “It neglects the science of how the body regulates weight.”

And as too many people know from direct experience, sometimes that regulatory process goes off kilter and pushes people into obesity and a whole assortment of metabolic diseases. Simply listening to your body is not enough to deliver metabolic health. Sometimes we need medical help to reset that metabolic regulatory function.

Click here for the article by Ruiz, here for the Hazzard study, and here for the study by Grider et al.

The Bread Eater, painting by Pieter Brueghel the Younger / WikiArt

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January 19, 2023