Intuitive Eating and Eating Disorder Recovery

April 26, 2011 General Interest

I was recently asked by Nina V, owner of the website www.helpforeatingdisorder.com, to write an article on Intuitive Eating and eating disorder recovery. I recently completed my training to become a certified Intuitive Eating Coach and was thrilled to share my thoughts. Enjoy.

Intuitive Eating is a phrase that is famous among many people hoping to recover from an eating disorder. It’s actually a concept developed by two dietitians, Evelyn Tribole MS, RD and Elyse Resch MS, RD. My goal with this blog post is to accomplish four things:
1. Explain the difference between Intuitive Eating and eating that is guided by an eating disorder (ED)
2. Discuss whether or not it’s possible to recover from an eating disorder by becoming an Intuitive Eater
3. Discuss the challenges of incorporating Intuitive Eating into eating disorder recovery
4. Share some tools to address those challenges.

An eating disorder is, by nature, the antithesis of Intuitive Eating (IE). This page from the IE website summarizes the basic premise of what IE is all about. But when I talk with my clients about the differences between IE and disordered eating, here’s what they tell me.

Disordered Eating is:
• Rigid
• Dictated by rules
• Ignores physical cues for eating
• Very judgmental and associated with feelings of guilt and shame
• Cues to eat or not eat are based on external factors or from the head, not the body

Intuitive Eating is:
• Flexible
• Dictated by whether or not you are hungry or full
• Allows you to enjoy a wide-variety of foods, without guilt or shame
• Cues to eat are largely based on your physical need and cravings for certain types of food

Is it possible to recovery from an ED by using IE?
This is a really great question. And this article, written by Evelyn Tribole, gives a fantastic explanation of how IE can be used in the treatment of an ED. It’s written for clinicians, but I use it as a handout with my clients and highly recommend you read it. Within the article is a table that explains how IE applies to EDs. I explain to my clients that when you are in the throes of an eating disorder, it’s too noisy to hear your health IE voice. So we use a structured eating plan (sometimes called a meal plan) as a bridge to walk you away from your ED and towards becoming an IE. However, the structured eating plan is only a tool to get you from an unhealthy eating disordered place, to a place that you can start listening, trusting, and responding to your body. It’s extremely important to note that the very nature of an eating disorder disrupts your biology. And following a structured eating plan is like using “Control-Alt-Delete” on your body, giving it time to heal and reset it’s natural rhythm of hunger and fullness.

I personally feel that it is extremely difficult to do this on your own if you are in the midst of an ED. In fact, I always recommend that anyone with an ED work very closely with a dietitian that specializes in the treatment of EDs. They can prescribe an appropriate structured eating plan, help you learn to reframe disordered thoughts about your body and food, and guide you to a place of trust between you and your body. It is very very hard to do this on your own.

What are the challenges of incorporating IE into ED recovery?
• In the beginning, your hunger/fullness cueing isn’t reliable or accurate so you cannot use that to guide your eating. While that is the goal of IE, it is not appropriate in the beginning stages of recovery.
• It’s easy to confuse your healthy IE voice with your ED voice, especially early on.
• Years of disordered eating create distrust with your body, and trust is the core of IE.

What are some tools?
• If possible, work with an experienced RD who specializes in treating eating disorders
• Read the article I shared earlier and keep the table of how IE applies to ED in mind
• Buy the book “Intuitive Eating” as well as the fabulous IE cds (which are different from the book). Hold this up as your gold standard ad goal for recovery!
• Don’t go it alone. Support is crucial for recovery and you deserve it.