by Barbara Berkeley, MD
It is a reoccuring theme, always pitched as a brand new idea: in order to lose weight we simply must stop dieting and eat "intuitively".
Recently Lynn Haraldson's Facebook page featured a post on intuitive eating. The Intuitive Eating school of thought holds that we will do better if we learn the proper signals of satiety sent by our body and if we face our "demons" by exposing ourselves to the foods we fear...in other words, our trigger foods.
For those who prefer the Cliff Notes, here's a summary of the article Lynn posted:
1. The idea of anti-dieting is "new thinking". (This is not true, by the way, this school of thought has been around for a long time.
2. The basic principles are to eat only when hungry, stop feeling guilty about food, and eat whatever the body tells you to eat.
3.If you stop focusing on eating less, you'll actually eat less.
The article gives an example of allegedly successful intuitive eating. Jill, 36, was addicted to a certain flavor of Ben and Jerry's ice cream. Instead of avoiding it, she stocked her entire freezer with ice cream and gave herself permission to eat as much as she wanted. While she ate too much of it in the beginning, she eventually grew sick of it. To quote Jill, "It lost its sparkle," she said. "I knew at that point that ice cream -- or any food -- no longer had an unhealthy grip on me." The article goes on to enthuse, "Jill ended up dropping 50 pounds -- without trying!"
Dear readers, let's be honest with one another. There is a reason that Americans spend millions each year on HCG drops, garcinia cambogia, electrified tummy belts and raspberry ketones. Despite our knowing very well that there are no easy cures for obesity, it's hard to stop believing. As a clinician, I put intuitive eating into the same category I assign to other miracle cures. It simply doesn't pass the common sense test.
The principles of intuitive eating are based on the idea that the obese person has an unhealthy relationship to food (so once again, it's all the fault of the overweight person) and that this relationship can be altered by "understanding" the signals of the body better. But there is a major flaw in this seemingly straightforward reasoning. Suppose it is the body's signals that are damaged and not the "relationship with food" at all? We have every reason to believe that this is the case; that the biochemical and hormonal milieu of those who gain weight easily has been altered and is no longer normal. How then are we supposed to rely on signaling if the signals themselves are crossed? This is akin to asking someone to get to California by simply following a road map and then giving them a road map with routes that lead to New Jersey. When you are significantly overweight, your body is unable to tell you when you are full and when you are sated. Your body is unable to give you the right information to make healthy choices. In short, your signals are messed up. Moving yourself onto a clean, healthy diet and avoiding triggers allows your vision to clear and your signals to start healing.
Intuitive eating is a good strategy for those whose physiology has healed, usually after weight has been lost. This return to normal does not happen for everyone. There are many weight maintainers who would not dream of exposing themselves to trigger foods, even long after weight has stabilized. In my own life, I am maintaining a fairly modest weight loss and have normal eating urges. Yet I am uncomfortable when in the presence of a great deal of modern food. It very definitely encourages hunger and craving. I much prefer to eat from my own menu. The idea of bringing bread and Mallomars into my house borders on the insane.
Which brings me to another hole in Jill's story above. Even if she did find that, after drowning herself in Ben and Jerry's, her favorite ice cream no longer looked good, how does that translate to exposure to Doritos, cupcakes and cinammon buns? There is always another trigger food out there.
While a couple of the commenters to Lynn's post say that the intuitive approach worked for them, most say that it either does not work or they would be afraid to try it. Of course they are afraid. What is novel about exposing oneself to dangerous foods 24/7? We call that America, and we've all been there, done that.
Eating intuitively is an advanced skill for those who have already done the difficult work of stabilizing their weight. It is a way of looking at eating that may be helpful to employ here and there along the way. And of course, there will be some people for whom it works. My suspicion is that that number is small. I'm sure you will let me know about your personal experiences.



