Does Intuitive Eating Work?
Pamela A. Popper, Ph.D., N.D.
Wellness Forum Health
The failure rate for weight loss programs – all of them – is very high. Frustrated, overweight and obese people who want desperately to be normal weight enroll in or adopt program after program, hoping for better results, but ending up getting nowhere, or even gaining more weight instead of losing.
Studies can appear to make some programs “work” because most are short-term, and almost anything will work in the short term. Tens of millions of Americans have been successful for 21 day, 30 days, or 90 days at a diet program, or several diet programs, but have not figured out how to change their lives.
Enter intuitive eating, a diet philosophy that teaches people how to develop a healthy relationship with food. So far so good; most overweight people do not have a healthy relationship with food. Proponents rightly state that diets don’t work and that in order to succeed, people should avoid dieting and instead learnt o listen to their body’s cues since”…you were born with all the wisdom you need for eating intuitively.” Participants are taught to “trust themselves” and to “make peace with food” which involves several principles. One is that that you should not tell yourself that any food is forbidden since doing so will “…lead to such intense feelings of deprivation that build into uncontrollable cravings, and often bingeing.” This leads to overeating and guilt. Another principle is to “Challenge the Food Police” who have made the “unreasonable rules” that have led to dieting failure. Overweight people are encouraged to “…eat what you really want in an environment that is inviting and conducive” which will lead you to the place where less food is needed in order for you to have “enough.”
Best-selling books have been written about the concept, health coaches advertise that they specialize in teaching intuitive eating concepts, but there is little research to back up the claims. The “evidence” consists mostly of people telling their stories of failing at dieting and finding “success’ which is usually not measured or quantified in any way, with intuitive eating. Again, almost all programs work in the short-term, and almost all programs, no matter how bad they are, produce a few people who succeed.
What further makes analysis of diet plans confusing and somewhat useless is that they often compare programs that are ineffective with one another, and then declaring that one terrible program is better than the others. The general public and even some health professional don’t necessarily realize this, and conclude that a certain diet is actually superior and “works.”
Such is the case with a small study published in 2015 that compared calorie restricted diets with intuitive eating. Sixteen obese and sedentary men and women were assigned to eat either a diet with 1200-1800 calories (the amount depended on the individual’s metabolic rate), which represented an average reduction of 500 calories per day; or to practice intuitive eating. The intuitive eaters were not given calorie intake targets. All participants were instructed to exercise only in the lab three times per week to avoid increased physical activity, which often accompanies starting a new diet program, from influencing the results. At three weeks and six weeks, participants received additional counseling and encouragement.
At three weeks, the participants eating the restricted calorie diet had lost about 5.3 pounds, and the intuitive eaters had lost slightly more. But at six weeks the restricted calorie eaters had lost an additional 2.5 pounds, while the intuitive eaters had regained their weight. Some were heavier at the end of the 6 weeks than they were before they started.
Since studies have shown that calorie counting and calorie restriction do not result in permanent weight loss for most obese people, this study says more about the lack of efficacy for intuitive eating than how effective calorie restriction is.
People do like to hear good news about their bad habits, so it is not surprising that many overweight people love this program. The idea that eating cinnamon scones in an inviting and conducive setting, combined with no “rules” to guide the eating pattern is very attractive. Intuitive eaters have no dietary guidelines – they just listen to their bodies and eat what they want. If I did that I’d weigh 300 pounds. I want cinnamon scones!
There are many reasons why intuitive eating cannot work. While some people don’t want to hear this, there really are good and bad foods and good and bad dietary patterns. Cow’s milk was designed to help a baby cow grow from 90 pounds to 800pounds in less than a year. It’s a bad food for people who want to be lean (or to avoid chronic infections, breast and prostate cancer, autoimmune diseases, constipation, acne and a host of other conditions). Eating cheese, no matter how inviting or conducive the environment is, will not result in optimal health.
Another issue is that in order to be successful at weight loss or health improvement, prescriptive communication is required. In addition to its dietary guidelines not being science-based, the USDA’s recommendations are delivered with instructions that are so vague as to allow almost anything. “Eat less saturated fat” and “keep sodium low” and “enjoy your food but eat less” “choose whole grains more often” and “Cut back on some foods” are difficult to follow. Terms like “less” and “cut back” mean different things to different people. People tend to interpret them to favor their dietary preferences, and also because they do not know and have never been taught the principles that guide healthful eating.
Prescriptive communication involves giving people directions that are understandable, clear, and actionable. “Eliminate dairy,” “no oils,” and “treats are for holidays and birthdays” are clear directives. Admittedly, these are not as popular as telling people to essentially eat anything the intuit that their bodies want at a certain point in time, but we have never been driven by a desire to tell people what they prefer to hear, or to publish garbage that panders to the public in order to sell books or programs.
So the bottom line is that there is a specific diet that promotes health and ideal weight for humans, just as there is a specific diet for all other creatures on the planet. Intuitive eating is a diet plan presenting itself as a “non-diet” that does not work.
Anglin J, Borchard N< Ramos E, Mhoon K. “Diet quality of adults using intuitive eating for weight loss – pilot study.” Nutr Health Jul 2013;22(3-4):255-264
http://www.choosemyplate.gov/ten-tips-make-better-food-choices