TPV Podcast Episode 358: How Intuitive Eating Has It Wrong

On this week’s episode, Stacy and Sarah take a look at the latest buzz in the health and wellness community – intuitive eating. Dig into the guiding principles of this practice and understand the scientific facts you need to consider when looking through the intuitive eating lense. Lastly, learn how you can navigate the diet extremes and the healthy eating gray areas to achieve your health goals and feel your best!

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The Paleo View (TPV), Episode 358: How Intuitive Eating Has It Wrong

- (0:41) Welcome
  - Hello Paleo View listeners!
  - Stacy is coming to you from Central Oregon
    - Sarah’s mom has been following along with Stacy’s travels via social media and loves the amazing family bonding they are having
  - Stacy shared on their latest adventures and the incredible experiences she is sharing with Matt and the boys
  - One of the things that Stacy did before leaving for her trip was to listen to a podcast on intuitive eating
    - This is something she thought she understood in concept, but she wasn’t aware that there are specific rules around the practice
    - She wanted to share this information with Sarah so that they could discuss her concerns
    - It is important for Stacy and Sarah to address what the concepts are that are helpful and good when listening to your body when trying to embrace a non-diet culture
      - I.e. looking at living a sustainable life longterm, not in an on-again, off-again, diet rollercoaster
    - Stacy and Sarah eat the way that they eat for longterm health; they focus on nourishing their body so they can be healthy
      - However, they also understand that socially and emotionally food can drive humans
      - There is nothing wrong with this, as long as we are aware of our longterm goals towards health
      - We can apply this still to intuitive eating without going over the edge
  - Sarah also didn’t realize that intuitive eating was actually an anti-diet framework
    - For Sarah, she had equated the phrases ‘intuitive eating’, ‘mindful eating’ and ‘listening to your body’ as all essentially the same thing
    - She had used these phrases interchangeably to talk about a concept that is ultimately body awareness
    - Sarah has a high degree of body awareness that was hard earned
      - It is a practice of mental health piece that has gone along with Sarah’s Paleo/AIP journey
      - This has gotten her to a place where she really understands her body’s signals
    - Now that Sarah understands that intuitive eating is its own thing there are some things that need to be cleared up
      - There are some very important factual details that Sarah needs to share
      - With this particular anti-diet framework there are some things that are not right
      - Sarah does agree with some of the points, but there are some really important scientific backed details that Sarah’s needs to address
  - But first, before we get to the discussion on intuitive eating, a word from our sponsor
    - This week’s episode is sponsored by EverlyWell
      - EverlyWell is an at-home lab testing company that offers a variety of tests, ranging from Food Sensitivity to Metabolism, to a Thyroid Test and Vitamin D
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      - EverlyWell takes all of the guesswork out of lab testing and puts the power into your hands to complete a range of important health tests all from home
    - To check out EverlyWell visit: https://everlywell.com/thepaleoview
      - Use code ‘ThePaleoView’ for 15% off
      - For more on Sarah’s and Stacy’s thoughts on EverlyWell, check out this podcast episode
- (13:40) Where Intuitive Eating has it Wrong
  - Before Sarah goes on her soapbox on where intuitive eating has it extremely wrong, she wants to cover the official trademark details on what this practice actually is
    - From their site:
      - “Intuitive eating is a non-diet approach to health and wellness that helps you tune into your body signals, break the cycle of chronic dieting and heal your relationship with food. From a nutrition professional perspective, intuitive eating is a framework that helps us keep nutrition interventions behavior-focused instead of restrictive or rule-focused.”
      - “Intuitive eaters give themselves unconditional permission to eat whatever they want without feeling guilty. They rely on their internal hunger and satiety signals and trust their body to tell them when what and how much to eat. They know when they want to eat veggies and also when they feel like having dessert (and don’t feel guilty or have any regrets with either choice).”
  - Conceptually Stacy loves the idea of intuitive eating, but the problem is that in practice this can go terribly wrong when someone is not in tune with their body
    - On the podcast that Stacy listened, the podcast host informed a listener that lethargic and bloated aren’t words that foods can make you feel
      - These are sneaky diet culture words
      - Foods are simply energy in, energy out
      - They can’t contribute to you feeling bloated
    - This is where Stacy had her ‘whoa whoa whoa’ moment
      - She is in full support of the belief that we need to listen to our bodies and not be on a diet rollercoaster
      - However, foods can contribute to how your body feels
      - Part of intuitive for Stacy is learning these things, but that is not the definition of this formal movement and program
  - There are concepts from this that Sarah wholeheartedly believes in
    - Behavioral modification is actually a really important aspect of successful weight loss maintenance
      - You can’t just throw someone on a diet and exercise program without addressing emotional health and behaviors associated with food and lifestyle
      - This is absolutely part of the healing process
  - Where Sarah completely disagrees with this practice is with this idea that food cannot have a physical consequence for people
    - There is a ridiculously huge body of literature that proves otherwise
    - These studies prove that food can have negative consequences on the body beyond allergies
      - This includes things like feeding the wrong strains of bacteria in the gut and altering hormone systems
    - One of the implications of this is that people are giving themselves permission, unconditionally, to eat whatever they want without feeling guilty
      - This includes this group of manufactured modern “foods” that are so tasty that they trigger eating for pleasure
        
        This is a very well studied field of science
        
        Hyper-palatable foods override satiety signals and alter dopamine response to food (leading to opportunistic overeating)
        
        These are typically foods that contain carbohydrates, fat and some kind of flavor enhancer such as fat
        
        These foods are engineered to be so rewarding on a dopamine level
        
        We are unable to tell if we are full/satisfied when consuming these foods because they are designed to be hyper-palatable
        
        They make it impossible for our neurotransmitters to do their job because they override our ability to tell if we are hungry or not
        
        This is well documented in humans and in animal studies
        
        These foods drive the overeating behaviors that are unhealthy
        
        How can you behavior modify if you are continuing to give yourself unconditional permission to eat these foods that make it impossible to listen to your body and modify behavior
        
        An example of this is your dessert stomach on Thanksgiving
    - As a consumer, if you were to say that you will intuitively eat the amount of this thing that is appropriate for you if you let go of diet culture and allow yourself to live in this moment and enjoy this food, that it would be physically impossible
      - This food has been modified to enhance your appreciation of it so that you eat more and more and more
      - Your body is not able to intuitively tell you that you are done
      - For most people that comes with salty snack and desserts
  - Hyper-palatable foods are defined as:
    - High energy density
    - Combination of carbohydrates and fat
    - Flavor enhancers (salt, MSG, additives, artificial flavorings)
    - The table that Sarah referenced:
    - The study on how these addictive foods work in our body
    - There is no amount of hyper-palatable food that is safe or won’t have this effect
      - The more of it you consume, the more you will enter into this vicious cycle of overeating behaviors, which is a precursor to obesity and binge eating disorder
    - One of the classic properties of hyper-palatable food is a really extensive ingredient list
    - The danger of triggering this dopamine reward center with hyper-palatable foods is that eventually the reward system becomes blunted
      - So you need more and more of the food to get the reward
    - Studies are showing the same changes in dopamine response in people with obesity and binge eating disorder as you see in drug addiction and alcoholism
      - This is because of the continuous consumption of this and how this impacts your dopamine signals over time
      - To the point where we are not listening to our bodies and we have created an addiction to these hyper-palatable foods
  - Sarah completely agrees with the idea of addressing mental health issues and associations with food
    - A lot of Sarah’s personal journey has been about healing from a history of binge eating disorder and her very unhealthy relationship with food
    - So much of her journey has been addressing her emotional responses with food and her behaviors around food
    - Sarah doesn’t believe that you can achieve healing while saying that you can eat anything
  - Stacy and Sarah 100% agree that diet culture is very detrimental
  - However, what Stacy and Sarah want people to think about longterm is where are you trying to get to with your health
    - This is where they want to focus their choices every day
    - How you make a choice today should leade to the vision that you have for the future
    - The more whole food, real food choices that you make, the more you will be able to listen to your body and respond appropriately to those signals
    - Am I hungry right now? Or does this taste good?
  - It is so important to understand the gray area
    - There are so many black and white rules out there and programs that people want you to follow
    - You think the rules are easier when you 100% know what you are allowed to do
    - But this is not reality, it is not a longterm sustainable way to live
    - We have got to come to terms with the idea that we are in charge of the things that make us feel our best
    - It is not about assigning an emotional definition to a certain food
      - What is good for you, may not be good for me
    - It takes so much time, and this is still a journey that Stacy and her family are on as they navigate what foods work best for them
- (33:44) Break the Rules Mindset
  - It is so important to not think of the way we eat as a set of rules
    - If you define a diet based on the foods you do not eat that doesn’t make the diet healthy or not
    - What makes a diet healthy is what you put in your mouth, not what you avoid putting in your mouth
    - This is one of the reasons why Sarah has worked so hard to create very thorough educational resources
      - Sarah feels that in public health we are missing these kinds of resources that teach what is in foods that the body needs and what is in foods that can undermine our health
      - It is important to get away from rules and get more into a solid foundation of health and diet education
  - There are still universal truths
    - Nutrient sufficiency is an important aspect for every individual
      - Paleo and AIP are not the only frameworks to hit these nutrient goals
      - There are multiple ways to structure a framework to work for people
      - This is where we hit gray
        
        This requires that you understand what works for your own body by experimenting while keeping the principle of nutrient sufficiency in mind
    - All human beings need adequate sleep on a consistent basis
    - Humans do not thrive in a chronic stress environment
    - We have to avoid prolonged periods of being sedentary
      - There are a lot of different ways that we can be active
      - It is simply about moving your body throughout the body
  - Again, this is the gray – recognizing that there are these universal truths and that you have this amazing opportunity to really understand your body
    - Detox your body from the things that prevent you from listening to your body
  - Sarah’s biggest criticism of intuitive eating as an anti-diet is that it makes space for these things we call food that completely undermind the principles in which they are based
- (39:45) When You Are Struggling to Get Results, How to Troubleshoot
  - The first recommendation is to take a solid look at what you are eating
    - Is there something that you are eating that might not be working for you
    - Is there something you are not eating that your body really needs?
      - Are you eating some nutrient dense foods?
      - Or might you be missing a really important nutrient?
  - You can do a three-day food journal
    - Sarah recommends using an app like Cronometer or MyFitnessPal to take a look at the micronutrient details
  - Also, take a look at lifestyle
    - Are you getting enough sleep?
    - Are you proactive in terms of stress management?
    - Are you including activity every single day, but avoiding overtraining?
    - Are you working on human connection?
    - Are you getting outside into nature?
  - There are certain underlying factors that are common that cannot be addressed with diet and lifestyle alone
    - In these scenarios you can:
      - Work with a functional medicine provider
      - Doing testing with EverlyWell to really understand when, where and how a medication, supplementation, short-term intervention, or a change in diet and lifestyle would help you achieve the results you are after, where professional guidance is needed
  - Stacy notes that this is where you have to understand that there comes a point when food may not be the reason why one struggles with weight
    - When you feel like you are doing everything right, there are things that are happening on a deeper level that prevent you from achieving the results you are working towards
  - The recommendations that Sarah is about to share is the opposite of where intuitive eating is going
    - Intuitive eating is saying, look your diet isn’t working for you so go ahead and eat whatever as long as you are “listening” to your body
  - We see in alternative health communities in general where we keep eliminating more and more foods when we don’t get the results we are working towards
    - This is why there are fad diets right now that are very popular right now that have a very limited collection of foods that are going to dietary extremes
    - These are not healthy practices and they are not scientifically valid
  - When you take a look at the common barriers that are straightforward to test forward, and when you work with an integrative or functional medicine practitioner to help manage these things it can be relatively straightforward
    - And looking at these pieces can make all the pieces of the puzzle fit together
  - To determine where to start, take a look at your symptoms
    - Do food journaling to capture these details
  - Here are the most common barriers:
    - Food Allergies and Intolerance
      - IgE, IgG
      - Possible Food Sensitivities
      - FODMAP Sensitivity
      - Histamine Sensitivity
      - Sulfite Sensitivity
      - Salicylate Sensitivity
      - Oxalate Sensitivity
    - Hormone Imbalances
      - Adrenal fatigue
      - Hypothyroidism
      - Sex hormone imbalance
    - Persistent Infections
      - Parasites
      - H. Pylori
      - Epstein-Barr
      - Lyme
    - Gut Health Problems
      - Poor digestion
      - SIBO
    - Severe Nutrient Deficiencies
      - Vitamin D
      - Any essential vitamin or mineral
  - When one is showing signs of resistance to weight loss, people tend to then adopt a more extreme diet strategy
    - Sarah would call the intuitive eating, antidiet still an extreme diet strategy
    - It is like the extreme opposite of the rules-based one, but it is still getting off course in terms of how food impacts health because it is not just energy in and energy out
  - It is human nature to be attracted to these more extreme approaches
    - If nutrient deficiencies are the thing holding you back from health, cutting out more foods or embracing junk food and not feeling guilty about it, are not going to approach that will correct a nutrient deficiency
    - If anything these approaches will magnify that deficiency
  - Changing our food is not always going to be the solution
    - This is why Sarah thinks increasing our education around health topics so that more people really understand the universal truths about diet and lifestyle, where all the gray areas are, where you have flexibility vs. the need for self-experimentation, and where to troubleshoot in a smart way
  - Whether you embrace dietary rules or are anti-rules, neither of these paths are the solution
    - The solution is a more thorough education for everyone
- (1:00:23) Closing Thoughts
  - Working towards ideal health is an ongoing journey, that changes based on the various seasons of life
  - Nothing is static
    - You can be doing everything right one day and wake up the next not feeling your best
    - That is not a personal attack on you, it is not because you did something wrong that you need to feel guilty about
    - It’s a sign and a symptom for you to say, ok let me listen, let me test, let me do these things to work towards feeling my best
  - If you want rules, ask yourself is this going to help me feel my best
  - For Stacy it is difficult because it is part of a community that she understands and genuinely gets it – diet culture is awful
    - However, she is not on board with the idea of walking away entirely from the idea of health and working to personally define what that means to you
  - Sarah reiterated that it is so important to remember that the goal isn’t to get to thin, the goal is to get to healthy
  - There was so much about intuitive eating that Sarah was hugely on board with when she was first reading up on it
    - However, her enthusiasm hit a wall when food quality was completely disregarded
    - Food quality DOES matter
    - We have to nourish our bodies
      - It is not an everything in moderation – this is not what our bodies need
    - We can implement our dietary choices to make room for treats
      - We don’t need to feel guilty about making choices that are suboptimal
    - Yes, let’s ditch the diet culture mentality, but it DOES matter what we put into our body
    - Food absolutely can make us feel bloated and lethargic
    - We are programmed to celebrate with food, to socialize with food, and bond over food
      - To say that any emotional response that you have to food means that you have a mental health issue that needs to be addressed is wrong
      - However, Sarah does agree with the fact that addressing our unhealthy attachments to food and our mental health issues around food is an important part of our health journey
  - Stacy thinks that intuitive eating is appealing to those who are desperately searing for something to feel better; who are struggling emotionally and physically
    - This program puts them on an unintentional roller coaster that is just as bad for them as what they were doing before
  - You have to know your body and to find the foods that nourish your body
  - To learn more and fine-tune your approach to healthy living, be sure to check out EverlyWell
  - Ultimately Stacy and Sarah want to educate you and provide you with tools that will help you live your best life