A listener recently got in touch to ask me if intuitive eating can play a role in the treatment of eating disorders. The short answer: yes, it absolutely does. Intuitive eating is an evidence-based approach to treating eating disorders. However, as with any complex issue, there are nuances and caveats to consider. In this blog post, we will explore the role of intuitive eating in healing eating disorders, emphasizing the importance of interoceptive awareness, the journey to intuitive eating, and the stages of treatment. If this is a sensitive topic for you, I encourage you to prepare before we jump in.
Part of understanding eating disorders is understanding the concept of interoceptive awareness. Interoceptive awareness involves perceiving physical sensations within your body, such as hunger and fullness cues. It involves tuning into your body’s internal signals, like realizing when your bladder is full and you need to use the restroom.
These physical sensations are largely a right-brain phenomenon while eating disorders, centered around our food rules and restrictions and judgements, are mainly left-brain functions. So in treating eating disorders, we want to shift that left-brain focus into right-brain thinking.
The Role of Intuitive Eating in Treating Eating Disorders:
Stage 1: Putting on the Cast – Restoring Structure
When you break your bone, we put a cast on it in the emergency department, and that provides some structure and some safety for the bone to heal. But the cast doesn’t stay there forever. Once the bone has healed, we take the cast off and then your muscles are allowed to strengthen up again and get movement back in the joints.
And so it’s helpful to look at eating disorders as your hunger and fullness meter being broken like a bone. Instead of a cast, the structure comes in the form of structured meal planning, providing stability and safety. It allows your body to mend and paves the way for the restoration of your hunger and fullness cues.
Stage 2: Building Interoceptive Awareness – Tuning In
Once the body and the brain understand that it is going to get nourishment on a regular basis, it’s much more able to switch into that right brain, interoceptive thinking because trust starts to form between the brain and the body.
The digestive system begins to understand that there is a regular source of nutrition coming in, and the metabolism switches from that maladaptive response into something that is much more biologically
normal for you. And then you’ll really be able to really start to tune in to your hunger and fullness signals.
Lots of people with eating disorders have fear around feeling full and what it means for them if they feel full. It can take a little bit of time to really understand how your body tells you that you’re hungry, and there are specific tools that we can teach to help people lean into that and experience that directly for themselves.
Stage 3: Responding to Cues – Trusting Your Body
Once you’re able to notice your hunger, then you can move on to the next step, which is allowing yourself to respond to that hunger in a timely and appropriate way. Coaching can be particularly helpful with this because your thoughts are going to get in the way a lot of the time during this phase of healing from an eating disorder.
Thoughts like ‘how can I be hungry if I ate a couple of hours ago?’ or ‘you’ll be fat if you eat right now’ can often get in the way of responding to the interoceptive signals that you’re getting.
And so part of the process here really involves normalizing hunger and fullness. When you’re feeling hungry, this is your body doing exactly what it was designed to do: tell you that it is time for more nourishment and more fuel. It’s the same with fullness. When you feel that it’s time to stop eating, that is your body telling you that you’ve had enough, and this is all we need for fuel right now.
You have to start to not only trust those feelings, but to really understand at a cognitive level that feeling full and feeling hunger is your body doing exactly what it is supposed to do.
Stage 4: Embracing Intuitive Eating Principles – Challenging Old Habits
This is where we really start to challenge the food police and work on making peace around food and giving ourselves unconditional permission to eat in an attuned way.
We can think of this as the “leftover effect”. People often hate eating leftovers because they’re bored with eating the same thing meal after meal. One of the reasons why food often seems so appealing when you have an eating disorder is because if you’re restricting it, it keeps that food exciting. And so when you do break one of your food rules, it feels incredibly emotionally charged.
Once you give yourself unconditional permission to eat something, and once you truly believe that it is always there for you if you want to have it, it loses its appeal. The goal is to simply make them neutral so that there’s no drama, excitement or fear around those particular foods anymore.
To engage in this part of intuitive eating, you really have to nail down the interoceptive piece so that you are not only aware of your hunger and fullness signals, but able to attend to them in an appropriate way.
Once you’re doing that, then you can start to experiment with bringing in some of your “forbidden” foods.
Poor self-care falls into all of this as well, because if you are not meeting the very basic needs of your body, then it’s very difficult to listen to what your body is trying to tell you. Adequate self-care needs to be in pace, and to a certain extent, you also have to be willing to experience discomfort as you work with the principles of intuitive eating. Those old diet rules will always resurface and the old habits and urge to restrict or binge are still going to be there.
Intuitive eating is not a quick fix but an evidence-based approach to healing eating disorders. The journey involves restoring structure, developing interoceptive awareness, responding to cues, embracing intuitive eating principles, and challenging old habits. By understanding the stages of treatment and the role of interoceptive awareness, individuals can work toward a healthier relationship with food and their bodies.
If you suspect you have an eating disorder, it’s essential to seek professional help and guidance from healthcare providers. Healing is possible, and intuitive eating can be a valuable tool on your path to recovery. But remember that you don’t have to go through it alone—reach out for support and care from your physician or healthcare providers who specialize in eating disorder treatment.
This blog was in response to a question I got from a podcast listener. I love hearing from you, and always encourage you to contact me with questions! Please reach out to me at firstname.lastname@example.org.