Eating disorders are harmful mental disorders highly prevalent worldwide, especially in women.1 A systematic literature review in 2018 found that the prevalence of eating disorders has increased from 3.5% in 2000-2006 to 7.8% in 2013-2018.1 The increased prevalence of eating disorders highlights a growing public health concern and a challenge for those providing treatment and recovery. There are many approaches to treating eating disorders; some have included intuitive eating in the treatment program.
Initially developed in 1995 by the registered dietitian nutritionists Elyse Resch and Evelyn Tribole, intuitive eating is a mind-body health approach that aims to help people appropriately respond to their hunger, satiety, and emotions to meet their physical and psychological needs.2 Since 1995, validation for intuitive eating based on evidence-based studies and many beneficial associations have been described that could aid in treating eating disorders. A systematic literature review in 2016 found that intuitive eating and those who practiced it were positively associated with positive emotional functioning, greater life satisfaction, psychological hardiness, greater body appreciation and satisfaction, unconditional optimism and self-regard, and a greater motivation to exercise for enjoyment.3 Also, intuitive eating was inversely associated with dieting, the internalization of the thin ideal, poor interoceptive awareness, and disordered eating such as binge eating, bulimia, and food preoccupation.3 These associations are beneficial to an individual’s eating disorder recovery. However, compelling demonstrations of intuitive eating abilities were associated only with cross-sectional and longitudinal studies. 3
In 2020, Hazzard et al. found that people with higher intuitive eating scores had better predicted psychological outcomes and reduced disordered eating among young adults and adolescents from 2010-2018.4 Participants with a greater baseline intuitive eating score and participants who increased their intuitive eating score over time were associated with a lower risk of severe depressive symptoms, low self-esteem, unhealthy weight control behaviors, extreme weight control behaviors, and binge eating. Notably, higher intuitive eating scores and increase in score over time were the strongest protective associations against binge eating behaviors.4 These findings promise the effectiveness of intuitive eating when treating eating disorders over time. It is more promising that individuals with eating disorders are taught intuitive eating practices. Richards et al. demonstrated the integration of intuitive eating in an established inpatient-residential eating disorder recovery program, which was effectively taught to patients with anorexia nervosa, bulimia nervosa, and eating disorders not otherwise specified.5 Collectively, all patients were able to increase their baseline intuitive eating score throughout the treatment, which led to significant improvements in disordered eating symptomology, psychological symptoms, spirituality, relationship skills, and sociability.5
Although these studies demonstrate that intuitive eating can effectively treat and manage eating disorders and their associated symptomology, Richards et al. suggest that intuitive eating should not be the only treatment form.5 Intuitive eating should include a more comprehensive eating disorder treatment program and intuitive eating should be introduced to an individual once they have redeveloped reliable hunger and satiety cues.5 Most importantly, intuitive eating should be a gradual process that requires flexibility and practice when incorporated into treatment. However, growing research suggests that intuitive eating can be a part of the solution to the growing public health issue of eating disorders.
References:
1.Galmiche, M., Déchelotte, P., Lambert, G., & Tavolacci, M. P. (2019). Prevalence of eating disorders over the 2000–2018 period: A Systematic Literature Review. The American Journal of Clinical Nutrition, 109(5), 1402–1413. https://doi.org/10.1093/ajcn/nqy342
2.Tribole, E., & Resch, E. (2020). Intuitive eating: A revolutionary anti-diet approach. St. Martin’s Essentials.
3.Bruce, L. J., & Ricciardelli, L. A. (2016). A systematic review of the psychosocial correlates of intuitive eating among adult women. Appetite, 96, 454–472. https://doi.org/10.1016/j.appet.2015.10.012
4.Hazzard, V. M., Telke, S. E., Simone, M., Anderson, L. M., Larson, N. I., & Neumark-Sztainer, D. (2020). Intuitive eating longitudinally predicts better psychological health and lower use of disordered eating behaviors: Findings from EAT 2010–2018. Eating and Weight Disorders – Studies on Anorexia, Bulimia and Obesity, 26(1), 287–294. https://doi.org/10.1007/s40519-020-00852-4
5.Richards, P. S., Crowton, S., Berrett, M. E., Smith, M. H., & Passmore, K. (2017). Can patients with eating disorders learn to eat intuitively? A 2-year pilot study. Eating Disorders, 25(2), 99–113. https://doi.org/10.1080/10640266.2017.1279907
By Julian Robles
