Is intuitive eating enough? Inner capacities vs. outer food cues

This week I was at a conference at the University of Texas at Dallas on Values in Medicine, Science, and Technology. One of the many nice things about academia is that there’s a group for just about any subtopic of interest, and an annual conference to go along with it. Going to one of these types of small, specialty conferences is kind of like dropping in on someone else’s party, already in progress. However, the host Matthew Brown was very welcoming, and the partygoers were interesting and fun. I knew a few of them already (hi Shari and Dan!), and made some new friends (one of whom may be blogging here soon!)

My reason for being there was to give a talk on public health and Health at Every Size (HAES) approaches to body weight. HAES endorses a view of health that includes three key parts:

• weight acceptance (instead of weight loss and maintenance)
• intuitive eating
• physical activity

Anyone reading this blog is probably already familiar with all of these ideas. I recently joined the Facebook groups Fit Fatties and Athena Triathletes, both of which emphasize and support all kinds of physical activity for all kinds of bodies.

It’s intuitive eating, however, that I’m thinking about more these days. Tracy has blogged extensively about her research and experiences around intuitive eating.  Here’s one of many of her great posts about it. In that post, discussing the book Intuitive Eating: A Revolutionary Program That Works,  she talks about the authors’ ten principles; here they are:

1. reject the diet mentality
2. honor your hunger
3. make peace with food
4. challenge the food police
5. feel your fullness
6. discover the satisfaction factor
7. cope with your emotions without using food
8. respect your body
9. exercise: feel the difference
10. honor your health with gentle nutrition

In my conference presentation, I talked about some worries I have about principles 2, 5 and 6- basically the ones about eating in accordance with hunger and fullness cues coming from our own bodies. But first, let’s hear from Tracy again about them:

Feeling your fullness (Principle 5) is the one that challenges me the most and that I have worked with most closely since I started this approach back in early January. The authors claim that “the ability to stop eating because you have had enough to eat biologically hinges critically on giving yourself unconditional permission to eat” (Principle 3: Make peace with food).

In order to feel your fullness, the authors recommend conscious eating. Instead of moving into autopilot, they suggest paying attention, eating without distraction, pausing part way through a meal to register whether the food still tastes good and whether you’re still hungry. Samantha is doing the same thing with her recent attention to mindful eating. They introduce the idea of comfortable satiety, where you’ve had enough to eat but are not overstuffed.  Respecting your fullness means stopping at comfortable satiety. In order to achieve this, you need to eat engage in mindful or conscious eating.

This approach sounds sensible, powerful, and yes, intuitive. Of course I should listen to my body, not all those external messages like this one:

But a big problem comes to mind.

It’s really hard to dodge and weave enough to avoid being caught up in environmental cues to eat when a) we’re not actually hungry; and b) when the food presented is not actually food we want.

Tracy points out in her post that the authors cite evidence in support of their intuitive eating program (which I look forward to checking out). However, there’s also loads of evidence about the strong influence of our environments on our eating. The presence of candy dishes, Danish pastries or doughnuts at a morning work meeting, larger portion sizes at restaurants—all of these (and many more) factors regularly shift us into modes of mindless eating  (also the name of a book by this guy  Brian Wansink).  Wansink and others recommend a host of remedies for this set of problems, ranging from downsizing our plates and cups to reconfiguring school cafeterias to place the salad bar more strategically.

My point here is that, as an individual, there are a lot of forces out there, many of which are designed to short-circuit my hunger and fullness cues. And evidence shows that they work incredibly well against us. This isn’t an argument against intuitive eating, but instead to say that I think the tools of intuitive eating are not enough on their own for constructing satisfying eating patterns. We need some outside help from a bunch of sources, ranging from tips for rearranging our pantries and fridges to put the foods we want to eat front and center, to lobbying government to redesign school cafeterias in ways that don’t make it harder to purchase and eat fruits and vegetables.

There’s a lot more to say about this, and I’ll be blogging some more about it. I also welcome comments from readers about their experiences with outside forces that try to block intuitive eating.