If you could cash in every diet like a frequent-flyer mileage program, most of us would have earned a trip to the moon and back. The global weight-loss industry market is expected to reach $278.95 billion by 2023, which could finance the trip for generations to come. Ironically, we seem to have more respect for our cars than for ourselves. If you took your car to an auto mechanic for regular tune-ups, and after time and money spent the car didn’t work, you wouldn’t blame yourself.* Yet in spite of the fact that up to 95 percent of all diets fail, you tend to blame yourself, not the diet! Isn’t it ironic that with a massive failure rate for dieting we don’t blame the process of dieting?
But what does failure really mean? It has traditionally referred to the fact that the majority of people who go on diets and lose weight gain it back, with many gaining even more weight. (Studies show that up to two-thirds of folks will regain more weight than they lost!) To focus on weight loss as the definition of failure fails to address the root issue: Why are people so focused on losing weight? Why is there a valuing of thinner over fatter bodies? Why do people value themselves based on the number on the scale? The failure of dieting is that it promotes weight stigma by not recognizing that people come in all sizes and shapes and that each individual is worthy just as they are. In this book, we want to provide you with information that may let you stop blaming yourself and your body. We’ll present some new ideas that will help you value your individuality and everything that makes you your authentic self.
Initially, when we ventured into the world of private practice, we did not know each other. Yet separately, we had remarkably similar counseling experiences that caused us to rethink how we work. This led to a considerable change in how we practice and years later was the impetus for this book.
Although we practiced independently of each other, unknowingly each of us got started by making a vow to avoid the trap of working with “weight control.” We didn’t want to prescribe a process that was only set up to fail. But while we tried to avoid weight-loss counseling, physicians kept referring their patients to us. Typically, their blood pressure or cholesterol was high. Whatever their medical problems, weight loss was thought to be the key to treatment. Because we wanted to help these patients, we embarked on the weight-loss issue with a commitment to do it differently: Our patients would succeed. They would be among that small 5 percent success group. Clearly, our consciousness had not as yet been raised to even question the whole focus on weight that pervades much of society. Also, at that time there was not the body of research that we have today, which shows dismal failure rates and harm from dieting.
We created beautiful meal plans according to our patients’ likes and dislikes, lifestyles, and specific needs. These plans were based on the widely accepted “exchange system,” commonly used for diabetic meal planning and “weight control.” We told them that this was not a diet, for even back then we knew that diets didn’t work. We rationalized that these meal plans were not diets, because patients could choose among chicken, turkey, fish, or lean meat. They could have a bagel, a muffin, or toast. If they really wanted a cookie, they could have one (not five!). They could fill up with “free foods” galore, so that they never had to feel hungry. We told them that if they had a craving for a particular food, they could go ahead and eat it without guilt. But we also reinforced, gently yet firmly, that sticking to their personalized plans would help them achieve their goals. As the weeks went by, our clients were eager to please us and followed their meal plans. We weighed them each week (something we would never do now!), and, finally, their weight goals were met.
Unfortunately, however, some time later we started getting calls from some of these same people telling us how much they needed us again. Somehow, the weight had come back on again. Their calls were very apologetic. Somehow, they couldn’t stick to the plan anymore. Maybe they needed someone to monitor them. Maybe they didn’t have enough self-control. Maybe they just weren’t any good at this, and they felt guilty and demoralized.
In spite of the “failure,” our patients put all the blame on themselves. After all, they trusted us—we were the “great nutritionists” who had helped them lose weight. Therefore, they had done something wrong, not us. As time went on, it became clear that something was very wrong with this approach. All of our good intentions were only reinforcing some very negative, self-effacing notions that our patients had about themselves—that they didn’t have self-control, they couldn’t do it; therefore they were bad or wrong. This led to guilt, guilt, guilt.
By this time, we had both reached a turning point in the way we counseled. How could we ethically go on teaching people things that seemed logical and nutritionally sound, yet triggered such emotional upheaval? On the other hand, how could we neglect an area of treatment that could have such a profound effect on a patient’s future health? (Or so we had been trained to think!)
As we struggled with these issues, we began to explore some of the popular literature, as well as scientific studies that suggested a 180-degree departure from dieting of any kind (even dietitian-approved). Some of the founding professionals who paved the way via a non-diet approach and influenced us included Jane R. Hirschmann, CSW; Carol H. Munter; Lela Zaphiropoulos, CSW; Susie Orbach, PhD; Janet Polivy, PhD; C. Peter Herman, PhD; and Leann L. Birch, PhD; among others. They proposed a way of eating that allowed for any and all food choices but did not address nutrition. Our initial reactions were highly skeptical, if not downright rejecting. How could we, as nutritionists (registered dietitians), trained to look at the connections between nutrition and health, sanction a way of eating that seemed to reject the very foundation of our knowledge?
The struggle continued. The “healthy” meal plans were keeping people attached to diet culture, with the intermittent despair that came with it, yet the “demand feeding” described in the popular psychology books in the late 1960s through the ’80s seemed incomplete.
Eventually, we resolved the conflict by developing the Intuitive Eating process with ten principles. Special note to health professionals: We have come to realize that this conflict, or cognitive dissonance, is a common experience for health professionals, who have been trained in weight-centric health care—that a person’s weight determines their health. There’s a lot more to health than what you eat—your relationship with food, mental health, social determinants of health, to name a few. Besides, body weight is not a behavior. It becomes a journey of the great unlearning and it feels uncomfortable at first. Just know that you are not alone in this reckoning.
Our book became a bridge between the growing anti-diet movement and the health community. How do you reconcile forbidden food issues and still eat nutritiously, while not dieting? We will tell you how in this book.
If you are like most of our clients, you are weary of dieting and following rigid food plans yet terrified of eating. Most of our clients arrive in our offices uncomfortable in their bodies. Intuitive Eating provides a new way of eating that is ultimately struggle-free and healthy for your mind and body. It is a process that unleashes the shackles of dieting (which can only lead to deprivation, rebellion, and rebound weight gain). It means getting back to your roots—trusting your body and your signals. Intuitive Eating will not only change your relationship with food; it will change your life. In fact, many of the clients mentioned in this book came to us simply for the purpose of losing weight. Even though they may have mentioned physical discomfort in their bodies or emotional discomfort, believing that they were not good enough unless they lost weight, they eventually learned to find comfort and gratitude in the “here and now.”
We do not judge people for their desire to lose weight—it’s a consequence of diet culture, which is ubiquitous and problematic. It’s a societal system of beliefs, messages, and behaviors that places value on a person’s weight and appearance, rather than well-being, which unfortunately, has become common and normalized. Diet culture reifies thinness, equating it with health and moral virtue, while demonizing some foods and elevating others. It’s difficult to go even a single day without hearing conversations, seeing ads, scrolling through social media that involve some aspect of shrinking bodies. Health professionals are not immune to diet culture, as some health care professionals put patients on calorie-restricted or entire food group–restricted diets, even though there is not a single study to date showing that it’s sustainable or efficacious in the long run, or without harm. Sadly, research indicates that health professionals are one of the main perpetuators of weight stigma.
The problem is that any focus on weight loss will sabotage your ability to reconnect with your body’s Intuitive Eating signals. When you focus on weight, it places your attention on external measures for eating—such as the portions of foods, the macros of food—rather than connecting you with your internal cues. (That’s why we like to say that Intuitive Eating is an inside job.) Instead, focusing on your day-to-day progress—such as getting more satisfaction from your meals and staying more present in eating and life—will give you a sense of connection, which can lead to feelings of joy and well-being.
But before we go on, we want to mention a caveat. This book was written by two cis-gender white women with thin privilege who feel grateful for the many privileges each acknowledges. Neither of us has dealt with food insecurity or the weight stigma that is experienced by many who may be reading this book.
It will be important to work with a practitioner who is trained both in Intuitive Eating and in the specialty issue affecting you, including but not limited to: trauma, medical nutrition therapy, eating disorders, and mental illness. In addition, some people don’t have access to the resources they need in order to learn this process, and that needs to be acknowledged. We acknowledge that we don’t even know all the reasons that might prevent people from accessing these resources. Intuitive Eating is a privilege.
We wish that the suffering that so many experience in this world did not exist. We will keep working toward making this a better world—one in which Intuitive Eating can be accessible to all bodies. Intuitive Eating is one tool, and we are constantly learning and striving toward radical inclusivity.
Intuitive Eating is a compassionate, self-care eating framework that treats all bodies with dignity and respect.
We care deeply about the relationship you have with your body and the relationship that may form between us as the authors and you as the reader. We are humbly open to feedback on how we can do better.
We hope you find that Intuitive Eating will make a difference in your life; it has for our clients. In fact, when our clients learned that we were writing this book, they wanted to share some specific turning points with you:
• “Be sure to tell them that if they have a binge, it can actually turn out to be a great experience, because they’ll learn so much about their thoughts and feelings, as a result of the binge.”
• “Tell them that taking a time-out to see if they’re hungry doesn’t mean that they can’t eat if they find they’re not hungry. It’s just a time-out to make sure that they’re not eating on autopilot. If they want to eat anyway, they can!”
• “When I come to a session, I feel as if I’m going to the priest for confession. That comes from all the times I used to go to the diet doctor, and I would have to tell him how I had sinned after he had weighed me. This isn’t coming from you, but the inner Food Police.”
• “I feel like I’m out of prison. I’m free and not thinking about food all the time anymore.”
• “Sometimes I get angry, because food has lost its magic. Nothing tastes quite as good as it did when it was forbidden. I kept looking for the old thrill that food used to give me until I realized that my excitement in life wasn’t going to come from my eating anymore.”
• “With permission comes choice. And making choices based on what I want and not on what somebody else is telling me feels so empowering.”
• “After giving up bingeing, I ended up feeling pretty low some of the time and even rageful at other times. I realized that the food was covering up my bad feelings. But it was also covering up my good feelings. I’d rather feel good and bad rather than not feel at all!”
• “When I saw how much I was using dieting and eating to cope with life, I realized that I had to change some of the stress in my life if I ever wanted to let go of food as a coping mechanism.”
• “Sometimes I have hungry days, and sometimes I have full days. It’s so nice to eat more sometimes and not feel guilty that I’m going against some plan.”
• “I get so exhilarated when I see a food I used to restrict. Now I think—it’s free, it’s there, and it’s mine!”
• “I’m so glad you’re writing this book; it will help me explain what I’m doing. All I know is that it works!”
• “When I’m in the diet mentality, I can’t think about the real problems in my life.”
• “This is the best I’ve ever taken care of myself in my life.”
Note: We recognize that gender is a spectrum, and in this version of Intuitive Eating we will be gender inclusive by using gender-neutral language and pronouns, unless we are referring to a specific person who has specified their pronoun.
Copyright © 2020 by Evelyn Tribole, M.S., R.D., and Elyse Resch, M.S., R.D., F.A.D.A., C.E.D.R.D.