In my post dated 12-09-08, I introduced many of you to the concept of a non-diet approach to weight and nutrition management, by way of something called "Intuitive Eating", a seemingly revolutionary take on nutrition counseling instituted by Registered Dietitians Evelyn Tribole and Elyse Resch.
Today, let' s continue our look at this important topic of discussion and hear directly from Elyse Resch, as she explains the concept first hand...
(I myself will return to the discussion in my next post)
I' m sure that there are many dietitians who have thought, "How can I possibly tell my clients that they can eat anything they want? Anything - french fries, ice cream, pop tarts - give me a break! They' ll end up malnourished, with high cholesterol and high blood pressure - better increase my malpractice insurance!
Well, maybe this is a bit extreme, but I’m sure some of you have thought that the approach of giving unconditional permission to eat and making peace with food is not only antithetical to everything you’ve learned in nutrition school but paramount to promoting chaos and a lack of boundaries in eating. You may not only be worried that your clients will end up out of control, gain weight instead of losing it, but that you will lose your hold on their eating and weight.
Well, yes, it’s true that you won’t be able to give them meal plans, tell them which foods to eat and which to limit, and count their calories or exchanges. If you adopt an Intuitive Eating treatment approach, you also won’t be able to weigh them each week to make sure they’re making progress (or, that is, you’re making progress with them.) All sounds pretty scary, huh? Well, I will admit, that I had similar feelings, twenty years ago, when I cut the umbilical cord from dieting mentality. But I will tell you that whatever fears may have emerged—the rewards that ensued were worth their weight in layers of meaningful and significant professional satisfaction.
For those who have no idea about what Intuitive Eating is, I will give you a very short course in it. I believe that each of us is born with all the wisdom he or she needs to have to know how to eat. If you watch an infant breastfeeding or a toddler eating lunch, you’ll see that this child knows exactly when she’s hungry and when she’s full. He knows which foods he likes and which taste “icky” to him. If these children are introduced to a wide variety of foods, and reintroduced to these foods on a regular basis, when they’re very young, they’ll have the opportunity to develop a broad and open palate to most foods. If they eat most of their meals with family members who eat a myriad of foods, they’ll learn by role modeling to try many of these foods. If they’re not given treats when they fall down or feel bad, they won’t learn to use food to deal with their emotions. If, instead, they’re comforted and allowed to express their needs and their feelings, they’ll learn that the proper antidote for feeling bad is nurturance and connection. If they’re not rewarded with play food for eating healthy food, they won’t believe that there are two categories of foods—that is, “good foods” that come first and “bad foods”, for which they have to wait. They won’t begin to overvalue the bad foods (or what I prefer to call “play food”) and beg for them in a power struggle with their caregivers. They won’t feel deprived, because they’ll know that all foods are equal, that they can have access to whatever they want to eat, and that they’d sometimes rather have a carrot than ice cream! (That’s a true story, which I’ll tell you more about later).
With proper attunement and response to a child’s signals of hunger and fullness and a trust that, on balance, that child will end up with a balanced intake of food, the road to Intuitive Eating is paved. If the parents are not influenced by fear of obesity, media images that promote under-weight role models, and their own need to control their children, the intuitive eating path will stay clear and available throughout a child’s life. As an adolescent and, later, as an adult, a healthy and happy relationship with food and body will endure. And, you may wonder, how do I know this?
I know this from reading the literature on restrained eating, the toddler studies, the research that has been done and is continuing to be done on Intuitive Eating, and from my own experience with my clients. I have the great privilege of working with clients who are committed to bringing up their children in a different way than they were raised. Even when these clients continue to struggle to shed their own history of dieting and eating disorders, they honor their own children by respecting their intuitive signals.
I have a client who was referred to me when her daughter was 7 months old. She walked into my office, threw her arms around my neck and thanked me for being willing to see her. She told me that not only did she not know how to eat, after a lifetime of disordered eating, but that she had no idea how to feed her child. This client is doing very well at re-discovering her own intuitive eater and her 4 and a half-year-old daughter is the one who often chooses carrots over ice cream. One morning, the child woke up and told her mom that she would like to have hearts of palm and tofu for breakfast. I swear this is true! This child also has her fair share of candy and cookies, but they hold no special value for her. Oh, and by the way, this child loves to play and dance and has a beautifully proportioned and muscular body.
Which brings me to movement. Yes, movement, not exercise. Intuitive Eating also addresses the body’s natural need to move—to move for the joy of it and to feel good and be strong. We all need to move and are meant to move, regardless of body weight. Separating movement from weight loss allows you to examine your exercise resistance and to keep moving, whether you feel the need to lose weight or not.
Which leads me to weight loss. You might wonder whether following Intuitive Eating principles will help your clients lose weight. Well, if they’re like the woman who called me for an appointment last week and told me that she was 5’9” and 140 pounds and that she wanted to lose 10 or 15 pounds—no, learning to respectfully respond to her body’s signals will not lead to weight loss. (By the way, I did not take that person on as a client!) But if someone has been ignoring hunger and fullness signals, eating for emotional reasons, not moving her body because she’s been “bad” on her diet, and is truly overweight as a result of this—then, yes, Intuitive Eating will eventually help her lose weight.
And, I emphasize the word “eventually”, because weight loss always has to be on the back burner while someone is focusing on changing his/her relationship to food. If weight loss is the primary goal, then every early decision about food will be based on whether it will promote weight loss, rather than whether someone is hungry or what that person’s food preference is.
Now... getting back to increasing your professional satisfaction by developing an Intuitive Eating approach to treating your clients—it’s amazing how it will change your life. In the early days of my professional life, and I’ve been in private practice for 26 years, I hated working with weight control. I didn’t even want to accept clients with this goal in mind. But try as I might, I couldn’t avoid it. I felt helpless when clients couldn’t follow the meal plans I was taught to give them or gained all the weight back they had lost by going on a post-deprivation binge.
When I finally surrendered to the realization that what I had been taught to do just wasn’t working and started researching the psychological concepts behind this failure, I was released to let go of this old diet mentality, let go of trying to fix my clients, and truly begin to help people to heal from the tyranny of dieting. And with that revolution came the true joy of counseling, the underpinnings of the book I co-authored in 1995 with a second edition in 2003, and years and years of deep and meaningful work.
So, if you’re intrigued, pick up a copy of Intuitive Eating, and read it with an open mind. I’ve been told by a countless number of people that it is the most nurturing and accessible book that they’ve ever read in this genre. I’ve also worked with and have received numerous letters from people who have, actually, lost gobs of weight and kept it off. I guess if you stop trying so hard to lose weight and just follow what you’re body tells you, it’s just not that hard! And, by the way, if you’re too busy to read the book, there is an audio version that is coming out in January 2009. It’s not a verbatim reading of the book but more of a discussion format with guided practices. I guess that will do!! Thanks!"