Intuitive Eating Is Not for Everyone

But it works for some people. Why does nutrition advice have to be so black and white?

Apr 26, 2023

Photo by Pablo Merchán Montes on Unsplash. This is the first photo that came up when I searched “intuitive eating.” Which is…not surprising?

My friend Melissa Gallanter is a registered dietitian in New York City, working with clients who are food insecure and living with HIV/AIDS, many of whom are BIPOC and in the LGBTQ community. She and her supervisor regularly read books together, a couple chapters at a time, and discuss them in the context of the HIV/AIDS social services organization where they work and the clients they serve, who are often experiencing intersecting systems of oppression. One book they read was Intuitive Eating by Evelyn Tribole and Elyse Resch.

As a weight-inclusive dietitian, Melissa was interested in learning more about the intuitive eating approach because it seemed aligned with the client-directed counseling she uses in her work, and she wondered how they could apply the principles, especially in the setting of food insecurity.

"I think it took two or three meetings together for us to put into words the feeling of dissatisfaction that we were experiencing as we were reading," Melissa told me. "Our intention was to directly use what we learned to better serve our clients, and we kept feeling like we weren't able to do so. So much of the guidance we were reading implied adequate food access, which none of our clients have at baseline. Once we put that into words, I think we became even more frustrated with the approach."

Melissa went searching for resources that addressed intuitive eating in the context of food insecurity, and came up with little. She found one podcast episode that touched on the topic, but the only advice the dietitian host offered was to help clients find food security before thinking about applying intuitive eating principles. "That bothered me a ton," said Melissa. "Because for so many people, food insecurity isn't something that will 'go away.'"

From Revolution to Cornerstone

If you work in the nutrition world, or spend any time in social media spaces populated by millennial dietitians, you have undoubtedly heard of intuitive eating. Dietitians Evelyn Tribole and Elyse Resch published Intuitive Eating: A Revolutionary Program That Works in 1995, deep in our collective fat-is-the-devil era of food. Snackwells had just been invented. Daytime television was a barrage of commercials for SlimFast shakes and Jenny Craig. It truly was revolutionary to hear two dietitians say you could eat anything you wanted, and that weight loss was not the goal.

The book — now in its fourth edition, its subtitle adjusted to a more 2020s-appropriate A Revolutionary Anti-Diet Approach — gets its message across in 10 "principles," which include tenets like Honor Your Hunger, Feel Your Fullness, and Respect Your Body. (You can read longer descriptions of all 10 principles here.) The New York Times recently called the approach "the cornerstone of the modern anti-diet movement" in a profile of the book's authors, which tracks how intuitive eating has entered the mainstream over the past 30 years. But, the article notes, not everyone is a fan.

Asked about people for whom intuitive eating does not gel, Ms. Tribole suggested that they most likely weren’t practicing all the principles.
“I’ve had a lot of people have the false impression that intuitive eating is simply not dieting,” she said, rather than adopting the comprehensive guidelines of its 10 principles.

There is also a brief mention of the privileges required to make intuitive eating a realistic approach.

Ms. Resch and Ms. Tribole acknowledge that intuitive eating itself is a privilege, but they nonetheless see the practice as a form of empowerment for all clients. “We’re teaching them how to trust themselves,” Ms. Resch said.

Empowerment for all clients? "Our clients often have to skip meals or eat smaller meals because there isn't enough food to eat, so the principle of 'honoring hunger' is not something we can always teach," Melissa told me. "There was a recommendation [in the book] to have all foods available that you may want to eat so that you have that choice to eat intuitively in each moment. That alone felt the most privileged. Many of our clients rely heavily on our food pantry and other pantry programs to have enough food, but with that, they don't get to choose what they have in their fridges."

The Unwritten Assumptions of Intuitive Eating

There is a general air of cluelessness around privilege throughout the profile, and no substantive answer to the concerns laid out by dietitian Liz Brinkman, who was interviewed for the article about a thoughtful blog post she published critiquing the intuitive eating approach. In it, she wrote:

In my experience over the past several years of trying to incorporate the Intuitive Eating model into my practice, I’m starting to realize that the Intuitive Eating book and its principles operate from unwritten assumptions that the reader (the person in pursuit of becoming an “intuitive eater”) is:
in a state of/has easy access to consistent safety and support,
adequately resourced with time, money, and a sense of agency,
aware of the effects of unresolved trauma,
actively receiving assistance from trustworthy attachment figures to heal from trauma, and
conscious of cultural conditioning towards the “thin ideal”, “beauty standards”, and “health standards”.
That’s a lot of unwritten assumptions and describes a very privileged (and small) group of people.

In the post, Liz doesn't propose doing away with the intuitive eating framework completely, but instead "we need to read it through a new lens," one that accepts the "intuition" that drives us can sometimes be seeking immediate safety and survival, which can mean eating behaviors that are at odds with the official Intuitive Eating Principles.

As she still identifies herself as a Certified Intuitive Eating Counselor, I was curious about how she is feeling about the approach these days. The truth is, Liz told me, these days she is using the term mainly for SEO. "The term intuitive eating has become shorthand for 'don't hand me a meal plan' and 'I'm interested in discovering if there is a source within me that relates to food in a different way,'" she said. "Some use the term to mean 'tell me it's okay to eat whatever I want, whenever I want it.' That's fine with me. I hope to attract folks who are looking for an alternative way to be with food that fosters nourishment and agency."

But, she continued, "Does the phrase intuitive eating stand in for 'I'm okay with fatness. I'm not okay with body objectification. I refuse to collude with healthism'? Unfortunately, no. So, 'intuitive eating' might bring people to me, but from there, we might have a long way to go."

Liz balks at the idea that there is a "right" way to be an intuitive eater, and makes a point of using "intuitive eating" to describe all types of eating styles with her clients. "Maybe it's my way of demystifying the term intuitive eating, and also to depolarize it. Taking the wind out of its sails. Instilling the notion that my client has intuition and that all intuition has a purpose."

“Pathologizing Things That Are Neutral”

In her book It's Always Been Ours: Rewriting the Story of Black Women's Bodies, dietitian Jessica Wilson writes explicitly about intuitive eating in the chapter "Can We Eat Our Way to Liberation?" (Spoiler: the answer is no.) While she initially embraced the approach, which she calls "not-a-diet with the safety features of a diet," over time she realized it was not the right fit for her practice. The rigidity around eating when hungry and only when hungry didn't work for those who weren't given a lunch break at work, or who weren't hungry during the hour their lunch break happened to occur. It didn't work for those who were disconnected from their hunger cues due to childhood food insecurity. This emphasis on biological cues, and on not eating for emotional reasons, makes eating for reasons other than physical hunger seem like a problem.

It is a gentler way of pathologizing things that are neutral, like eating for celebrations, while grieving, while hanging out with friends, with your friend who is struggling, because you failed an exam, because it's Wednesday, or Thursday, or any day, and it tastes good.

More from Jessica Wilson:

"Dismantling Diet Culture Will Not Make It Safer for Us to Exist"

Anjali Prasertong

February 1, 2023

Read full story

For many people, food is much more than fuel — especially for immigrant, BIPOC, and non-Christian Americans.1 Food can be how you express love or share joy with your loved ones. It can be a connection to your ancestors. It can be how you worship in your everyday life, or for special occasions. When food and culture are deeply entwined, eating is emotional — and to behave otherwise is not intuitive.

And Yet…

And yet and yet and yet! Just because intuitive eating isn't right for everyone doesn't mean it is wrong for everyone — but that binary is the story I often see on dietitian social media. Black or white. Intuitive eating is everything or intuitive eating is worthless. There is nothing in between.

And isn't that always the thing with nutrition advice? No one wants you to speak from the gray zone in between. No uncertainty. No "this may or may not work for you." It's all or nothing, and people are okay with paying for Nothing if you tell them you are giving them All.

I'm not here to tell you intuitive eating is worthless. For people with specific privileges, it may or may not be a useful approach. And even if you cannot directly apply the principles in their entirety, they may still bring value to your relationships with food.

My friend and registered nutritionist

Laura Thomas

Can I Have Another Snack?

is a Certified Intuitive Eating Counselor, and she gently pushed back when I initially brought up the topic of the privilege of intuitive eating. (It was more of a tirade at that point.) She has seen intuitive eating principles help some of her clients build more trust and connection with their bodies. "I think the most powerful thing intuitive eating can offer is trusting yourself," she told me. "If people are caught up in cycles of restriction-bingeing-purging and other distressing behaviors around food and exercise, they often label themselves as broken or defective." Intuitive eating is just one set of tools for repair, and it may not work for everyone — but that's okay.

Melissa has found a way to bring some of the ideas of the book into her counseling, in ways that meet her clients' needs. "A lot of the ideas within Intuitive Eating mirror the anti-diet, weight-inclusive, and client-directed counseling approaches that I have found more inclusive of the food insecurity setting," she said. "Being able to explore making peace with food can be something done in any setting, and I've definitely explored this with clients. We've talked about 'good' versus 'bad' foods and where those labels come from — social media, fad diets, childhood — and I've worked with clients on finding value in the food choices they make, regardless of whether they choose the apple or the bag of chips. I challenge my clients to walk through their hunger/fullness cues throughout their days and help many clients who don't know how to identify those feelings to learn how each feels. We talk about self-compassion, and I often bring up the challenge to my clients to talk to themselves as if they were a friend of theirs."

For nutrition professionals who want to muck around in the gray space where there is no Right or Wrong, Liz Brinkman has the following recommendations:

Re-work your definition of what it means for you to be successful as a clinician. Remind yourself that you are no one's savior or healer.
Identify binary thinking. Try to always give a third example or option. (See activity 3 and 5 in Lucy Aphramor's training.)
Co-create eating experiments with clients that provide a space for trial and error within structure/support. Be explicit that "not doing" the experiment is relevant. (Inaction, avoidance, resistance, and/or "noncompliance" mean something in this work.)
Practice sitting with compassion and curiosity, noticing your own distress or conditioning with how a client eats or their behaviors around food. Whether they really eat in a permissive manner — some might want to call this "over-eating" — or use strategies labeled "maladaptive" by the patient, culture, and other healthcare providers, or do it "perfectly."
Learn about harm reduction. Gloria Lucas is blazing a path in this space.
Learn how to measure progress without making it about weight loss. We love this post.

How do you feel about intuitive eating? Have you found a way to make it work for you or the clients you work with? Do you have any advice for living or working in the "gray zone" of nutrition guidance?