Intuitive Eating for Individuals With Orthorexia Nervosa
Research suggests that restrictive dieting can lead to a higher body mass index (BMI) over time, and a greater future likelihood of being overweight, a preoccupation with food, guilt about eating and higher levels of depression, anxiety and stress. In other words, restrictive eating, otherwise known as dieting can potentially lead to an eating disorder known as orthorexia nervosa, which is characterized by the obsession with eating only “pure” and “healthy” foods in order to prevent illness and increase longevity. Unlike anorexia nervosa, orthorexia is not about losing weight or changing one’s body type but rather is based on prolonging an individual’s lifespan through eliminating unhealthy foods. This obsession with pure and clean eating can lead to perfectionism, social isolation, extreme feelings of guilt or shame when consuming unhealthy foods, severe anxiety, and interference with one’s professional and personal aspects of life due to this obsession. Many researchers believe that instead of focusing on what is clean, healthy and pure, it may be more beneficial to focus on the body’s internal hunger and satiety cues and how the body reacts to certain foods. Should an individual ignore his/her craving for chocolate just because it is deemed unhealthy? Or should they listen to his/her body’s craving? The concept of intuitive eating is the exact opposite of restrictive eating and could potentially be the treatment for individuals who are struggling with orthorexia nervosa.
What is intuitive eating?
Intuitive eating was popularized by two dietitians, Evelyn Tribole and Elyse Resch, who published a book on the subject and developed a website dedicated to the topic. The term intuitive eating is often interchangeably used with “mindful eating”; both terms describe the same approach to listening to one’s body and allowing it to guide them on when and how much to eat, rather than being influenced by their environment, emotions or the rules prescribed by diets. Mindful eating involves developing an awareness of internal hunger and satiety cues and making conscious food choices. It emphasizes the importance of paying attention to the emotional and physical sensations experienced while eating.
Unlike many other diets, intuitive eating encourages and individuals to eat what they want; no food is off-limits. While some may expect this to lead to eating more high-fat or high-sugar foods, research suggests that this is not the case. Advocates of intuitive eating suggest that the more you restrict yourself, the more likely you are to binge later.
Cure for eating disorders?
Research suggests that intuitive eating may lead to a reduction in binge-eating symptoms and eating for external and emotional reasons. Intuitive eating is also associated with greater positive body image, body satisfaction, positive emotional functioning, and higher self-esteem. Further research found that higher levels of intuitive eating predicted lower eating disorder symptoms, compared with calorie counting and frequent self-weighing. This is a contrast to typical restrictive dieting, which has been associated with an increased risk of disordered eating, one that may be greater for those who also experience symptoms of depression and low self-esteem. Many individuals who begin their eating disorder recovery process are often unaware of what hunger or fullness even feels like anymore, and this is because the extremes of both are what characterize eating disorders.
A person may only know what severe hunger and fullness are, but the reality is that these signals in the body are actually much more subtle. How does a person undo years of eating disorder behaviors and learn how to reconnect with subtle signals of hunger and fullness? For many people in eating disorder recovery, this begins with slow steps, starting with regulating eating habits and normalizing hunger. Intuitive eating can help these individuals listen to their hunger and satiety cues as well as learn to eat what their body is craving.
Sources: Denny, K. N., Loth, K., Eisenberg, M. E., & Neumark-Sztainer, D. (2013). Intuitive eating in young adults: Who is doing it, and how is it related to disordered eating behaviors? Appetite, 60(1), 13–19. http://doi.org/10.1016/j.appet.2012.09.029
Bacon L, Aphramor L. Weight science: evaluating the evidence for a paradigm shift. Nutr J. 2011 Jan 24; 10():9.