Intuitive Eating with Chronic Illness
Intuitive eating is for everyone, including those with a chronic illness or disease. Diabetes, PCOS, hight cholesterol, or IBS do not have to hold you back from making peace with food.
If this is your first time here - hello and welcome! My name is Hannah and I am a non-diet dietitian with a mission of helping people ditch the diets and make peace with food.
Intuitive eating advocates for throwing out all diets. But if you have a chronic disease, you may have been recommended to follow a particular diet to treat the condition. Or perhaps you would like to follow certain dietary guidelines to prevent chronic disease and illness. In this blog I will explain how intuitive eating can be incorporated by those who are looking to treat or prevent chronic illness.
What is intuitive eating?
Intuitive eating is a non-diet approach to eating that was developed by two registered dietitians, Evelyn Tribole and Elyse Resch. There are 10 principles of intuitive eating with a goal of helping you improve your relationship with food and your body.
Reject the diet mentality
Honor your hunger
Make peace with food
Challenge the food police
Discover the satisfaction factor
Feel your fullness
Cope with your emotions with kindness
Respect your body
Movement - feel the difference
Honor your health - gentle nutrition
If you are new to intuitive eating and looking to learn more, check out my ultimate beginner’s guide.
What is a chronic condition?
Simply put, a chronic condition is an illness or disease that lasts one year or more and requires ongoing medical care. This is not the same as a getting a short-lived sickness or injury. A chronic condition will need to be managed over a longer period of your life.
Examples of chronic illnesses/diseases
Diabetes
Polycystic Ovarian Syndrome (PCOS)
Heart disease, including high cholesterol
Kidney disease
Celiac disease
Irritable bowel syndrome (IBS) and irritable bowel disease (IBD), including Crohn’s disease and ulcerative colitis.
Cancer
If you have a chronic condition, you may have been handed generic handouts from a healthcare provider with general nutrition advice to manage your condition. Oftentimes these handouts include a set of food rules that must be followed and foods that you need to cut out. This is very different from intuitive eating, which involves learning to listen to your body rather than relying on food rules to dictate your food choices. It’s no wonder why you might feel like intuitive eating is not a good fit for you if you have a chronic condition.
Will weight loss improve my chronic disease?
According to Dr. Google and weight-centric medical providers, many chronic diseases are supposedly improved by having a “healthy” BMI and weight loss. Many healthcare providers will tell their patients that they must lose weight to treat their condition. But BMI and weight are not high quality indicators of health, especially as stand-alone data. Not to mention that intentional weight loss is rarely sustainable over a long period of time and weight cycling (defined as a series of losing weight and gaining it back and then losing it again - a common result of dieting) can actually be worse for your health than maintaining a higher weight.
It is very possible to eat nutritious foods, live an active lifestyle, and practice other health-promoting behaviors and still have a larger body. At the same time, those in thin or straight-sized bodies may rarely exercise or incorporate health-promoting behaviors. The point is that the size of a body is not what causes a disease. And weight loss (which is not a behavior, by the way), may not improve your chronic disease.
It’s also worth mentioning that even if weight loss was an evidence-based treatment or cure for chronic conditions, there is currently not a safe and sustainable weight loss method to recommend. As I’ve mentioned, most intentional weight loss fails. This leaves the patient labeled as “non-compliant” and, in some cases, shamed by their medical team for not being “disciplined” enough.
Practitioners who recommend weight loss as a treatment are doing a disservice to their patients and clients. Not only does this weight-centric approach not address the root problem, but in many cases the patient is not even advised on how to go about losing weight. This might lead to them doing their own research and practicing unsustainable or even dangerous methods. Or they might become so frustrated and confused by the lack of guidance that they decide to not make any changes at all, which once again may leave them labeled as “non-compliant” by their healthcare provider (can you tell that I don’t like that word?).
If you have been told to lose weight to manage your condition, I am sorry. You deserve so much better. The good news is that there is another way to improve your health in a way that doesn't involve shame, fear of food, and trying to make yourself smaller.
How can intuitive eating be incorporated by those with a chronic condition?
Ready to stop using diets to manage your condition? I’ve got some tips to help you get started.
Take note of how certain foods make you feel
Forget what the generic handout or Google says you should or shouldn’t eat. How do you feel when eating certain foods? You are the only expert of your body.
As an example, gluten and dairy are often scapegoats for those with PCOS. People with PCOS are often recommended to cut these foods out to alleviate symptoms. While doing so may help some individuals, there are many individuals with PCOS that can tolerate gluten and dairy just fine.
Try to identify how foods make your body feel without allowing the influence of diet culture to tell you how you “should” be feeling when eating those foods.
Challenge misinformation
You’ve likely heard many claims about the “best” way to treat or manage your chronic illness. Clients tell me all the time that they thought they needed to cut out sugar, do intermittent fasting, or avoid the “white whale” (meaning all white foods - I cannot make this stuff up) because this is what they were told or learned when doing their own research.
I highly recommend obtaining your nutrition information from credible sources and, if you are able to, work with a trusted registered dietitian for individualized care and recommendations.
Incorporate gentle nutrition
Intuitive eating is not anti-health. Making health-promoting food choices is actually highly recommended. But these choices should not be made at the expense of your mental health or relationship with food.
Intuitive eating with a medical issue doesn’t mean you should eat a food that’s harmful to your body. Remember that intuitive eating is an act of self-care. Despite how diet culture portrays it, intuitive eating is more than just eating whatever your heart desires (even though you have full permission to do so). It is about honoring your body and eating in a way that feels good.
For example, a person with celiac disease is recommended to avoid gluten. Does this mean that they are in the “diet mentality” for avoiding gluten? Or that gluten is a “bad” food? The answer is no on both accounts. A gluten-free diet is an evidence-based approach for celiac disease, but it is not an evidence-based diet for weight loss. See the difference?
Put simply, find nutritious foods that you enjoy and also make you feel good. For example, if your goal is to eat more fiber but you despise brown rice, it’s okay to choose white rice. You can get your fiber from other foods that you actually do enjoy.
Remember that you are more than your condition
Rather than thinking of yourself as a “diabetic”, shift this language to “a person with diabetes”. Diabetes (or whatever condition(s) you have) is not your entire identity! You are not a disease. You happen to have a disease and you also have unique qualities that make up who you are as a whole person.
Bottom line
Intuitive eating can be a great fit for those looking to manage their chronic condition. Shame and guilt around eating is not good for your health regardless of your condition, which is why intuitive eating and making peace with food can benefit anyone.
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