Can I Practice Intuitive Eating If I Have Chronic Disease?
By Jessica Jones, MS, RD, CDE
Intuitive eating and chronic disease may not sound like they go together. After all, what’s intuitive about managing a complex health condition? You may be tempted to start eliminating, restricting, or even just throw in the towel on making any changes at all to your diet.
But the truth is, Intuitive eating can be your ally in creating a health relationship with the food you eat, benefiting the management of any chronic disease.
Keep reading for a simpler, healthier, and more sustainable way to approach eating and managing your chronic disease.
In this article we’ll cover:
What Intuitive eating is.
What classifies as a chronic disease
The research behind intuitive eating and chronic disease management
6 steps for using intuitive eating to treat chronic disease
How to get more support for treating your chronic disease through intuitive eating
What exactly is Intuitive Eating, anyway?
Intuitive eating is a well-studied, weight inclusive and evidence based model of eating that was created by two dietitians over 25 years ago. Through 10 key principles you learn how to move away from external cues and rules for eating and tune into your body’s internal cues, honoring and respecting your body in the process.
What is considered a “chronic disease”?
Simply put, a chronic disease is any disease state lasting 1 year or more, requiring ongoing medical care or adjustment to daily life. It’s something more than a stomach bug or a short-lived illness or injury. Chronic disease is something that you will likely be managing and living with for a long period of time.
Some examples of common chronic diseases:
Inflammatory Bowel Syndrome (IBS)-
Inflammatory Bowel Disease (IBD) Including Crohn's disease and Ulcerative Colitis
Chronic Lung Disease
So, why is there confusion about whether or not intuitive eating can be used to help with a chronic disease?
As mentioned above, intuitive eating requires listening to your body cues and relying on internal factors (like hunger and fullness) to drive your food choices. This is essentially the opposite of a diet or strict food rules. On the flip side, with any chronic disease, you’ve likely been given a handout or a set of rules on what you can and cannot eat to manage symptoms or improve your disease state in some way (i.e. food rules). It’s no wonder this is confusing and that merging the two seems impossible. The good news is, not only is it possible to eat intuitively with a chronic disease, intuitive eating can help you more than any diet or rule book ever could.
Here’s what the research says:
Many people with a chronic disease are told that they must lose weight in order to improve their health and symptoms, hence why they are often told to go on a restrictive diet. However, research suggests that focus on weight loss as a way to manage your chronic disease can create more health problems, not less. Up to 77% of people who intentionally lose weight, regain that weight within 5 years. This weight cycling has a significant negative impact on health. Regardless of how much weight a person gains or loses, the cycling pattern creates an environment of increased inflammation, reduced insulin sensitivity, and increased morbidity and mortality related to cardiovascular health.
Alternatively, research suggests that markers of disease can decrease when you learn to recognize and honor your hunger, and an important principle of intuitive eating. Dieting, which often requires ignoring your body’s request for energy (through hunger) makes it less likely that you will know what initial hunger feels like. Intuitive eating helps you to reconnect with your body, learn what hunger feels like to you, and honor that hunger by eating adequately and consistently.
Case and point: A 2010 study found that honoring initial/gentle hunger (versus waiting until
you get hangry) significantly improves insulin sensitivity and other cardiovascular risk factors. The reality is that most people need to train themselves to recognize initial hunger. Intuitive eating gives you the tools to effectively recognize and honor that hunger.
What you eat is only one of the many factors that influence chronic disease management. Despite what diet culture tells us, most of the factors that influence health and your ability to manage a chronic medical condition are out of your control. The environment in which you live, your education, how much income you have, and your access to quality healthcare, food, and transportation all have a significant impact on your health. Diet and exercise are just a tiny slice of the pie.
6 steps for using intuitive eating with a chronic disease
1. Assess what you already know about how food affects you.
Not what you’ve heard or what a handout from your doctor has told you. Look back at your own lived experience and determine how food has impacted your individual body.
Have you noticed that your blood cholesterol was lower when you were taking daily walks? Does your blood sugar seem to spike when you drink juice or pop? Take note of how different foods or activities have influenced your health and symptoms in the past. Keep track of these observations and be open to experimenting.
2. Quiet the mental bully telling you that you are “bad” or “good” for your food choices or how your disease is progressing.
Do your current thoughts often tell you that you are good or bad for eating a certain food or that your symptoms must be your fault? It’s important to remember that many aspects of your disease are out of your control and that you’re not to blame.
In fact, stressing about your health and every food choice you make could be making things worse. Living with chronic stress can weaken your immune system and lead to the damage of multiple body organs over time.
3. Work on identifying what hunger, fullness, and satisfaction feels like to you.
This is an important step if you often go several hours without eating only to have hunger hit you like a freight train or if you consistently eat way past the point of fullness. When you primarily listen to external rules about when and how much to eat, your hunger and fullness awareness may need a little bit of practice.
Just as important as hunger and fullness is allowing yourself to be satisfied with your food. It’s easier to eat to a comfortable fullness when you choose food that sounds good to you at the time.
4. Release your condition from your identity.
You are not your disease. Instead of thinking of yourself as a “diabetic” or a “heart patient”, work on taking back your own identity. You are a person with unique qualities, skills, and values. You also happen to have a chronic disease, which is just one part of you. When you can remove your disease from your identity, respecting your body becomes an easier feat.
5. Challenge what you’ve learned about health and nutrition in the past.
Diet culture seeps into every aspect of nutrition in some form or another. Even with chronic disease management, you’ve likely heard several non-truths about how you should eat.
Many of these non-truths revolve around restricted foods, or foods you need to avoid for your health. I’ve heard from more than one client that they “don’t eat bananas because there’s too much sugar in them”, or that they have to “avoid white foods” to help manage their disease. Challenge these myths about nutrition and work with a professional to determine realistic and gentle nutrition interventions that can help you.
6. Utilize gentle nutrition to nourish your body and mind.
Even in an anti-diet world, nutrition can play a key role in helping you to manage your chronic disease. Find foods that you truly enjoy and have the nutritional value that you are looking for.
For example, fiber has been found to help lower cholesterol levels, stabilize blood sugars, and other health benefits. If you don’t like whole wheat bread, that’s ok. Find other sources of fiber that you do enjoy.
The bottom line
Intuitive eating is possible if you have a chronic disease. Diabetes, heart disease, IBS, or any other chronic condition does not have to hold you back from improving your relationship with food and your body. You don’t need to wait until your symptoms improve or you reach some arbitrary goal, where you are now is the perfect time to start.
Want to work with a registered dietitian to help manage your chronic disease?
Jessica Jones Nutrition is currently accepting new clients. Are you ready to make peace with food and start managing your chronic disease with intuitive eating and not another restrictive diet? You can book your free discovery call so we can learn more about your specific needs and how we can help.
With 35 years of combined experience, the Registered Dietitians at Jessica Jones Nutrition are helping people with diverse backgrounds heal their relationship with food and improve their health.
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