The Intuitive Eating Journal: Your Guided Journey for Nourishing a Healthy Relationship with Food by Elyse Resch

Based on the popular anti-diet program, Intuitive Eating, this guided companion will help you pay attention to your body’s natural hunger cues, and develop a healthier relationship with food. 

The Intuitive Eating Workbook for Teens by Elyse Resch

A new, non-diet approach to adopting healthy eating habits! Drawing on the same evidence-based practices introduced in Intuitive Eating, this workbook for teens addresses the ten principles of intuitive eating to help you listen to your body’s natural hunger and fullness cues.

Do you struggle with stress eating, overeating, emotional eating, or binge eating? You aren’t alone. Sometimes, when we’re not feeling so good, food can seem like a great comfort. The problem is that over time, overeating can lead to several physical health problems, as well as depression and lowered self-esteem. So, how can you put a stop to unhealthy eating behaviors before they become ingrained, lifelong habits?

With this breakthrough workbook, you’ll learn to notice and respect your body’s natural hunger and fullness signals, find real eating satisfaction, cultivate body positivity, and build a profound connection to your mind and body for years to come. Each chapter includes an important principle of intuitive eating, and includes worksheets and activities to help you connect with and deepen your skills.

Whether you’re a teen, a parent, a clinician, or a certified intuitive eating counselor, this proven-effective workbook is an essential resource.

Intuitive Eating, 4th Edition by Evelyn Tribole and Elyse Resch

The go-to resource––now fully revised and updated––for building a healthy body image and making peace with food, once and for all.

When it was first published, Intuitive Eating was revolutionary in its anti-dieting approach. The authors, both prominent health professionals in the field of nutrition and eating disorders, urge readers to embrace the goal of developing body positivity and reconnecting with one’s internal wisdom about eating―to unlearn everything they were taught about calorie-counting and other aspects of diet culture and to learn about the harm of weight stigma. Today, their message is more relevant and pressing than ever.

nurture by Heidi Schauster, MS, RD, CEDS-S, SEP

There is so much confusing information about feeding families out there. Nurture: How to Raise Kids Who Love Food, Their Bodies, and Themselves is an expanded follow-up to Nourish, my first award-winning book. Nurture is a compassionate guide for parents and caregivers about feeding, eating, and discussing bodies with children and teens. I write from my nearly 30 years of experience treating clients with disordered eating, my own lived experience as a recovered person, and as a parent of two young adults. I weave stories from my clients’ and families’ experiences with sound advice based on current research. The book reads like a conversation with a kind fellow parent who has happened to do decades of fieldwork on the topic. It’s a sane and sound read that everyone who spends time with kids will benefit from reading.

This book is a life-enhancing tool for:

  • Parents and caregivers who have had their own food and body issues and don’t want to pass them on to the next generation

  • Parents and caregivers with kids exhibiting body image concerns

  •  Parents and caregivers with kids exhibiting disordered eating who want direction

  • Parents and caregivers with kids in larger bodies who feel unclear as to how to help them in the fat-phobic culture we live in

  • Parents and caregivers with picky eaters who don’t want to create dynamics around food that might lead to eating and body issues later in life

  • People who spend time with children and teens and want to create an inclusive health-and-well-being-enhancing culture around them

Unapologetic Eating by Alissa Rumsey, MS, RD
Unapologetic Eating by Alissa Rumsey, MS, RD

Unapologetic Eating by Alissa Rumsey, MS, RD

In her new book, Unapologetic Eating: Make Peace with Food & Transform Your Life, registered dietitian and certified intuitive eating counselor Alissa Rumsey helps you explore your history with food and your body and question societal expectations to get to the bottom of the complexity and find a clear path forward—forever free from diets! Using a relatable four-step approach, Rumsey teaches you how to reconnect with your body using your relationship with food as the entry point. She provides actionable tools you can use to confidently nourish yourself physically, mentally, and emotionally. You’ll learn how to make peace with food, improve your body image, trust your intuition, and reclaim the space to eat and live unapologetically. Say goodbye to the constraints of dieting and hello to the freedom and empowerment to live your most fulfilling life.

Fat Talk by Virginia Sole-Smith
Fat Talk by Virginia Sole-Smith

Fat Talk by Virginia Sole-Smith

Fat Talk is a stirring, deeply researched, and groundbreaking book that will help parents learn to reckon with their own body biases, identify diet culture, and empower their kids to navigate this challenging landscape. Sole-Smith draws on her extensive reporting and interviews with dozens of parents and kids to offer a provocative new approach for thinking about food and bodies, and a way for us all to work toward a more weight-inclusive world.

How to Raise an Intuitive Eater by Sumner Brooks and Amee Severson
How to Raise an Intuitive Eater by Sumner Brooks and Amee Severson

How to Raise an Intuitive Eater by Sumner Brooks and Amee Severson

A manifesto for parents to help them reject diet culture and raise the next generation to have a healthy relationship with food and their bodies.

thenutritiontea

Shana Minei Spence,MS,RDN,CDN (she/her) is a non-diet, weight inclusive dietitian who created this platform for an open discussion on nutrition and wellness topics considering all the information circulating around these days.

thethicknutritionist

Natasha Ngindi is a non-diet nutritionist helping you find peace around food, love your body, and move in ways that bring you joy!

v_solesmith

Virginia Sole-Smith (she/her) writes about diet culture, anti-fat bias, feminism and health. She is a journalist whose latest book is, Fat Talk: Parenting in the Age of Diet Culture

Food Psych

Helping people make peace with food since 2013. Registered dietitian nutritionist, certified intuitive eating counselor, and journalist Christy Harrison, MPH, RD, CEDS talks with guests and answers listener questions about making peace with food, healing from disordered eating, learning body acceptance, practicing intuitive eating, escaping harmful wellness culture, and more–all from a body-positive, anti-diet perspective. Along the way, Christy shares her own journey from disordered eater and dieter to food writer and anti-diet dietitian. This podcast challenges diet culture in all its forms–including the restrictive behaviors that often masquerade as wellness and fitness. Food Psych® is designed to offer safe and non-triggering support for listeners in recovery from eating disorders, weight stigma, and body shame.

The Role of the Dietitian in Eating Disorder Treatment

The Role of the Dietitian in Eating Disorder Treatment

By Timberline Knolls Staff

Treating a person who has developed an eating disorder can be a complex process that requires the dedicated service of a multidisciplinary team of professionals.

Dietitians are among the many experts who can play a vital role in helping people establish a solid foundation for long-term eating disorder recovery.

Depending on a person’s specific needs, their comprehensive treatment for an eating disorder may address the medical, psychological, behavioral, and social concerns that contributed to or were exacerbated by their struggles with disordered eating. Services provided by dietitians can contribute to positive outcomes in each of these areas.

In an article that was published Nov. 17, 2020, on the Journal of Eating Disorders website, authors Shane Jeffrey and Gabriella Heruc wrote that dietitians’ contributions to eating disorder treatment include identifying “the severity of malnutrition, the presence of disordered eating habits, and deficits in nutritional skills and knowledge that inhibit the attainment of adequate nutrition.”

In other words, dietitians at eating disorder treatment facilities may work with patients to help them achieve improved health by expanding their understanding of vital nutrition-related concepts, eliminating self-defeating behaviors, and developing a better relationship with food.

Accomplishing these efforts may involve services such as:

  • Assessing patients’ eating behavior patterns
  • Providing nutrition counseling and education
  • Creating individualized meal plans for patients
  • Helping patients develop more effective coping strategies

A dietitian’s work in eating disorder treatment can involve both providing valuable information and dispelling myths or misconceptions.

For example, one unfortunately common misunderstanding about nutrition is that following a “healthy diet” somehow means abandoning enjoyable foods, sacrificing choice, and limiting variety. Not true! As dietitians help patients develop their meal planning skills, they will introduce them to the wide range of delicious options. Patients learn that, truly, all foods fit.

The concepts of balance and choice can also be key elements in a dietitian’s work with patients in an eating disorder treatment facility.

People who receive treatment for eating disorders may have a wide range of problematic behaviors from restricting to bingeing to compensatory methods. In all cases, a dietitian can help the patient develop a meal plan that provides necessary structure while also offering appropriate amounts of choice, variety, and flexibility. The dietitian can also help the patient understand the nutrition and behavioral concepts that are fundamental to a healthy relationship with food. For many people this creates the foundation for moving towards developing interoceptive awareness and eating intuitively.

As a result, patients won’t merely follow a schedule that tells them when, what, and how much they should eat. Instead, they will have a firm grasp on the reasons for their new behaviors. This can help them take ownership of their continued recovery and escape the fear- or frustration-based patterns that had previously characterized their eating behaviors.

To support patients in following their new meal plans, dietitians may also work with them to develop healthier coping skills. This may be especially beneficial for patients who had previously engaged in disordered eating behaviors in an attempt to punish themselves for perceived failures or numb themselves from emotional pain.

Regaining control of one’s thoughts, decisions, and actions is a vital part of eating disorder recovery. Through continued personalized service, dietitians help patients develop the knowledge, skills, and capabilities that can allow them to achieve long-term recovery and experience improved quality of life.

The Tools of a Nutrition Therapist

The Tools of a Nutrition Therapist

Written by Jenn Burnell, CEDRD, Regional Director of Clinical Outreach for Carolina House

Every day, individuals seek professional nutritional help in implementing the “perfect diet” that is blowing up their social media feeds.  To make it even more confusing – and potentially dangerous – is that there are varying levels of nutrition experts marketing their services, and knowing who to trust can be just as daunting.  Nutritionist? Dietitian? Medical Nutrition Therapist? Nutrition Coach?  What does it all mean? It can mean everything and/or nothing at all – and if someone is seeking help for eating behaviors that have become life intrusive and are impacting their health, seeking a properly qualified professional is even more crucial.  So… just to make this even more murky, I’m going to add one title more to the mix: Nutrition Therapist.

First off, I must acknowledge that using Nutrition Therapist is not an accredited term nor a certified title- in fact it is not even 100% used among Certified Eating Disorder Registered Dietitians (CEDRDs), which are considered the most experienced practitioners in the eating disorders field.  “Nutrition Therapist” technically can be freely used by anyone, so it is be important to check that the provider also is a Registered Dietitian or Registered Dietitian Nutritionist (RD/RDN).

 

A nutrition therapist provides (want to guess?) nutrition therapy to clients seeking eating disorder recovery and help around chronic dieting patterns.  Nutrition therapy is different from the typical pictures of a dietitian in a lab coat telling a person what to and not to eat.  Instead of focusing on nutrition education and standardized meal plans, a nutrition therapist guides a client along on a self-discovery journey around their beliefs around food.   By dispelling myths with sound nutrition information, and providing a non-judgmental space for clients to discuss, explore, and challenge the “whys” of their thoughts and behaviors, the nutrition therapist helps move an individual towards a life enhancing relationship with food.  On top of this, a nutrition therapist also must provide clinical nutrition interventions to aid in the medical complications associated with eating disorders.

Sounds simple enough, right?  Actually, as many seasoned nutrition therapists will tell you, it takes a long time to hone in on these skills, which often means attending various trainings that are not typically provided in most didactic nutrition programs. Understanding counseling approaches such as motivational interviewing (MI) is integral to help guide clients through the resistance and ambivalence around their detrimental behaviors.

A nutrition therapist must also have a strong understanding of therapeutic modalities that mental health clinicians use when treating eating disorders, such as cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), acceptance and commitment therapy (ACT), family-based therapy (FBT), and internal family systems (IFS) to name a few.  Incorporating the language and principles from these approaches not only help create cohesive messaging within one’s treatment team, but it also makes the nutrition therapist more effective in helping their clients.

What about specific nutrition-focused approaches that are best practices for nutrition therapists?  Effective nutrition therapists understand, embrace, and embody the principles of both Intuitive Eating (IE) and Health at Every Size (HAES), and discuss nutrition using a non-diet approach.

I first discovered the book Intuitive Eating back in 1997 at my first job out of grad school.  I credit that book, written by Evelyn Tribole and Elyse Resch, for changing my life both professionally and personally, and plotting the course that led to where I am today.   Their first edition shattered my world as a way to “Make Peace with Food”, and its Ten Principles around breaking the diet mentality served in working with all of my outpatient clients, especially those coming in for weight loss.

Where some aspects of the book may be challenged by staunch non-diet proponents, the overall message embraced by nutrition therapists around the IE model is that of body trust: that the vast majority of individuals have an innate ability to sense hunger, satiety and what food will best honor your needs in that moment.  However, as idyllic as it sounds, it is that simplicity and freedom that can make it seem inaccessible to eating disorder clients.  Also, it could leave individuals (especially those black-or-white thinkers) feeling like a “failure” if they ate when not hungry or past satiety, which are what we as humans and social beings all do from time to time.  Cue Ellyn Satter…

Ellyn Satter is another pioneer in creating guiding principles for nutrition therapists.  Her simple handout called “What is Normal Eating?”, which was penned in 1983, still resonates true today.    Where much of her work revolves around child feeding dynamics, her Eating Competence Model (also known as ecSatter) is based on two key elements: 1) the discipline of providing yourself with regular, reliable, and rewarding meals and snacks and paying attention while you eat and 2) the unconditional permission to eat what and as much as you want at those regular eating times.*  These principles require more structure around eating, which differs from IE, yet both can be important tools for eating disorder clients at different points in their journey.

A component of both Intuitive Eating and the Eating Competence Model, and often discussed in nutrition therapy, is the concept of mindful eating (ME).  Some people may confuse Intuitive Eating and mindful eating on the surface, but they are quite different.  The idea of mindfulness is all about being present in the moment and fully aware of the experience (in this case the meal or snack).  Mindful eating does not suggest anything about your physical state (i.e., whether you are hungry or full) in order to do it, just the ability to notice all that is happening in that moment.  An objective and curious awareness is often the best approach in implementing ME in nutrition therapy work.  Some ideas include: Notice the color of the plate…What do you notice about the temperature of the food/how does the weight of the food feel on in your hand or on your utensil?… and one of my favorite questions: If I was an alien that came from outer space, how could you describe it to me?  If a client does or does not like a food (which is completely okay), a nutrition therapist might ask what is it about the food that objectively is not their preference – notice what specifically about the taste or texture is not appealing, or is one aware if a thought versus or past experience is making that decision.

Lastly, where not a nutrition specific strategy, I would be amiss if I didn’t discuss the importance of Health at Every Size® in nutrition therapy for eating disorders.  I was first introduced to this platform at the Binge Eating Disorder Association (BEDA) conference in 2012, where it created this landing space for the things that inherently made sense from my experiences in weight management and eating disorder work, and shared solid and pivotal research to support it all.  At that time, the take-home messages I assimilated were that 1) one cannot determine anything about one’s health based on a person’s body size, 2) the shame and stigma our society creates around larger bodies is the true health crisis and 3) weight cycling and chronic dieting are the culprits related to poor health versus size or weight.   What I have grown to truly understand over the years is that HAES is really a social justice movement advocating for safety and inclusion of bodies of all sizes (and colors and gender identities and abilities).  In order for a nutrition therapist to be effective in their work, they must truly embody size diversity acceptance, and have done a thorough assessment of their own weight biases.  This can be hard and uncomfortable work, especially because dietetic education provides so many guidelines around weight management.

If you are looking to work with a nutrition professional on eating disorder or chronic dieting struggles, do not be afraid to ask them about their qualifications and approaches to working with clients.  Are you a registered dietitian?  What do you know about Intuitive Eating or Health at Every Size?  What is your approach to weight management?   If you are an RDN hoping to learn more on how to effectively work with clients seeking the above help, there are several resources listed below.  Also – seek out the support and supervision of the many amazing CEDRDs and Nutrition Therapists that are available to mentor and share their vast knowledge with you, and help our world break free from the frivolous search for the perfect diet.

Online Resources:

Where to find a qualified nutrition professional (CEDRD/ Nutrition Therapist)

 

Jenn Burnell is a regional Director of Clinical Outreach for Carolina House, an eating disorder program in Raleigh/Durham, NC.  She is a Certified Eating Disorder Registered Dietitian Supervisor, and owns CEDRD Nutrition, where she helps RDNs in becoming Nutrition Therapists.

Mindful & Intuitive Eating for BED Recovery

Mindful & Intuitive Eating for BED Recovery

Written by MEDA undergraduate intern, Stephanie Wall 

Binge Eating Disorder (BED) is the most common eating disorder in the United States (NEDA, 2018). About 3.5% of American women, 2% of American men, and 1.6% of American adolescents currently suffer from BED (ED Referral, 2018). It is characterized by recurrent episodes of eating large quantities of food, often very quickly and to the point of discomfort. Those who suffer from BED tend to feel a loss of control during the binge and experience shame, distress, or guilt afterwards. Further, compensatory measures, such as using laxatives or forcing oneself to vomit, are not enacted to counter the binge. In addition to typical therapy for eating disorders, such as Cognitive Behavioral Therapy (CBT) or Dialectical Behavioral Therapy (DBT), using both intuitive and mindful eating techniques can be quite powerful in helping those struggling with BED.

A common symptom of BED is engaging in any new practice with food or fad diets. This contributes to body dissatisfaction, food and body preoccupation, and weight stigmatization (Tribole, 2017). The fallout from this mindset is mandating what and when one eats, regardless of one’s biological needs. In those with BED, this rigidity can lead to a binge, and thus feelings of a loss of control. This is known as the binge/restrict cycle.

Intuitive eating can be helpful in breaking this cycle. Intuitive eating is a personal process of honoring your health by responding to your body’s biological signals (Tribole, 2017). Here at MEDA, the EmbodiED Group focuses on self-compassion in their sessions, emphasizing this idea. Because a major idea in intuitive eating is listening to oneself and meeting one’s needs, the individual undergoing this change must be ready for it. This is a key factor for therapy to work, which is why intuitive eating works best for those who have the internal motivation to recover.

One major component of intuitive eating is “legalizing all food” (Hirschmann, 158). This means viewing all food in the same way, in order to remove the idea of “good” vs. “bad” calories. Because namely “junk food” is consumed during a binge, removing the negative connotation associated with that food may help alleviate some of the guilt felt after a binge. This also destroys the idea of “trigger foods” because all food is seen as the same. Many individuals who suffer from BED believe that even the slightest consumption of a certain kind of food will automatically invoke a binge session. According to Dr. Sandra Aamodt, a neuroscientist, hunger and energy use are controlled by the brain, mostly without one’s awareness. Thus, if we truly listen to our bodies and eat without guilt, the more we will naturally crave nutritious food.

Moreover, the idea of the “clean the plate club” has to be disregarded for intuitive eating to work. Being sure that everything on a plate is eaten disconnects us from our bodies and our feelings of fullness (Tribole, 2017). The basis of intuitive eating is to eat when hunger strikes. By legalizing all food as well as ending adherence to rigid rules, intuitive eating can be achieved.

Often those with BED eat when they are overwhelmed and stressed. To eat both intuitively and mindfully, we must ask ourselves how we are feeling and thus why we are eating. As a therapy, having the patience to sit with their feelings instead of eating to quell them is very effective (Tribole, 169). This coincides with mindful eating, based on concepts in the Buddhist faith, which involves being fully aware of what is happening within and around you in the moment. In addition to learning how to eat intuitively, learning how to eat mindfully is important.

Staying present and mindful while eating “allows you to feel the direct experience of your body and the many sensations of eating” (Tribole, 137). Someone who eats mindfully acknowledges that there is no right or wrong way to eat, varies their degree of awareness surrounding the experience of food, accepts that their eating experiences are unique, directs their attention to eating on a moment-by-moment basis, and gains awareness of how they can make choices that support health and wellbeing (The Center for Mindful Eating, 2013). A common method for eating mindfully is eating with one’s non-dominant hand. In one study, participants were instructed to eat popcorn while watching a movie. Unknown to them, the popcorn was a mix of fresh and stale. Those who ate with their non-dominant hand recognized the stale popcorn, and ate less of both the stale and fresh popcorn. Their counterparts didn’t recognize the stale popcorn and ate more (Tribole, 2017).

Experts suggest starting gradually with mindful eating by eating one meal a day or week in a slower, more attentive, manner. Thinking about the flavor, texture, temperature, and aromas of what you want to eat before you settle down to eat will help you eat in a mindful manner (Tribole, 135).

Intuitive and mindful eating are quite useful for re-establishing one’s relationship with food, however these concepts will not address all components of the eating disorder. Typical forms of therapy proven to work include Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), and interpersonal psychotherapy. By working on both the physiological and psychological aspects of Binge Eating Disorder, recovery can be achieved.

Citations:

Aamodt, S. (2013, June). Why Dieting Doesn’t Usually Work. Lecture presented at TEDGlobal 2013. Retrieved August 2, 2018, from https://www.ted.com/talks/sandra_aamodt_why_dieting_doesn_t_usually_work/transcript

Baer, R., Fischer, S., & Huss, D. (2006, March 03). Mindfulness-based cognitive therapy applied to binge eating: A case study. Retrieved August 2, 2018, from https://www.sciencedirect.com/science/article/pii/S1077722905800574

ED Referral. (2018). What is Binge Eating Disorder? Retrieved August 7, 2018, from https://www.edreferral.com/binge-eating

Harvard Health Publishing. (2018). Mindful eating may help with weight loss – Harvard Health. Retrieved July 31, 2018, from https://www.health.harvard.edu/healthbeat/mindful-eating-may-help-with-weight-loss

Hirschmann, J. R., & Munter, C. H. (2010). Overcoming overeating. Place of publication not identified: OO Publishing.

McQuillan, S. (2014, October 21). Mindful Eating Helps Prevent Overeating. Retrieved July 31, 2018, from https://www.psychologytoday.com/us/blog/cravings/201410/mindful-eating-helps-prevent-overeating

NEDA. (2018, February 22). Binge Eating Disorder. Retrieved July 26, 2018, from https://www.nationaleatingdisorders.org/learn/by-eating-disorder/bed

The Center for Mindful Eating. (2013, August). Introducing Mindful Eating. Retrieved July 31, 2018, from https://www.thecenterformindfuleating.org/

Tribole, E., & Resch, E. (2017). The Intuitive eating workbook: Ten principles for nourishing a healthy relationship with food. Oakland, CA: New Harbinger Publications.