It’s no secret that I love the framework of intuitive eating and have used it heavily with my clients in the past and present. However, when you’re around something for long enough, you start to see some flaws and become a little disillusioned. So, am I calling intuitive eating debunked?
Not exactly. There are still many intuitive eating benefits, but it’s not without its problems. In today’s post, I’m going to break down 5 main issues I have with the intuitive eating framework and anti-diet space because, frankly, I think we need to talk about them.
Before we get into my intuitive eating critiques – or my intuitive eating icks, if you will – let’s quickly review what intuitive eating really is.
What Is Intuitive Eating?
Intuitive eating means listening to internal cues such as hunger and fullness rather than relying on external cues like calories, a diet plan, or the time of day.
It also means approaching your nutrition from a non-judgmental place and not beating yourself up for having foods that diet/wellness culture deems as “unhealthy.”
With intuitive eating, no foods are considered “bad” or off-limits. This approach to nutrition is often embraced by anti-diet dietitians and other individuals looking to break away from diet culture.
Still, even though the goal of intuitive eating is a good one, there can be instances of intuitive eating not working and issues with the movement as a whole.
Intuitive Eating Debunked? My 5 Intuitive Eating Icks as an Anti-Diet Dietitian
Ick 1: Over Corrections about Food Morality
Before I get into this, let’s start with some context. First of all, I’m a dietitian. Of course I agree that nutrition matters when it comes to our health. But it doesn’t matter as much as most of the things you see online lead you to believe.
Specific foods don’t even matter – it’s patterns that matter and the net effects of those patterns that impact your health in the end. The intuitive eating framework and I are in agreement about that. It focuses heavily on moving away from labels like “good/bad” and even “healthy/unhealthy.”
Overall, I think this mindset does help individuals build a better relationship with food that is more nutritious without overanalyzing food ingredients. However, what I see happen a lot is a fear of discussing anything when it comes to health-promoting foods and habits because we’re too afraid that it’ll be “diet culture.”
We end up being so afraid of assigning morality to food that we end up completely avoiding the discussion about its nutrient profiles. In my opinion, an overcorrection of never talking about nutrient profiles is not a solution either.
How to Combat Food Morality Overcorrection
As a dietitian, I believe I should be empowering my clients to better understand how their bodies work and how different foods impact them. And I aim to do this in a way that is free from obsessive food rules, stress, and feeling like their food choices and/or weight make them a “good” or “bad” person.
For example, if a client drinks soda every day and enjoys it enough to not want to eliminate it completely, but they ask me if they should switch to diet soda, I’m most likely going to say yes – as long as they don’t mind the switch.
The consistent intake of regular soda isn’t doing anything for them health-wise, and if they can get the same satisfaction out of diet soda then they might as well make the switch. (I know some of you are losing your minds about the artificial sweeteners in diet soda – that’s another topic for another time). The point is, there are situations where encouraging healthy eating is better for someone’s overall health, including their mental health if it makes them feel happier to be healthier.
Now I don’t think that this is directly discouraged by intuitive eating, but it’s certainly not encouraged either, and some things get lost in translation because of that.
There is, of course, the principle of gentle nutrition within the intuitive eating framework. I think this generally seeks to help others make health-promoting choices, but as I said it can get watered down depending on the teacher.
Intuitive Eating Ick 2: Cherry-picked and misleading data
Like most movements in the nutrition and wellness space, intuitive eating proponents like to share a lot of data and stats about the impact of diet culture on health.
If you’ve looked into intuitive eating vs dieting, you may have seen some of these claims:
- 95% of diets fail
- Starvation mode makes dieting ineffective
- Obesity does not negatively impact health
- BMI is useless
But is there actual intuitive eating science to back these up? Let’s find out.
Claim: 95% of diets fail
This statistic is based on a study that was done in 1959 on 100 people who were given a “diet” then sent on their way with no follow-up. In what world is that a study that we want to start citing statistics about? The author of the study actually said about 40 years later that he doesn’t understand why people keep citing his study.
It’s also annoying how this blanket statement is used with no context added.
What do we mean when we say fail? Usually, “failure” means keeping the weight off that was lost for over a year. Sometimes I see people say 2-5 years.
What do we mean when we say “diet” in the context of this statistic? Typically, what I see is that most intuitive eating/anti diet people who say this mean that 95% of intentional weight loss attempts fail, but that’s simply not true. In a study done on over 5,000 overweight people, half lost and maintained >5% of their weight and a quarter of them lost and maintained 10% of their weight for over 8 years.
Perhaps people use this statistic when they are referring to classic restrictive diets like Noom, Optavia, Slimfast, etc…But we don’t have any data to claim the 95% statistic specifically, and we shouldn’t pull statistics out of nowhere.
Claim: Starvation mode impacts your weight loss potential
As a follow-up to the statistic I just mentioned, many people in the anti-diet crowd say that sustained weight loss is impossible due to starvation mode. If you haven’t heard of this, it’s basically the idea that if you over-restrict your calorie intake, your metabolism shuts down and you’ll hit a weight loss plateau that you can never recover from – and that you’ll gain all the weight back plus more because now your metabolism is slower.
Typically, those who talk about starvation mode often cite two studies to support their claims: The Minnesota Starvation Experiment and the Biggest Loser study. Unfortunately, these studies don’t tell the whole story.
The Minnesota Starvation Experiment
A group of men in the 1950s volunteered to have their food intake cut in half for 6 months. These men were lean to begin with, at an average of about 154 lbs. By the end, most of the men lost more than a quarter of their body weight and were suffering from severe side effects, including disordered eating, food obsession, extreme weakness, edema, fatigue, anemia, and physical signs of malnutrition.
Interestingly, their metabolic rates appeared to drop down more than you would initially expect with metabolic adaptation. The estimated amount of adaptation should have been about 200 calories a day. Instead, their resting metabolic rate (RMR) decreased by about 600 calories per day.
The Biggest Loser Study
The Biggest Loser was a reality show in the United States where obese individuals competed to see who could lose the most weight the fastest. Contestants lost about 40% of their body weight and subsequently saw an average decrease of 664 calories in their RMR – more than the anticipated 370 calories of metabolic adaptation.
Not only that, but 6 years later a follow-up study on the contestants showed a persistent metabolic decrease of about 700 calories a day with 500 of those being due to metabolic adaptation, despite having regained 90 lbs on average.
So what gives? Based on these 2 studies, it seems like your metabolism can crash, burn, and bring the whole Amazon forest down with it. Naturally, it’s not that simple.
Metabolic adaption or adaptive thermogenesis is absolutely real. But it’s not nearly as drastic or permanent as some lead you to believe. It’s mainly the result of the body getting smaller and having less overall tissue requiring energy.
Evidence shows that every living tissue requires calories to function daily. Muscle burns about 13 kcals/kg per day, our organs require 100’s of calories per day and even fat burns 4.5kcals/kg per day.
As our body gets smaller, we now have less tissue to maintain. Less energy required means lower energy needs from foods, aka a lower metabolism. But this doesn’t mean your metabolism is broken.
The two studies mentioned above are the only 2 studies that exhibit anything like this happening. In fact, other research has shown that this doesn’t typically happen in those who sustain weight loss.
We also have some other findings on the Biggest Loser study. A secondary analysis by Kevin Hall showed that weight regain was NOT linked to metabolic adaptation. In reality, those who had the greatest levels of adaptation regained the LEAST amount of weight. So even though some people had greater than expected metabolic adaptation – it didn’t actually worsen their outcomes.
Finally, a systematic review of 33 studies showed that in better-designed trials – metabolic adaptation from weight loss was tiny, or no longer significant. In other words, starvation mode is a myth.
Claim: Obesity does not negatively impact health
This claim is where many people start to think that intuitive eating doesn’t work. They think it’s a great concept, but once we get to this point, they are not on board. Intuitive eating is closely entangled with the Health At Every Size movement. This movement relies heavily on the basis that obesity does not negatively impact health, stating that correlation doesn’t equal causation.
Unfortunately, this just isn’t true. This umbrella review shows obesity is causative of stroke, heart disease, and pulmonary embolisms. Yes, correlation doesn’t equal causation in a single study, but it can when we have a mountain of evidence collectively saying the same thing.
In this 5-year study of 3.5 million men and women, for example, researchers found nearly a 50% increase in cardiovascular disease risk in even metabolically healthy obese individuals. Another study followed 380,000 people for 5-10 years and found that metabolically healthy obese individuals still had higher rates of diabetes, fatal heart conditions, respiratory disease, and all-cause death.
Simply put, the data just isn’t there to support the claim that obesity has no negative effects on health.
Claim: BMI is useless.
This intuitive eating claim is one I’m not too mad about – but I do think it gets extreme at some point.
The anti-diet crowd always points out that the body mass index was created by Adolphe Quetelet, a statistician and astronomer, not by a doctor or someone in the medical field. They also point out that the data was based on European, affluent men – making the BMI categories racist, sexist, and ableist. And then of course we have the argument that BMI doesn’t take into account muscle mass – a great argument to make.
But all of these points are leaving out some important information: the data.
There are a few papers showing a strong association between BMI and body fat %, despite the fact that BMI doesn’t take body fat % into account in the actual calculation. There have also been some studies looking at BMI among people of color, specifically. This study was done on over 1,000 South Asians, this one on over 400 north Indian females, and this one on over 1500 Nigerians.
But in these studies, there were of course outliers where it was not correlated. This goes to show that it’s more helpful to assess the status of a population, not on the individual level.
I’m not at all dismissing the fact that the origin of BMI disregarded people of color (and women, and those of a lower socioeconomic status) completely. However, I’m pointing out the fact that despite that, we still see associations between BMI and body fat % no matter where in the world you’re from. BMI can be a somewhat helpful tool when looking at overall populations.
Still, I do think BMI is often used incorrectly in Western medicine. It should be a small part of the overall picture of someone’s health – not the sole determinant.
Intuitive Eating Ick 3: Intentional weight loss is never okay
This is a bandwagon I used to ride hard. Intentional weight loss is a big reason we have issues with eating disorders – I understand that. However, that doesn’t happen every single time, and we ALL know people who have lost weight in a perfectly reasonable and healthy manner and their relationship with food AND their body is fine. And in some cases, they’re healthier for it.
What I see ALL the time with intuitive eating, anti-diet, and HAES practitioners is a statement like “We support body autonomy but do not agree with intentional weight loss”… okay, so you don’t support body autonomy then.
If you can’t stomach helping a client find reasonable ways to lose fat, they’re going to find someone else who is probably going to feed them a bunch of harmful information. While their intentions may be good, intuitive eating dietitians and other practitioners need to stop gaslighting people and trying to convince them that they shouldn’t want to lose weight.
Of course, there is a caveat. There’s a big difference between intentional weight loss that is helpful and intentional weight loss that is harmful or just flat out unnecessary. There are also people who want to lose fat and would benefit from it and other people for whom it won’t make any difference to their health or self-esteem.
For many of the women I work with, I’ve found that focusing on weight isn’t actually getting them anywhere. It’s even harmful in some cases. That is because of the population and clientele I work with. But this doesn’t mean that intentional weight loss is never ok for anyone. There are plenty of people outside of the population of women I work with who are completely fine when they pursue intentional weight loss.
Intuitive Eating Ick 4: Feelings Overriding Facts
Many people in the anti-diet space choose to turn a blind eye to all the evidence I (and others) have presented because they are largely dominated by feelings. Phrases like “lived experience” are used to justify using anecdotes to guide practices. They would rather not be concerned with facts when it disputes how they feel.
In many cases, the arguments they make and the labels they use (e.g. anti-diet, HAES, fat-positive, weight-inclusive, intuitive eating, non-diet, etc) become their identity, and they cling to them as tightly as possible. If you disagree with them or present data that contradicts their feelings, it often results in name-calling for being racist, ableist, privileged and many other career-ending names.
This makes it nearly impossible to converse with these individuals. At some point, people are talked down to, disrespected, and even downright bullied. I’ve seen it happen many, many, many times (in a small number of cases it was even directed towards me).
You’re either with them or you’re not. There’s no in-between. This kind of all-or-nothing thinking is exactly what we’re often trying to get away from in the diet culture world, and yet it still exists within intuitive eating, anti-diet, and HAES spaces.
Intuitive Eating Ick 5: Intuitive Eating “Coaches”
My last and final point is the intuitive eating “coaches” you can find all over TikTok and Instagram. For those who don’t know, you can become a certified intuitive eating counselor in 6 weeks through the official intuitive eating website (for a fee of $1,500, of course).
These are often people regurgitating any data provided by intuitive eating materials without any understanding of how to interpret said data (see: Ick #3, cherry picked/misleading data). These coaches end up being trained in the ways of intuitive eating and HAES, including being angry at anyone who disagrees with them.
I strongly believe this kind of work should be reserved for trained and licensed professionals – such as registered dietitians and mental health therapists – particularly those who have had additional training in eating disorders.
So, Is Intuitive Eating Debunked?
After reading this, you might be surprised that I align myself with intuitive eating at all. Which I can understand!
Quite frankly, I feel a little embarrassed to support intuitive eating these days. I really don’t love using the label “intuitive eating” with my work because of the connotations that come with it that I don’t want to be associated with. It’s not that I don’t agree with the core of it and think it provides incredibly valuable tools, it’s that there are so many flaws and individuals who have ruined it for me and many individuals who are seeking better health beyond just “food freedom” (although that is incredibly important).
As a professional, I’ve learned to take the helpful intuitive eating resources and apply them where it makes sense for my clients, but stick with things being as evidence-based as possible. If it seems like intuitive eating doesn’t work for a client, I can leave behind anything not benefiting them.
I’m curious: have you spent much time exploring intuitive eating? Have you felt similarly to me on any of the points mentioned?
If you’re ready to learn more about how to improve your individual nutrition, I’d love to chat. Shoot me an email at michelle@yatesnutrition.com or explore my signature group coaching program, Nourished & Free®.