Trusting the Body to Trust its Hunger Signals: An Evidence Based Investigation into Intuitive Eating

Saturday, March 5, 2011: 10:40 AM-12:10 PM
Point Hilton at Squaw Peak
Punitive and obsessional thoughts about eating and weight perception underlie most eating disorders. Dietary and nutritional guidelines are laden with rules that suppress the body’s natural intuitive eating ability. Proponents of the “intuitive eating” philosophy contend that patients can relearn to trust the body’s hunger/satiety signals and reestablish its innate food wisdom. Researchers, cognitive of the numerous physiological pathways controlling hunger and the current psychosocial conditioning, argue that reestablishing mechanisms of self-regulation are an illusion and unobtainable. This presentation attempts to introduce a practical middle ground that will reduce the confusion, establish trust and result in long term recovery.
I. Conventional Diets doe not Work

  A. Pathological diets and eating disorders

  B. Health and psychological risks

  C. Failure and rebound

  D. Counter regulation: Deprivation triggers binging

  E. Preoccupation

  G. Emotional eating

H. Habituation: sensory specific satiety

II. Intuitive eating: without conscious reasoning

  A. Reliance on internal hunger/satiety cues to determine when and how much food to eat

  B. Unconditional permission to eat when hungry and whatever food desired

  C. Eating food for physical rather than emotional reasons

  D. Nutrition is not the driving force

     i. Orthorhexia: Health consciousness as a negative attribute

    ii. Gentle Nutrition

   E. Natural weight: Health at every size

   F. Children: intuitive eating is innate

   G. American Style eating: Low in pleasure; high in health consciousness

   H. History

III. Research: Bacon ’05; Hawks ’05; Tylka ’06; Smithian ’08; Messinger ‘09

IV. Limitations of studies and criticisms

   A. Too small; non-definitive; self-reported data

   B. Technique: vague; subjective; ambiguous

   C. Gentle eating too subjective, individualized, and subtle

   D. Too much time, effort, trial and error, nebulous outcome

   E. No gastrointestinal, neurological or biochemical data

   F. Deterioration of trust

V. Review of internal and external hunger

  1. Hunger; Appetite; Satiety; Satiation
  1. Internal Cues

        a) Digestion; nutrients

        b) Nuclei; neuropeptides

        c) Inflammatory markers

        d) Gut peptides

        e) Hormones; receptors

 2. Externality 

  1. Genetics
  2. Disease; medications
  3. Sleep; Seasonality; Exercise
  4. Hedonistic System
  5. Restraint Theory; cognitive
  6. Cultural
  7. Sensory
  8. Conditioning
  9. Instinct
  10. Implied Norms of Appropriateness
  11. Emotional Triggers

VI. Suggestion for alternative

The success rate of conventional diets is discouragingly low. Additionally, food restriction may lead to health and psychological risk as well as eating disorders. To address the obesity crisis, there is a great need to explore alternative strategies. One such paradigm has been intuitive eating which is designed to awakening the body’s natural recognition of hunger and fullness:


  1. Reliance on internal hunger/satiety cues to determine when and how much food to eat
  2. Unconditional permission to eat when hungry and whatever food desired
  3. Eating food for physical rather than emotional reasons

This non-dieting approach has bee then subject of articles and books since the early 1970s. The term intuitive eating was coined by two well-intentioned master’s level dietitians, Evelyn Trioble and Elyse Resch, in their 1995 book, Intuitive Eating. There are published studies that concluded that this method can maintain BMI, reduce cardiovascular risks, decrease preoccupation with food and heighten self-esteem.

            Several researchers have argued that the recommendations on how to recognize ‘comfortable satiety” or identify ‘internal cues” are too often vague, subjective, individualized and ambiguous. The contentions that hunger and satiety cues involving no conscious reasoning will return can set up false hope in a population that needs to reestablish trust. There are currently no biochemical, gastrointestinal or neurological markers that can be measured to support the intuitive eating theory.

            The message to intuitively eat should be credited in its attempt to help encourage eating disorder patients to develop a healthy relationship with food, discern physical and emotional eating, reintroduce pleasure and emphasize self-love of one’s body regardless of size. What is needed is a revamping of the terminology and recommended practices to make it more evidenced based so that the philosophy can become a sound alternative that will provide a more universal acceptance rather than remain a constant topic of controversy

Primary Presenter:
Ralph E. Carson, RD, PHD

Dr. Carson has been involved in the clinical treatment of obesity and eating disorders for over 30 years. His unique background in medicine (BS Duke University and B. H. S. Duke University Medical School) coupled with nutrition and exercise (BS Oakwood College, Ph.D. Auburn University) has prepared him to integrate biophysiological intervention with proven psychotherapeutic treatment. He consults with eating disorder programs and presents at conferences around the world. Dr. Carson is currently the nutritional consultant of the Women's Center, A Pine Grove Program and an IAEDP board member. He has recently published Harnessing the Healing Power of Fruit.