Understanding Intuitive Eating with Susan Albers, PsyD

Podcast Transcript

Speaker 1: There's so much health advice out there, lots of different voices and opinions, but whom can you trust? Trust the experts — the world's brightest medical minds, our very own Cleveland Clinic experts. We ask them tough, intimate health questions so you can get the answers you need. This is the “Health Essentials Podcast,” brought to you by Cleveland Clinic and Cleveland Clinic Children's. This podcast is for informational purposes only and isn’t intended to replace the advice of your own physician.

Kate Kaput: Hi, and thank you so much for joining us for this episode of the Health Essentials Podcast. My name is Kate Kaput, and I'll be your host. Today, we're talking to psychologist Susan Albers about intuitive eating. If you've spent your whole life dieting or obsessing over what you eat, the concept of intuitive eating might come as a shock to your system. Instead of following rules and restricting what you eat, intuitive eating asks you to trust your internal hunger and fullness cues to help you decide what and how much to eat. Studies show that intuitive eating is associated with positive body image and self-esteem and lower rates of disordered eating. Dr. Albers is here today to talk us through the principles of intuitive eating and how you can begin to apply them to your own life. Dr. Albers, thanks so much for being here with us.

Susan Albers: Thank you.

Kate Kaput: So, I like to start by asking our guests to tell us a little bit about themselves and the work they do. So, what can you tell us about what you do here at the Cleveland Clinic?

Susan Albers: I'm a clinical psychologist at the Cleveland Clinic. I've been here for 18 years. It has been an honor and a pleasure to work here. I am so excited about the work that I do and the patients that I have. I've worked with a number of different patients over the many years that I’ve been here. Ranging from individuals, to those who have chronic eating issues, all the way to those who just want to have a healthier relationship to food, more mindful eating. My specialty is mindful eating. Over the past two years, I have seen an increase in the number of patients who are seeking therapy for eating issues due to the pandemic. And this reflects what is happening overall in the world.

There's been an increase in the number of people who are struggling with emotional eating, stress eating, chronic eating problems, due to the stress and anxiety that is happening in the world. Also, something that has changed over the past two years due to the pandemic is I'm doing more teletherapy. So in the past, I was seeing patients within a distance of Wooster. I work at the Wooster Family Health Center, but now due to teletherapy, I'm seeing patients all over Ohio. So if you're someone who is seeking some assistance with eating issues and distance or time was something that's stood in the way in the past, this is really the time to reach out and connect with myself or another mental health professional.

So, as I said, it's been an honor and pleasure to work with so many different patients who have eating issues, but also depression, anxiety, because all of these issues go hand in hand at times with eating struggles.

Kate Kaput: Absolutely. So, on that note, let's dive right into intuitive eating. Can you explain this concept for our listeners? What is intuitive eating?

Susan Albers: So intuitive eating may be a concept that you have heard a little bit about lately because it's a very popular concept. And it is based on the philosophy and way of eating based on a groundbreaking book by the authors, Evelyn Tribole and Elyse Resch. And it was originally written in 1995. And I actually have it here on my desk. I have an updated version that I keep handy because it's a book that I often use. And these authors coined the term and what it means in a nutshell, and we're going to get into the nitty gritty of it, all of the principles and how it plays out practically. But just as a brief overview, it is about making peace with food. It's about learning how to listen to your body, how to honor your hunger and deciding what to eat. And this is such a tricky task, of the patients that I work with.

The number one thing that people come in saying to me is, "I don't know what to eat." We live in a world that we have so much access to information, health research, and still it is one of the number one questions that we struggle with. I have patients that are CEOs of companies or busy moms, and they say, "I can handle so many things in my everyday life." But the number one thing that they just can't get control over or a healthy grasp on is eating.

So, this is one avenue that is very well researched. And we'll talk more about that research. That can be a key to helping you with this issue in your life. And I've actually had the pleasure of working with Evelyn Tribole on different eating disorder panels. And so I hope to do her philosophy justice today, because she's a lovely individual. She lives in California. She likes to surf and I've just learned a lot about her and this philosophy over the years.

Kate Kaput: Great. And so how does intuitive eating differ from dieting? I think so many of us are pretty familiar with the concept of dieting. How is intuitive eating different?

Susan Albers: It is radically different. It is the polar opposite of dieting. So, if you're listening and you have this gut reaction like, "Oh, no." Or you're curious, but a little ambivalent or suspicious because you've been dieting for a long time, just hang in there with me because it's very different. Dieting essentially gives people rules about what to eat and what not to eat. Don't eat sugar, don't eat fat, don't eat gluten, specific rules — external rules.

Intuitive eating is the opposite. It doesn't use external rules. It teaches you how to listen to what your body needs, listen to what is happening on the inside. And that doesn't necessarily always follow a set of rules. For example, it doesn't follow “don't eat after six o'clock.” If your hunger tells you that's what you need, then it's about honoring and listening to it. In this concept, there are no foods that are off the table.

So, you don't have to get rid of any food groups, which is often a relief to dieters. What I do want to say front and center is what it is not because I think this is one of the things that either turns people away from intuitive eating, or puts on the brakes, is they often think it's just eating whatever you want. And that's not the case. If I just ate whatever I wanted, I'd be eating French fries 24/7 through the day. And that is not what happens. So, I really wanted to emphasize that is not what it is. And as we talk today, because we are so enmeshed in diet culture, it can feel a little wrong or different, radically different from what you've known. So, hang in there with me.

Kate Kaput: And some of us just have no idea how to listen to our intuition when it comes to food because of years of dieting and disordered eating. And so I would love as we go along for you to talk about how we tap into that intuition so that we're not eating French fries all the time because if my intuition tells me that I want French fries all the time, then maybe my intuition needs a little bit of recalibration.

Susan Albers: It's true because after years and years of all these dieting messages, we get very confused, and intuitive eating helps us to unlearn a lot of those rules and rewire our brains to think about food in a much different way.

Kate Kaput: Perfect. So, before we get into the principles of intuitive eating, can you give us some examples, just so that people really understand a little bit better what we're talking about before we delve in. What are some examples of intuitive eating? What might intuitive eating look like in your everyday life?

Susan Albers: So, I want to give you a really brief example. And as I was thinking about this podcast today, I was looking for examples in everyday life. And I want to give you a little example of my daughter and her example of eating, and as we talk about the 10 principles, you will see how it really applies. So, this week, my daughter, who is a teenager, was in the kitchen for breakfast. She sat down, she poured a bowl of cereal. She took about three bites and she pushed aside the bowl and she said out loud, "I don't want this." And she got up.

So, she was listening to what it is that she wanted or didn't want. That was not something she wanted in the moment. Now the dieter or the clean plate club eater would start to have the critical mind going in their head saying to themselves, "Wait, I don't want to waste this. Shouldn't I eat at all?"

That's not what happened. She got up, she went to pick up a muffin from the counter and she cut it in half and put it on her plate. So again, the intuitive eater was asking herself, "How much of this do I really want? How much is realistic in terms of what's going to make me satisfied?" She sat down, she ate it and then she said, "I have a test today and I have track practice. This isn't going to do it. What else do we have?" Isn't that a common question the kids ask? What do we have? What do we have to eat? So I said, myself knowing the nutrition science and thinking about, and this is one of the principles of food, of how it powers us, I said, "Let's have some eggs. It has some good protein. Protein helps with focus, energy." Made her some eggs with cheese, put it on her plate.

She got up, she went to the refrigerator, got out some guacamole, put it on top. Now one would think that she was going with the nutrition science of that this is going to help with energy and focus, but this is not where the teenage mind was. She loves guacamole. It is one of her favorite foods. She could eat a lot of it. She was going with what satisfied her, what was going to make her really happy and feel content. And then after she was done with that, she got her backpack, she put in some snacks, both healthy snacks, some fruit, but also some gummy bears. So again, no foods are off the table and off she went to school. I thought it was such a beautiful snapshot of how mindful eating and intuitive eating can play out in the moment in just little snapshots of everyday life.

Kate Kaput: Yeah, I love that. It sounds like it's really what you want, what you need, how much you need, how much you want, finding that balance between all of those. So, let's dive into the principles of intuitive eating. As I understand it, there are 10 principles. Let's walk through them one by one. And as I go through each of them, you can tell us a little bit about each of them. So, the first one, and you've started to talk about this a little bit, is “reject the diet mentality.” What can you tell us about that?

Susan Albers: This is a very tough one because we live in a diet culture-focused world. Everywhere we turn, we hear messages about dieting, about being thin, and it can be very tough for people to put aside the dieting mentality. In fact, I was just talking with one of my patients and just listening to her language around how she talked about food, that there was certain candy that she couldn't resist or that were a temptation, even the language in which we talk about food is I imbued with these ideas that we should be dieting at all times.

And so principle number 1 is being able to identify and recognize when you're being influenced by diet culture. If when you are making a decision, you are making it based on calories instead of what it is that you want to eat or what would be satisfying, one of the things that I would recommend for people to begin to live this principle is to play what I call “I spy diet culture.” And in your world, identify when you see ads related to dieting, media around dieting, this is a big one, social media posts that are promoting fad dieting or unhealthy dieting techniques. And you will be amazed at how often it will pop up, just everywhere you look.

Even the word “skinny jeans” is an example of kind of this diet culture of really urging us at all costs, even sometimes to the detriment of our health, to be thin.

Kate Kaput: Yeah, that's a good point about skinny jeans, the language that can create feelings, right? Cheat meal, guilty pleasure, things like that.

Susan Albers: Yeah. Even in magazine covers, they can give such conflicting messages. You may see on a magazine cover this beautiful dessert that makes you want it and crave it, yet at the same time, it says, "10 principles for losing weight." So we even get these conflicting messages about dieting.

Kate Kaput: Right. So, that leads me into the next question, which is in a world that is so full of diet talk and weight obsession, do you have any other tips for bucking this mentality and shifting your thinking, maybe especially when you're talking to someone who is not in that place? Someone who's really into dieting, maybe it's your mom who you talk to all the time about health and body, and it's just normalized in those conversations. How can we create those boundaries to say, "You know what? That's not me right now." To create that healthy space for ourselves.

Susan Albers: Yeah. I think it's important to notice when it's happening, really listen for these examples of diet culture. They're so subtle in different ways that they can pop up. Also, avoid engaging in dieting chit chat. Often, people are talking about their diet, giving little tips, things like this. And we need to not engage in that because it perpetuates the idea that this is really important and normalized. Also, when we hear people engage in saying negative things about their body, really giving them a different perspective on that, about normalizing weight and body size.

So, as we start to listen and, most importantly, use different language, language about acceptance, about size diversity and eating mindfully or intuitively instead of dieting. So, moving that dieting word aside and inserting the words, “intuitive eating” and “mindful eating.” And so interesting, so even with my kids, I will say things like, "Do you feel you're eating mindfully?" or, "How could we eat this in a mindful way?" And notice how different that is than, "You shouldn't eat this." Or any focus on shameful language around food or dieting.

Kate Kaput: And so I don't want to totally derail us from the principles, but I think it's relevant and you just mentioned it. What is the difference between intuitive eating and mindful eating? How are they the same? How might they go together and what are any of the differences there?

Susan Albers: Intuitive eating and mindfully eating are very similar. I like to think of them to be like cousins. They share a lot of principles. Those principles that are similar are honoring your hunger, paying attention to the foods that make you feel satisfied, understanding what your interceptive cues are. Those cues are about satisfaction, about hunger, about fullness. The main place in which they diverge is that intuitive eating has 10 very specific principles to follow and mindful eating is based on the concept of mindfulness, which is a well-researched field of scientific research in itself. But the language is a little bit different. It's around awareness, observation, noticing, non-judgment. So, the language is a little bit different, but at the heart of it, they share very similar principles.

Kate Kaput: And it sounds like they can go together pretty easily. Lots of similar thinking.

Susan Albers: You can be eating intuitively and mindfully at the exact same time.

Kate Kaput: Perfect. So the 2nd principle is “honor your hunger.” What can you tell us about that one?

Susan Albers: Yeah. Hunger is a biological response and a need. And again, in our diet culture world, we often are taught to look at hunger as the enemy. Something that we ignore, that we run away from, that we curb our cravings. And what happens when we do that? Often it backfires. The more you say no, no, no, the more you want something. Like if you don't eat all day, what happens when you get home from work? You are overly hungry. You just eat and eat and eat.

It's a little bit like ... How I explain it to people is if we try and ignore other biological factors in our lives, if we tell ourself, "Ignore your breathing, don't breathe," or, "If you have to go to the bathroom, ignore it or avoid it." We would never say that to ourselves about these basic biological needs.

But we do it about hunger all the time. And, like I said, it really backfires. The one that I do a lot of writing about myself is the notion of “hanger,” which is the term anger and hungry together. It's that irritable feeling that you get when you ignore your hunger. It's a really good example of how hunger is a messenger and whenever you feel hungry asking yourself, “What is that message trying to tell me? Am I full? Am I hungry? What's going on in my body?” So instead of shooting the messenger or shoeing away that messenger, welcoming it in.

Kate Kaput: Perfect. Yeah, I think a lot of us operate under this belief or have in the past this belief that we should be suppressing our hunger. That if we're feeling hungry, it means the diet is working. And it sounds intuitive eating really flips the script on that kind of thinking that if you're feeling hungry, it's because your body needs something.

Susan Albers: Yes. And so the key here to live this principle is asking yourself, what are you hungry for? And what is your hunger telling you that you need or want?

Kate Kaput: All right. So number 3 is “make peace with food,” which we've talked a little bit about. Tell us more about that one.

Susan Albers: Making peace with food is stop fighting with food. And this includes putting an end to statements like, "I shouldn't eat that," or, "I shouldn't have this." All these languages that indicate that you're at war with food. Now, making peace with food means that you have to welcome back in some of the foods that your diet has forbidden, things like maybe it's pasta or bread or eating at a certain time of the day.

Every dieter will tell you a certain food that they read an article about that was fattening or was bad for them. And whenever they try to eat it, now all those feelings, thoughts, judgment, guilt, rush back in. So, making peace with food begins with saying, "I can have this” versus “I can't." And this can be a radical shift for people who for many years have avoided certain foods or felt shame or guilt.

Kate Kaput: Absolutely. I would imagine that's really scary for some people, right? But my mind has been telling me for years and years that this is an absolute no go. How can you convince your brain otherwise to start moving in that direction?

Susan Albers: Yeah. Some of it is basing yourself on giving it a try and trust. It's that saying, “what we resist persists,” and that really applies to this category with food, anything that we tell ourselves, we can't have what happens? We want it even more, and I've seen this really time and again with clients. One of my clients told me a story about how she didn't even really like this particular cake, but because it was not on her diet, what did she want? That was all she could think about it. She went searching for it and went to certain stores and hunted it down simply because it was off her list of foods that she could eat. So, the power of not being able to have something can really play games with our minds.

Kate Kaput: The 4th principle is “challenge the food police.” What does that one mean and who are the food police? What is the food police?

Susan Albers: Yeah. No foods are good or bad. And this is a shift in the language that a lot of my clients have to start with because we grow up thinking about, and labeling foods as good or bad. Instead, certain foods are healthier than others, but it just is what it is. It's OK to have a donut. It is OK to have some of these foods. So the food police often reflects what is known as the “inner critic.” That voice inside your head that starts to criticize and judge everything that you're eating.

And the most important thing to do for this principle is ask yourself, “Where is this food police voice coming from?” Sometimes, it's coming from a parent, it's words that they have said to you. Sometimes, it is your own internal judgment. Sometimes, the food police are actually an external voice. Sometimes, it is a partner who is making little critical comments, or a parent who is making a judgmental statement about your size.

So, we have to identify where are the food police coming from. Why are they creating these rules? And importantly, are these rules helpful to you or not? And often, they're not very helpful and they're arbitrary rules that are not set in stone. They are not laws, but they can feel very punitive if you don't follow them.

Kate Kaput: It's a little empowering to think, too, that these aren't actual rules, these aren't laws, you get to decide what feels right for you? What fits you? There's no actual rule book, people who say, "Oh, I haven't had a carb for 10 years." That's not a rule — you're allowed to eat that donut every once in a while.

Susan Albers: And people have very conflicting voices in their heads about what to eat. Some people will give the feedback this food is fine to eat and then other people will not. So, you have to use your own internal judgment. And these rules are ones that really keep people frozen and stuck because they're in “there,” they play on a subconscious level. So, bringing those rules up into your awareness, I also encourage people to do what I would call a diet legacy history of different people in their lives and what they have contributed to the way that you eat. So, maybe your primary family, how did they eat at home? What were some of the messages that they gave you about how to eat? And it's interesting, when you look back through families that you can see that certain families have different rules or different pressure to the way that they eat.

Kate Kaput: Right. And that the messaging that comes from all those different pieces of your life really impact what you see as the rules and being able to break those down as you work toward intuitive eating. I want to group together principles 5 and 6 and have you tell us about both of them at the same time because they feel a little bit related.

So 5 is “discover the satisfaction” and 6 is “feel your fullness.” What can you tell us about those and how you can both discover the satisfaction, feel satisfied, feel happy and also know when to stop and when to feel full? I think that's something that so many of us struggle with.

Susan Albers: Yeah. Eating food should be enjoyable. Something that we want to do. And really, it's built in on a biological level that we have to obtain some pleasure for food or we just simply wouldn't do it. My dad lost his sense of taste several years ago due to an accident and people around the pandemic, often people lost their taste and what happened? They didn't enjoy food.

It was one of the first times that many people really got a sense of, due to that not being able to taste food, how important that feeling of joy is around food. But going back to the example of my daughter, she was eating her cereal and it wasn't satisfying. She pushed it aside because it just wasn't giving her any pleasure. Now, there's two kinds of pleasure and in this principle, we're talking about cognitive experience, not just what you feel physically, but is it a satisfying taste?

Does it make you feel satisfied? I had a client once who, for a year, just ate protein bars. Was following a diet, was not eating other foods and to this day she could not eat another protein bar. She overdosed on it, it was just not satisfying or fulfilling and robbed her of many different kinds of nutrients. That relates to feeling your fullness. And that is checking in with your body to feel if you're feeling satisfied physically, not just mentally, like “this tastes good and I'm enjoying it,” but also does it resonate with your body and your hunger.

Kate Kaput: And so, I mean, a lot of us have a skewed sense of fullness because we're used to eating large portions or maybe we have a history of disordered eating, a history of binge eating. How can we begin to truly recognize when we're feeling full? What are those cues of fullness that we might be inclined to miss?

Susan Albers: And fullness is really a tough one. As you mentioned, because of years and years of eating huge restaurant portions or restricting your food intake and ignoring your hunger, all of a sudden it teaches your body not to trust those signals. But the good news is that you can really relearn them and it can take some time to really trust those signals. One of the things I recommend, at least to begin with, is to take out that word “full” and start by focusing on, "Am I not hungry anymore?" to really eat slowly, eat mindfully, and as you're eating, to continue to check in with your hunger.

We often at the beginning of a meal say, "I am starving. I'm really hungry." And at the end saying that you're full. But often, we are not checking in with ourselves along the way as we're eating. So, as you're taking some bites, make sure that you're checking in with yourself. Also, another exercise is to leave some bites on your plate. Often my clients will say, "I grew up in the clean plate club. And so I eat every single thing on my plate. Can't even imagine leaving something." And so one of the exercises that we do is encouraging people to leave a couple and see how they feel. Does it affect their level of satisfaction or hunger? And sometimes, they're surprised at how this changes their perception of how much food really makes them feel satisfied.

Kate Kaput: So the 7th principle is “cope with your emotions, with kindness.” What can you tell us about the role that your emotions play in your eating and how finding healthy ways to cope with your emotions can help you begin to have a healthier relationship with food?

Susan Albers: Food and feelings are so intertwined with each other. 75% of our eating has absolutely nothing to do with our physical hunger. We eat because we're bored, we're stressed, we're anxious, all of these emotional reasons. And this principle is about finding kind ways to nurture, distract, comfort, cope with feelings that you have with activities that help you to reduce your stress rather than with food. Food doesn't fix feelings. And we have all learned that time and time again.

So, there are other ways that we can respond to our emotions when we're feeling the need to stress eat in kind ways. So, doing yoga classes or stress reduction, reading a book, some Netflix or distraction. There are ways that we can identify what it is we're feeling and instead of feeling stress and making a beeline for food, we pause for a moment and ask ourselves, "What am I feeling? And what does this feeling need?"

Sometimes, it's food — and I want to put this out there that it's OK. Sometimes, if you're stressed and you want to do a little bit of stress eating, that's OK. But when we turn to food over and over again, to soothe or comfort our feelings, that becomes a bigger issue. So, responding to those emotions that you think that you want to eat, sometimes you do, but other times there are other activities that deal with that feeling so much more accurately.

Kate Kaput: And if I remember correctly, you have at least one book, right? About figuring out some of the other things that you can do to cope with those feelings instead of just turning to food, is that right?

Susan Albers: That's right. 50 Ways to Soothe Yourself Without Food, and in this book, I talk about different strategies that are free or almost free and are easy to do. You can do them in the moment. Some of them are shifts in your mindset of how you respond to those emotions. Some are stress management techniques, some are creative. So, there are all different ways that we can respond to our emotions that are soothing and calming.

Kate Kaput: Great. So, tell us about principle number 8 is “respect your body.” What do we mean by that? And how does it fit into the structure of intuitive eating?

Susan Albers: Yeah. Everybody is different and we are influenced heavily by our genetic blueprint. So, we can't diet our way into a different body that is not made for us. So, this one is really about respecting size diversity, that all bodies are welcomed and approved of and beautiful and wonderful, celebrated. And this one is a tough one often for my clients who are really struggling with body image. And one of the things that I recommend for them as a start is that we work on acceptance of that idea, that everybody is different and is meant to be different, body neutrality. Instead of jumping to, "I love my body." Which sometimes just doesn't fit for people because of our diet culture. But body neutrality. Really accepting your body as it is, what it does for you, how it helps you. And sometimes, this is a little bit easier start for people to get to.

But most importantly, we respect our bodies, and this might be ways such as throwing away clothes or giving them away that don't fit anymore. Sometimes, my clients will say, "In my closet, I've got a whole section of one size, a whole section of another size,” and they're holding onto those clothes for a time where they fit in them again. They're really focused on changing their body in some way. So, that's one example of how to show some body respect. And also, wearing clothes that feel comfortable that allow you to move and make you feel good about your body.

Kate Kaput: So, that's actually a good point. I was recently reading an article that said something about if you're trying to lose weight, you should not get rid of any of the clothes that don't fit you anymore. You should hang on to them because it will motivate you to lose that weight. And I thought to myself, "All that really does is mean that you have to wear clothes that don't fit you and that you feel bad in. And then you feel bad about yourself." And so I really love that as a tip for intuitive eating, because I think, yeah, respecting our body means looking at our body, maybe if not positively, neutrally and saying, "I'm just going to do for my body what it needs." And in some ways that's wearing clothes that fit and look good on you and that you feel good in.

Susan Albers: That's the perfect example of a story about diet culture, of encouraging people to hang on to their skinny clothes or their clothes when they were at a smaller size. So I mean, it pops up in these very obvious and not obvious ways.

Kate Kaput: And some of these things stick with you, like you said, they become your mental rules. Well, I read once that I should hang onto these clothes forever because they'll motivate me. So, you never buy new clothes. And you're like, "Why do I feel so bad about myself?" Well, maybe you should get rid of the clothes that don't fit and just accept your body as it is right now.

Susan Albers: Even looking at them in the closet. As someone opens up the closet, it can bring up such feelings of shame or guilt every single morning. They start off their day and think about how that cascades throughout their day in terms of what they eat and how they feel about themselves and how they set themselves to the world.

Kate Kaput: Right. So, related to respecting your body, we worry a lot about what other people think about us. And I think this is one where people start to worry, well, even if I start to believe that all bodies should be celebrated and accepted that my body should be celebrated and accepted, then others still won't accept us as we are. How can we get past that as we're working on respecting ourselves, also worrying less about how others might see us?

Susan Albers: We do have to remember that people who judge other people, often it's a reflection of more about them than it is about you. People who are insecure about their weight often project judgments onto other people. So, we do have to keep that in mind when someone is not accepting or judgmental, it often reflects more about where they are on their own self-esteem and their own mental state of mind. And it can be difficult. It absolutely could be difficult. We want to surround ourselves with people who are supportive of our size, our diversity. That we are more than just a number on a scale.

One thing that you can do, that's really important, is social media. Go through your social media, look what's popping up. If there are a lot of messages that are negative, that foster this idea of not accepting your body as it is, or you scroll past and you start to feel uncomfortable about your body, that is someone to unfollow. And then on the opposite side, make sure that you are following people, organizations, quality information, uplifting people who are advocating for size diversity.

Kate Kaput: Great. So let's move into numbers 9 and 10. And again, we're going to package them together because these are two things that you hear about a lot together, out in the world, they are “movement” and “honoring your health with the gentle nutrition.” What can you tell us about those two as they relate to intuitive eating?

Susan Albers: One of the number one things that people do when they are thinking about losing weight or dieting or things like that is around exercise. And we really have to take a good look at why people are exercising. What is motivating them? Research will agree and just personal experience, people will agree that exercise is great for our health, for our mental state. It's fun, it's enjoyable. It makes us feel good. But what happens with dieters is that they are pushing themselves to do some movement to burn calories. And that turns into a negative.

So, we want to encourage people to do movement that brings them joy. And notice — not exercise, but movement — because exercise can sometimes be grouped with “I've got a sweat and lose calories,” but some kind of movement. Maybe it is dancing or walking your dog counts, playing tennis, surfing, whatever it may be.

So, ask yourself why you are doing the activity you're doing. So for example, I had a client who told me that she was running every morning and she hated it. She absolutely hated it. And I said, "Well, why are you running every morning then?” I said, "There are other kinds of movement that maybe you would enjoy more." And we went through a list and she found one. The dieter or chronic dieter is pushing themselves to do activities because it's going to burn calories instead of something that they will enjoy.

And then the last principle, “honoring your health with gentle nutrition” was intentionally by the authors put last in this order. And the reason that they put it last was because all the other principles are about tuning in. There's a little bit of external information that we need for understanding nutrition, looking at studies and understanding the science behind nutrition. And what they're saying, it is perfectly OK, and good to use nutrition as a guide to help us understand our internal cues.

So, for example, the example with my daughter, protein. She had eggs in the morning. Science will tell us that that's a great choice in terms of keeping people feeling full and energized. And so we can pair both the internal of what we know and what we feel from foods that we eat with the external science and use those two things together.

Kate Kaput: That makes a lot of sense. So, bringing in what you know about nutrition, the wisdom of nutrition and what it can do for you, but not those hard calorie counts that you must eat this, you must not eat that, et cetera, you've mentioned weight loss a little bit, people who are trying to diet to lose weight — a question that a lot of people have about intuitive eating is well, “Can I lose weight doing intuitive eating?” And it sounds that's not really the point. What can you tell us about intuitive eating and weight loss?

Susan Albers: To sum up the 10 principles of intuitive eating, what I would encourage people to do is do a 10-day challenge. Each and every day, take one of the principles and really just focus on that principle for the day. Notice how it comes up, how you can put it into practice, some of your challenges, your struggles, how it improved your life and do one principle every day. Because it can be very overwhelming to try and incorporate these all at once. So, that might be a great way to start eating in a much more intuitive way.

People often ask about weight loss. This is probably one of the number one questions, “Will I lose weight?” Here's the answer. And sometimes people feel a little bit ambivalent or this is a hard answer. The point or goal of intuitive eating is not about weight loss. And sometimes, clients will struggle with this because that's something that they want in their life.

But let me explain why. Weight loss is part of diet culture, it pushes you and changes your mentality into shame and guilt in a way that being healthy and focusing your efforts on improving your health and your joy around food do not. And so do some people lose weight with intuitive feeding? Absolutely. Why? Because they stop binge eating, they are increasing the joy of their movement. They are not falling into “all or nothing” patterns of eating. They are eating just the foods that they love.

So, there's many ways in which these principles actually lead people to naturally lose weight because they're listening to their internal hunger instead of diet principles. Sometimes, people gain weight if they have been restricting or dieting severely for a long period of time. Really, it comes down to your body will do whatever it needs to do. And I know that can be a tough one to wrap our minds around because it's so different than the diet mentality that promises you to lose 10 pounds in 10 days. That kind of thing. It doesn't make those kind of promises. What it does promise you is that you're going to have a better relationship with your body and with food.

Kate Kaput: So, that's what I was going to say is, the trade off is that it sounds all the things that you just mentioned sound really happy, right? They sound like a really good place to be in with your body. To move your body because you're having fun moving your body. To eat enough and to eat what you like but to know when to stop. All of those things sound really satisfying. I know that intuitive eating is associated, like we said at the beginning of the podcast, with lower levels of dissatisfaction. What can you say about the mental satisfaction of learning to eat intuitively?

Susan Albers: Studies have shown that people who do intuitive eating have higher retention rates in regard to this way of eating than dieting. So, they've looked at people who have started dieting and people who have done intuitive eating, and they have found that they are able to sustain it for the long term because with diets, you can only do it for a certain period of time and you just get tired or restricted or just messes with your mind in regard to food. So, people find it to be really sustainable.

In the beginning, we mentioned research. That's one of the things that has changed over since this principal has been released in 1995, it's been studied research and updated in the past few years. Now, we're 30 years later, which really shows it has lasted the test of time, something to be said for that. And that is well researched. And study after study just shows that it's really helpful to people, their body, their mind, their mentality, just a lot of great research that backs it up.

Kate Kaput: All of that sounds great. So, you mentioned a couple of tips for helping people get started. I love the idea of focusing on one of the principles each day. What other challenges might people face when they start trying to eat intuitively and are there any other tips that you can share to help folks as they begin?

Susan Albers: One of the most, I would say, classic intuitive eating and even mindful eating exercises is to tune into your hunger, using a scale from one to 10, with one being starving, 10 being overly full, and before you eat, as you eat and after you eat, check in where you are on that scale. Because often, a plate is put in front of us and we eat. And we're not really asking ourselves how hungry am I or am I even hungry? People are often surprised when we start working on reducing emotional eating and increasing mindful eating, intuitive eating, of how often their brain says to them, "I'm hungry." But they take a pause, tune in, asking themselves, "Am I really hungry?" How often they are just bored, stressed, procrastinating or even trying to calm and soothe. So really, taking an emotional pause, checking in with yourself, these are all really important first steps to becoming a more intuitive eater.

Kate Kaput: Great. Dr. Albers, is there anything that we haven't discussed today that you think is important for our listeners to know about intuitive eating, especially if they're just getting started in the process?

Susan Albers: I think if you've been dieting for years and years, this can be a challenge for you. So, notice that. And then also, sometimes social factors around us can make intuitive eating really challenging. For example, if you go to a birthday party and someone gives you a piece of cake, but you don't really want the cake. Sometimes, those social pressures can be difficult. Also, multitasking, reducing multitasking is a great way to boost your intuitive eating. When we are scrolling, we're not tuning into what's happening in “here” as we're eating. So, my challenge to you is to put your phone aside, even if it's just for a few minutes, when you eat, just eat. This is going to help you to tune in and listen to those hunger cues. It's actually really a tough one.

It sounds really easy, but we're so focused on our phones and distractions when we eat. So I would say that that is a challenge for people out there. I guess my main message is just give this a try. Review the principles, try that 10-day challenge and see what happens. You may notice what a struggle it is to fight some of those internal diet rules and expectations that you have. But my hope for you is that like the many, many patients I work with and people in the world, that you develop a really peaceful and healthy relationship with food.

Kate Kaput: I think that's what we all want and deserve and this sounds like a great way to hopefully begin to change our thinking about food and achieve that goal for ourselves. Dr. Albers, thank you so much for being here with us today, and for speaking with us on this important topic. This was really interesting to me and I hope for our listeners as well.

Susan Albers: Yeah, thank you.

Kate Kaput: Thank you. To all of our listeners, if you would like to schedule an appointment with Cleveland Clinic Center for Behavioral Health, please visit www.clevelandclinic.org/behavioralhealth or call 216.636.5860. Thanks for being with us today.

Speaker 1: Thank you for listening to “Health Essentials” brought to you by Cleveland Clinic and Cleveland Clinic Children's. To make sure you never miss an episode, subscribe wherever you get your podcasts or visit clevelandclinic.org/hepodcast. You can also follow us on Facebook, Twitter and Instagram for the latest health tips, news and information.