3 Things Dietitians Want Therapists to Know About Intuitive Eating

A guest post by Kathleen Hahn, MS, RD, LD

As a dietitian, when I work with clients on Intuitive Eating, I recommend that they also meet with a therapist regularly. Our relationship with food is tied closely to our mental health, so having a therapist to turn to when difficult topics come up is crucial for my clients in making progress. 

If a client does not have a therapist, I refer them to a therapist who is either certified in Intuitive Eating or has a background in weight-neutral body image work. But many clients already have a therapist. And sometimes their therapist has never heard of Intuitive Eating. When this is the case, I reach out to the therapist to provide insight into the work I am doing with the client and to collaborate on how we can best help.

Three things I share with therapists about Intuitive Eating:

1. Intuitive Eating is an evidence-based approach linked to better health outcomes than restrictive dieting.  

People often turn to dieting and caloric restriction when they are unhappy with their body size or have health concerns; however, caloric restriction does not work for most people long term.

In fact, dieting is linked to negative outcomes such as “overeating, depression, low self-esteem, poor body image, weight cycling, and eating disorders”. Not only do diets cause harm and fail to have the desired long-term outcome, but dieting also often leads to weight cycling. Weight cycling is when someone loses weight and then regains it. Weight cycling has been linked to worse health outcomes than simply staying at the higher weight in the first place.

It is clear that dieting often worsens the very problem that someone wants to address in the first place.

Intuitive Eating, on the other hand, has positive outcomes. This evidence is not simply anecdotal. Intuitive Eating has been well-researched over the past 20+ years, and it is clear that it accomplishes much of what dieting falsely promises. Intuitive Eating has been linked with increased body appreciation and self-esteem as well as improved blood pressure, lipids, and decreased disordered eating.

Intuitive Eating is a psychological approach to repairing someone’s relationship with food and their body and revives their ability to tune in to their body’s needs. This leads to increased body appreciation and strengthens their autonomy.

A key difference between Intuitive Eating and dieting, however, is that Intuitive Eating does not make any promises about weight change. This leads me to the second point that I highlight when providing an overview of Intuitive Eating for a therapist.

2. Clients may gain weight. 

Weight change is not uncommon when clients are working through Intuitive Eating principles. If someone gains weight, sometimes they lose the weight again, but sometimes they do not. Their weight is not the point.

Some people have been restricting their food intake for many years, and their weight may be lower than their genetic predisposition. Naturally, they gain weight when they eat the amount of food they need.

Some people gain weight for a period of time when they work through foods that they have been fearful of, but then they lose weight again when their food intake stabilizes.

Weight gain can feel scary to the client. It can be uncomfortable to people around the client as well, including the therapist, because we live in a world that associates health with weight loss. And most people, including therapists, have an unconscious anti-fat bias and may find it appalling if their client starts gaining weight while working with a dietitian.

If you find yourself in this camp – afraid of weight gain and worried for people around you – you would benefit from a better understanding that the ties between body size and health are tenuous at best. BMI (body mass index), in particular, is an egregiously flawed parameter that has been applied to health. BMI, despite its rampant use, is useless in understanding individual health.

To better understand how BMI is flawed and how this drives our misunderstanding of health and body size, check out this detailed blog post here. The moral of the story is that weight has erroneously been tied to health, which drives all sorts of unhelpful dieting behaviors and weight discrimination. These ties are false and we would all be better off if each of us understood this more deeply.

The final part of Intuitive Eating that I like to discuss with my client’s therapist is attunement.

3. One of the core principles of Intuitive Eating is attunement, and a therapist is a key collaborator in helping a client work on this. 

Developing attunement is foundational for someone working through Intuitive Eating because the goal is to tune in to the body to understand its needs. I find it valuable to collaborate with therapists on helping a client develop attunement because many therapists have additional tools they can provide to clients. In addition, increasing bodily awareness can bring up a client’s history of trauma, and it is invaluable to have the therapist in the loop on the work we are doing.

When I share the above three points with a therapist, I usually find them to be receptive, and their interest in Intuitive Eating increases. Our conversation opens up the doors for ongoing communication. Also, I hear from clients that they (the client) feel more comfortable speaking openly with their therapist about their relationship with food and their body when their therapist has increased understanding of the work they are doing with a dietitian.

In summary, Intuitive Eating is a sustainable approach that helps clients repair their relationship with food, increase their trust in their body, and often helps with health conditions. Therapists are a crucial partner for dietitians in helping clients develop their ability to eat intuitively, and it is beneficial when therapists better understand the premise and impact of Intuitive Eating.

To learn more about Intuitive Eating, check out the website or books.

Get to know Kathleen on our community page.

Feel free to reach out to Kathleen at kathleen@eatwellcollective.com with any questions.

“Intuitive Eating is a compassionate, self-care eating framework that treats all bodies with dignity and respect.”  ~ From Intuitive Eating by Evelyn Tribole & Elyse Resch

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