Intuitive Eating Basics and Benefits: Quickstart Guide to Mindful Eating

This episode was pre recorded as part of a live continuing education webinar on demand. CEUs are still available for this presentation through all CEUs. Register@allceus.com Counselortoolbox you I'd like to welcome everybody to today's presentation on understanding intuitive eating. I am your host, Dr. Donnelly Snipes. Today we're going to identify the 10 +1 principles of intuitive eating. If you go to the book on and there is an authoritative book on intuitive eating, the authors have 10 principles. I add an extra one that I think is really important when we talk about this and I will tell you which one is not included in their book. We're going to describe the interaction between mood, health and eating and begin identifying tools to help people get off the dieting roller coaster. Now. A lot of us work with people who have mood issues. A lot of us work with people who are in recovery from addiction. Very rarely do people come to a mental health counselor and say I want to lose weight, so why are we talking about this? But because people need to have good nutrition in order to fuel their body and give it the building blocks it needs to make the neurotransmitters so they can feel happy and healthy and all that kind of stuff. We want people eating healthfully. We don't want them going on super restrictive diets. Diets also reduce self esteem and other things. When people are obese, it often impacts their sleep. People with obesity have a much higher rate of sleep apnea. It obesity having excessive body fat is correlated with alterations in testosterone and estrogen levels which can also affect mood. We want people to be be able to maintain a weight that is appropriate for them. And I have lots of issues with the BMI scale because that doesn't take into account your proportion of bone to muscle to fat. It's just height and weight. And that doesn't give you a good idea because there's a lot of bodybuilders who have excessive BMIs and they are in really good health, maybe have a little too too little fat. As a matter of fact. There are other ways to measure body composition. But what we're really talking about here is helping people find that niche where their body wants to be their biological set point. Other interesting points about eating that when people are obese they actually show that they have lower dopamine than people who are not obese. Dopamine we know is our secret chemical and it's associated with the endogenous opioids which are our pleasure chemicals. And there are lots of Neurobiological overlaps between our reward pathways for food as well as our reward pathways for other addictions. People in recovery from other addictions very often engage in unhealthy eating, not intuitive eating, because they are trying to cope with feelings. A lot of these things are going to come out, which is why food and intuitive eating may become a part of a treatment plan for people. Let's go on to what intuitive eating is. And this is from intuitiveeating.org Reject the Diet mentality. Honor your hunger, make peace with food. And I call this forbid, forbidding. And we're going to talk about that some more. Challenge the food police in your own head. Respect your fullness. Discover the satisfaction factor. Use food for physical nourishment and not in response to feelings. Respect your body, exercise and honor your body with good nutrition. Now, I know exercise is not part of eating necessarily, but it's one of those factors that the authors included in the 10 principles for intuitive Eating, and we'll talk about why that is when we get down there. Rejecting the diet mentality is the first principle. We want people to develop a lasting way of eating. If you go on a diet or when you go on a diet, people typically cut out certain foods that they fully intend to add back in later, and they typically restrict their caloric or their energy consumption significantly and not to a level that can be maintained. Yes, you may lose weight quickly that way, and for some people, that's important, you know, under medical supervision, yada, yada, yada. But for most of us, the preferred way to do it and the way to make a more lasting change is to figure out how we can eat healthfully and for nourishment in a way that makes sense for our own body. For people with eating disorders, this is a terrifying concept. They like numbers. They like to be within certain guidelines. If you're working with somebody with an eating disorder, you're going to have to really ease into this and respect their way of coping. Therefore, maybe looking at, instead of only eating 800 calories a day, let's look at what somebody your age, weight, size, gender, etc. How many calories you ideally are supposed to be getting to have healthy nutrition. And let's start working from there. That may make them feel a little bit more comfortable. A lot of times people with eating disorders are not ready or willing to quit counting calories and carbs and macros and, you know, all that kind of stuff. We want to work with them. For your person who doesn't have an eating disorder, helping Them recognize that we want them to be able to eat healthfully and eat what they want forever. Generally, if you eat for hunger and hunger alone and you stop eating when you're full, your body is going to help you stay at your biological set point, which is the appropriate generally weight for you. It may not be the same for your neighbor or your sister or your mother. It's the appropriate weight for you and your body will self regulate its energy requirements in that way. Yo yo dieting wreaks havoc on your body and leads to weight gain and low self esteem. Yeah, go figure. Yo yo dieting leads to weight gain, but we see it over and over and over again. People go on these restrictive diets for a period of time, then they get off the diet and they haven't changed their habits or the reasons that they're eating or how they're eating and the weight comes back on. And then some research has shown that recurring attempts to diet signals the body that food supply is often insufficient and leads to greater fat storage than if food was always abundant. When you work with someone with an eating disorder, for example, initially when they start eating a appropriate level of food, appropriate level of energy for them, they are probably going to gain weight and this is terrifying for them. We're talking about intuitive eating in general here. This is not a recommendation for necessarily someone with eating disorders, but I do feel it's necessary to point out some of these challenges. When the body realizes that there isn't a famine, then it doesn't hold on to fat quite as much. Dieting is correlated with the development of metabolic syndrome, which is characterized by central obesity, belly fat, insulin resistance and hypertension that increase the risk of type 2 diabetes and cardiovascular disease. They've seen that people who diet more often and especially tend to diet more restrictively tend to have worse overall physiological health outcomes. Dieting puts additional stress on the cardiovascular system, especially this yo yo dieting, because you, you'll lose a certain amount of weight in a period of time, but generally the weight comes back on a lot faster. And the cardiovascular system evidently has a hard time keeping up. And recurrent weight gain is associated with increased depression and hopelessness. So many people go in and they lose weight and they feel like, okay, I'm finally back down to whatever weight and then they gain it back and they feel defeated and oh, I don't want to diet again. And then they go on a diet again. And each time they go on a diet, a lot of times it gets harder. And we know the older we get, the Harder it gets to lose weight too. Therefore, it's important for people to, when we start helping them respect their bodies, that they set reasonable goals and focus less on. And this is kind of a pipe dream, focus less on numbers and weight and more on how they feel. So many people are not ready to do that, which is where, as clinicians, we need to step in and help them explore their relationship with their body image and with their body itself. We want to have people identify what they can do different, what they do differently. When they're on a diet, that can be helpful. If they've been on diets before and maybe they've restricted their calories and the way that they manage to not overeat when they're on a diet, for example, is to carry a water bottle with them so they stay feeling full more. Well, we know that a lot of times people eat when in fact that they're actually just dehydrated. That's not necessarily a bad strategy to start with. What else do you do when you're on a diet that can be helpful? Maybe they don't keep junk food in the house. That can be another good step to take. It doesn't mean you can't have junk food. It just means it's not there at 10 o' clock at night when you're trying to get sleepy and you're kind of restless or stressed out from the day. There are things, there are tools that people have developed when they've been on diets that help them stay on those restrictive diets, that they can transfer and help them use that they can transfer and use to help them stay on this intuitive eating plan, which is a lifelong plan. We try to avoid the word diet. It's a way of eating. It's a nutritional lifestyle. Encourage people to set small goals, such as paying attention to what they are eating. Mindful eating is so important in intuitive eating. Think about the last meal you had, or you may be sitting there listening to this webinar right now, eating and not really focusing on what you're eating. You're just listening to me talk and you may be doing your progress notes and eating with the other hand. That's not intuitive eating and that's definitely not mindful. When we pay attention to what we're eating, we tend to eat more slowly. And it sends our brain signals that, hey, we're getting, you know, some good food in here. Let's notice what it is. I have a bad habit of eating quickly. And sort of the joke around our house is, well, Mom, Will taste it in 30 minutes or so when the message actually gets to her brain. And that's not good. That is not a good habit to be in. So we want to help people start paying attention to what they're eating. And that can be a first goal. Even if they're not ready to reject the diet mentality yet, have them start focusing on their food and savoring. Encourage them to only eat when they're sitting down and not distracted. We don't want them walking through the kitchen and grazing. That's not intuitive eating. That's habit eating or stress eating. Or we'll talk about cognitive eating in a little while where you start thinking about, oh, that sounds really good. I need to have that right now. And you get hooked with that thought. I have to have a pizza right now. I have to have whatever. Checking in with yourself. Is your mind telling you that you're hungry, or is your gut telling you you're hungry? If it's your mind, then is it telling you you're hungry, or you just really want the flavors that you're envisioning? Encourage people to eat from dishes, not the box. And if you go and get fast food or something at lunchtime, you're not going to have particular dishes. I don't expect you to keep dishes at work. But encouraging people to not be, you know, having the whole bag of M and Ms. Or the whole bag of Oreos and just sitting there eating, get out a serving, whatever serving is for them, put it on a plate, and then notice what they're eating and how much they're eating. It is so easy if you're eating out of a box, to all of a sudden eat the whole box and be like, oh, my gosh, didn't even realize. Put it on a plate. And we talked earlier about potentially carrying a water bottle. That helps a lot of people who otherwise are often dehydrated coffee. Now I drink decaf, so it's a little bit different. But caffeine is a diuretic. When people are drinking Coke, Dr. Pepper, caffeinated coffee, tea, anything with caffeine in it, they're depleting the fluid in their body. You think, well, they're putting fluid in their body. Yes. And they're depleting it at the same time at a faster rate than they're replenishing it, which is why so many people, especially Americans, are chronically dehydrated. Encourage people to carry a water bottle. You can get the water bottles now that have the little insert that you freeze so it Stays cold all the time. I know, I prefer cold water. Remain aware of hidden forms of dieting. Some of our clients will try to argue or adopt certain methods of eating and say, well, this is not a diet, this is a lifestyle. This is a low carb lifestyle or a low fat lifestyle or a grain free lifestyle. Intermittent fasting. I only eat for the six hour window every day. Taking supplements to lose weight. When I was watching TV the other day, they had a supplement on that. The people were bragging that they didn't have to change their eating habits at all. They just took this supplement and they lost four times more weight. And I'm thinking to myself, well, there's probably a problem with that. I'm not sure what it is, but is that really what we want to do? And excessive exercise can also be a hidden form of dieting. Okay, I can eat this, but I have to do an extra two hours at the gym. Challenging people to look at why they're doing this. If they are eating low carb because they feel better when they are low carb and their doctor's good with it, well, that's fine. If they are eating low carb because they want to drop fat really fast and get extra lean, well, that's the diet mentality. We want to look at the rationale, not just the behavior, but the rationale behind the behavior. Encourage people to honor their hunger and become aware of their body cues. When are you hungry? And a lot of us really don't get hungry that often because we tend to not intuitively eat. And so our body never actually gets or rarely gets to that point of actually being hungry where you're like, oh my gosh, I'm so hungry I could eat the paint off the walls. Been there a few times. But just learn to differentiate between being hungry and thirsty. For me, when I'm thirsty, I have a feeling in the back of my throat. It feels kind of dry and tickly, if you will. Sometimes if I don't know, I just drink a glass of water first and wait 15 or 20 minutes. And if I'm still hungry, then you know, I have an idea. And sometimes your body is having you crave or cueing you that you want to eat a particular type of food. Salty, sweet, sour, something. Those tastes often indicate your body is telling you it needs something. And when we're eating, when we're craving salt, a lot of times our body may be having difficulty regulating our fluid. Could mean that we're dehydrated. That's beyond the scope of this presentation right now. But there's a lot of information out there about listening to your body cues and what different cues may mean. We'll talk about some of them in a little while. When people don't intuitively eat, sometimes they eat when they're not physically hungry because the clock says so. It's five o'. Clock. This is when we eat dinner. Gonna eat. No, that's not intuitive eating. That's eating by the clock. Or, you know, I am famished and it is 2:30 in the afternoon. That's not, you know, I ate lunch two hours ago and dinner's not for three hours. I can't eat right now. No, that's not honoring your hunger. If you are famished, if you are having those true body cues that you're hungry. You know, intuitive eating would say, you know, let's take a look at that. Some people eat when they're tired. You think, well, if maybe I'm tired because my blood sugar is low, so let me eat. Or I'm tired and I'm having a hard time falling asleep, so let me eat, maybe it'll help me get sleepy. It's amazing how we think food can both keep us awake and get us sleepy. A lot of people confuse exhaustion with hunger. Remember that our circadian rhythms are responsible for helping regulate the secretion of ghrelin and leptin, our hunger and satiety hormones. Therefore, if we are sleep deprived, our internal body cues are probably going to be somewhat out of whack anyway. Sleep is important. Some people eat when they are bored. When they're upset, they're bored. Nothing else to do. Let me grab a handful of peanuts or something. I'm upset. I'm going to comfort myself with a pint of ice cream or half a gallon or whatever it is for you. I'm happy. Let's celebrate. Let's go out to dinner and eat cake. All of those things we tend in American culture at least, we tend to eat for just about every emotion. I'm grieving. After my mother died, people were bringing food over constantly. And I was thinking, there's more food than we could possibly eat. But eating at least was soothing in some way. Is that the way to soothe our feelings? As clinicians, we can help people start developing tools of distress tolerance and effective coping. Therefore, when they feel an emotion, they may initially want to go eat. They may want to stress eat or anger eat or happy eat. But they can stop and recognize this is a feeling. I'm not wanting to eat for hunger. I'M wanting to deal or celebrate a feeling. What else can I do or celebrate to do to deal with or celebrate that feeling? Sometimes people eat because they're with people. You go out to dinner with your friends after work. You're not really hungry, but they're eating, and you feel weird just sitting there staring at them. Well, let's figure out how you can handle those situations if you still want to go out with your friends. No sense sitting around the house or going home just because you're not hungry. Other times, people eat because they're alone. They don't have other people around. So kind of goes with that whole boredom thing. I'm feeling lonely. Food is comforting. Yes. When we eat, it tends to increase dopamine and serotonin levels. This is true. However, there are other ways that we can do that besides eating. Because a lot of times when we're eating to increase neurotransmitters, we're not eating for hunger. We're eating for our heart. Some people eat when it's a habit, and that kind of goes along with the clock. I have a bad habit. When I come home, put my stuff down in the foyer, go directly to the kitchen. I don't even think, am I hungry right now? I think, I'm home. Time for me to get something to eat. It doesn't even have to be a mealtime when I'm cooking. Horrible habit that I'm working hard to break. Pay attention to your habits when you eat. When I was little, we used to go to the grocery store. My mother would always get some kind of junk food, and she would bring the bag of potato chips or whatever it was up into the car, and we would eat on the way home. That was just what we did when we went to the movie theater. It was a habit. We would just get popcorn. That's what you did when you were at the movie theater. It wasn't because we thought, oh, I'm starving. It was because that's what you did. It was a habit. And sometimes we eat because we want more. Dopamine is high, and dopamine is our pursuit chemical. And you ate something, it was really good. The dopamine says, oh, you want more of that? Well, that's cognitive eating. When we check with our stomach, a lot of times it says, no, you're really full, but our brain's going, but you want more? Well, yeah, I may want more, but do I need more? Am I eating for hunger? And in these times, we need to help people develop scripts to tell themselves to Help them put away the leftovers, they can eat it tomorrow. Think about how much enjoyment they will get being able to have it for a second day. However, they need to talk themselves off the ledge, so to speak. Quiet that voice inside their head that is hooked, as we would say in acceptance and commitment therapy, hooked on that thought. Have them separate that thought. Unhooking. We can use that act technique. Instead of saying, I have to have another serving, I'm having the thought that I have to have another serving. Having a thought, we can let thoughts go. Making peace with food involves forbidding. Forbidding unless it's medically contraindicated. If it's something you can't eat because you'll get anaphylactic shock or you're diabetic and it's something you just can't have, of course, no, most of the time. And a dietitian friend of mine told me this 25 years ago, if we forbid ourselves something, if we say, I can't have chocolate or I can't have pizza or I can't have ice cream, and then we start thinking about it, the more we say we can't have it, the more we perseverate on it, the more we perseverate on it, the more we set ourselves up for a binge. Forbidding. Forbidding is very useful. It's just a matter of figuring out, okay, maybe having unlimited chocolate and candy in my house is not a good idea for me to have around at those kind of weak times or whatever, when I'm not being super intuitive, but it doesn't mean I can't have them. I can have, I can keep snack packs, for example, in the freezer at the office. Something that can allow me to have a small amount, but. So I don't feel deprived, but I'm not as tempted to return to cognitive eating as opposed to intuitive eating, disinhibition and self efficacy. When. And they find the more people are restrictive about food, the more likely they are to disinhibit, which means if you're on a diet and you know you're only supposed to eat 800 calories a day and you have a big breakfast and you eat 450, 500 calories, which really isn't that big of a breakfast, people who tend to be more restrictive might disinhibit after that and go, well, I blew it. There's no way I can only eat 200 calories the rest of the day. I blew the day. I might as well just eat whatever. It's a Free for all. And there's a sense of no self efficacy there, no ability to control what they eat. Disappointment. We want to help people be able to reset more quickly. A lot of people with disinhibition, they don't reset until the next day. We can help people start to reset and think, okay, I overate at that meal or just now. It doesn't mean I have to continue to overeat for the rest of the day. But it also doesn't mean I have to not eat anymore for the rest of the day. We, we want to help them reset, just like we talk about in dialectical behavior therapy. Improve the next moment. All right, that moment, you know, I wasn't eating really intuitively, may have overeaten. How can I improve the next moment? How can I get back on the path of intuitive eating? We don't want people to get on that yo yo where they overeat and then they starve, because that again sets them up for overeating again and more disinhibition. Encourage people to address food phobias. This can be any food that people are, quote, afraid of. I can't eat that. That's just. I can't. That's not something I can eat because I'll gain weight or I won't be able to control what I eat. Encourage people to look at food that they've forbidden and why they've forbidden it and explore those fears about the food and their relationship with those foods. Challenge the food police. The food police are those voices in your head that tell you which foods to eat or not to eat. You know, you should eat this, but. And you shouldn't eat that. Well, you know, I don't like the word should. The food police tell you how much to eat. They are the ones that are looking at your plate going, really? Do you need that much? The food police tell you how much to weigh, when to eat. A lot of us grew up in families where the food police were part of the clean plate club. You were supposed to stay at the table until you finished your dinner. Didn't matter whether you were stuffed or not. You were supposed to stay there until you finished your food. A lot of us internalized that message. So we hear the food police going, you need to finish what's on your plate. The food police might tell you about who's judging you. Who else in the room is looking to see what you're eating and judging whether you should or shouldn't be eating that. And the food police, again, tell you what you should or shouldn't have eaten. We need to just shut down that food police, get in the moment and focus on what is my body telling me that want to eat, I need to eat. And we're going to talk in a little while about how to figure out how much to eat once we start recognizing the difference between hungry, full and stuffed. Help people explore where these voices came from. Where did the food police come from? The media. The media is horrible about that. Telling you how much you should eat, how much you should weigh, what foods are bad on any particular week you're cutting. Media is telling you to cut something out of your diet completely, which goes back to that whole forbid forbidding. Now, your family may have had very interesting rules around food. Other people may have made comments to you at one time or another. Maybe you were eating a bear claw and somebody walked by and said, you know, do you really need to be eating that right now? Oh my gosh, that would stick with so many people. Bear claw sounds really good right now. But I digress. Personal knowledge could be another place where those voices come from. And personal knowledge is a good thing that goes with intuitive eating. Personal knowledge says, you know, I know when I eat that I feel kind of sluggish for the rest of the day, so maybe that's not the best food for me. Or I know when I eat that I feel really good and energized. I that's good. That's where intuition comes in. Personal knowledge tells you, you know, what is it that helps you eat that? What is it that you can eat for breakfast in the morning that helps you stay full through the rest of the day? For some people, for example, oatmeal is a great breakfast because it has some stick to it. Iveness for other people, my husband eats oatmeal and an hour later he's ravenous. It's up to you and your personal knowledge to identify what to eat and what your body needs in order to make fact based choices, not emotion based, not what the media says. What does your body tell you and what makes sense for you and what makes you feel the best with this. You want to make sure that you don't insist on 100% compliance to any, anything even intuitive eating. Sometimes you're going to go back for seconds even though or thirds, even though you really weren't hungry anymore. That's okay. That goes with that disinhibition thing. All right, you weren't 100% perfect with your intuitive eating. What next? How do you get back on the path Just get back on that bike and keep going. Make peace with fullness. It takes about 20 minutes for your body to cue your brain that you're full. A lot of us can devour an entire meal in under 20 minutes. That means before our brain even has a chance to go, okay, you know, I think you're getting full. We've probably already overeaten. Your empty belly, when it's not distended, is about the size of your closed fist. Next time you're at a restaurant, or even if you're eating right now, take your closed fist and put it right next to that food or that big old plate of food and think to yourself, you know, full means I'm filling up my tummy. It doesn't mean I'm expanding it to 10 times its size. It helps you kind of conceptualize. Okay, you know, let's start thinking about what full might mean. Let me eat enough that it might fill up that space that's about the size of my fist and see what that feels like. This is how we start learning the difference between full and stuffed. We've all had those meals, especially Thanksgiving, and those times where we eat way more than we need to and we're uncomfortably full. It's on a continuum. You've got ravenous to stuffed, everything in between. Figuring out where comfortably full is. You're not still hungry, but you're not over full either. In order to do this, to make peace with fullness, we have to help people slow down. Encourage them to eat with their left hand. Takes a lot longer. Feels a lot more awkward. Probably don't want to do it in public. Have them take mini bites. They can cut their food up before they even start eating into very, very small bites. The cool thing about mini bites is you can take time to savor and identify different flavors. Figuring out what's kind of, what's the smallest bite I can take and get all of the flavor from this food. Fork down. Between bites, put your fork down. Or if you're eating something that's hand food, put the hamburger down. Put it down. Wipe your hands on the. On the napkin. Chew your food. I'm not a big one. I know you're supposed to chew your food like 20 or 30 times or something. I'm not going to count how many times I chew my food. I'll just be honest with you. And I start grossing myself out when I can hear myself chewing anyway. That's probably not going to be something I will do. May work for other people. I would rather focus on the flavors as I'm eating, you know, and sometimes the textures. Encourage people to remember that leftovers are going to be there to enjoy tomorrow once you're full, okay, let's put it aside and then you can enjoy it tomorrow and maybe even the next day and the day after that. Stay hydrated. Hydration helps us feel fuller, helps us feel more content and satiated, and encourage people to learn about foods and eating patterns that promote fullness for them. Higher fiber tends to make people feel fuller when we eat healthfully. When we have actual grains and vegetables and stuff in our diet, we tend to have more fiber, which tends to make us feel fuller and stay feeling fuller longer. Encourage people to use food for hunger, not emotions. Have them make a list of their feelings and ways to cope with or celebrate them without food. Every feeling. Wesley just said he tried to explain the concept of mini bites to his cat and she hates it. Oh yeah, cats are not intuitive eaters. They are extremely picky. But that's probably the funniest thing I've heard today. Anyway, make a list of your feelings and ways to cope with or celebrate them without food. When you're happy, what can you do to celebrate when you are sad or depressed or lonely? This kind of goes with those distress tolerance skills from dialectical behavior therapy. Whatever it takes for people, encourage them to have a list. And it's important to actually have that list written down because when they are emotional, when they're in their emotional mind, they may go for that autopilot response of eating. If they have a list, then they're more likely to at least check the list first. They may not like anything on there, but they'll at least check it first. Have people pause before getting food to notice if they're hungry or something else. Too often we just eat on autopilot. Encouraging people at least at the beginning to keep food journals. And they have lots of apps online which are really awesome. I suggest people keep online journal nutritional journals so they can get a breakdown which happens automatically in a lot of the apps of the vitamins and minerals they're getting. Then they can go back and look at what they've eaten and how they felt they may notice. You know, the usrda, the recommended daily allowance of the different vitamins is very generic. You know, about this much for every adult. Okay, well a six foot five, I don't know how many hundred pound man is going to need more vitamins than me at 5 foot 4. The RDA is a general guideline. You may not need as much or you may need a little bit more of certain nutrients to feel good. Check on those. Check at your nutrients on those days that you feel good and go, okay, you know, this is what I ate. These are the nutrients that I had. Okay, maybe my vitamin C was a little low. It is what it is. That's okay. The days you don't feel so good, take a look at what you ate. Maybe you realize you didn't get enough protein or whatever the case may be. It can give you ideas. If you're having particular cravings, pay attention to that. Look at your nutritional printout to figure out, are there particular nutrients that you might be low in? And what foods can you use to maybe supplement that nutri nutrient if that's something that. That you want to do. And I say foods because our body can synthesize food from nutrients from food a whole lot better than nutrients from a pill. And it is way too easy to OD on different nutrients, which throws the whole system out of whack. Try to get it from natural foods. Generally, if you're low in a particular nutrient, like magnesium, you may be craving a particular food like chocolate, and that's your body going, hello, Magnesium levels low. Got to have something. Or if your iron is low, you may crave red meat. I'm a vegetarian. I don't eat meat. And if I have this insatiable craving for red meat, I'm thinking, oh, I'd love a steak right now. That gives me a clue that my iron might be a little bit low or my vitamin B12. Either way, I know that there's something amiss because I just don't crave that. Encourage people. And that's where the intuition comes from, knowing what your body is trying to communicate. Checklists. If people aren't willing to keep journals, they can have a checklist that they go through before they eat. Am I hungry? Am I sad? Am I this? Am I that? And also, dishes goes back to that whole, don't eat out of the bag. If somebody has to put their food. They made the decision that they're going to put their food on dishes and not eat out of the bag, they may think twice before eating. I know I do. If the kitchen is all clean and shut down for the night, so to speak, and I get a craving for a snack, I may go in there and I'm like, you know what? Now I don't want to have to do a dish. And I already did the dishes for the night. Maybe it's just because I'm lazy, but it Works for me. Encourage people to reconceptualize food addiction and reclaim their power. Addictions are a coping response to dysphoria. It doesn't mean that you have complete control over all foods. Addictive behaviors, whether it's eating, drinking, sex, otherwise alter neurotransmitter levels. It increases serotonin, it increases dopamine, it increases endogenous opioids. They found that the core reasons for compulsive food consumption include reward driven eating as opposed to physiological hunger. People are often trying to eat to raise those dopamine and serotonin levels. They don't feel well, their neurotransmitters are out of whack. It's important to recognize why they're eating. Does it mean that they can't eat now because it's not physiologically driven? No, not necessarily. I mean, ideally they wouldn't, but I want them, at least in the beginning, just to start developing an awareness of why they're eating. Some people have a psychological preoccupation with food. That cognitive eating that I talk about. I'll watch commercials on TV, which is why I love the non commercial TV and I'll see something at 9 o' clock at night that just looks fabulous and I start thinking about it and perseverating on it and that could lead me to eat not for hunger, but because that sounds really good right now. Perceived lack of control around food often another reason for compulsive food consumption. People don't feel like they can control themselves if they have M&Ms. In the house or whatever. Part of this is autopilot and goes back to that preoccupation. They're hooked to their thoughts. They're telling themselves, if it's in the house, I cannot help but eat it. Well, let's unhook from that thought. I am having the thought that if it's in the house, I can't help but eat it and then start working, working through dealing with those thoughts. And some people compulsively eat because of frequent food cravings, which can be because of emotional reasons. But when we're taught. What I'm talking about here is more persistent nutritional deficiency. They're not getting enough of something and so they're regularly craving those foods. Foods that are high in fat and foods that are high in carbohydrates are most notorious for increasing dopamine and serotonin levels and helping us feel better, if you will. Food is also associated with past experiences. If you're eating a brownie and you remember Going back, you know, when you were a kid making brownies with, with your mom or your dad and eating brownies and it was a happy time, then you may eat a brownie because not only does the sugar and the fat increase your serotonin, your dopamine, but the positive memory ramps it up even more. Want to pay attention to what's the benefit I'm getting out of eating right now? Is it satiating my hunger or is it filling my heart? Encourage people to respect their body. Embrace body positivity. Stop comparing yourself to everybody else on tv, in your office, at church, in the store. You are you. Nobody is made exactly the same. Encourage people to explore themselves as a person. Your body, your physical body is one aspect of you as a person. Let's talk about what else. What else is there that makes you, you and you special and you awesome as a person? If for some reason, you know, some science fiction land, your brain was transplanted somewhere else and your body just ceased to be and you were, you know, in a computer, what would make you awesome as a person without that body? Explore what size means to you and why. A lot of people with eating disorders have very rigid thoughts and very negative thoughts associated with larger sizes. It represents to them characteristics that they don't want to have. It's important for people to start examining that and figuring out, so what if I'm not a size 4, 2, 1, whatever it is. So, you know, what does that mean? What does it mean to be a size 16 or a size 24? What does that mean to me? And why encourage people to wear comfortable clothes? It is, you know, some of us have the tendency, especially like after you have a baby and stuff, that you want to get back into those pre baby clothes. So you're sucking it in and you're uncomfortable all day long. Well, that wears out your energy and it kicks up your HPA axis and it's just unpleasant. Let's be respectful to your body. You know, you just had a baby. Let's give it a little bit of slack here. Wear comfortable clothes. As your body gets back in sync, you'll get back to your biological set point. Which brings us to throw out the scale. People's weight can yo, yo as much as five pounds on any given day for a lot of reasons that, you know, I will let your mind figure out. That can throw people into a complete tailspin. Throw out the scale. Encourage people to judge how they're doing. If they want to judge their weight somehow or their health by how they feel and how Their clothes feel on them. You know, if your clothes feel like they're starting to get a little tight, then you might want to check, you know, whether you're eating intuitively or eating emotionally. Being chained to the scale increases most people's stress levels. Increased stress, interestingly enough, increases cortisol, which also increases belly fat. If you have difficulty maintaining a healthy weight, encourage people to get screened for diabetes. That can make it difficult for people to keep a healthy weight. Pcos, which is polycystic ovarian syndrome, or hormone imbalances, which can contribute to hunger, it can contribute to low thyroid. It can contribute to a lot of things. Thyroid imbalances. Hyperthyroid can make people keep a weight that's too low because their thyroid is going over time and they're hungry all the time. Hypothyroid tends to lead to weight gain and is really a lot more common than you might think. And it can be present in children, and you can get it at any point. You can be going through your whole life, and then all of a sudden you're 45, you go in for your physical, and the doctor says, you know what? Your thyroid's a little low. If people start feeling sluggish, start feeling a little depressed, get them screened for thyroid. It's, you know, a standard blood test. Depression can also make it more difficult for people to maintain a healthy weight because their energy is low, so their movement is low, and they're probably going to tend to be craving those comfort foods. That may help increase serotonin and dopamine and sleep disturbances. As I said earlier, your sleep helps set your circadian rhythms. Your circadian rhythms help regulate the influx and the levels of ghrelin and leptin, which are the hormones that let you know that you're hungry or you're satiated. If those get out of whack, then you're not going to necessarily know when you're hungry and when you're full because those hormones are not in balance. Exercise, intuitively, exercise increases energy and oxygenation. Exercise easily. I'm not saying go out and do 95% of your VO2 max. Actually, we'll get to that. Exercise improves sleep. They've shown in multiple studies that it helps improve sleep. It reduces cortisol, which is responsible for some belly fat. It's also responsible for some anxiety and other symptoms. They found that low intensity at 40 to 50% of your target heart rate training zone, which is not very high at all, helps reduce cortisol. That is a easy walk around the block or Whatever that's not going on a run or going to the gym necessarily. Exercise increases serotonin, which impacts hunger and depression. Serotonin helps regulate our hunger cues. Melatonin is made from serotonin. So if you have enough serotonin, you have enough melatonin, you're probably gonna sleep well. And serotonin we know is somehow not quite sure how yet involved in depression. And so we do want to pay attention to that. If we exercise, we increase serotonin and it may reduce stress, possibly through distress tolerance. You've had a bad day and you go to the office or go after the office, you go to the gym and work out. You may be working out some of that stress that built up during the day, some of that cortisol that's circulating through your body, which can help you relax and get better sleep and feel better. Now, sleep is the one that they don't talk about in the book. And I think it is so important, as you can tell, because I've talked about it multiple times. Sleep deprivation significantly increases ghrelin levels. Those are your hunger levels and is associated with a higher consumption of calories. Even one to three hours of sleep deprivation can make people start craving more, more food. The ghrelin levels go up and the leptin levels go down. We're not exactly sure why. Stress, shift work, pain medication, side effects, alcohol, sleep apnea, just plain old poor sleep hygiene or having infants in the house or anything else can go to cause somebody to be sleep deprived. Encourage clients to do a sleep hygiene survey to make sure that they're getting enough good quality sleep. Honor your body with good nutrition. When you're depressed, exhausted, angry or stressed, you will often crave comfort foods which are low in nutritional value. Oreos sound really good, but they ain't got much to them but sugar. Poor sleep is associated with depression and anxiety as well as disrupted ghrelin levels. When you have poor nutrition, it contributes to depression, exhaustion and irritability. Poor nutrition. So what are we talking about here? In order to make dopamine, which is our, you know, one of our pursuit chemicals, motivation chemicals, energy chemicals, you need to have tyrosine, which is an amino acid. You need to have B6 and you need to have iron. In order to make serotonin and melatonin, you need to have calcium, B6, magnesium, iron, folic acids, zinc and vitamin C. In order to make norepinephrine, which is your focus chemical and one of your excitatory chemicals, you need tyrosine, that amino acid, B6C and iron, and to make glutamate from glutamine, the amino acid. There are over 107 regulators and cofactors that the body needs. Wasn't even going to try to list all of those. And with serotonin, the amino acid you need is tryptophan. You can get all of these from a relatively healthy diet. It doesn't have to be crazy strict. Eat colorfully. Eat things that are what you would consider nutritious. This is a little slide that just kind of shows you. For serotonin, tryptophan needs iron, magnesium, calcium, B6 and folic acid to convert it to 5 HTP. Then they need vitamin C, B6, zinc and magnesium to convert it to serotonin. And if you don't have enough serotonin, you can have gut and heart problems, sleep problems, cravings for carbohydrates and certain drugs, fibromyalgia and other pain conditions. Nutrition is so important and intuitive. Eating will help people make sure they're getting all these nutrients. The body knows when it's low. Good nutrition, gently. And this is really important. If people are trying to become intuitive eaters, that doesn't mean they're going to say, okay, I'm going to turn my life around and only eat nutritious food. Well, let's go gently. Let's start making small changes. One change a week. Maybe have them make a list of foods that they love. Macaroni and cheese is one of my favorites. Do I eat it every day? No. But I do periodically make it because it's a food I love. It's good nutrition. Encourage people to try a new recipe each week. Notice how they feel after they eat certain things. Have people eat colorfully. And my friend who is the dietitian suggested to my class one time, you know, when you have a plate of food in front of you, there should be at least three different colors, not varying shades of white and brown. Three different colors on your plate at each meal that will help you get good nutrition. Figuring out, you know, the food pyramid and how many servings of this and how many servings of that. Most people don't have that kind of patience or desire to be quite that analytical. Three colors is pretty easy to figure out. Take what you want and put half back. Our eyes are usually way bigger than our guts. Take what you want. That looks good. Put half back. If you're still hungry afterwards, you can go back for seconds. Use a smaller plate. A dinner plate is way bigger than your fist. I use the salad plate. At our house, when we eat, because it's a smaller and it tricks your brain into recognizing or it tells your brain how much you're eating. When you have a big plate, you only have a little bit of food on it. Your brain thinks, hey, I'm getting chipped. Well, use a plate that's appropriate for the amount of food that you're eating. Keep binge foods out of the house, but not out of your life. If you love pizza, well, maybe, you know, periodically you can go out for pizza or order it in, but only order one pizza. Avoid buffets if you have to get your money's worth. You know, I can't go to a buffet without, you know, thinking, oh, I need to go back and, you know, get my money's worth. Well, that's not intuitive eating. That's, you know, gorging. Keep a nutrition log to learn what your body needs. And we talked about that online. It's great. It does it automatically for you. Now, back in the day, you know, I used to have to write all those things down. I love being able to just pull it up and see, you know, generally what I'm getting. Plan your menu of options and prepare ahead. Make sure that in your pantry or your refrigerator, you have, you know, six meals, six types of meals that you could make and prepare ahead of time. That way you're not getting home going, I am ravenous. I am going to eat the first thing I see, and then the second and the third and the fourth. If you have your meals ahead of time in our house, I will make pasta ahead of time. I'll make rice ahead of time. I will make a lentil loaf ahead of time. And then I can combine them in different ways with different vegetables and things throughout the week. Because by the time I get home from work, I'm not really thinking of being, you know, whoever some famous chef is. Close the kitchen once you finish eating for the day. Do the dishes, clean the sink, and then the kitchen is closed. A lot of times we won't want to disturb the cleanliness and go back in there and make a mess. And as I said multiple times, keep a water bottle with you. Significant evidence indicates episodic dieting and yo, yo, weight loss is physically and psychologically harmful. Intuitive eating teaches people to pay attention to the signals their body sends them. Learn to differentiate between hunger, exhaustion, emotional states, and compulsive thinking. And address the underlying issues of cravings and excessive hunger. And when I say underlying issues, again, I'm referring to any physiological issues that may be going on, such as sleep deprivation that is increasing your ghrelin levels and your cortisol levels too high. As I said at the beginning, this was just the highest, highest level of overview Introduction to Intuitive Eating. If you want to learn more about intuitive eating, Neuharbinger has two books and these are the people who developed intuitive eating. So these are the Go Buy books, the Intuitive Eating Workbook and the Intuitive Eating Workbook for teens. You can get that@newharbinger.com you can save 25% on your whole order. This, this particular order with promo code 1168. Snipes. Are there any questions? I was afraid I wasn't going to get through by one o', clock, but I managed to pull it through. Wesley asks, where would multivitamins fall in all this? Well, our body synthesizes food from nutrients from food a lot better than nutrients from multivitamins because they are limiting factors. When you eat one vitamin, it may enhance other vitamins and restrict the availability of other vitamins. When food is present in the ratios, whatever the ratios are in the healthy foods, then they are in the right ratios to be bioavailable to your body. Does that mean that nobody should ever use a multivitamin? Not necessarily. I know there are a lot of doctors who are actually recommending against them now, but there are a lot of doctors who still recommend them. That's a medical decision. As far as multivitamins impacting hunger, no, they haven't really found an impact on hunger throughout the day of multivitamins. What we do know is if somebody is super deficient in a particular vitamin or mineral, then they're probably going to have cravings. But cravings are different than hunger. Like I was talking about the red meat craving. I can have that craving and not be hungry at all. But I can be thinking, you know, I would give anything for a steak right now. Encouraging people to pay attention to their cravings. So at their next, at the next time that they're hungry, they might be able to satisfy that. And again, going back to that, not insisting on 100% compliance, there are going to be times when people may throw their hands up and just be like, you know what? Screw it, I want to eat right now. And it could be because of grief, it could be because it is a celebration and you know, somebody has cake. Whatever the case is, it's a matter of being kind to yourself and then getting back on the horse. Not staying on the emotional eating path or the cognitive eating path, but at a certain point saying, okay, I allowed myself to experience that emotion or to, you know, do what I had to do. Now I need to, you know, get back on the intuitive eating bicycle, so to speak. Between writing notes, filing insurance claims and scheduling with clients, it can be hard to stay organized. That's why I recommend Therapy Notes. Their easy to use platform lets you manage your practice securely and efficiently. Visit therapynotes.com to get two free months of Therapy Notes by just using the promo code CEU when you sign up for a free trial at therapynotes.com. If this podcast helps you help your clients or yourself, please support us by purchasing your ceus@allce.com or getting your agency to sponsor an episode. A direct link to the on demand ceus for this podcast is@allce.com podcastceus that's allce.com podcastceus to sponsor an episode of Counselor Toolbox and reach over 50,000 clinicians per week. Go to allce.com Sponsor thank you.