Can I Practice Intuitive Eating if I Have a Food Related Medical Condition?

A common question I get from new intuitive eaters is whether you can practice intuitive eating if you have a food related medical condition. You’ll be happy to learn that the answer is yes! Read on to learn how gentle nutrition and intuitive eating fits with medical nutrition therapy.

This post is a sneak peek at my new book, Gentle Nutrition, which is being release on the 23rd. Place your pre-order today on Amazon, or support local bookstores and order on Bookshop!

Perhaps you are reading this as someone with a health diagnosis, who has been told to manage your condition with a strict diet. If that’s the case, you may be wondering if intuitive eating is for you. The way intuitive eating is often portrayed on social media is with cute quips about ditching diets and no food rules and many, many donuts. When your doctor, the person you’re supposed to be able to trust to give sound advice for treating and managing your medical condition is telling you it requires a special diet, it’s easy to write intuitive eating off.

Unfortunately, diet culture has infiltrated healthcare, and this has resulted in people often being prescribed diets much stricter than necessary when they’re diagnosed with a nutrition-related health condition. With minimal training in nutrition, doctors can be just as susceptible to nutrition misinformation as anyone else. Most doctors have very little understand of what nutrition advice is realistic or sustainable. Some of my clients have been told to follow a “zero-sodium diet” for hypertension (this would kill you) or to cut out all carbohydrates for diabetes. And I have seen fad diets like intermittent fasting and keto recommended to my clients for conditions, ranging from PCOS to gastric reflux to cancer— conditions in which there is next to zero evidence supporting the use of these diets. In my experience, clients are just as likely to learn about a fad diet from their doctor as they are a friend or online.

Intuitive Eating, Gentle Nutrition and Food-Related Medical Conditions

In most cases, gentle nutrition can be used to manage food related health conditions. Often, it’s a matter of directing the mindset toward positive nutrition and zooming out to see the big picture. For example, instead of eliminating refined grains and following a low-carb diet for diabetes, one can focus on increasing whole grains and eating consistent amounts of carbohydrate throughout the day. Or, instead of following a strict low-fat diet for high cholesterol, it would be smart to focus on increasing monounsaturated fats, cholesterol-lowering high-fiber foods, and antioxidant rich fruits and vegetables. If you can, I encourage you to work with an intuitive eating and Health at Every Size®-aligned dietitian. Alternatively, you may be able to find intuitive eating resources for your condition online. I have a blog series on intuitive eating for IBS, diabetes, and PCOS and I love these HAES- aligned nutrition therapy handouts created by dietitian Meghan Cichy.

Occasionally, more rigid nutrition approaches may be indicated, or even the restriction of certain foods. For example, a gluten free diet for celiac disease, or counting carbohydrates to help dose insulin for people who use rapid-acting insulin as part of their medical regimen. Other times, you might find limiting certain foods is helpful. For example, I have a client with diabetes who is very reactive to added sugar. For most people with diabetes, they can include sugar in moderate amounts along with fat, protein, and/or fiber, and not experience a major fluctuation in blood glucose levels. However, this client has had diabetes for a long time and is more sensitive, experiencing big spikes followed by drops in her glucose levels that leave her feeling pretty awful. What she has found is that limiting added sugar, using other ways to sweeten foods (including sugar substitutes), while also leaving flexibility for fun foods on occasion has helped her manage her glucose levels without feeling too restricted. That’s not to say she never feels restricted - she does sometimes! - but it’s a conscious choice she’s making that’s rooted in self care, not deprivation.

In considering nutrition therapy for health conditions, it’s helpful to revisit the hierarchy of nutrition needs. For every health condition I can think of, the bottom three tiers of the pyramid are the same for everyone. Whether you have an autoimmune condition, IBS, diabetes, or PCOS, your body still needs the same nutritional adequacy, balance, and variety as everyone else. There may be adaptations to the top tier of the heirarchy to individual foods and nutrients that can help manage medical conditions, but if the bottom three needs are not met, these changes are unlikely to help.

That said, you get to define what gentle nutrition looks like for you. If you find through experimentation that you feel better eating in a way that perhaps looks more “rigid” from the outside, that’s perfectly fine. It can feel scary to receive a health diagnosis, and if you feel more comfortable managing it with a specific way of eating, there is nothing wrong with that. For some serious or life-altering diagnoses, you may be willing to try anything, including strict dietary approaches. It may not align with intuitive eating, but you get to decide how you want to care for and feed your body. I just hope that you will be honest with yourself about the physical and mental effects of it and stop doing anything that isn’t working for you.

What if I Have Been Told to Lose Weight to Manage my Medical Condition

If you are at a higher weight and have a health condition for which you have been told to lose weight, I am so sorry that you were given lazy medicine. Weight is not health, and there is no medical condition that affects only fat people. Even if losing weight could help a medical condition, there are no diets that have been shown to result in sustained weight loss for more than a small number of people. If a doctor, a dietitian, or any healthcare provider has told you to lose weight to manage your condition, that’s like they’re prescribing to you a medication that works less than 5 percent of the time. So, here’s something you could do: ask your provider what they would recommend for someone with a BMI of 22. More than likely, their recommendation is going to be the best approach for you too. There isn’t a separate set of nutrition rules for people with bigger or smaller bodies— nutrition is nutrition!

If this blog post was helpful, follow my intuitive eating Pinterest board for more inspiration.