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Intuitive Eating – another fad? Or something more…

Intuitive Eating – another fad? Or something more…

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You may have recently heard the words “Intuitive Eating” or “Mindful Eating” in the news, on social media, or in a post on your favourite blog. The Globe and Mail even wrote a lengthy article in early January stating that intuitive eating is the new “non-diet” of the year. But what exactly is intuitive eating, and can it really help you improve your relationship with food and your body?

Intuitive eating is an approach to eating that shifts away from rules, rigidity around eating, and dieting. It encourages listening to your internal cues for hunger and responding by eating food that you enjoy and that makes you feel good both physically and emotionally. We have now seen that intuitive eating has been shown to improve both our physical and psychological health over the long-term (Bacon, 2010; Van Dyke & Drinkwater, 2014). If intuitive eating doesn’t sound all that fancy, it’s because it isn’t. Intuitive eating is essentially a much-needed back to basics approach, where we are encouraged to focus on our individual needs and preferences as a guide to developing a balanced relationship with food. You won’t find any “good” or “bad” foods in this approach, nor will you be encouraged to cut certain items out of your routine. The idea here is to stop looking outwards for a diet guide on how to take care of your body, and to begin looking inwards to better figure out what YOU need to feel good.

A good parallel here is when you think of an infant’s relationship with food. Infants cry when they’re hungry, and typically slow down their feeding when they’re full. Then they cry again when they’re hungry, and the cycle continues. Infants don’t ask themselves “how many calories are in my milk?” or “I can’t be hungry yet, I just ate!” or even “the other babies aren’t eating this much, why am I?!” – they simply listen to their bodies, feed when they’re hungry, and stop when they’re full. Pretty cool, right? Unfortunately, between infancy and adulthood, we’re inundated with messages about what we should or should not eat, how we should or should not look, and how anything less than the “thin ideal” or a “clean diet” is ground for shaming ourselves and others. As a result, we’ve naturally lost our inner compass, our inner guide that helps tell us what we need and want to feel satisfied.

Essentially, you and only you can tell yourself what your body needs, and it’s time to start listening.

So, how do we go about transitioning from focusing on external cues for eating to focusing on our internal needs? The following is a brief guide that will help you begin your intuitive eating journey, alongside some helpful reading recommendations to dig deeper into this subject.

Step 1: Learn to accept our bodies as they are, let go of diet culture

  • This is a really difficult step, and yet it’s essential. Letting go of thin ideals and shaming our bodies allows us to not only feel more connected and comfortable in our skin, it also lets us stop trying to control our eating behaviours with the goal of shrinking our bodies. If we can accept our bodies as they are, food can become about meeting our needs and experiencing pleasure, as opposed to an attempt to control and punish our bodies under the guise of ‘health’. When we try to use food to control our body size, i.e. when we try to diet, we have to retain that level of restriction in order to keep pushing down our weight. There is no freedom to ask ourselves what do we like, what are we in the mood for, how much would we like to enjoy? Instead, we are focused on “what am I allowed to eat?” in order to maintain this control. This approach ultimately backfires for most people as well, resulting in binge eating in an attempt for our bodies to finally feel that their needs are met. For these reasons and more, letting go of diet culture and accepting our bodies is crucial.

Step 2: Start getting curious about your personal hunger cues

  • We spend so much of our time assuming we should or should not eat because of the time of the day, because of what others are doing, or because of what we have eaten previously. None of this is focusing on what our body is asking for, so start by simply being mindful of your bodily cues for hunger. Do you feel a growl in your stomach? Do you suddenly have fantasies about different meal options? Does your concentration decrease slightly?

Step 3: Ask yourself what it is you’d like to eat.

  • What are you in the mood for? What do you have available? There is no right or wrong answer here, only you know what you’d like to eat!

Step 4: Eating mindfully.

  • Try to slow down, taste the flavour, the texture, and the temperature of your food. Notice how your pleasure for certain flavours changes throughout the course of your meal. Check in with your fullness cues. Are you feeling full half way through your meal? Are you still hungry at the end of your meal? Use these cues to guide yourself in either slowing down and finishing your meal or adding an extra snack to ensure that you’re satisfied.

Step 5: Be compassionate, non-judgemental, and flexible with yourself

  • Each meal is a learning opportunity. Sometimes we don’t feel full during a meal but then feel stuffed 30 minutes later. This helps us learn for the next time that we might need a little bit less of this specific recipe, or that we want to eat more slowly in the future. There is no “bad” or “good” way of doing this, it is simply a curious and open learning experience each time.

  • There are often reasons that we eat that are independent of our fullness cues, such as when a meal is really delicious and we’re willing to feel extra full in order to keep enjoying it, or when we know we’re only going to have a small window to have a meal during our workday. All of these situations are part of the fabric of intuitive eating. The idea is not to do this “perfectly” – in fact, that’s the exact opposite of the idea. The goal is simply to start becoming more curious about what your body needs and why it’s asking for what it needs in any given moment.

  • Become curious about other reasons that we might be eating, such as to hold onto pleasure, push back boredom, or cope with difficult emotions. These different motivations for eating are not problematic, they’re simply worth noticing. If we’re eating for reasons that are unrelated to our hunger and energy needs, then we might wish to expand on other ways to have those needs equally met, so that we have options in the future.

Ultimately, intuitive eating is about finally allowing yourself to accept and celebrate your body, and beginning to re-acquaint yourself with your inner guide for how to strengthen your relationship with food.


Tobey Mandel is a clinical psychologist in Westmount, Montreal, Quebec, at Connecte Montreal Psychology Group. The team at Connecte loves writing about ways to boost our mental health and bring psychology into our everyday lives. For more helpful tips, check out Connecte’s blogspodcast, follow @connectepsychology on Instagram or like us on Facebook.


References

Van Dyke, N., & Drinkwater, E. J. (2014). Relationships between intuitive eating and health indicators: Literature review. Public Health Nutrition, 17, 1757-1766.

Gagnon-Girouard, M. P., Bégin, C., Provencher, V., Tremblay, A., Mongeau, L., Boivin, S. Lemieux, S. (2010). Psychological Impact of a "Health-at-Every-Size" Intervention on Weight-Preoccupied Overweight/Obese Women. Journal of Obesity, pii: 928097. doi: 10.1155/2010/928097

Tribole, E., & Resch, E. (2012). Intuitive eating: A revolutionary program that works. Third Edition. St. Martin’s Press.

Bacon, L. (2010). Health at every size: The surprising truth about your weight. Dallax, Texas: BenBella Books, Inc.

My cancer experience… as an outsider looking in

My cancer experience… as an outsider looking in

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Friday, August 31st, 2018 will be the last day of my postdoctoral fellowship at the Psycho-Oncology Center of the Sainte-Justine Hospital. Wednesday, September 3rd, 2008 was the beginning of my doctoral studies and my thesis focused on breast cancer and one of my clinical internships was at the Psychosocial Oncology Program of the Jewish General Hospital. Since it has been close to 10 years that I have been involved in cancer research and clinical work, I thought I would share some of what I have learned thus far.

The first thing that comes to mind is how resilient people are throughout their cancer trajectory (diagnosis - treatment - survivorship or end of life). Indeed, it requires great strength to be able to cope with a life-threatening diagnosis and adapt to lifestyle changes that can have permanent consequences. A study reviewed 57 published articles and found several personal attributes and characteristics related to resiliency throughout different cancer phases such as optimism, hope, realistic expectations, social support, spirituality and supportive provider communication, etc (Molina et el., 2014). In sum, it is of utmost importance to promote resiliency to meet the psychosocial needs of patients whether they are undergoing treatment, their treatment is completed or whether they are in palliative care. In fact, several cognitive behavioral and existential interventions have been elaborated to foster resiliency to improve quality of life and enable psychological well-being or posttraumatic growth (Loprinzi et al., 2011; Lee, Robin Cohen, Edgar, Laizner, & Gagnon, 2006). 

 

Forces beyond your control can take away everything you possess except one thing, your freedom to choose how you will respond to the situation.

― Viktor E. Frankl

 

The second thing that comes to mind is the word distress. I have read, heard and witnessed that word countless times throughout my cancer experience. Distress is the 6th vital sign in a cancer population and it is estimated that 33% of the cancer population suffer from significant distress (Howell et Olsen, 2011). Also, it has been associated with worsened health-related quality of life, lesser treatment adherence and lower satisfaction with care (Howell et Olsen, 2011). Although it is recommended to screen for psychological distress along the cancer continuum, it has been reported that patient’s distress often goes unnoticed and the patients are not referred to psychosocial services available (Cohen, 2013; Johnsen et al., 2013; Mitchell, 2015). Also, patients considered as “survivors” report distress as several struggle to find a new sense of normalcy or cope with adverse long-term effects.

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Considering that approximately 1 in 2 Canadians will receive a cancer diagnosis in their lifetime and that the survival rate after 5 years is estimated to be 60% (Canadian Cancer Statistics, 2017), it becomes apparent how assessing psychological distress and promoting resiliency is imperative to enable psychological well-being and improve quality of life throughout the cancer trajectory. There are several resources available: several hospitals have a psychosocial oncology department offering several services (psychologist, social worker, spiritual aid, musicotherapy/artherapy, mindulfness/yoga interventions). The Canadian Cancer Society also has a community service locator which is a directory of different services available for patients or caregivers. Lastly, I have suggested several books to patients who have completed their treatment and are seeking support and struggling to find their “new normal”. Please see below for the list of resources and books.

Dans cette tranche de vie, il n’y aura eu ni duel, ni vainqueur, ni vaincu. Juste un magistral coup de poing, des descentes aux enfers sans demi-mesure et ce bain d’humanité

 ― Françoise Stanton, extrait d’un témoignage tiré du livre Tu n’es pas seule

The last point I would like to make is that although my focus has been on the “patient”, I would be remiss not to mention the family and friends of said patient as their cancer experience matters as well. They too show great strength and can experience distress which can go unnoticed, and they too can benefit from some of the above-mentioned resources.

Finally, what I learned thus far is how much I want to keep learning, broaden my cancer experience and share my knowledge.

Stay tuned!


Annélie S. Anestin est une psychologue à la clinique Connecte Groupe de psychologie de Montréal. L’équipe de Connecte aime bien écrire sur les diverses façons d’améliorer notre santé mentale et inclure la psychologie dans notre vie quotidienne. Pour plus de conseils utiles, consultez les blogues de Connecte, les baladodiffusions, suivez-nous sur Instagram @connectepsychology ou aimez notre page sur Facebook.


Books

  • Tu n’es pas seule, L’expérience du cancer : paroles de femmes. Collectif dirigé par Dominique Lanctôt, Les éditions de l’Homme, 2015, qc
  • Man’s search for meaning, Viktor E. Frankl
  • La route du sens, L’art de s’épanouir dans un monde incertain, Jean-Louis Drolet

Links

References

Ministère de la santé et des services sociaux. La détresse des personnes atteintes de cancer : un incontournable dans les soins. Édition: La Direction des communications du ministère de la Santé et des Services sociaux. http://publications.msss.gouv.qc.ca/msss/fichiers/2017/17-902-11W.pdf.

Molina Y, Yi JC, Martinez-Gutierrez J, et al. Resilience Among Patients Across the Cancer Continuum: Diverse Perspectives. Clin J Oncol Nurs. 2014; 18:93-101.

Loprinzi CE, Prasad K, Schroeder DR, Sood A. Stress Management and Resilience Training (SMART) program to decrease stress and enhance resilience among breast cancer survivors: A pilot randomized clinical trial. Clin Breast Cancer. 2011; 11:364–368.

Lee V, Robin Cohen S, Edgar L, Laizner AM, Gagnon AJ. Meaning-making intervention during breast or colorectal cancer treatment improves self-esteem, optimism, and self-efficacy. Soc Sci Med. 2006; 62:3133–3145.

Howell D, Olsen K. Distress- the 6th vital sign. Curr Oncol. 2011;18:208-210.

Cohen, M. The Association of Cancer Patients' Emotional suppression and their Self-rating of Psychological Distress on Short Screening Tools. Int J Behav Med. 2013: 39;29-35.

Johnsen, A.T., Petersen, M.A., Pedersen, L., Houmann, L.J., & Groenvold, M. (2013). Do Advanced Cancer Patients in Denmark Receive the Help they Need? A Nationally Representative Survey of the Need Related to 12 Frequent Symptoms/Problems. Psychooncology. 2013; 22:1724-30.

Mitchell, A.J. (2015). Screening and Assessment for Distress. Oxford University Press: New York.

Canadian Cancer Statistics, 2017. http://www.cancer.ca/en/about-us/for-media/media-releases/national/2017/canadian-cancer-statistics-media-fact-sheet/?region=on.