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    The author and publisher have provided this e-book to you for your personal use only. You may not make this e-book publicly available in any way. Copyright infringement is against the law. If you believe the copy of this e-book you are reading infringes on the author’s copyright, please notify the publisher at: us.macmillanusa.com/piracy.

    To all of our clients and patients, who have taught us so much

    Acknowledgments

    There are many people whom we would like to thank, without whose help, encouragement, and inspiration this book would not have been possible.

    David Hale Smith, Inkwell Management, LLC, our agent, who was instrumental in generating overwhelming interest in this concept.

    Jennifer Weis, our editor, for her enthusiasm and support of Intuitive Eating and for her practical vision and input.

    Mollie Traver, editorial assistant, for her clear and prompt communication, inspired ideas, and boundless encouragement in bringing the third edition of Intuitive Eating to fruition; Robin Carter, assistant editor, who good-naturedly helped expedite the publication of the second edition of Intuitive Eating; and Tina Lee, editorial assistant, who cheerfully kept us on the straight and narrow with details in the first edition.

    Desy Safan Gerard, Ph.D., for her psychological support.

    Marc Weigensberg, M.D., who contributed spiritual guidance for the second and third editions.

    Sue Luke, R.D.; Elaine Roberts; Diane Keddy, M.S., R.D.; and Kristin Loberg, B.A., member of the Authors Guild, for their review and comments.

    Arthur Resnikoff, Ph.D., for his feedback on the psychological principles used in this book.

    Andrea Volz, secretarial assistant, for her endless hours in the library.

    And lastly, our families and friends, whose unselfish understanding gave us the freedom to complete this book.

    Notice: This book is intended as a reference volume only, not as a medical manual. It is not a substitute for any treatment that may have been prescribed by your doctor. If you suspect that you have a medical problem, we urge you to seek competent help. Keep in mind that nutritional needs vary from person to person, depending upon age, sex, health status, and total diet. The information discussed here is intended to help you make informed decisions about your eating and health.

    Contents

    Title Page

    Copyright Notice

    Dedication

    Acknowledgments

    Notice

    Foreword

    Introduction

    1. Hitting Diet Bottom

    2. What Kind of Eater Are You?

    3. Principles of Intuitive Eating: Overview

    4. Awakening the Intuitive Eater: Stages

    5. Principle 1: Reject the Diet Mentality

    6. Principle 2: Honor Your Hunger

    7. Principle 3: Make Peace with Food

    8. Principle 4: Challenge the Food Police

    9. Principle 5: Feel Your Fullness

    10. Principle 6: Discover the Satisfaction Factor

    11. Principle 7: Cope with Your Emotions without Using Food

    12. Principle 8: Respect Your Body

    13. Principle 9: Exercise—Feel the Difference

    14. Principle 10: Honor Your Health with Gentle Nutrition

    15. Raising an Intuitive Eater: What Works with Kids and Teens

    16. The Ultimate Path Toward Healing from Eating Disorders

    17. The Science Behind Intuitive Eating

    Epilogue

    Appendix A: Common Questions and Answers About Intuitive Eating

    Appendix B: Step-by-Step Guidelines

    References

    Resources

    Index

    Also by Evelyn Tribole

    About the Authors

    Copyright

    Foreword

    This [the brain’s] integrative function illuminates how reasoning, once thought to be a “purely logical” mode of thinking, is in fact, dependent on the nonrational processing of our bodies.

    —Daniel Siegel, M.D., Mindsight, 2010

    Intuitive Eating was originally published in 1995. Over the years, thousands of people have read this book. While reading it, they have had a sense, at a gut level, of “getting it.” We’ve gotten many letters and e-mails saying, “you’re writing about me,” or “how did you know I felt this way,” or “finally someone gets it.” Just as so many have “gotten it”—there are others who have asked what Intuitive Eating really means. Are we just driven by instinct? Do we just “know” what and how much and when to eat? In introducing this third edition, we’d like to take this opportunity to be as clear as we can in answering the question of what Intuitive Eating really is.

    Knowing a bit about the human brain can help to understand why we’re born with all the wisdom we need to be Intuitive Eaters. It can also help us to see how we’re able to live an Intuitive Eating life, even while being bombarded by the unending choices of natural and refined foods available to us every day—and the relentless diet messages that abound.

    Humans are privileged to experience a dynamic interplay of instinct, emotion, and thought, which work together to orchestrate life, and are mediated by the brain. Psychiatrist and mindfulness expert, Daniel Siegel, M.D., calls this process “Mindsight.” There are three regions of the brain responsible for this powerful integration.

    The first region is called the reptilian brain, because when the early reptiles roamed the earth, they acted and responded exclusively by instinct. They didn’t rationalize or feel—they simply just went for it. As life evolved, another level of brain function developed, called the limbic brain, which mammals also possess. Emotions and social behaviors originate here. In the limbic brain, feelings are layered upon the instincts of the reptilian brain. The instincts originating from the reptilian brain are sent to the limbic brain, which serve to expand the awareness (Levine 1997). Eventually, the third key region of the brain evolved, called the rational brain, or the neocortex. The rational brain integrates instincts and feelings from the other two brain regions. The rational brain does not control instincts—instead, it perceives the instinctual and feeling parts of our beings and reflects upon them. The rational brain creates thoughts and language.

    Intuitive Eating embraces all three parts of the human brain. In infancy and toddlerhood, eating is mostly instinctual. As we grow older, thoughts and feelings often play a part in our decisions about eating. As we often tell our clients, our bodies are not just composed of the tongue and the stomach, but also the mind. We have often heard someone say, “I thought that as an Intuitive Eater, I could eat whatever I wanted. So, now I eat whatever I want and as much as I want, whenever I feel like it!” This comment actually distorts the premise of Intuitive Eating. Yes, make peace with food, and eat what pleases your palate. Yes, give yourself the freedom to eat unconditionally, and eat as much as you need to satisfy your body. But, eating whenever you feel like it, without regard to hunger and fullness, might not be a very satisfying experience and might also cause physical discomfort. Attunement with your body’s satiety cues is an important part of this process.

    As an Intuitive Eater, you will be honoring your brain, because it is part of your body. As you go through the principles of Intuitive Eating, you will be storing information in the memory “files” that you create and house in your brain. When you feel hungry, you will need to pull up several of these files, while deciding what to eat. You will evaluate how hungry you feel and then think about what foods might satisfy your hunger and your taste buds. You might even go through a series of sensual imaginings of the taste and texture and temperature of different foods. You also may open the file to reflect on past eating experiences. You might ask yourself whether your present eating choice has worked out for you when you’ve eaten it in the past. Did it sustain you long enough? Did it make your blood sugar crash? Did you end up with indigestion? Or did you thoroughly enjoy the food and want to have it again? Your emotions may also come into play when you have the desire to eat. Might you be upset and are craving food to comfort and soothe yourself? Or are you bored and thinking about eating as a distraction? Considering these possibilities might inform your decision of what to eat, or even whether to eat at all.

    In the beginning of your journey to reclaim your Intuitive Eater, you will probably be hyperconscious of hunger, fullness, satisfaction, thoughts, and emotions. Your brain will need to be highly in tune with your tongue and your stomach. As you become more adept at recognizing your inner signals, you may find that your instincts and intuitive wisdom take more of a prominent role in your eating experience. So, Intuitive Eating is truly about trusting that you will be able to access all of the information you need to have, by using all of the aspects of your brain—your reptilian instincts, your limbic connection with your emotions, and your rational thoughts.

    Getting back to the roots of this book, it is hard for us to believe that it has been seventeen years since Intuitive Eating was originally published. Although the time has flown by rapidly, the years have been packed with profound experiences. We have received an innumerable number of phone calls, e-mails, and letters from people in all parts of the country and around the world. These communications have brought us into the lives of people we could never have known without this book. We have heard stories about how Intuitive Eating has changed lives and healed relationships with food and body. We have talked with people who are in the beginning of their journey and are reaching out to us for more individualized intensive work—whether in person or by telephone. We have also received thanks from those who have used the book as a springboard for their own personal healing and have easily succeeded in the process on their own.

    We have been asked to refer people to nutrition therapists in other locales who are familiar with Intuitive Eating. We have given talks at professional meetings, as well as to students and to the lay public, and have made television appearances and been interviewed on the radio. We have been quoted in articles in newspapers, magazines, and on the Internet. Intuitive Eating is being used throughout the country in numerous eating disorder treatment programs. In addition, professional colleagues have asked our permission to use Intuitive Eating as the basis of college lectures, workshops, and seminars of their own.

    The impact of all of these experiences has been deeply meaningful for us. It has given us the opportunity to broaden the work that we had previously done in our offices or by telephone, working with individuals one-on-one. We have been able to extend the philosophy of Intuitive Eating to those whom we would have never been able to reach, if not for the book.

    It has touched our souls to be able to hear how Intuitive Eating has changed the lives of so many. One of the most frequent comments that we have heard from people concerns the despair that was felt after years and years of failed dieting experiences and the new hope that blossomed after finding and reading Intuitive Eating. We have heard how some have cleared their minds of punitive and obsessive thoughts about their eating and body perception. This clearing has made room for positive thinking and determination to make serious life changes. Self-esteem has catapulted, as people have reported the empowerment they have felt by working with a process that honors the validity of one’s inner voice. Through Intuitive Eating, they have learned to trust the wisdom that has always been within, but has been blunted by years of self-doubt. Doubting their innate eating signals had extended to doubting their beliefs about many other aspects of their lives.

    We have heard stories about people who have left abusive relationships, made peace with estranged loved ones, and have made significant career changes, once their struggle with food and body has been resolved. We have also heard about new romances that, for some, could not have been possible while they were occupied with body concerns and focused on the latest doomed diet attempt. Intuitive Eating has freed all of these people to go on with their lives, while leaving behind self-doubt and despair.

    Intuitive Eating has also changed the lives of many of our professional colleagues. At every conference we attend, we hear comments from nutrition therapists and psychotherapists about how grateful they are to have this book to give to their patients. They tell us how it makes their lives easier, having it for use as a guidebook in their private practices, for classes they teach, and for seminars they give. We have also found, in our own professional lives, that having a book available, which we have written, allows our patients to take something home with them to use as a reference. We’ve been told that it helps some people feel that they can carry a part of us with them for support when they need it!

    In this third edition, there are some new additions that we hope will reach a broader base of readers and will offer some new tools for everyone. Firstly, we have added a chapter that looks at how Intuitive Eating works with kids and adolescents. Our goal is to help parents protect their children’s inner wisdom about eating, with which they were born. We also want to give advice to parents about repairing a fractured relationship that they may have with their children around the eating experience. How wonderful it would be if all children were able to retain their inborn Intuitive Eating throughout their lives!

    Secondly, we have included a chapter on the research validating the benefits of Intuitive Eating. When we originally cultivated the premise of Intuitive Eating, we reviewed evidence from hundreds of studies, which, in addition to our clinical experience, ultimately formed the basis behind the ten Intuitive Eating principles. Although our original concept is evidence-based (or more accurately said, evidence-inspired)—it’s really not the same thing as saying, “studies show that Intuitive Eating works.” Until recently, that is.

    When we first wrote Intuitive Eating, we had no idea that our concept would generate many studies, which we find absolutely exciting! To date, there are over twenty-five studies on Intuitive Eating, with several that are currently underway.

    We have also updated the chapter on eating disorders, to present our current thinking about when and how to apply Intuitive Eating principles in the treatment of eating disorders. We have also shifted our focus to finding satisfaction and have come to see it as a driving force in the Intuitive Eating process. You will see how finding satisfaction in your eating will be profoundly affected by all of the other principles in the book. Updates have also been made throughout. Over the years, we have especially become sensitive to the impact that any mention of numbers has on our readers. Whether the numbers refer to weight, height, or serving sizes and recommendations, these numbers can trigger comparison and negative feelings. So, wherever possible, numbers have been removed.

    In addition, be sure to check out our new Intuitive Eating resources section, which provides information on resources (including our new Intuitive Eating Online Community)—to give you the tools and information to further support your Intuitive Eating journey.

    We have also felt that it was very important to keep the appendix, entitled “Step-by-Step Guidelines” in this version of the book. This readily accessible outline will be a boon to old and new readers as you go through this journey. If it’s your first time around with the book, you can choose to read the book in its entirety and then use the outline to remind you of the whole process. Or, you might decide to read about one principle at a time and then use the part of the outline that refers to that principle to fortify your focus on each step. Readers already familiar with the Intuitive Eating process can use this section as a way to review the entire concept and as a handy shorthand method of checking to see if they’re on track. Whatever you choose, we hope that “Step-by-Step Guidelines” will provide a helpful tool for you in your Intuitive Eating work.

    Finally, we would like to express our gratitude to the many people with whom we have had the honor to meet and work with over the years. You have been our teachers, even as we have counseled you on your healing path. You have inspired us to continue this work and bring out this third edition of Intuitive Eating. Thank you!

    Introduction

    If you could cash in every diet like a frequent flyer program, most of us would have earned a trip to the moon and back. The nearly $60 billion a year weight-loss industry could finance the trip for generations to come (Bacon and Aphramor 2011). Ironically, we seem to have more respect for our cars than for ourselves. If you took your car to an auto mechanic for regular tune-ups, and after time and money spent the car didn’t work, you wouldn’t blame yourself. Yet, in spite of the fact that 90 to 95 percent of all diets fail—you tend to blame yourself, not the diet! Isn’t it ironic that with a massive failure rate for dieting—we don’t blame the process of dieting?

    Initially, when we ventured into the world of private practice we did not know each other. Yet, separately, each of us had remarkably similar counseling experiences that caused us to rethink how we work. This led to a considerable change in how we practice and years later was the impetus for this book.

    Although we practiced independently of each other, unknowingly each of us got started by making a vow to avoid the trap of working with weight control. We didn’t want to deal with an issue that was only set up to fail. But while we tried to avoid weight-loss counseling, physicians kept referring their patients to us. Typically, their blood pressure or cholesterol was high. Whatever their medical problems, weight loss was thought to be the key to treatment. Because we wanted to help these patients, we embarked on the weight-loss issue with a commitment to do it differently: Our patients would succeed. They would be among that small 5 to 10 percent success group.

    We created beautiful meal plans according to our patients’ likes and dislikes, lifestyles, and specific needs. These plans were based on the widely accepted “exchange system” commonly used for diabetic meal planning and weight control. We told them that this was not a diet, for even back then we knew diets didn’t work. We rationalized that these meal plans were not diets, because patients could choose among chicken, turkey, fish, or lean meat. They could have a bagel, a muffin, or toast. If they really wanted a cookie, they could have one (not five!). They could fill up with “free foods” galore, so that they never had to feel hungry. We told them that if they had a craving for a particular food, they could go ahead and eat it without guilt. But we also reinforced gently, yet firmly, that sticking to their personalized plans would help them achieve their goals. As the weeks went by, our clients were eager to please us and followed their meal plans. We weighed them each week, and finally, their weight goals were met.

    Unfortunately, however, some time later we started getting calls from some of these same people telling us how much they needed us again. Somehow, the weight had come back on. Their calls were very apologetic. For some reason, they couldn’t stick to the plan anymore. Maybe they needed someone to monitor them. Maybe they didn’t have enough self-control. Maybe they just weren’t any good at this, and definitely, they felt guilty and demoralized.

    In spite of the “failure,” our patients put all the blame on themselves. After all, they trusted us—we were the “great nutritionist

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