Is Intuitive Eating for Diabetes… Counterintuitive?

“I think intuitive eating sounds cool and all, but don’t some people just need to diet?”

There are very few instances in which going on a strict diet is medically necessary. And diabetes is not one of them. 

This isn’t to say that diabetics don’t need to learn about their condition and make lifestyle changes to better their health, it’s just that they don’t need to be on a strict or restrictive diet to see a positive change. In fact, most people who do go on diets are not able to sustain them in the long term and end up not only regaining the weight they’ve lost but usually gaining more back. This "weight cycling" can actually worsen insulin resistance in diabetics.

In order to understand how we can use intuitive eating with diabetic patients, we will group some of the related principles to discuss. If you’d like to learn more, there are resources at the end of this post that can help elaborate on these topics.

Principles 1, 3, and 4: reject the diet mentality, make peace with food, and challenge the food police

Strict diets don’t last. And with a chronic condition such as diabetes, you need lifestyle changes that will last throughout all phases of life. These principles are all about freeing yourself from the societal expectation of dieting so that you can have a healthier relationship with food. 

Principles 2, 5, and 6: honor your hunger, discover the satisfaction factor, and feel your fullness

Many people have lost sight of not only their hunger and fullness cues but also how to listen to and react to these. Using a hunger-fullness scale such as this one and working with patients to help them practice identifying hunger and fullness can prevent overeating or, on the other hand, from going long stretches of time without eating. This can ultimately help prevent both low and high blood sugar spikes while improving their relationship with food.

Principles 7, 8, and 9: cope with your emotions with kindness, respect your body, and movement - feel the difference

Help patients get over the emotional and mental challenges they might face when it comes to food. This often involves practicing healthier coping mechanisms that don’t involve binging on food. Additionally, some patients refuse to buy themselves new clothes when they gain weight and go up a size - in turn, they have a worsened body image and mood because none of their clothes fit right. We need to help patients find more positive sources of motivation that don’t involve self-punishment. Similarly, we can help patients find forms of exercise that don’t feel like a punishment to them. If they dread running, for example, help them find a form of cardio that they can enjoy - such as tennis, swimming, hiking, etc. Look into ‘joyful movement’ for more ideas. 

Principle 10: Honor your health through gentle nutrition

Teach your patients more about diabetes; go beyond the generic explanation. Involve them in the process - practice classifying foods by macronutrients or walk through scenarios of what they can do for low and high blood sugars. Teach them what habits will help prevent blood sugar spikes and give them practical examples for real-life application. Explain to them the why - they are so used to being told to exercise but might not understand how it can make a difference. This can help them make food choices that feel good to them in both the short and long-term.

By equipping our patients with information on how they can better their health and giving them tools that they can use day-to-day, we can empower them to make the changes necessary to improve their health.

Resources:

• American Diabetes Association and Intuitive Eating
• American Diabetes Association and Yo-Yo dieting
• Principles of Intuitive Eating
• Book - Diabetes Counseling & Education Activities: Helping Clients Without Harping on Weight by Megrette Fletcher

-SB