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Prakash Chandran: In America today, we have several troubling statistics about obesity that seemed to indicate a lack of emphasis on educating and empowering people to make good decisions about their nutrition. In a culture littered with convenient food options and fad diets, sometimes it's hard to make sustainable changes to our lifestyle. But what if we abandoned the idea of good foods and bad foods and what does it look like to meaningfully choose intuitive eating?

Here to teach us all about it is Rachel Bons. She's a registered dietician nutritionist at Ridgecrest Regional Hospital.

This is the Ridgecrest Regional Hospital podcast. My name is Prakash Chandran. So Rachel, thank you so much for being here today. We truly appreciate it. You know, you heard me mentioned intuitive eating in the introduction. Can you tell us a little bit more about what that is?

Rachel Bons, MPH, RDN: Yeah, sure. Hi, everyone. So intuitive eating, I wish I could really break it down and give you one sentence that tells you what it is, but it's just such a complex thing that I'll do my best. Intuitive eating is a framework that guides us to prioritize our health in the way that we eat. It's actually 25 years in the making. The book was first released by two registered dieticians. Their names are Evelyn Tribole and Elyse Resch. They're both registered dieticians and they also have advanced certifications in eating disorder rehabilitation as dieticians.

So as this framework has been around for 25 years, we've learned a lot about the effects of intuitive eating and that it is a very evidence-based practice of eating. And simply put, this framework of intuitive eating helps you prioritize your health while creating a more positive relationship with both food and your body. So instead of focusing so much on your weight or other things that you may not have as much control over as you would like to, intuitive eating prioritizes health behaviors and caring for yourself.

There are 10 principles and I'm not going to sit here and read them to you and bore you. But there are some principles that I like to point out to people just so you can get your toes wet to kind of understand what intuitive eating is all about.

So, two of the biggest ones that I think help people get started are honoring your hunger and feeling your fullness. A lot of us in Western culture, we eat to survive. We're in survival mode. We're just throwing food down the hatch on a busy work day. And we're not really listening to our hunger and fullness cues. And intuitive eating takes us back to our instincts that we were born with as a baby. When a baby is hungry, fussy, they know that they're hungry, they need food and they stop when they're full. This is an instinct that we all have. And this framework and the book that they wrote, it helps you rediscover getting back to your body's natural instincts around food.

Prakash Chandran: Okay. Understood. And so, I want to like try to unpack what this looks like in practice. So, I know you were mentioning it's a framework that helps us prioritize health while creating that relationship with the food and the body. Now, unfortunately for me, I love food and I love to eat and I love to unfortunately eat things that have sugar that might not necessarily be good for me. So when we think about intuitive eating, how does that work in practice?

Rachel Bons, MPH, RDN: That is an excellent question. So I will use your example of loving sugar and we'll pick like a favorite ice cream. So I'll say Moose Tracks for me is my favorite ice cream. And when you have this diet mentality about your eating, and rejecting the diet mentality is one of the principles, you believe, "Oh, my goodness. All sugar is bad for me. I'm not healthy if I have ice cream. I can never have ice cream and ice cream is a forbidden food and it's a bad food." And what that creates is a very negative association with the food. And if you're not supposed to have something, whether you're an adult, a child, whatever, what do you want more than anything in the world is that thing that someone told you you cannot have.

And so when you take away the restriction and you take away the rules that surround food that we've created for ourselves and that very heavily diet mentality, you may find that keeping that forbidden food in the house, if you keep it in your freezer consistently, it loses that novelty. And you may forget that you even had the Moose Tracks in the freezer because it's no longer forbidden, it's no longer off limits.

And what we know now, as we continue to learn about nutrition science, is that what matters more than your weight or one specific food that you do or don't eat is consistent health behaviors for a long period of time. So do you eat fruits and vegetables most days of the week? Do you get up and move your body? Whether that's something as simple as getting up and vacuuming your house, go out and walk your dogs. It doesn't have to be this big, "I throw a hundred pounds around in the gym and I only eat broccoli and chicken every day." That's not what health looks like. Health is a spectrum and it's just not that simple.

Prakash Chandran: So one of the things that I learned from what you said is it doesn't feel like intuitive eating is a diet, right? It's this framework. So talk a little bit about how people can think about starting intuitive eating and maybe the guard rails, if there are any that are put in place that help them change their behavior.

Rachel Bons, MPH, RDN: Okay. Where do you even start? I think one of the best places to start is to break away from, "Oh, I need to diet to be healthy. I need to restrict myself. I need to cut all this out and I need to do this" because the more extreme of a method that you do to try to be healthier, try to lose weight, whatever your health goal is, the less likely that that behavior or goal is going to be attainable or sustainable.

One of my least favorite diets as a dietician is the keto diet. If you are going crazy on keto and you do it for a couple months and you just burn out and you gain all the weight back, which is very common with dieting. Up to two thirds of people who diet, usually gain the weight back. And it's because they've gone to an extreme to do so. When you choose to intuitively eat and foods are no longer off limits, there's the common discrepancy of, "Oh, well, I can eat whatever I want, then I'll just eat chips and ice cream every day, and I'll never eat vegetables." And that's not what intuitive eating is. It's also making choices where you prioritize your health. "Intuitively, I really want some pasta with dinner, but I also know that cooking some chicken and broccoli to go with it would make this meal balanced and nourish me to be my best." So you're not depriving yourself of the pasta, but you are also making nutritious choices. So stop breaking away from that mentality that you need to diet and that there are good and bad foods, I think is the best place to start.

Prakash Chandran: So, you talked about how this was introduced 25 years ago, and there's a lot of evidence-based research that has shown that this is actually beneficial, that people are benefiting from intuitive eating. Can you speak to some of the benefits that people see from this framework?

Rachel Bons, MPH, RDN: Yes, absolutely. You think, "Oh, intuitive eating, how can that possibly be good for you to be allowed to eat pasta and to be allowed to have dessert?" But what we've seen from over 25 years of research and hundreds of studies is actually decreased blood pressure, decreased triglycerides, overall improved mental health. I think one of the big things that we neglect to think about when we think about eating is how eating and dieting affect our mental health. And health is not linear, it's a spectrum. And to think that health is just eating and exercise is to neglect the social and psychological and your mental health as well, which are just as important. And so, when you eat intuitively and you are listening to your body and you're not restricting and you don't feel guilty for having foods you enjoy, you have overall improved mental health and usually lower rates of eating disorders and also decreased binge eating. There's a overall better sense of wellbeing. People are also found to have more variety in their diets and we know that variety in our diet is what's best for us and people who intuitively eat also have higher HDL cholesterol, which is our good cholesterol. So there's so many benefits that we're seeing and intuitive eating definitely is not going anywhere. It's really growing, which I'm really excited about. We're just going to keep seeing more and more studies that are going to show us even more positive things about intuitive eating as we go on.

Prakash Chandran: So, I mean, it sounds amazing. But there is an element of discipline that I think comes with intuitive eating. Like you said, for example, if I'm going to eat, maybe just a sole plate of meat, and then I might say, "Hey, you know what? I might want to cook up some vegetables here." So what's intuitive to me, and what I actually do about that intuition might be very different than what is intuitive to someone else. So how do you go about, I guess, addressing that principle that people have different intuitions about what they should eat and when they should eat?

Rachel Bons, MPH, RDN: That's a great question. I would say first, what is right for me and my nutrition is not right for the next person. So, it's easy to want generalizations about food and nutrition. And I get a lot of patients that ask me, "Just give me a list of what I can and can't eat," and nutrition and your health isn't that simple. Every person has different nutrient needs, different hunger needs because their body is different, their activity level is different. So to kind of touch on what you're asking, I would say most people, I won't say all people, most people know the basics of nutrition, "Fruits and vegetables are something that I should be getting consistently. My plate should be balanced with fruits and vegetables, whole grains, and a protein." And so using this framework to choose to nourish yourself without restriction allows you to use your own discretion about what you want, what you need and what's best for you.

The 10th principle is honoring your health with nutrition. They call it gentle nutrition because we're keeping nutrition in mind, but we're not making any hard and fast rules because the hard and fast rules are where we spiral into negative mental health patterns with food. So instead of extreme rules with food, it taps into that variety. Someone who eats intuitively can have a variety of foods and they're going to be adequately nourished.

Prakash Chandran: Got it. If someone is listening to this and they have tried all of the fat diets that are out there, they've tried a lot of things to either get healthy, to lose weight, for whatever reason, it hasn't been working for them. What are quick fixes and changes that people can do to start taking better care of themselves and their bodies?

Rachel Bons, MPH, RDN: So I would say the best quick fix is to choose to not diet anymore. That's a really hard decision for a lot of people to make, and it takes them a long time to realize how negatively dieting is affecting their life. People think, "Oh, well, if I just lose weight, I'll be happier." And you may lose the weight and still find that your body image and your mental health are not improved because of the extremes that you had to take to get there and that weight loss often doesn't solve the problem and what does is promoting health behaviors.

So, if I have a diabetic patient, obviously I'm going to educate them to balance their blood sugars using nutrition, but I'm also going to tell them that they're not bad for having a cookie, but how to balance that in their life. And so I think that's the beauty of intuitive eating, is you're learning to nourish yourself without needing to diet anymore. You no longer have this restriction and all or nothing mentality. You drop that and you have grace with yourself and you see how much that can improve your mental health and your overall quality of life.

Prakash Chandran: So Rachel, the final thing that I wanted to ask, and this might be a hard question to address, but I think that some people might be listening to this. And this is certainly kind of cycling in the back of my mind, is that intuitive eating is kind of eat what you want when you want, and listen to your body. And I think that maybe explaining parts of the principles or the framework might give people a good indication around how it's maybe not that, but it's listening to your body based around guidelines, right? So maybe you can explain that or expand on that just a little bit more.

Rachel Bons, MPH, RDN: Sure. It's very common to think, "Oh, intuitive eating. What do you mean I can eat whatever I want. I'll just binge it all the time." And I think that's when our brains are still so focused on dieting because we've been deprived for so long and intuitive eating is definitely a process.

When I began to intuitively eating, there are definitely times where I overate something. But you take those experiences where you maybe overeat or you have a food or snack that doesn't sit very well with you and you take those experiences and you will learn from them. And what's funny is certain foods, a lot of people who intuitively eat or on that journey, they find, "For years I wasn't allowed to eat Oreos. And I finally started to allow myself to eat them. And you know what? They're not even that good to me anymore." And so it's this journey of allowing yourself those foods and then realizing when they lose that high value, they lose their novelty, and it's not something you're eating all the time. You may have it at a birthday party or whatever and it's not a big deal because you're nourishing yourself with a variety of foods, fruits, vegetables, lean proteins, and an Oreo or two, because you can and it's not off limits.

Prakash Chandran: Well, Rachel, I really appreciate your time. I think that is the perfect place to end. Thank you so much.

Rachel Bons, MPH, RDN: Thank you.

Prakash Chandran: That was Rachel Bons, registered dietician nutritionist at Ridgecrest Regional Hospital. Thanks for checking out this episode of the Ridgecrest Regional Hospital podcast. To learn more, please visit rrh.org or call (760) 499-3780. If you found this podcast to be helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you.

Thank you so much for your time. My name is Prakash Chandran, and we'll talk next time.