Intuitive Eating and Chronic Illness


I want to talk about intuitive eating. In the body positivity world, intuitive eating is often held up as militantly as diets are in toxic diet culture. The problem with intuitive eating is that it assumes a baseline of health—that is, it rests on the assumption that your body is functioning optimally and that there are no foods that will flare up your chronic illness or make you feel sick. Intuitive eating advocates often promise that it will result in your body feeling its best. When intuitive eating is held up as the only right way to eat, it sets up folks with chronic illnesses to feel like failures, because the reality is that intuitive eating just doesn’t work for many of us. 

I have so many clients who come to me because their illness is triggering their eating disorders. They have panic attacks at the thought of eating because they never know if what they eat will make them sick. Something that they ate yesterday with no symptoms today leaves them with intense gastrointestinal distress or body pain. Eating at all feels unsafe, and they find that they would rather just not eat than risk the pain that eating often causes them. There is no way for intuitive eating to help people in these situations, and the promise that it will is deeply harmful. 

Conversations about diet culture often claim that anyone who suggests dietary restrictions or specific protocols is a participant in toxic diet culture, and these claims make it less safe for people with both chronic illness and histories of disordered eating to work with people like me, who are invested only in helping them to heal. My work by absolute necessity requires restrictions, and these restrictions are designed to make eating feel safe again. It is so important to include nuance in your conversations about these things that leave room for folks with chronic illness to seek out the help they need and deserve without feeling like they are participating in diet culture when they absolutely are not doing so. 

Here’s the thing: I practice intuitive eating with my clients. It’s just intuitive eating with an asterisk that notes that their body needs intuitive eating* to happen within a specific framework in order for them to feel well. I work extremely hard to honor my client’s cravings in ways that will not trigger their illnesses. I specialize in finding substitutions for trigger foods that make it so that my clients can eat their favorite foods without getting sick. We need to broaden our definition of intuitive eating to include other ways that it can look.

Those of us with chronic illnesses deserve to be able to honor our bodies needs without being shamed for doing so. We deserve to be able to work to heal our bodies and control our triggers without hearing that the ways our bodies require us to restrict are harmful. We are not participating in diet culture, we are honoring the needs of our bodies. So when you talk about body positivity, please keep us in mind. Make room in your conversations to include the exceptions. Let’s start talking about intuitive eating*, rather than just intuitive eating.