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Intuitive Eating with Diabetes, PCOS, and other Chronic Conditions

 So you’ve heard about intuitive eating, but you don’t know if it’s for you because you live with a chronic health condition. There are 10 principles of intuitive eating, focusing on rejecting diet culture, finding your hunger and fullness cues, discovering satisfaction in food and movement, and gentle nutrition. While a chronic condition may pose a barrier to one or more of the principles, it is possible to start by focusing on the components that are within your ability. Read on to find out how you CAN eat intuitively with diabetes, PCOS, or any other chronic condition!


What About My Weight?

Many chronic health conditions carry the stigma that they are caused or worsened by weight, but clinical research has still failed to definitively show this to be true. Weight or BMI is not indicative of health. Those in the “overweight” or “o—-” BMI category lead just as long and healthy lives as those in the “normal” BMI category, if not longer. And of individuals with a chronic illness, those in the “overweight” or “o—-” categories actually have better health outcomes and reduced risk of death. In addition, weight cycling (or yoyo-ing between weights due to dieting) increases inflammation, which may exacerbate symptoms. This is all to say that many people worry about gaining weight when choosing to follow Intuitive Eating, but there is no evidence to show that gaining weight in response to honoring your body’s needs, will have a negative impact on your condition or overall health. We recommend checking out these resources for more reading material in this area!


What About My Health?

Living with a chronic health condition, you may be worried about your health. (By the way, you don’t have a moral obligation to do so!) You may have heard that intuitive eating is a “slippery slope” because it allows people to eat whatever they want, including unregulated amounts of “junk” food. It can be true for some people that, at first, they find themselves only wanting to eat “bad” foods. This is because these foods have been restricted (possibly for decades) which increases the body’s cravings for a food. However, this phase truly is just a phase. Once you replenish your body with all the nutrients (yes this includes carbs or sugar!) it has been lacking, you will notice a reduction in cravings. The gentle nutrition stage is where you are better able to choose foods that support your (weight neutral) health goals. This is where there is the most opportunity for your body to guide food choices that support its needs, including those of a chronic condition. If you need support around attunement to your needs or weight neutral health goals, working with a dietitian can be game changing.


What if I'm not Connected to My Body?

One of the most important tenets of intuitive eating is interoceptive awareness, or the ability to understand sensations that give you information about the internal state of your body. Interoceptive awareness is how you know when you need to use the restroom, when you are hungry, when you are full, and when you feel anxious or stressed. For those of us who have struggled with diet culture (everyone, duh!), we may find it difficult to tune into our hunger and fullness cues because we have been told for so long to ignore our hunger and eat past fullness during the “last supper” before a new diet. Hunger and fullness cues can also be hard to notice, due to some medications, older age, stress, depression, trauma, or neurodivergence. Struggling with interoceptive awareness doesn’t mean you can’t eat intuitively, though! It takes practice to build interoceptive awareness, so you might need some external support at first. Some find it helpful to set reminders or place visual cues to remember to check in with their body and scan for hunger/fullness signals. Having compassion for your body and yourself, identifying your needs, and setting up systems to meet those needs mindfully is the epitome of intuitive eating.


What if I'm Overwhelmed?

 Living with a chronic condition can be completely overwhelming! The daily tasks required to monitor and manage your health added onto everyday life can lead to feelings of anger, exhaustion, stress, or depression. Sometimes emotions may drive us to eat foods that bring comfort and/or eat past fullness in an effort to cope. Intuitive eating principles guide us to “cope with our emotions with kindness”, which ultimately means developing a tool box of coping skills and choosing one to compassionately meet our emotional needs. Sometimes food is that coping skill. And that’s ok!!! If you find that eating is your only coping strategy, you might consider experimenting with different outlets for your emotions, looking for a support group, strengthening your self-compassion muscle, and continuing to focus on other areas of intuitive eating.


What if Eating isn't Pleasurable?

 Chronic conditions sometimes come with pain or discomfort from eating certain foods or eating at all, and in these cases, pleasure is the last emotion tied to food. If this is where you’re at, know that the taste buds are not the only part of the body that we honor in intuitive eating. Part of gentle nutrition is being able to practice “Food-Body Choice Congruence”, or the balance of food decision making based on taste, physical symptoms, or health values. Although you still have radical permission to eat any food, even those that can exacerbate symptoms, you can pair it with the awareness of Food-Body Choice Congruence to make the most informed and kind decision for yourself.


What if I'm Not Able to Enjoy Movement?

One of the principles of Intuitive Eating is about movement. Intuitive Eating advocates for engaging in movement that brings you joy and makes your body feel good, not a militant exercise routine. However, not everyone lives in a body that is capable of regular movement, or any movement that feels joyful. That’s totally understandable! If this is the case, focusing on tolerable movement, which may manage your symptoms, or just moving on to focus on other parts of Intuitive Eating could be more practical for you. 


Final Thoughts; TLDR

Intuitive eating can seem foreign, even out of reach, especially for those with chronic conditions. There truly is room for ALL bodies and people to live in intuitive eating, though! From PCOS to rheumatoid arthritis, from diabetes to GERD - there may be areas of the intuitive principles you need to modify, but if you can learn to turn down the volume on diet culture and treat your body with compassion you CAN eat intuitively with a chronic condition!


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