“Real” Science

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Some of you may or may not know that one of my favorite activities is solving crossword puzzles. Not just any puzzles, mind you, but the Sunday New York Times crossword found in the very back of the magazine. Every Sunday, I eagerly sift through my newspaper and find the magazine, ready to start working on the puzzle and figure out all of those elusive answers. This week, as I was thumbing through the pages, I came across an article under the “Well” section of the magazine, which caught my eye: “Mind What You Eat: Can ‘intuitive’ eating be as effective as calorie counting?” written by Gretchen Reynolds. The picture accompanying this article was that of a corpulent, blind-folded man, whose stomach was feeding itself a piece of pizza.

Given the nature of the work that Jonah and I do, I was intrigued to see what Ms. Reynolds had to say about intuitive eating, especially since the idea of intuitive eating is still relatively unknown to most of the general public. As I read on, however, my curiosity turned to disappointment and frustration. The article was riddled with inaccuracies, and, above all, truly missed the point of what intuitive eating is all about.

Although the idea of intuitive eating (also called the “non-diet approach”) has been around for many years, Evelyn Tribole and Elyse Resch, two registered dietitians, brought the topic to the public’s attention in their 1995 book “Intuitive Eating.” In the book, the authors explain the 10 Principles of Intuitive Eating, including such ideas as “Reject the Diet Mentality,” “Honor Your Hunger,” and “Make Peace with Food.” The authors assert that by following these principles, an individual can create a healthy relationship with food, mind, and body. The basic “rules” of intuitive eating are quite simple: eat when you are hungry, eat what you are hungry for (not what someone else or some diet is telling you to eat), and stop eating when you are satiated.

While the book does discuss the likelihood that by eating this way one will reach their “healthy weight,” it is in no way meant to be a diet book or a how-to weight loss treatise. One’s “healthy weight” is not based on the BMI or what popular culture says is healthy – it’s the weight that one’s body arrives at when he or she is engaging in healthy behaviors such as eating intuitively, engaging in pleasurable physical activity, and managing stress.

Since weight loss is not the ultimate goal of intuitive eating, I was confused as to why Ms. Reynolds decided to compare the approach with calorie counting to see which resulted in more weight loss. In addition to this, the article was flawed in a number of ways.

Ms. Reynolds begins her article by saying that intuitive eating has not been studied extensively by researchers. This statement could not be further from the truth! Per the Intuitive Eating website, there have been over 40 studies which have looked at the health benefits of intuitive eating. According to Ms. Tribole who posted her reaction to Ms. Reynolds’ article on her own Facebook page, “last month a systematic review was published on Intuitive Eating with 24 studies, totaling over 9,000 people.”

Ms. Reynolds’ article goes on to discuss a study in which 16 overweight men and women were split up into two groups of eight: one group was assigned to a restricted-calorie diet between 1,200 and 1,800 calories per day, while the other group was to engage in intuitive eating. At the end of the study, which ran a total of six weeks, the researchers found that those in the calorie-controlled group lost more weight than those in the intuitive eating group. Given these results, posits Reynolds, limiting one’s calories is a more effective way to lose weight than engaging in intuitive eating.

Yikes. This article is problematic for a number of reasons. Firstly, the study itself is a poor one to use, as it has an extremely small sample size of 16 subjects and is conducted over a measly six-week time period. Secondly, to draw any conclusions about health outcomes from this study is wildly irresponsible. And thirdly, duh, of course the calorie-restricted group lost weight! This study literally gives us no useful information!

We all know that going on a diet results in weight loss for the vast majority of people. The question is: how likely is it that those individuals will actually keep the weight off for a significant period of time? Given that we know that approximately 95% of people regain the weight they lost through dieting, I’m willing to bet dollars to donuts that all of the individuals in this silly little study regained the weight they lost during the first six weeks of the study. In fact, I wouldn’t be surprised if they ended up heavier than when they started!

I guess the thing that bothers me most about this article is how it completely misses the point of what intuitive eating is all about. Intuitive eating is about eating in a way that promotes one’s health, not in a way that is meant to result in weight loss. Ms. Reynolds reinforces the diet mentality of the general public by her assertion that cutting calories is what is necessary to reach a healthy weight. Articles like this one just create more confusion for Jonah’s and my patients, as it backs up the ideas that weight loss should be one’s ultimate goal and that long-term maintenance of weight loss is achievable.

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