What Is Intuitive Eating and How Can It Help During Cancer?

January 31, 2023
Hillary Sachs, MS, RD, CSO, CDN, and Kristina Dimitra Thomopoulos, MS, RDN, CDN, ACSM-CPT

Hillary Sachs, MS, RD, CSO, CDN, is a board-certified specialist in oncology nutrition and founder of Hillary Sachs Nutrition. She has counseled and educated hundreds of people at various stages of their cancer journeys on the impact their nutrition has on their treatment and overall well-being. Kristina Dimitra Thomopoulos, MS, RDN, CDN, ACSM-CPT, is a clinical dietitian at The Cancer Institute at St. Francis Hospital. She is a PhD candidate in nutrition sciences at Drexel University with a concentration in nutritional neuroscience and secondary data analyses. Ms. Thomopoulos has no relationships to disclose. View Ms. Sachs’ disclosures.

We are all born with the ability to self-regulate our food intake. Babies know when they are hungry and when to stop eating when they are full. Through conditioning, such as hearing phrases like, “Take one more bite,” or, “Clean your plate,” we override our natural intrinsic system of self-regulation and shift to an extrinsic one.

Through intuitive eating, which is described in the book Intuitive Eating by Evelyn Tribole and Elyse Resch, a person can re-learn the ability to self-regulate their food intake. Intuitive eating is the practice of trusting your own body to tell you when to start and stop eating and to tell you what your body may or may not need.

During cancer, you may experience changes in self-image or appetite, which can make it difficult to eat and get the nutrition you need. Here, learn more about intuitive eating and how it can help people with cancer and survivors.

How can intuitive eating be helpful for people with cancer and survivors?

People’s relationships with their bodies can be complicated, and receiving a cancer diagnosis can make that relationship even more complex. People with cancer may have an especially difficult time trusting their bodies after their diagnosis. Because of this, they may seek to follow strict nutrition rules for a sense of control and stability. Or, they may find that certain cancer medications make them eat more or less that may require them to lean on external cues to regulate their food intake.

Intuitive eating can be a helpful practice for people with cancer and survivors who may be struggling with self-image or food intake. Practicing intuitive eating can have many benefits for people with cancer, including:

  • Increasing body acceptance and body positivity

  • Building self-trust

  • Learning to tune in to self-cues to help figure out what foods make your body feel its best

  • Shifting the focus to what to do instead of what not to do 

Practicing intuitive eating takes the focus off of weight and avoids categorizing foods as “good” or “bad.” And, with guidance, practicing intuitive eating can decrease stress and promote a better relationship with your body, which can be liberating both during and after cancer.

How is intuitive eating practiced?

You should always talk with your health care team before introducing changes to your diet. If practicing intuitive eating is recommended for you, the steps below can help you get started.

1: Reject the diet mentality.

Realize that most restrictive diets result in failure. Just like you would not go on a medication that had a very high failure rate, you should not follow a diet that is not proven to work. For most people, restricting foods and depriving yourself does not work. 

2: Honor your hunger.

If you struggle with overeating, fueling your body regularly with all 3 macronutrients—proteins, fats, and carbohydrates—can help reduce the primal drive to overeat. 

3: Make peace with food.

Realize that all foods can fit in your diet! Ultimately, all foods break down to the same biochemicals in our body, giving us energy. Of course, some foods may offer more nutrients than others, but that doesn’t mean that any 1 food item or group is bad. Giving yourself permission to eat all foods and avoiding labeling foods as “good” or “bad” can help reduce food-related guilt and the drive to overeat these foods when given access to them. 

4: Challenge the “food police.”

Remember that your food choices do not make you a good or bad person. Don’t let yourself or a family member or friend monitor your eating and tell you what you should or should not be doing. Tune in to your body cues to learn about what works for you. Challenge people who have unhelpful rules around food and try to impose them on you.

5: Feel your fullness.

Start getting familiar with your body’s hunger/fullness scale to learn when to start and stop eating. Pay attention to this scale while you’re eating by pausing, so you can truly experience the food you are eating. 

6: Discover the satisfaction factor.

Create a pleasant eating environment without other distractions. Sit down and indulge in the experience of eating. Practice using all of your senses to experience the food: see the food, think about where it came from, smell it, taste it, and savor each flavor of every bite. 

7: Cope with your feelings without food.

Food is intertwined with many aspects of our lives. It is first and foremost a source of fuel to power us through our day, but it is also something shared with family and friends. For many of us, food is a source of comfort. And while it is fine to use food as comfort, it should not be your only tool for coping with difficult emotions. Talk with your health care team about exploring different ways of coping with feelings beyond food.

8: Respect your body.

Everyone comes in a different shape and size and has a different body composition. If you are struggling with self-image, focus on what your body does for you each and every day, and accept that some days may be harder than others.

9: Exercise and feel the difference.

Exercise should not be a punishment for what you ate in a given day, but rather a celebration of all that your body is capable of. Find a type of exercise you enjoy doing: dancing, walking, or even hula hooping. You are more likely to do it and stick with it if it is something you like. Moreover, research supports that movement of any kind is better than none.

Ultimately, intuitive eating is rooted in self-compassion. If you find yourself struggling with intuitive eating, try practicing a self-compassion exercise. Think about: would you talk to a friend the way you would talk to yourself about your body, food, or eating habits? 

If you are interested in practicing intuitive eating, talk with your health care team about what is recommended for you.


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