Brigham Young University research indicates the best way to lose weight may be to toss restrictive diets in favor of "a hunger-based anti-dieting approach" where when and how much you eat depends on what your body tells you.
That approach, called "intuitive eating," translates into lower cholesterol levels, body mass index and cardiovascular disease risk, according to Steven Hawks, professor of health science at BYU, who led the small study that is published in today's issue of "American Journal of Health Education."
Hawks has had his own long-term experience with intuitive eating, and the result has been a 50-pound weight loss and improved health and fitness, he says.
A "classic yo-yo dieter," he says he lost a lot of weight by restricting calories but always gained it back, only to begin again. When he started teaching a class about healthy weight management 15 years ago, calorie counting was at the forefront, but he found it dissatisfying and probably not the answer for his students. He decided to learn to follow his body's cues, eating what and when he wanted, based on hunger. "The weight came off easily, and I have maintained a very stable weight."
Fast forward: BYU researchers developed an intuitive eating scale, which they published as part of earlier research. They based the current study on two groups of people:
Those who scored high on intuitive eating and those who were at the other end. The latter tend to be dieters who use "external structure to determine how much they eat," he says.
They looked at differences in health outcomes, including BMI, levels of good and bad cholesterol (LDL and HDL respectively) and triglycerides, all relevant to cardiovascular risk.
"It turned out intuitive eaters have a lower BMI than those who were not. About a third of the variance is a function of intuitive eating rather than people dieting or more external food-based plans," Hawks says. "We found HDL, the good cholesterol, tended to be higher, triglycerides tended to be lower. Based on the overall blood lipid profiles, intuitive eaters have lower cardiovascular risk than nonintuitive eaters. It seems to be positively associated with the health measures we looked at."
The study is too small to be definitive, but it's tantalizing evidence that more research needs to be done, he says.
While Hawks can't say definitely that intuitive eating leads to lower body weight, studies by various researchers over the years show that people who begin to diet at a younger age (females more often than males) actually tend to gain weight. "Intuitive eating may be a way to head that cycle off," he says, "by stopping kids from becoming dieters in the first place. Dieting may be a key contributor to weight gain. People need to get into a more healthy relationship with food."
It's particularly important because the American culture puts a lot of pressure on women to diet, even women who are not overweight. "They are trying to lose weight when there's no health reason to do so," he says. "Instead, it may encourage weight gain and preoccupation with food," and even spawn eating disorders.
Those in the BYU study came in all different body types, he says, but the high scorers for intuitive eating, regardless of body type, had lower BMI and fewer concerns about weight or food.
Two attitudes and two behaviors are the core of intuitive eating. First is body acceptance and the attitude that dieting is harmful, Hawks says. Then people must learn how to not eat for emotional, environmental or social reasons and learn how to interpret their own body signals, such as cravings and hunger, and how to respond in a healthy way.
While this study focuses on the health benefits of intuitive eating, the researchers are also studying whether it can be taught to those who don't normally eat that way. The answer seems to be yes.
Intuitive eaters tend to enjoy food more, he says. They "tend not to have a lot of cravings. When they want something, they have it. People with a lot of food taboos and rules have a lot of cravings and when they give into it, they go overboard." And contrary to what many people expect, intuitive eating actually increases control over food, rather than lessens it.
The take-home message, Hawks says, is that his profession, public health, "continues to promote dietary restraint as the best way to manage the obesity epidemic. If you go to any Web site, you'll quickly find articles about counting calories. I hope we can begin to open a new way, that restrictive dieting is not necessarily the best approach to take, since it seems to compound the problem."
Next, Hawks plans to do a large-scale study across several cultures of intuitive eating, which he calls a "nurturing approach to nutrition, health and fitness as opposed to a regulated, coercive, restrictive approach."
The research team included Hawks, Hala Madanat, Jaylyn Hawks and Ashley Harris.