Season 3, Episode 7: Navigating Intuitive Eating with Digestive Disorders & Chronic Illness

Welcome back to The Gut Show! In this episode, we have the privilege and the honor of learning from cofounder and coauthor of Intuitive Eating. We are going to talk through what intuitive eating actually is, we're going to talk about it from even a psychological side and how the brain is involved in the intuitive eating process and how this whole movement really came to be. We’re also going to talk about some of the specifics around navigating intuitive eating with chronic illness and specifically digestive disorders like IBS.

So if you've thought about maybe making peace with food and tuning into your own intuition, but have been held off maybe because of your symptoms and some of the issues that you've had around diet with your condition, then this episode is for you! Elyse Resch is our guest and she is a dietitian, and is currently in private practice out of California and she specializes in Health at Every Size and intuitive eating and has had years of experience navigating this and working with individuals to finally reclaim their freedom from diets and diet culture, as well as make peace with their bodies and with food. So enjoy today's episode, enjoy everything that Elyse has to share and then connect with us if you have any questions or thoughts that you want to share!

Today’s episode is sponsored by Seed. Their signature product, the DS-01™ Daily Synbiotic, is a combination of science-backed probiotic strains and prebiotics that work in synergy to promote healthy digestion, ease of bloating, glowing skin, and more. You can learn more about Seed and the Daily Synbiotic at www.seed.com. Use my code erinjudge15 for 15% off your first month's supply.

Below is a transcript of the podcast recording, please excuse any grammatical errors.

Erin Judge: Elyse, thank you so much for being on today's show! Before we dive into intuitive eating, and kind of the nitty gritty of the work and how that can overlap with digestion, I want to hear more about your story. So kind of, you know, I know you're a dietitian, but what happened along your life that led you into your work in intuitive eating and what you do now?

Elyse Resch: It's such a great question because I have quite a history! So I got out of college and became an elementary school teacher, which had been my dream my entire childhood, probably as a rebellion against my father who wanted me to do something else. But I love teaching, it was wonderful, I did it for about four years and then I had my son and thought all my kid attention I wanted to go to my own child, I didn't think I wanted to do this anymore as a career. I mean, I was at home for a couple of years, and then decided to go back to school. And interestingly, the family I was involved in at the time was very orthorexic - my in laws were all for the purpose of trying to keep everybody healthy so they wouldn't lose anyone, that kind of control thing, and so they pulled me into it. My own family wasn't like that, but once I had met my son's father when we were in college, and I got involved with that family and I started becoming kind of orthorexic myself, but not major eating disorder, not restrictive for any other reason other than, oh, maybe that food is unhealthy.

In any case, after I had my son, I thought I would have another child. And to make it very short, I went on a diet and that was the first time that I'd ever really, actual dieted for weight loss, thinking what people thought in those days, oh, lose a few pounds before you get pregnant, which is the opposite of what anybody should ever do. And unfortunately, I never got pregnant again. And I want to say to any of your listeners, this is not what you want to do. You do not want to be restricting food, you do not want to be doing that to your body.

I went back to graduate school at 30 after I wasn't having another child and I thought, well, I had thought about what are the things I wanted to do but it was the perfect fit given the family I was involved in at the time. And then I learned in graduate school that even one pound of weight loss a week can cause infertility. And it was devastating. And no doctor could figure out what was wrong. No doctor said to me, what are you eating? Have you been losing weight? So what got me, you know, into the field was the focus on food and nutrition. And I did a traineeship with a facility affiliated with Children's Hospital Los Angeles, which was called the Center for Child Development and Developmental Disabilities. I was working there after I graduated and got my degree and I loved it and I thought my career would be in the realm of helping people and families with kids with developmental disabilities but didn't work out that way. I didn't get those referrals, I got referrals from a lot of doctors who were very, now I understand, fat phobic, weight centric, thinking that I could help them help their patients fix their cholesterol, their blood pressure, their blood sugar, by weight loss. And it just never felt right to me, intuitively it just never felt right. It wasn't a field I wanted to go into and I got thrown into it and I didn't know what to do. And in graduate school, we weren't taught anything about the dangers of weight loss. And this is a long time ago, we were not taught a thing about eating disorders other than one day in a developmental nutrition course, they showed one picture of someone who had anorexia and that was it.

In any case, I started doing what now I look back at and realize did harm, I put people on meal plans. I never called them diets, I always gave them lots of freedom with it, but it was still directed externally by me. And some people just did so well, you know, and I'm embarrassed to say this, I even weighed them in those days. This is 40 years ago, so I have to have a little self compassion for what I didn't know then and what I know now. In any case, then there were people who couldn't follow the plan and I didn't know what to do with them, I was stymied. And I'm a good student, I always did well, you know, in school and everything that I did professionally up to that point, but this I did not feel I was being effective in any way. And one day there was a young woman who came back to me after I'd given her a plan and she said, I can't do this, I'm binging and I didn't know what to do with it.

Fortunately, sometime after that, I started reading some of the very early non diet, now it's anti diet, but it was non diet thinking, which introduced to me this whole realm of let people eat whatever they want to eat, which at first was like, how can I do that, I have a Master of Science degree in nutrition, I know that certain foods are healthier, quote unquote, than other foods. However, it opened something up inside of me and I have always been interested in psychology and I started really tuning into the psychology of eating and the psychology of food and the psychology of people and came to an understanding that everything I had been doing was wrong and that there had to be a different approach. So I thought, I'm gonna write a book about this and I got on my computer, and I put some chapter headings and some notes on there. And then it was so interesting, my coauthor Evelyn Tribole lives an hour away from me and she would come up once a week to see a patient or in my offices. And one day, we were walking down the hall toward each other and I noticed that she was a little unhappy about something and she said, I'm trying to write this book with this woman, a psychologist and she doesn't know how to write. And it was just this moment, this flashbulb, you know, and I said, well, first of all, I knew I was a good writer, I had been….Gosh, I’m bragging about myself, aren’t I?

Erin Judge: We should all brag a little bit more!

Elyse Resch: I had been an English minor in college and I loved to write, and I just said I'll do it with you, thinking I'll take over the psychology part of it. And that's kind of how it started. And Evelyn had had some similar ideas, and we just collaborated and put it together. And this was in 1993, a long time ago. And we wrote the first edition of Intuitive Eating, which is completely outdated at this point. And so 27 years ago, longer than that, at this point, was when we started the writing, and it has evolved, as you know I'm sure, over the years. So long answer!

Erin Judge: I know, that's so helpful to hear some of that backstory, and I think people listening, you know, especially if you didn't come up in dietetics, because I'm a dietitian so I came up through similar training, and I graduated, my undergrad in 2014, so I was going through my internship program, 2014 to 2015. And I also didn't get much education in eating disorders, I got probably a lot of the same education that you did, and what to do, and everything was very scripted, you know, here's the manual. And I understand to a degree, I think, why we get trained, like we do, because we learn metabolism, we learn the science and science feels very calculated, right where you do this, and then it happens here. And then we do this and, you know, there's these plans that we can give, and it's easier to to learn this versus that than it is to learn the nuance of a human being and what all they need.

So I think hearing, you know, where intuitive eating is gone, it can be easy to, I think, brush over how out of the norm that probably was at that time, when you guys were bringing this up, I can only imagine just knowing how, even now, some misconceptions around things can be and so I appreciate that you guys, you know, took that leap and began to do that work because, you know, that's something that I believe now dieticians are starting to learn, but I didn't even learn that a few years ago. And I did you know, I did harm for sure in some of my first jobs and the work that I did. I don't have to weigh my patients and weight loss is never really something that comes up that often, but the patterns from past weight loss goals or the normalization of you know, weight loss being something you should be seeking and those messages and like you mentioned how people are raised to, you know, well, that's junk food, or that's not good and you know, we don't eat that. That weaves into even my clients who are dealing with digestive issues where they may not be seeking weight loss in the moment from me, but then the language comes out around how they feel when they eat certain foods or why they may choose certain foods over others, and then we build in the fear. So there's a lot of layers to it that people aren't always aware of, because it has become so normal.

Before we get into kind of using intuitive eating and just how that looks in a more complex sense with maybe some chronic illness and especially digestion, I would love for you to break down what intuitive eating framework is for those maybe who aren't as familiar. You can talk about how it's evolved, if you would like, I know that you guys just came out with a new version, so we'd love to hear that broken down.

Elyse Resch: So before I do that, I do want to honor the science we learned in training, because it's so helpful for me to explain to some of my clients what happens when they restrict, you know the connection with the survival part of their brain. And so I do love that I know that science, it is helpful, I didn't have to throw out the science, I just had to throw out some of the other ideas. In any case. So the generalized definition of intuitive eating is that it's a self compassionate self care framework helping people get reconnected with their internal wisdom about eating that they're born with. It's based on 10 principles, which are not rules, they're just guidelines to help you get there. And that's true, and I love it. And I have another definition that I love even more, which is that intuitive eating is a dynamic interplay of instinct, emotion, and thought. And that addresses three parts of the brain that have to be honored and looked at when we're becoming intuitive eaters or reconnecting with our intuitive eating.

One of the misconceptions in the world is that, oh, you just don't ever have to think, your body tells you everything, it's just all instinct. But that's not true. The instinctual part is what's called the reptilian brain, it's at the top of the brainstem and it's what the dinosaurs had, kept them alive, survival, you know, send out messages, eat, so you survive. And we have that as humans as well. And then there's the limbic, or the mammalian brain, which sits on top of this reptilian survival part of the brain and that's the base of emotions and social behaviors. And mammals have that, your dogs that are probably sitting right next to you, they have that part of their brains, they’re social beings, they have feelings, they express it to you, but they can't talk about it, although some of my clients think that their dogs do speak English.

But in any case, what differentiates us as humans is the neocortex and that's the rational part, the logical part of the brain. So we have to take all of that into consideration, because sometimes our instincts are affected by our emotions, or by physical issues. Even oh, gosh, I've had clients who have had COVID who have lost taste and smell. And that certainly affects them, even though they get the instinct to eat, they don't want to eat because it doesn't taste good. So we have to look at the emotions involved in that and then use that logical cognition to be able to make the best choices for ourselves. So I think it's important for anyone who's listening to throw out that thought of it's just eat whatever your body tells you whenever. It's so much more nuanced and complex than that. So that's my long, long answer to your question, which I seem to do.

Erin Judge: I am so glad you broke that down! And I think, thinking about those different parts of the brain, to me connects as a practitioner and like, oh, yeah, that's why we do things that we do. And that brings us into the digestive part. So when we're dealing with clients with digestive disorders, like IBS, small intestinal bacterial overgrowth, where, you know, there's excess gas production, and we're dealing with bloating, you know, we're dealing with very real reactions in the body that we can see and we can feel and many times these are related to food. Now, is it specific foods, how we eat, you know, there's a lot of complexities there, but you're eating food, and you're having symptoms that shouldn't be there when you eat food. I want to get into, I think a few layers of this, like what you mentioned, you know, the stretching of the gut, is that something that you talk with your clients about ever about, like, you know, hunger and fullness cues, because that's something that comes up fairly often, whenever our clients are coming in and you know, we introduce intuitive eating, or maybe they've come across intuitive eating, and they really want to try it, and they look at the principles and it feels so counterintuitive or out of reach, because they come in and say, you know, I don't know when I'm hungry, I don't know when I'm full or if I am full, I feel like the difference between fullness or discomfort and bloating or hunger or anxiety, or, you know, they're so lost in what their body's trying to communicate and making peace with food also seems very out of touch and they can't even feel like they can get to gentle nutrition. So I'd love to start this conversation about this kind of complexity and kind of breaking down maybe some those misconceptions that intuitive eating can't be at play, and maybe some of your expertise and what you as a team and as a practitioner come up with for some of these cases.

Elyse Resch: So I'm going to start in a way you probably didn't expect, and I do believe, not for all people of course, but there's a lot of people who have disordered eating and eating disorders and are experiencing gut problems. And I want to give you an example of a former client who has now graduated from high school, but she was 15 when she found me, and she had heard about intuitive eating. And she was just this industrious kid who went out there looking for information, found me and said to me, I want to work with you, I have had GI problems for years, for three years, I've been to every GI doctor and every time I've gone to a doctor, I've had to eliminate this food, I've had to eliminate that food to the point that I've lost my period, my hair's falling out and my stomach issues are not any better. My gut issues are not any better. And so we worked together helping her nourish yourself, guess what? All of her GI issues went away.

Now, I'm not suggesting that it's all that, obviously, there are some people that have some serious conditions or things that have to be addressed like celiac disease, where we can talk about that more in terms of intuitive eating. So I want to start there, because I think that what we have to do first is look at people's beliefs about the power of foods. There's so much else connected to it besides the food itself. Are you restricting? Are the recommendations you’re getting so restrictive that your GI tract isn't working well? I mean, so many people end up with restrictive eating leading to gastroparesis, so that their stomach emptying is slow. And I’ve got a theory on that, I don't think I've ever read it scientifically, but my theory is that everything slows down so that you can absorb more of the nutrients from your food. If it's going through you really fast, there's not much absorption. I'm saying this without scientific background, but it's I mean, you know, in that sense.

Erin Judge: Right. We think about our bodies they want to preserve and so you know, we funnel energy other places, like why not? I mean, we know that when we eat fat, our bodies slow down naturally. So it's like, oh, we need more time to break that down, which is phenomenal that our bodies know to do that correctly. So why would they not do that if they know we're not getting enough and we know, we need to preserve what we're getting it? I think it would, it might make sense.

Elyse Resch: So you know, what ends up happening is that sometimes gut issues just get worse and worse and the bloating gets worse and worse, because everything's kind of piled up in there because it's not moving through. And I think that it's important for anyone who's having gut issues to really take a deep look as to whether they're having an impact from diet culture, whether they're, you know, their focus has been to, well, okay, the doctor is telling me to eliminate this, good, maybe I'll lose some weight. And to investigate that. And that's why it's important for them to work with a dietitian who is intuitive eating informed, who is health at every size informed, so that we can sort out those pieces because that one client I mentioned, it was so powerful. I mean, this poor kid was having problems and everything she did, restricting, leaving foods out, made it worse, and worse and worse, until she started trusting her body. And when she trusted her body, and that means maybe some foods don't feel as good in our bodies, and that's okay. But she got her period back, her hair started to grow. She felt amazing, she felt happy in her body. We're still in touch from time to time, this girl is going to be president one day or something, she's just amazing. So, you know, that's an important piece of it to start there, versus just jumping into what the doctor says.

The other piece is, unfortunately, there are some gastrointestinal practitioners who just throw out things like go on the FODMAP diet, you know, get rid of all these foods. And what ends up happening is they're not really able to differentiate if there's a particular food that's bothering them, they just get rid of everything, then they're more restrictive, they're not feeding their bodies and their gut, and things get worse. So I have problems with that approach as well. I mean, sure, I'm happy to help a client, take one food and see whether they feel a lot better if they're not eating that food, but these big general approaches just exacerbate the problem.

And then something else I don't want to forget to say before we get into intuitive eating with this is that so much is about artificial sweeteners. I have so many clients with eating disorders who are chewing whole packs of sugarless gum a day or they're eating those bars. Anytime you see something that says no sugar added and then you look at it, you see there's sugar alcohol in there, which causes all kinds of gut problems. I mean, I can't even chew one piece of sugarless gum without giving me a problem. So I want to throw that out there for your listeners because some people never actually look at that part. They don't talk about it when they're seeking help. And they eliminate the sugarless gum, they eliminate the sugarless mints and those bars. And I had a client last night who has had anorexia for years and years and stomach problems and said to me, she quit all of her artificial sweeteners and her gut is working beautifully. Now, I don't want to simplify, in anything I'm saying, I don't want to say it's one thing or the other, but I think these are things we need to take into consideration.

Erin Judge: I agree, yeah, and I see it in practice all the time. You know, I think it's something I bring up to clients a lot too, or, you know, advocating for themselves as well. So even those listening, if someone gives you a diet recommendation, as do this, or, you know, take this out, but they've never actually looked at what you're eating or asked you really what you're eating, to me, that's the biggest red flag. We utilize the low FODMAP diet in our practice, never first, and if someone tells you to eat low FODMAP, but they've never even assessed if you're even eating FODMAPs, or even having reactions that could align with that, or I like to tell clients, you know, if you're eating nothing, and someone tells you to eat differently, you know, what good is that going to do? You're not eating anything. And we do see that often where there's, you know, restriction and skipping meals, there's, the body is not supported with nutrition at all, no foods, or you know, there's no consistency. And so, you know, the bodies all over the place. And, you know, that's definitely a better place to start because if the body isn't supported, it can't work with you, our bodies don't work that way.

Elyse Resch: Well, nothing works well, our brains can't work if we're not nourishing ourselves. And I do talk about the microbiome a lot with my clients and the connection between the brain up in your head and the brain in your gut. There's messages that go back and forth through the vagus nerve, 90% of our serotonin is made in our gut. So you know, if we're not nourishing our bodies, we're not nourishing our gut, we can't make the neurotransmitters that get sent to the brain our heads to help our emotions and we get all anxious, and it sends messages to our gut. It's not that it's psychosomatic, which has a pejorative, you know, sense to it, but there is a mind body connection for a lot of people. And so there's so many areas that I need to explore with people and I would hope practitioners would explore before they just go, as you said, go on the FODMAP diet, I've had several people come to me and say a GI doctor just threw them on the FODMAP diet. I mean, I know which foods on the FODMAP diet my body doesn't like, but there are a few of them. I have a lactose intolerance but if I take lactase I'm fine.

Okay, so there's all of that that has to be looked at, then when you look at certain conditions, if someone has celiac disease, the approach for me and I remember a boy, this is a long time ago, he was 16 years old, he had just been diagnosed with celiac. His mother brought him in and she was understandably anxious, she had heard how terrible it would be if he, you know, didn't follow a diet for that, quote, unquote. And first, I asked him to come in so I could talk to him about what he was going through before I talked to the mom. And I emphasized for him all the things that he could continue to eat, versus the doctor telling him now you can't have this anymore. Now, you can't have that. And it was like, yeah, you can have your french fries and your chips and the meat from that. And by the way, let me just preface this by saying the amount of gluten free foods that were available then was pretty small. It was very difficult. People had to send away to other states to get a bread that tasted horrible. It's just horrible. And so with the big focus on gluten free, which I've got a lot of feelings about, at least the advantage of that, and I like to look at the cup as half full, is that there have been so many products made which are so great for people who actually have celiac disease.

And I do understand that some people with biopsies do have a gluten intolerance, and I understand that. But you know, the more majority of people out there saying, oh, gluten is bad, gluten ss terrible. They don't even know it's just a protein that's in wheat, you know, what are you demonizing it for? So again, with something that's, you know, diagnosed like celiac, it's looking at what can you bring into your eating that you can enjoy and be satisfied with? And by the way, you were talking about hunger and fullness before and I do want to say that I don't ever start with hunger and fullness when I'm helping people return to their intuitive signals. There's so many issues, especially people with gut problems or eating disorders where they can't tune into the hunger and fullness, and they get very frustrated and then throw the whole thing away. So I prefer to start working with people to look at satisfaction. And that's why I'm saying with that boy with celiac, what foods do you love that can satisfy you? Oh, yeah, I love popcorn in the movies, or I love you know, I love french fries. And it kind of shifts their sense of deprivation to a sense of what they can have, and the willingness to accept that certain foods are not good, they're not gonna be able to eat without damage to their bodies. So there's that. I've worked with people with autoimmune diseases who have had some testing, and there's been some restrictions for them. Okay, let's just find a way that you can eat that is satisfying within the context of the foods that you really like, and that you are able to eat without a problem. So that's a little bit of an answer to your question.

Erin Judge: That's a good focus, it's almost freeing, even for people listening. I think sometimes, and I've heard this from people before, I don't really believe this because I came around, you know, in a circle approach to all of this myself. But sometimes people approach I think intuitive eating, or when we start talking about developing a healthier relationship with food, and just kind of those conversations, there's this mental block that comes out of, well, I need to be able to eat all food, like I can't eat all foods yet. I think sometimes we don't realize that we have the ability to do the satisfaction work, or look at what we can or what we're eating now and get, you know, take a step there, and then even look at how we're thinking about those foods that we might not be eating yet and take a step there. So that is interesting to think more about the satisfaction and not even just looking at what you can because we talked about that, I think we could do a better job at not just saying, this is what you can eat, focus on what you can, focus on what you're adding focus on what you're including, but thinking about it on a deeper level of like enjoyment of what you're adding and including. That's a really good perspective. I think it's interesting.

Elyse Resch: And it's how I work with other things, too, when people come and have very high cholesterol or high blood pressure. You know, it's not only the approach of you can't have, it's what can I have that is going to benefit me like with people with high cholesterol. Do you like oatmeal? do you like beans? That might help with your cholesterol versus you can't have this or that. And the other thing I want to say in regard to what we're talking about is that if there isn't a diagnosed like celiac disease, a diagnosed illness, or just what do you call it a disease? Celiac disease?

Erin Judge: We call it IBS, like a disorder, a condition it’s not considered a disease, it’s something you're living with that is altering maybe how your body is naturally functioning at that moment.

Elyse Resch: Well, sometimes just certain foods don't feel good, but you choose to have it an anyway because it's not going to do damage, but with getting gas and bloating. Oh, well. I mean, garlic doesn't like me anymore. At my age, a lot of things don't work as well on my body as they did when I was young. However, I will often have it anyway. I'll take a alpha-galactosidase oxidase enzyme with it, and it helps a lot and if I get a little gassy oh, well, it's not damaging me. So sometimes you can choose to eat some of these foods even if there is a side effect. It's like, are you focused on the gas and bloating because of diet culture and thinking that your body has to always look slim, trim, flat stomach, you know, that's where we go back to the disordered eating and how it's all convoluted with this. It's like, okay, so sometimes we're bloated, maybe it's worth it, maybe that, you know, garlicky sauce on my pasta was absolutely worth it.

Erin Judge: Yeah, that's interesting. How do you…….so someone's trying to decipher that, because I think that can sometimes be a blurry line of like, well, why am I afraid of this food? Or why am I afraid of the symptoms that I'm having? You know, there is a spectrum, I think some of the fears very real, we've had a bad experience where maybe you had diarrhea, or you had an accident, or you're in so much pain, you know, we don't ever want to discount that. But to be able to navigate, okay, what is actually influencing my decisions? Or like, what is behind the choices I'm making? Do you have something that you walk people through as they're maybe approaching intuitive eating and trying to figure out and decipher some of that messaging kind of in the background?

Elyse Resch: And it goes back to that instinct, emotion and thought, I mean, we want to respect the messages our bodies give us. And so yes, if there's a particular food where you get immediate diarrhea an hour later, and it happens every time, then you're able to say as an intuitive eater, my body is telling me that that particular food causes this and I'm going to choose not to have that food because I don't want that result. But of course, also with that is looking at the whole are they being nourished, all the things we talked about before, but getting to the point where they are nourished and there isn't an eating disorder mentality going on and there's a food that really causes a distress, yeah, so we have to mourn the loss of the freedom to have that food because the result is so detrimental to our well being. That is, we just make peace with it. This is not in the same realm at all, but I am allergic to shrimp, and calamari. Calamari I had in Spain many years ago, and I had never had it before and that's when I learned I was allergic to it. It's not such a big deal. But I liked shrimp, but I like to go to things where there's shrimp cocktails, but I don't eat it, because breaking out in hives all over my body is not worth it. And so I make peace with it. Because it's not a restriction that's coming from a disordered eating, eating disorder place, diet culture place, it's just my body tells me it doesn't do well with that, in fact, it’s pretty awful. Being on a train in Spain, on your way to Portugal with hives all over your body, and not being able to get medication was not a fun experience.

So, in any case, you know, there's such a range. Also I have a client who has Crohn's disease, and she's had a couple of surgeries, and she knows which foods give her pain, and she knows what she can eat that's fine. And she also knows she had a history of anorexia, so she also knows which foods she is afraid of that, you know, she might put in the category of they're going to give me pain from her old, restrictive thinking, versus does it really and we've had to work through some of those things where, yeah, there's a lot of foods she can't eat, but she has a lot of food she can eat, and she's just making peace with it.

Erin Judge: Yeah, yeah, that's such a good perspective. And we see that happen often, something that we do, and I wonder if this is a good way of using principles and picking your brain a little bit, I also really want your perspectives. I think, as a practitioner, there's so much involved in this right, like you're mentioning, you know, there's a lot of pieces to these puzzles and conversations and, you know, when you're working with somebody being able to pull out, like, what are your thoughts there and even exploring that, and for the person living with it, it can be overwhelming to explore all these things. So where are we usually start is just with the labeling itself, and then allowing, you know, based on that label you have, where does that come from? So for example, you know, if we're going through like the low FODMAP diet, we just talked through what's your label of a high FODMAP food? And usually it's, you know, high FODMAP foods are bad, like, they're bad for me, right? All FODMAPs are bad. And then, you know, we break that down. Well, what if what if we challenge that food and your mentality is that it's bad? Like, your body might, you know, respond poorly, because now there's anxiety, or what happens if you actually can eat that food? Like, what happens if the apple is fully fine with your body? You know, how are you going to handle that at that moment when in your mind, you've labeled it bad? How do you approach that? Do you also start with like the labeling piece? Do you go from a different approach? Or is that an accurate use of that and those principles?

Elyse Resch: Well, I like to inform people about the nocebo effect. People know placebo, something that they think is going to make them feel good and makes them feel good, even if it's nothing, you know, just a little bit of sugar pill versus medication. But the nocebo effect is so powerful, you believe you're not going to feel well, you don't feel well. And that's where the mind body connection. So really helping them understand where they got their information. First of all, was it a reliable source or was it that part of diet culture wellness community, that's putting out a lot of inaccurate, and I won't even call it information, but it's inaccurate, what's being put out there and understanding that you've been taught by some not necessarily responsible place, that this food is bad, and it's gonna make you feel bad, and it makes you feel bad. Look how powerful your mind is. So I agree, the labeling is really important. And the sorting out, there are a lot of foods on that FODMAP list. I mean, sorting out which ones really are problematic and which ones aren't. And this is partly how you can, as you explain FODMAP, and you talk about the sugar alcohols, and it helps us sort out whether people are actually taking in artificial things that are causing them gi problems, as well. But I like what you're saying about let's just look at what you think about it and how, you know, how's that affecting this? And let's try to have a neutral approach and really see if there is something that definitely gives you a problem afterwards.

Erin Judge: Yeah, let's hit on neutrality. I like that you use that word. That's something we try to bring up, you know, neutral, neutrality and when you've had such an up and down relationship with food, whether that's nostalgia with certain foods and like well that food feels cozy, and then you have foods and it’s like well that food feels scary. The idea of neutrality also in that mix can sometimes be hard to wrap our minds around, so I'd love for you to break that down a bit of what you mean by neutral, like the neutral approach, and how do you start kind of getting there?

Elyse Resch: So that kind of is connected to the making peace with food, I say, let's have all foods be emotionally equivalent, meaning, I know that certain foods have more nutrient density than others or we might know that this food might cause a reaction, more of a reaction than the other. But let's not feel good about ourselves or bad about ourselves based on what we're eating. So neutrality is, I'm going to not take a not good or bad approach to this, just a neutral approach, and if I happen to eat foods that end up giving me some, you know, GI problems, some gut problems, okay, I'm not a bad person, I didn't make a bad choice. Every body or each body has a different way of functioning. Some people, some foods work fine for some and don't work fine for others. But let's not put a moral imperative attached to it. You know, this is not a good food or bad food, I'm not a good person or a bad person by eating that food. And that kind of calms people and lets them look at it without judgment.

I like to say come from a place of curiosity, not judgment. Let's just be curious about, let's see how this works for you. Let's see where the, as I said, where's the information you got this, may be influencing what you think is happening here and let's look at what's real, what's not so real. And that young woman I was talking about who had resolved her GI problems, she does have a gluten sensitivity, but sometimes she has some gluten and a little bit of it doesn't bother her. She doesn’t, I want to repeat, she doesn't have celiac disease. That’s another whole story. So yeah, so approaching these things without judgment, approaching these things without judging yourself or the food itself helps you get to the truth about whether it works for you or it doesn't work for you.

Erin Judge: Yeah, yeah, that's great. And then being able to take all that work. So all of the work, I guess the result of it is getting to be like that girl, where it's not that, oh, she avoids gluten, and then goes and eats all the gluten all day long, you know, until she's completely miserable. Like, she gets to make the choice and like the power of her choice. We talk about that often, of, you know, autonomy, and you should be able to choose and you only can choose. And I think what you said about activating all those parts of your brain and kind of acknowledging all those parts of your brain. So I would love for you to talk about that too, like how someone gets, you're talking through the work, you know, reflecting being curious, listening, you know, what thoughts are coming out? Like, where are things coming from, you know, really doing that hard work of deciphering what's going on inside. What does it look like to be an intuitive eater with making choices? Is that a fair question?

Elyse Resch: Well, yeah, it is a clear question because I think that the people who think that it's just instinct, don't believe they have a choice, or that they're taking and making a choice, it's just my body's telling me, so this is what I'm going to have. But the choice comes with autonomy. That's what autonomy is about is being able to be your own person and figure out what works best for you. And so I think that definition was important before because of intuitive eating, to understand that you're also going to use that cognitive part of your brain to make the choices that are best for you. And sometimes instinct tells you like, I had some kind of stomach bug a couple of weeks ago, and really, all I wanted was a big bowl of chicken noodle soup, and that was instinctual and it helped, it actually was a great thing. But most of the time, it's just thinking about what do I feel like eating? Is it going to be satisfying? If you are having a serious gut problem with it, you know, maybe I'm going to choose to have a little bit of it, or I'm just not going to have that now, but I'll have something else that satisfies me that I know isn't going to cause any physical problems.

Erin Judge: Yeah, yeah. I think that that goes back to you know, misconceptions about intuitive eating and it seems like one misconception is not owning the choice that you know, and I hear people talk about it you know, if if I eat, like I have a client who just in one of our groups, you know, is asking for tips, she's going to a party in New Orleans, right? And she’s asking for some tips of navigating that. She's working through figuring out you know, what her by saying and she brought up, you know, oh, it would be hard to resist a beignets. I don't know if I'm saying that correct. It's like, yeah, well don't! Enjoy the heck out of that, you know, enjoy it, eat it, like, maybe it's one and maybe that feels good. Maybe it's two, maybe it's three, you know, but enjoy it and be present with it, you know, having the power to choose. I think sometimes there's this misconception that, oh, well, if I get to choose to eat it, I need to eat all of it. Like, if someone gives me a piece of cake, and I decide that I'm going to eat the cake, I need to eat this whole piece of cake. Versus, I'm still a good intuitive eater if I eat two bites of the cake.

Elyse Resch: Yeah, I'm sorry, I'm jumping in. It's so connected with if there is a restrictive thought going on, I really, not only does this make me feel bad, but I shouldn't be eating it because it's quote unquote, fattening or it's whatever. And I'm not going to eat it again later, so I better eat it all right now, and then you don't feel well, and then you're mad at yourself, and then it's, you know, turns into a really negative situation, versus I have full freedom to choose what I want to eat. Now, let me admit, sidebar, if you have food security, I mean, there are people with food insecurity who don't have that. And I just want to, you know, use that caveat on that. However, let's assume that somebody does have the privilege of being able to get whatever foods they want. And it's like, well, you know, I can get this later, even from New Orleans, I'm sure there's restaurants around that have food, you know, in other places that they can get. And so I think you have to be very careful to look at whether you're thinking beyond how's my body going to feel, but I'm restricting and I better get it all in now, I'm going to be big bad now and I'll be good later. It does get so convoluted. So there's so much disordered eating thought going on within the realm in the world that you're, you know, focusing on in terms of gut problems, and in, really, in the whole world of eating. And so it's really scary to me, how many people I run into, who are even my age who are still talking about this is good food, this is bad food. Oh, my goodness, I had so much of that, I'll be good tomorrow. It's really disturbing.

Erin Judge: Yeah, I agree. I agree. And I hope, I can only hope I guess that things are changing. I think sometimes the hope is higher. And sometimes it feels like, right back, you know, in the same circles. But I do believe that there is some change happening and there's challenge and I think with the rise of just individuality, I think there's a lot of challenge of well, it's the this good side of rebellion of well, why like, who gets to tell me what to do? You know? It's like, well, what do I really want? You know, what, how do I want to treat myself? Like, do I have to go to the gym, you know, the day after I eat my piece of birthday cake that I enjoy getting? Do I have to go do that because this person told me or this, you know, messaging is telling me that I need to do that? Or can I do what I want to do or like what I want to feel like doing?

Elyse Resch: I think it's come a lot, you know, there's a political aspect of this, what's going on politically in our country, and so many people who've gotten fed up with being told what they should do and what they shouldn't do in regard to their body size, or what they should eat or shouldn't eat. And they are finally at a point of look, I don't want to go on any of those restrictive things. I'm really open to intuitive eating. And I think it is spreading, I think it's all you know, it's being spread through social media, intuitive eating. And also I even just got this this morning, not that your readers can see this. But I got the cover of the Polish edition of intuitive eating and a week ago, I got the Turkish edition, I’ll have to show it to you another time.

Erin Judge: That’s so exciting!

Elyse Resch: But you know, it's being translated into so many different languages. It's all over the world. And so it is spreading. There was no social media when the book first came out in 1995 and so it was much harder to reach people than it is today. Of course, there's also the downside of social media that's promoting the other side of the coin. But yes, I have to believe things are changing.

Erin Judge: Yes. And I think even looking at just our evolution of generations, right? Where if one generation is changing that thought, the generation that we lift up, whether we raise them in our families, or we mentor them or you know, I think that that does cycle through and that is exciting! I come from a generation that was also raised on, even from a small town and somewhere where there wasn't a big focus on what foods were good or bad, it was really access to food and you know, our food was fried vegetables or canned things because that's what we had available and didn't have you know, fresh things in variety. And you know, I grew up on cheese pizza. That's what I had and I liked it. And I, I mean, I became a dietician, so I went through my disordered eating at college because of the things I was learning, and just discovering, and you know, so grateful that my body helped me kind of get through some of those thoughts. And I always say, with my IBS, and it was, you know, trying it all, and then kind of letting go of the grip, that it all came together and things really worked out. And it's interesting, because it is letting go of that, like control and restriction and all the rules and then allowing the knowledge I had gained to actually translate into my decisions from an enjoyment and actual practical standpoint was really big.

With social media, so that was a sidebar, a little sidebar. I do think I agree. I think it's changing, and I'm hopeful. But also, I think, with intuitive eating, what are some of the misconceptions that have come up? Because we see the rise in you know, the gravitation towards it. And it's so much more complex than just outlining the the 10 principles, right. It's more complex than just reading the book. There's a lot that is deep here, because it goes deep into who you are, and your beliefs and all of these different pieces. So what are some of the misconceptions that you've seen come up that you would like to shift?

Elyse Resch: Yes, I will. And just before I say that, just one more piece about how I can tell that things are changing is there was a talk that Evelyn and I gave a couple of years ago at our dietetic convention, over 2000 young dietitians - I don't think everyone was young, but dietitians came and other professionals to this talk and it was standing room only - the word is spreading.

Okay, so misconceptions. Number one, that it's the hunger fullness diet. This is where we began this conversation, you know, you're having trouble figuring out your hunger and fullness, well, this is not you can only eat when you're at a certain level of hunger, and you must stop at a certain level of fullness. No, no, no, no, no, eventually, especially if you're tuned into satisfaction, you start to recognize that food just tastes better when you have an appetite, when you're comfortably hungry, not when you have no hunger or when you're so ravenous, you're in primal hunger. So the hunger and fullness diet is what actually puts a lot of people in the eating disorder professional world saying you can't use intuitive eating with eating disorders, because people are not getting their hunger and fullness signals or in your you know, realm also. But there's so much more to intuitive eating, there's eight other principles that can be worked on, starting with satisfaction. So that's one piece.

The other piece that intuitive eating is going to lead to weight loss. And so here's, this is just another diet that's going to get you there and so people start approaching it like it's a diet and the rules, they're taking the rules as rigid and their goal, rather than being able to tune into their internal wisdom and feel good in their bodies, is to lose weight. And that's a misconception. Sometimes people's weight changes, sometimes it goes up, sometimes it goes down, sometimes it stays the same. But that is not, you know, the focus or goal of intuitive eating. So that's a problem when people do that.

And there's also a lot of co-opting of intuitive eating in the diet culture world, which is just infuriating and we don't have a lot of power against it so we just have to keep speaking about it. And this other piece that we talked about before that intuitive eating is just eat whenever you want, whenever you want, as much as you want. I have a slide one of the talks I give that shows this long tongue of a snake. And I say your tongue is not the only part of your body you want to think about. So it's not just this is what my tongue wants. It's hmm, I have no hunger, that's not even going to taste very good. My tongue happens to tell me that but I don't really want it right now. Or how does my body react to shrimp and calamari? Or how does my body react to a particular you know, sorbitol or whatever it is. So it's not just this, go for it all for you know, everything you want at any time, use that rational part of your mind some of the times to think about what's going to be best for you.

People are very scared that if they're given permission to eat whatever they want, they'll never stop eating it. And so when you fully embrace intuitive eating, what ends up happening is this concept of habituation takes place and habituation means the greater the stimulus, the less the response. So the more you have the freedom to choose in an autonomous way what you're going to eat as much as you want for ever, if you can get your hands on it, then foods become not that they're not delicious, but they just are no longer forbidden nor so exciting because they're forbidden. They're just part of everyday life, and you get bored. Habituation has to do with boredom, you know, if you're eating the same thing over and over, which is an assignment I sometimes give clients who are so scared, they'll never, you know, they'll never be okay with a certain food. After even a few days, it's like, oh, as long as they know that, they'll always give themselves permission to have it, habituation sets in, so no fear there.

Erin Judge: Yeah, thank you for breaking those down. I think that's a good thing to remember, someone might be exploring, you know, getting into the exploratory phase or kind of dipping their toe. I think understanding those misconceptions is nice. What if someone is if they're saying, you know, I'm excited about this? I'm really interested, where would you suggest that they begin?

Elyse Resch: In terms of what they read, or?

Erin Judge: So maybe they don't have the book, I think, I guess that would be the most obvious place to start, but maybe even talking through, you know, how to check with their providers, if they're working with someone or you know, I don't know, whatever you think if someone's interested in they're not sure,

Elyse Resch: A really good point when they're talking to their providers, whether it's a dietician, or the psychotherapist or their psychiatrist or their MD, find out whether they're fat phobic, find out whether their focused on being weight centric, find out these things, because the information you're going to get might lead you astray from intuitive eating. So that's the first piece, I do advise doing some of the reading. One of the places I send people is to my Intuitive Eating workbook for teens, because even though I wrote directly toward the teen developmental stage, I am a believer in inner child work. And I believe that all of us carry with us the feelings of our toddlers, of our teenagers throughout our lives and so I found that a lot of people by reading that book, it's more, it's not as it's ….how can I describe it, extremely described in the book, you know, in the book, every detail of it, it's more of a shorter hand version of what Intuitive Eating is, and it helps people get in tune with their inner teen and heal some of the things that happened to them. So many eating issues start in those early years and I do believe we can heal those, go back in and heal those problems.

Some people just want to read all the research, so the intuitive eating fourth edition that came out, actually, no, it's two years ago, I kept saying one year, but it was 2020. It's great, read the whole book. And then there's other things, my journal that came out, which is a really abbreviated version of each of the principles and then room for reflection and writing. And there's the workbook and lots of stuff, a deck of cards right now, it’s really fun. It's like a tarot deck, you pull a card, and whichever card it is, is the one you need to work on and learn from.

Erin Judge: Fun, I love it! And I can link all of that in the show notes if anyone is thinking, oh, I want to you know, explore some of that. And then what's gonna be next for intuitive eating. So we know it's more than the book, it's more to the principle. So what's coming next with the movement and with your work?

Elyse Resch: Okay, and I'm going to say that, and then I have a client in a couple minutes, so I'm going to have to stop. Well, um, I feel as if we are passing the torch. And there is a new book that just came out that is called How To Raise An Intuitive Eater written by Sumner Brooks and Amee Severson and I got the privilege of writing the foreword for the book. It's phenomenal and I think that this is the place to go where we're going to prevent the disconnection with our intuitive signals, they emphasize looking at your own relationship with food as a parent and what you convey to your children, and raising your kids with that sense of trust in their own bodies.

I'm still writing little pieces here and there, but I was involved in writing five books in six years, and I'm kind of burned out on full books, but I do reviews and I'm really promoting that book because I think it takes you down to the core and really helps. So that's where that's going and I seem to be, I don't really know how to post on social media very well but I'm really happy reposting on my story things wonderful things that other people post so I've gotten a little more into Instagram than I used to be. But that's it.

Erin Judge: We'd love to see you more on there and I appreciate your time. Thank you for sharing some of your wisdom and your work and into some of this nuance that is okay to explore and okay to dive into no matter what it is going on which is such a good refreshing reminder, so thank you so much!

Elyse Resch: it was really nice talking with you and thank you for letting me come on and talk away!