By Dr. Jamie Long
If you’re prescribed Ozempic or another GLP-1 RA medication like it (e.g., Wegovy, Mounjaro, Zepbound, Tirzepatide, Semaglutide, etc.) you may have a renewed interest in healing (or improving) your relationship with food. For many individuals, GLP-1 medications have reduced food noise and quieted food cravings which in turn, provided more mental bandwidth to make intuitive, nutrition-informed decisions that honor well-being. This blog post describes the principles of Intuitive Eating and how they can be applied during one’s GLP-1 journey.
Intuitive Eating is an evidence-based eating framework that aims to improve wellness by connecting mind, body, and instinct. However, one’s natural intuition on how to achieve health and nourishment can become disrupted by years of dieting, misinformation, deprivation, body mistrust, and health conditions. The principles of intuitive eating aim to increase responsiveness to biological hunger and fullness cues while honoring pleasure and inner wisdom. The authors of the best selling book, dietitians Evelyn Tribole and Elyse Resch, break down the Intuitive Eating philosophy with 10 principles.
Principle 1. Reject the diet culture
Many higher weight individuals have been immersed in diet culture for years. Approximately 76% of people categorized as obese tried diet and exercise to manage their weight (compared to 26.5% of “normal” weight individuals). And these diets have done you dirty! It’s estimated that up to 95% of dieters will regain more weight than they lost within five years.
If this was you, know that you didn’t fail the diet, the diet failed you. And don’t beat yourself up if you’ve tried numerous diets. The diet industry is a master shape shifter, slyly rebranding itself into the “next best thing.”
GLP-1 medications are not a diet, and you don’t need to diet while on one. This is the time to heal your relationship with food, not start another miserable diet! Promise yourself that it’s different this time and that you’re finally done with the on-again, off-again diet hamster wheel. The first step in healing your relationship with food, mind, and body is to reject diet culture from here on out.
Some diets are obvious to spot, whereas others are more insidious. A good way to spot diet culture is to notice any program, “lifestyle” or nutrition plan that promotes unrealistic and rigid rules, demonizes food, ties food or weight to moral value, and/or prioritizes weight loss.
Principle 2. Honor your hunger
Hunger is biologically natural and a sign that we’re alive! When we are aware of the physical sensations that signal we need to eat, we’re able to keep our bodies fed with adequate energy. Bodies need energy every hour of the day. Even at rest, the body needs energy to perform its most basic functions. Give yourself unconditional permission to eat when your body needs fuel. If you don’t, it’s much more likely you’ll overeat at the next meal due to a primal drive to seek nourishment.
It’s true that GLP-1s will suppress some hunger, but it will not eliminate it all together; and that’s a good thing! Some folks have become afraid of or frustrated by hunger because in the past, physical hunger was present despite the body being adequately fueled. It’s possible that this type of constant hunger is the result of hormonal and metabolic issues; things that GLP-1s help with. While on a GLP-1, you’re less likely to get this type of chronic hunger. During this time, make an effort to re-connect to hunger cues and re-establish a trusting relationship with your body. Pay attention to both obvious and subtle hunger cues (e.g., headache, low energy, etc) so that you can honor it.
Principle 3. Make peace with food
Nothing tastes better than forbidden. Telling yourself that you can’t or shouldn’t have a particular food, can lead to uncontrollable cravings and binge eating. The only food you “shouldn’t” have are ones that are spoiled, poisoned, or you’re legitimately allergic to. No one will develop a nutrient deficiency just because they allowed themselves to eat dessert, fast food, processed food, etc.
Making peace with food means to give yourself full allowance to eat anything, at any time. By doing so, it removes the thrill and fixation which in turn, frees you to experience food neutrally and honestly. Many people discover that when they give themselves full permission to eat what was once deprived, they eventually discover it wasn’t that irresistible after all.
During a GLP-1 journey is a great time to introduce new foods or eating patterns (e.g., snacking) that were previously avoided. You may have a history of not trusting yourself with certain foods out of fear of binging on it. GLP-1 medications influence the dopamine pathway by decreasing the reward that is felt and many people report a significant decrease in food’s reinforcing power. Practice making peace with all foods and trust that you can learn how to eat anything and everything in moderation.
Principle 4. Discover the satisfaction factor
Humans are biologically wired to derive pleasure from eating; this is what helps motivate us to do it again so that we stay alive. Food is so much more than fuel. It’s a part of our culture, our family traditions, and is a joyful part of living. When you eat what is genuinely pleasurable to you, you’ll feel satiated and content; an important part of wellness. Diet culture imposes many rules and restrictions on what you can and cannot eat (eh hm, no carbs) which limits the joy you derive from eating. How sad!
There are GLP-1 receptors in cells all throughout the body including the tongue. This means that while taking the medication, you may notice increased taste sensitivity. What a great opportunity to experiment with new foods and explore what truly tastes and feels good to you.
Principle 5. Feel your fullness
Diet culture has created a lot of anxiety and shame around fullness which ultimately resulted in many people learning to avoid or ignore the sensations. Also, chronic distractions between eating on the go to eating while looking at a device have made it extra challenging to experience fullness cues. Reconnecting to satiety signals requires mindfulness and some practice.
GLP-1s make it easier to experience fullness by slowing gastric emptying. However, it’s still important to practice appropriate meal pacing and stopping to mindfully observe fullness cues. Pacing is important because your body needs time to receive fullness cues. If you eat too quickly, you may become uncomfortably full before your brain receives the signal that you’re no longer hungry.
At the end of this post is an option to download a hunger/fullness scale which can be handy when observing the subtle differences between being hungry, neutral, and full. *Note: eating past fullness and eating while distracted from time to time is completely normal.
Principle 6. Challenge the food police
The “food police” are the internal and external messages that enforce diet culture rules and myths. The food police messages are unreasonable and they constantly change. Food has no moral value which means you are not “bad” if you eat cake, just as you’re not “good” if you exercise in order to earn your food.
While on a GLP-1 medication, you might be introduced to new food rules such as how many grams of protein you must consume or how much of a caloric deficit you need. Separate the helpful suggestions from the diet culture noise. Remember, food police is rigid, unworkable, and uses guilt and shame to motivate behavior. Practice softening the strict rules that usually include “shoulds,” “oughts,” “musts,” and “good” vs “bad.” You are the expert of your body; attune to what feels good and what personally works for you. Flexibility is key.
Principle 7. Cope with your emotions with kindness
Food won’t fix feelings. Notice the ways you’ve used food to cope with stress and painful emotions and know that it’s normal. So many people find comfort and distraction from difficult situations and feelings with food. And still, food cannot solve problems or resolve emotional issues in the long-term. Rather, emotional eating is likely to make you feel worse over time. The aim here is not to totally eliminate emotional eating, but rather to expand your tools for coping.
During a GLP-1 journey, it may become even more apparent the role food played in emotion regulation. With the food noise and cravings quieted, you may notice unresolved anxiety, boredom, sadness, or anger. Ask yourself (or explore with a mental health therapist) how else you can practice self-compassion and tend to psychological challenges. Remember that feeding yourself adequately and regularly are actions of self-care.
Principle 8. Respect your body
Diet culture has many people convinced that “beautiful” has a very particular look. And that look is thin. Although there’s been some progress with celebrating diversity including size diversity, there’s still a long way to go. In the meantime, it’s important to reject any narrow definitions of health and beauty.
Some research reports that up to 70% of weight variation is attributed to genetics (more than any other trait). It’s important to accept your genetic blueprint and let go of an “ideal” body or exact goal weight. Know that bodies come in all shapes and sizes. Your body is your home for life, treat it with loving self-talk and loving actions.
It’s easy to get swept up in the glorification of weight loss during a GLP-1 journey. But I’m willing to bet that weight was only one factor in your decision to take a GLP-1 medication. Remember your why, and let go of chasing a particular “look” or rigid weight loss goals. You can do so by centering non-scale victories and by being willing to let the “weight” chips fall where they may. Try trusting that a healthy body weight for you will be wherever your weight settles as you give your body what it needs (food, water, movement, sleep, and GLP-1!). Listen to your body and treat it with respect.
Principle 9. Movement — feel the difference
There’s no need to be obsessive and militant about exercise just as there’s no need to “earn” your food. Take notice and let go of strict regulations dictating what you must do for exercise, for how long, and to what end. Be mindful of how it feels to move and stretch your body, instead of the calorie-burning effects of exercise. This means you can reject any rigid rules about what “counts” as exercise in order to find joy in movement.
There are so many way to move and stretch a body that don’t require going to the gym or even breaking a sweat. Finding ways to move your body that’s truly enjoyable, is much more likely to motivate you to do it again and again. If exercise becomes a punishment, it will soon become a dreaded chore. Know that whatever is punished, you get less of.
It’s true that strength training is particularly helpful in mitigating lean body mass loss during a GLP-1 journey. If you’re open to weight-lifting, try flexibly experimenting with it. This means that you may opt for a 30-minute at home dumbbell workout or join a local gym. What’s most important is that you re-establish a rewarding relationship with movement that’s sustainable, workable, and convenient for you.
Principle 10. Honor your health with gentle nutrition
A commonly misunderstood assumption of Intuitive Eating is that its framework is solely about eating when you’re hungry and stopping when you’re full. Or eating whatever you desire; however you want, whenever you want. Such notions are overly simplistic understandings of Intuitive Eating which ignores several principles including principle 10: honoring health with gentle nutrition.
Gentle nutrition is about utilizing your knowledge of food, health, fitness, and your own body in order to make decisions that nourish you and honor your inner wisdom. Being gentle with nutrition means that you trade unsustainable health standards for a flexible, personalized, and intuitive mindset. It’s the middle path between unrelenting adherence to diet culture “rules” and eating whatever you have a craving for. This final principle is about practicing workable behaviors that promote your emotional and physical health.
GLP-1 medications affect parts of the brain that are linked to hunger (e.g., the hypothalamus) and they also affect the dopamine pathway by reducing the reward that is felt from eating. With the food noise and food cravings quieted, you may observe that it’s easier to make intuitive decisions that honor both well-being and taste preferences. You can use this increased mental bandwidth to allow your knowledge of nutrition to flexibly inform food choices while connecting to how your body feels.
Practicing this principle may also look like making a decision to eat even when you’re not hungry because you know that your body needs fuel.
Lastly, please know that you do not need to eat perfectly to be healthy and remember nutrition is only one piece of a multifactorial health picture.
In conclusion, there are many benefits of a GLP-1 medication that make the practice of Intuitive Eating more accessible than ever before. If you have tried to apply the principles of Intuitive Eating (in the past or recently) and felt it didn’t work for you, I encourage you to consider (or reconsider) how it could benefit you now. The practice of Intuitive Eating can be the path to food freedom and set a person up for success on any GLP-1 journey. If you’d like support around taking a GLP-1 medication, I am here to help. Reach out to schedule a phone call with me and learn more about my GLP-1 counseling services.
Download The Hunger/Fullness Scale:
