Intuitive Eating While on a Medical/Therapeutic Diet

On my blog, I talk a lot about how the ‘average Joe’ is better off following the least restrictive diet possible. The media likes to sensationalize claims about the health benefits of avoiding gluten or dairy (or other random ingredients), especially without much evidence/support.

A lot of my motivation for debunking those claims comes from personal experience with unnecessary dietary restriction (surprise, surprise…)

During my disordered eating days, I ran the whole gamut of different diets…everything from vegetarian and vegan, to Paleo, to gluten-free, to dairy-free, to low-carb. None of them were medically necessary for me (though I was completely convinced that I had medical reason to be gluten-free for about 2 years) and none of them actually made me feel better, physically. On some of them I lost weight, which was always the underlying goal if I’m going to be totally honest, but on many of them I actually ended up gaining weight because they made me binge. The mental strain of restriction has a way of making cravings intensify. Even today, I sometimes find myself feeling like I should maybe avoid dairy or gluten because of suspicious symptoms, but just the festering thought of doing that makes me crave desserts. Sometimes I even end up overeating as a subconscious reaction to the lingering fear of food deprivation. It’s a real thing!

For *most* people, dietary restrictions are unnecessary. But what about when they aren’t?

But what about the situations when dietary restriction isn’t just a symptom of an eating disorder, but instead has evidence to be therapeutic for a person’s given medical condition?

As a functional medicine doctor, I work with these individuals every single day. My 9-5 is filled with people whose physical health would (and usually does) benefit from medically-supervised, restrictive diets, which are initiated for a therapeutic purpose for which there is scientific evidence. In other words, restrictive diets are clinically-indicated for many of my patients. If you are one of those people, I want to encourage you that intuitive eating is for you, too.

Intuitive eating is for you, too.

Medical/therapeutic diets and intuitive eating aren’t mutually exclusive. They can, and should, co-exist.

Before I dive into some tips for maintaining a sense of food freedom, even with medically-indicated dietary restrictions, I want to make one thing clear: restrictive diets, even with clinical evidence, are not the *only* solution for managing a health problem. There are always, always other options, and if your doctor doesn’t tell you that, find a new doctor.

Second, healthcare providers should always evaluate the risk/benefit of the diet in the context of the patient’s health history. For patients with a history of disordered eating/eating disorders, the risk of relapse is real and should not be ignored. A dysfunctional relationship with food creates significant health problems—physical, emotional, and spiritual—and these health problems are just as valid as migraine headaches, digestive issues, or a skin rash. You have the right, and your doctor has the responsibility, to consider the unwanted side effects (if we might call them that) which might be caused by the diet. If the risks (i.e. emotional trauma or relapse) outweighs the potential benefit, a medical diet is not appropriate for you.

Tips for Eating Intuitively on a Medical/Therapeutic Diet

1. Eat enough, eat early, eat often.

Dietary restrictions can make it difficult to figure out what to eat. When your go-to or favorite foods become off-limits, it’s not always easy to find alternatives. For example, if you find out that you have a dairy allergy and need to eliminate dairy from your diet but are accustomed to half-and-half in your coffee and yogurt for breakfast, suddenly your morning source of fat and protein is off limits. Skipping those macronutrients at breakfast isn’t going to help you, so it’s essential that you continue to eat balanced, regular meals. This means eating a source of protein, carbs, and fat at every meal, and ideally every snack, too. It also means eating frequently enough throughout the day, trying not to go more than 3 hours between.

Skimping on macronutrients or calories not only makes us feel awful (hello, low energy, insomnia, anxiety, headaches…) but it can trigger overeating and binge eating behavior. Getting enough calories can be a challenge with most restrictive diets, and so my #1 encouragement is to make sure you’re getting enough food in general.

2. Satisfaction is key.

Let’s go back to the non-dairy example for a minute. Let’s say you eat yogurt every morning because you like to eat yogurt, and it offers enough protein so that you remain satisfied throughout the morning. Those are both really good reasons to eat yogurt. Without being able to eat dairy, it can be difficult to find a replacement food that tastes similar but offers the same nutritional value. (Coconut milk yogurt, for example, has far less protein than dairy yogurt.) Instead of caving in to convenience, think hard about which types of foods you tend to find satisfying and why, and research examples of other sweet or savory foods that you might enjoy. Keep a list so that when you have a taste for yogurt with fruit, for example, you know where to look for other ideas that will be both filling and satisfying. (Overnight oats made with almond milk and non-dairy protein powder, for example.)

3. Don’t read between the lines.

Another thing to keep in mind is that one necessary dietary restriction doesn’t mean they are all necessary for you.

A church friend of ours has celiac disease and needs to avoid gluten. We had her and her husband over for dinner a few weeks ago and when I was looking up gluten-free dessert recipes, I was frustrated that the majority of the ones I found were not only gluten-free, but sugar-free, dairy-free, and a million-other-things-free, too. I wasn’t trying to make a “clean” pseudo-dessert, I just wanted a good recipe for a tasty and satisfying dessert that would be safe for my friend to eat.

I can’t, of course, knock down recipes that I haven’t tried. But I’ve eaten enough banana “nice” cream and date-based brownie bars in my disordered eating days to know that I don’t like them even 1% as much as I like the real thing.

Just because the internet is overrun with excessively restrictive recipes doesn’t mean that you need to follow suit. Dig a little deeper (and maybe avoid Pinterest) so that you can find recipes that are the least amount of restrictive possible while still following your medical/therapeutic diet.

4. Bring a dish.

Restrictive diets easily can get in the way of our abilities to participate in social activities that involve food. Birthday parties, holidays, and other celebrations almost always involve snacks or meals, and in most cases, those snacks or meals aren’t necessarily compliant with dietary restrictions. (How could they be? There are so many different types of dietary restrictions.)

One of the ways that I encourage patients when they are attending these events is to bring a dish to share. That way, they don’t have to feel isolated by the fact that their BYO meal looks so different from the other party food, and they can bank on having an option or two that they know will be satisfying. When we don’t come prepared, we can feel really limited by the snack or meal choices, being stuck eating plain salad because the macaroni and cheese or fried chicken aren’t gluten-free, for example. Bringing a dish or two to share is a great way to make the meal and snack experience feel as normal as possible.

5. Find community with non-food activities.

Just like parties can be particularly challenging with restrictive diets, regular social meet-ups often revolve around food, which can create extra stress/pressure surrounding dietary restriction. While most restaurants are able to accommodate dietary restrictions in some capacity, sometimes it can be easier to avoid those situations altogether.

Instead of going out with a friend for lunch, try meeting up at a park for a walk, getting together for a game night, joining a book club, or finding other activities/hobbies that you can share together that don’t involve food. This isn’t to say that there isn’t value and goodness in breaking (gluten-free) bread together, but it can be refreshing to avoid those situations at times instead of constantly being bombarded with the reminder that you need to eat differently. In the same way, dietary restrictions can create food preoccupation, and having opportunities to invest in activities and relationships that don’t involve food can offer a welcome respite.

I share more about navigating a healthy relationship with food, even one that involves dietary restrictions, in my new book, Fulfilled. In addition to sharing about my own experiences with restrictive diets, I explain in the book how I walk clients through the process of cultivating a sense of balance in their relationships with food, exercise, and their bodies. Fulfilled is available for pre-order at AmazonBarnes & NobleIndieBound, my publisher’s website, or any online or retail shops where you usually buy books!


3 thoughts on “Intuitive Eating While on a Medical/Therapeutic Diet

  1. Pingback: Wednesday Thoughts
  2. That was a great read! What would you suggest for a newly diagnosed diabetes person who does not want to be on metformin for the rest of their life?


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s