IE is not a diet or a specific food plan. Instead, it focuses on interoceptive awareness, which involves identifying, understanding, and responding to internal signals and the body’s physical and emotional cues (e.g., feelings of fullness, hunger, racing heartbeat, sadness), to establish a healthy and trusting connection with food, the body, and emotions. Although IE may result in weight change as a byproduct of this improved relationship, weight is not the primary focus of this approach.^[1]

IE is a weight-neutral approach. The ultimate goal of IE is a transformative shift in a person’s overall approach to eating. IE is founded on 10 principles of self-care, and the process of change is divided into 5 main stages.^[1]

IE is based on the following 10 principles:

1. Rejecting the widespread mentality that a healthy weight can only be achieved through restrictive diets
2. Listening to the body’s hunger cues and eating when one is hungry, not when one is ravenous
3. Eating all foods and rejecting feelings of guilt or judgment around certain foods
4. Identifying and challenging negative thoughts and beliefs about eating certain foods
5. Recognizing signals of fullness and satiety
6. Eating foods that provide both physical and emotional satisfaction
7. Finding kind ways to cope with emotions instead of turning to food
8. Respecting and accepting one’s body, regardless of appearance
9. Moving and exercising for the joy and well-being it brings, not just to burn calories
10. Prioritizing overall health and well-being in making food choices

As outlined in the original IE approach, the first stage of change typically involves a readiness to “try something different” after a history of unsuccessful dieting attempts. This phase is followed by an explorative phase during which people consciously refamiliarize themselves with their intuitive signals (e.g., hunger, satiety, and taste preferences) and experiment with new foods that were previously restricted. This conscious thinking then solidifies into long-lasting behavioral changes during the crystallization phase, in which obsessive thoughts about food fade, and decisions regarding food become more intuitive. During this phase, people might still exceed their fullness cue, or regularly eat previously “forbidden” foods, but usually in smaller amounts before feeling satisfied. In the fourth stage, called the intuitive eater awakens phase, intuitive eating becomes more effortless. In this phase, people may begin to see a shift in their food choices, less fear in dealing with emotions, and increased acceptance and respect for their body. Finally, in the last stage, the treasure the pleasure phase, the changes achieved in earlier stages becomes the “new normal”. People in the last stage now view food, emotions related to eating, and physical activity in a different way, honoring and valuing their bodies for what they truly are.^[1]

IE and other nondieting approaches, such as the health at every size (HAES) approach and mindful eating, share many common components. However, they differ in their emphasis on certain aspects. HAES is both a treatment approach and social justice movement that promotes health-supportive behaviors and access to resources for people of all sizes while acknowledging that health is not determined solely by body weight.^[9] IE emphasizes developing a healthy and positive relationship with food by listening to the body’s signals. In contrast, mindful eating involves being fully present and aware of the act of eating, savoring the taste and texture of food, and eating at a slower pace without any distractions.^[4]

Forming a healthy relationship with food requires time and effort. A healthy relationship with food incorporates principles like relaxed eating, preference over position, balance, and flexibility.

Relaxed eating involves listening to your body’s hunger and fullness cues and being attuned to all aspects of food, including emotional and social aspects. It involves eating with flexibility and enjoyment without feelings of guilt or judgment. “Preference over position” emphasizes the importance of choices, adapting decisions to different situations, and avoiding rigid eating habits or food preferences that could lead to obsessive behaviors. Balance encompasses consuming a variety of foods, eating everything but in moderation, eating for both nourishment and pleasure, and rejecting restrictive diets for better physical and mental health. Flexibility involves being able to deviate from preferred food choices and quantities and allowing yourself to be spontaneous. Flexibility is not synonymous with a lack of self-control or poor health, and it’s an important aspect of a healthy relationship with food.^[11]

IE is intended for everyone who wants to improve their relationship with food, whether they are following strictly prescribed diets to lose weight or restricting their eating habits to improve their health. According to IE, various eating personalities may benefit from this approach — for example, “careful eaters” who scrutinize every food situation, people who constantly diet and jump from a diet to the latest trendy one, and “unconscious eaters” who are unaware of when they eat because it often happens while doing something else, like watching TV, working, or studying.^[1] More research is required to assess the benefits of following an IE approach for specific groups of people, such as people with eating disorders, people with obesity, and people with chronic illnesses.

IE is typically delivered by IE-certified medical professionals such as dietitians, doctors, pharmacists, health coaches, and psychologists. This delivery can be done either through face-to-face workshops or guided self-help programs. One study found that when intuitive eating is delivered through a guided self-help modality, the participants showed better retention and attendance, compared to workshop delivery.^[8] However, more research is needed to evaluate the effects of specific delivery methods on long-term outcomes.^[3]

Contrary to common misconceptions, IE is not synonymous with uncontrolled eating. Additionally, IE does not appear to lead to an increase in body weight or a decrease in diet quality, as it is often believed. Instead, IE is about making peace with food and the unconditional permission to enjoy foods, including those previously considered “forbidden”, while remaining in tune with the body’s physical and emotional cues in order to accurately meet one’s needs. ^[1]

Preliminary results from various IE intervention studies indicate that diet quality is either maintained or improved while following an IE approach.^[6]

It’s important to note that although IE does not prescribe specific foods to eat or avoid, it does not deny the health benefits of consuming certain categories of food (e.g., fruits, vegetables, fish). Similarly, IE does not deny the health benefits of exercising, but there is an emphasis on helping people focus on how exercise makes them feel (e.g., better sleep, less stressed, more empowered, more energetic), instead of how it makes them look. ^[1]

“Reject the diet mentality” is a core principle of IE. According to Tribole and Resch, people with a diet mentality typically believe that to lose weight or be healthy, they need to follow a restrictive diet or control the types and/or amount of food they eat. IE discourages this way of thinking, which means that following an IE approach while dieting to lose weight contradicts the core principles of IE.

The IE approach emphasizes prioritizing interoceptive awareness (the ability to recognize the body’s signals and emotional state) over weight loss, which should be deprioritized. Weight loss requires substantial dietary restraint and often ignoring hunger cues, which is not compatible with IE.^[1]

A weight-neutral context is critical to retain fidelity to IE’s unique approach.

Sometimes dietary interventions are necessary due to underlying medical conditions, such as diabetes, allergies, and celiac disease. One study from 2022 assessed the association between IE scores and diet quality among women with gestational diabetes at one year postpartum. The study found that higher IE scores were positively associated with improved diet quality. IE scores were also inversely associated with weight, body fat, and insulin resistance.^[10] Moreover, the adherence to the Swiss Society of Nutrition (SSN) dietary recommendations (particularly recommendations on dairy, fiber, and fruit intake) was evaluated, and higher IE scores were associated with improved adherence. This study included only cross-sectional and longitudinal associations, and the intuitive eating scale (IES) that it used was adapted, including only 2 out of its 3 subscales. It’s also important to note that the results were not consistent among the 2 IE subscales used. Therefore, the results should be interpreted with caution.

Additionally, it’s important to note that although IE encourages eating all foods and rejecting dieting as a mentality and food-related guilt, it acknowledges that people with chronic diseases (e.g., celiac disease) or food allergies have to eliminate certain foods from their diet to prevent symptoms. According to the IE approach, people who have to eliminate certain foods from their diet can continue to do so while still using IE to improve their overall relationship with food.^[1]