Q. I am a "complimentary" health care practitioner. It's very popular among my colleagues to recommend intense dietary restrictions to most of our patients (such as no sugar, no dairy, no wheat). After reading Intuitive Eating, I'm concerned that in the absence of a documented condition such as celiac disease, we may be doing more harm than good as we just add to the guilt and shame our patients already feel about food. What are your thoughts?

A. I agree with your inclination. Well-meaning diet restrictions may do more harm than good, especially when you factor in mental health and wellbeing. To achieve authentic health, a person needs to be attuned and responsive to inner satiety cues and basic needs. This includes the ability to eat in a manner that is satisfying and pleasurable.

Yet the pleasure of eating has become a lost art in the USA. Instead, eating is commonly viewed as something that will kill you, cure you, or make you fat. This is where we can take a lesson in the pleasure principle from France.

An international study found that Americans worry the most about their health and enjoy eating the least. In contrast, the French are the most food-pleasure-oriented and least food-health-oriented. [1] Notably, France has nearly half the obesity rate compared to the USA, for both adults and children [2].

When food restrictions are placed on a chronic dieter, or on a person who chronically feels guilty about eating, it increases the “forbidden food” burden. Consequently, rigid food rules interfere with the individual's ability to "hear" or be attuned to the eating experience of his or her body.

Instead, upon eating forbidden foods, there is usually a tremendous feeling of guilt, which becomes somaticized. For example, chronically dining on sugary, processed foods and meals doesn't usually feel good, physically—but this physical discomfort is equated to the emotional feeling of guilt. But when morality and judgment is removed from the eating experience, a person can truly ask, “If given the same set of circumstances, would I choose to feel this way again.” Usually, the answer, is no.

Ultimately, it feels better when you eat healthy, satisfying meals, most of the time. But this needs to be experienced, without judgment. If a person is truly inner-attuned, it’s possible to eat within any dietary framework such as “eating green” or eating “whole foods”, while paying attention to hunger, fullness, satisfaction and so forth.

[1]Rozin P et al (1999). Attitudes to food and the role of food in life: Comparisons of Flemish Belgium, France, Japan and the United States. Appetite,33, 163–180.

[2]International Obesity Task Force EU Platform Briefing Paper http://www.iotf.org/media/euobesity3.pdf [accessed May 12, 2010].