When most people think about “healthy eating”, they usually focus on what they eat. That might mean trying to eat more fruit and vegetables or less fast food, or counting calories.

But there’s a lot more to healthy eating than just dietary intake. Behaviours and attitudes around food are also important^[1].

Take, for example, orthorexia nervosa^[2], which is an obsessive preoccupation with consuming only “healthy” foods. If healthy eating only means ingesting healthy foods, then people with orthorexia are super healthy.

But people who live with this eating disorder often^[3] struggle with relationships and report poor quality of life, among other issues.

Research suggests that shifting the focus from food itself to our experience of eating can have a range of health benefits. Let’s take a look.

Why are we so obsessed with diet?

Equating “healthy eating” with “healthy diet” may have taken off in the early 1980s with panic over the “obesity epidemic^[4]” in Western countries – defined as a rapid rise in the prevalence of people in the population with a body mass index (BMI)^[5] of 30 or greater.

But causes of obesity are complex and poorly understood^[6], with numerous possible explanations beyond simply what a person eats. And admonishing overweight people to eat “healthier” has done nothing^[7] to reduce population rates of obesity.

There is some evidence that this fixation on weight has resulted in increased rates^[8] of disordered eating and eating disorders^[9] – both of which involve problematic eating behaviours and distorted attitudes towards food, weight, shape and appearance.

Clearly, something needs to change in how we think about healthy eating.

Listening to your body

A growing body of research on intuitive eating has found this approach has an array of health benefits^[10].

Intuitive eating^[11] means trusting internal body cues that tell us when, what and how much to eat. For example, tuning into your stomach growling telling you it’s time to eat, or noticing feeling full or satisfied, or that you may crave certain foods because your body wants specific nutrients (such as protein after exercising).

Studies have shown this approach can lead to^[12] better physical and mental health^[13] as well as better diet quality^[14], and is associated with lower BMIs.

Research also shows eating at regular intervals^[15] and eating with other people^[16] also lead to better overall health and diet.

But if you find it hard, you’re not alone

Most of us are surrounded by food environments that make healthy eating difficult.

Unhealthy food environments promote overeating and encourage us to override our innate signals of hunger and fullness.

When we’re surrounded by cheap and accessible sugary snacks, fast foods and large portions – and lots of marketing – it can be hard to develop a positive relationship with food.

The issue is particularly acute for people in more disadvantaged communities^[17].

For example, in our research with rural Australians about food and eating, most told us they wanted to eat more healthily, but found it difficult for many reasons^[18], These included busy schedules and the cost of healthier food.

Habits and emotional eating^[19] can also make healthy eating difficult.

So, what works?

For most people, healthy behaviours and attitudes to eating mean a balanced, flexible and non-judgmental approach, without fear of “bad” foods. It means paying attention to hunger and fullness cues.

But it also means recognising that food is a source of social and cultural connection. A healthy attitude to food doesn’t ignore nutritional information – it incorporates this knowledge into a broader and more joyous approach to eating.

Here are three suggestions to get you started.

1. Recognising signs of hunger and fullness

These may differ from person to person. Can you hear your stomach start to growl or your energy begin to dip? Is it a while since you ate? And while eating, is there a point where the hunger has gone away and you no longer feel a strong desire to continue eating? Some people find using hunger^[20] and fullness scales useful.

2. Reframing “bad” foods

Is there a food you really like but don’t eat because you consider it “bad” or “forbidden”? Try incorporating a small amount into your next meal or snack. You may find that doing so brings greater joy to your eating while simultaneously taking away its power^[21].

3. Eating with people

If you normally eat by yourself or “grab and go”, see if there’s a way to plan more time for meals and include other people^[22] – whether this is more family meals or group lunches with coworkers.

But some people have to follow a specific diet

People with medical conditions that require a particular type of diet – such as those with diabetes or coeliac disease – need to follow that advice. But they may still be able to have healthy behaviours and attitudes towards food even within these constraints.

For example, one 2020 study of people with type 2 diabetes^[23] found that more intuitive eaters had better control of their blood sugar levels.

The bottom line

So – if you don’t have a medical condition that prevents it – go ahead and have some of that birthday cake. And then listen to your body when it tells you you’ve had enough.

If you feel that you have an unhealthy relationship with food that is interfering with your life, please contact your GP to discuss your options. You may also want to contact the Butterfly Foundation^[24] for support.

References

1. ^{^} are also important (content.vu.edu.au)
2. ^{^} orthorexia nervosa (doi.org)
3. ^{^} often (pmc.ncbi.nlm.nih.gov)
4. ^{^} obesity epidemic (doi.org)
5. ^{^} body mass index (BMI) (www.ncbi.nlm.nih.gov)
6. ^{^} complex and poorly understood (doi.org)
7. ^{^} done nothing (doi.org)
8. ^{^} increased rates (butterfly.org.au)
9. ^{^} disordered eating and eating disorders (www.nationaleatingdisorders.org)
10. ^{^} array of health benefits (doi.org)
11. ^{^} Intuitive eating (www.intuitiveeating.org)
12. ^{^} lead to (breakbingeeating.com)
13. ^{^} mental health (doi.org)
14. ^{^} better diet quality (doi.org)
15. ^{^} regular intervals (doi.org)
16. ^{^} eating with other people (doi.org)
17. ^{^} people in more disadvantaged communities (doi.org)
18. ^{^} difficult for many reasons (doi.org)
19. ^{^} emotional eating (doi.org)
20. ^{^} hunger (www.health.qld.gov.au)
21. ^{^} taking away its power (www.sbs.com.au)
22. ^{^} include other people (doi.org)
23. ^{^} type 2 diabetes (doi.org)
24. ^{^} Butterfly Foundation (butterfly.org.au)