3 Reasons Why Intuitive Eating Works For Gestational Diabetes

When it comes to managing gestational diabetes and deciding on your best course of action, you’ll likely be met by a barrage of information and advice. “Eat this, not that.” “Make sure you workout, but not too much.” “Say goodbye to carbs for the next 3 months.” But what if your approach could feel simple and sustainable? 

What if intuitive eating could help you keep your relationship with food front of mind while you also manage your blood sugars and support a healthy pregnancy? 

Read on to learn more about some of the research behind intuitive eating for gestational diabetes and see how you can apply this approach to your pregnancy.

First off- what is intuitive eating?

There are 10 essential principles to Intuitive Eating:

Intuitive Eating, established by dietitians Evelyn Tribole and Elyse Resch in 1995, is a proven mind-body approach with 10 Principles. Supported by 90+ studies and a weight-neutral stance, it fosters a strong mind-body connection, promoting self-care through heightened interoceptive awareness to meet individual physical and psychological needs.

1. Reject the diet mentality
2. Recognize your hunger
3. Make peace with food
4. Challenge the ‘food police’
5. Feel your fullness
6. Discover the satisfaction factor
7. Cope with your feelings without using food
8. Respect your body
9. Movement- feel the difference
10. Honor Your health- Gentle Nutrition

Intuitive Eating is a rejection of diet culture and restriction. It’s all about developing and fostering self trust in an attempt to be able to understand your body cues, honor them, and move on. No calorie counting, ruminating, or guilt over what you eat. It’s about making peace with ALL foods and responding to your body’s needs with compassion instead of judgment.

If you’re interested in learning how to practically apply these principles to your pregnancy, be sure to check out my blog series that goes more in depth. Start with principle #1 here.

What About the Research?

If this all sounds a little too good to be true or too woo-woo, I hear you. It is a different approach than what many healthcare providers will teach and it certainly goes against the diet culture most of us have grown up in. I know you want the best for your baby now and into the future. Rest assured, this Intuitive Eating approach IS evidenced based (meaning studies show it makes a difference in health outcomes).  

Let’s dive into some of the research together to see what it has to say about health outcomes when intuitive eating is applied in pregnancy. I’ll work to keep this simple and highlight the facts (because I know not everyone loves all the research and science-y parts like I do lol, no judgment, I get it) but if you’d like to look into these studies more, they will be linked throughout this blog.

3 Reasons Why Intuitive Eating Works For Gestational Diabetes

1. Supports glucose management during pregnancy

We’re going to look at a few different studies throughout this post, but let’s cover one of my favorites first. This research takes a closer look at the benefits of intuitive eating during your pregnancy (later we’ll talk about benefits related to actual birth).

I have to start by mentioning something called the intuitive eating scale. This scale, or “quiz”, is essentially an assessment designed to show you how “well” you are implementing the principles of intuitive eating. 

A study looked at the relationship between intuitive eating scores and the experience a group of folks had in pregnancy (essentially, did a higher intuitive eating score have any effect on things like blood sugar, weight gain, etc.). You may be surprised at the findings:

Research (linked at the bottom of this article) has shown the following:

• Higher Intuitive Eating Score, lower weight gain in pregnancy: For every one point greater total Intuitive Eating Score at baseline, there was a 1.7kilogram (or 3.7 pounds) lower gestational weight gain (Paterson, 2019). Y’all know I don’t love focusing on weight gain in pregnancy and we also know from other research that “normal” gestational weight gain varies from person to person and pregnancy to pregnancy and is NOT a direct measure of your health or the babies health. BUT it is interesting that for folks who practice Intuitive Eating have less gestational weight gain. Not by alot, but it was significant enough to drawn the correlation. I suspect this may be due in part to the benefits of Intuitive Eating helping with binge eating, honoring hunger cues, being able to feel fullness, and generally eat foods that are nourishing without judgement.
• Better glucose management postpartum: research showed a lower fasting plasma glucose (aka your blood sugar first thing in the morning)  at 6-8 weeks postpartum (Quansash, 2019). A lot of the work you will be doing in your pregnancy when you have gestational diabetes is working to manage your blood sugars. This is why it’s exciting to see that a higher intuitive eating score was related to an easier time keeping blood glucose where it should be. I also know how tricky it is to get those fasting numbers in range for so many of you!
• Additional postpartum benefits: I know this isn’t related to the actual time of pregnancy, but it’s also important to note that this study found higher intuitive eating scores associated with higher body image satisfaction, less disordered eating, less depression symptoms (Lee, 2020). This is amazing news! 

This research and the assessment scores show us that intuitive eating can have a variety of positive outcomes for blood sugars, body image, and more! This is why it’s so important to not overlook the positive impact intuitive eating can have on not only your mental, but also your physical health.

Learn where you fall on the scale by completing the assessment here.

2. May reduce complications during birth

Now that we’ve looked at the pregnancy experience, let’s take a look at the birth experience. Many pregnant folks with gestational diabetes will be encouraged to be induced early, and this is the route many will take, due to possible complications at birth. But what if managing your gestational diabetes and blood sugars well during pregnancy could reduce the numbers of complications and therefore the need for induction?

If you have gestational diabetes, treatment with nutrition changes, exercise, and sometimes medicine, is necessary to maintain healthy blood sugar levels. When the risk of complications from gestational diabetes is reduced with treatment, then there is usually less potential benefit from labor induction for gestational diabetes. Put another way, folks with well managed gestational diabetes tend to have similar birth outcomes to folks without gestational diabetes. 

To make a long story short and sum up some of the research found in the Hyperglycemia and Adverse Pregnancy Outcomes” (HAPO) study, when you have gestational diabetes, it is common practice to recommend induction, however the American College of Obstetrics and Gynecology recommends:

• Against induction before 39 weeks if your condition is well managed with diet and exercise alone and waiting until 40 weeks and 6 days for labor to start on its own 
• Induction before 39 weeks if blood sugar is not well managed, but there are tradeoffs with having a baby born prematurely too

This shows us that your condition CAN be managed through certain lifestyle changes, like nutrition and movement, which may reduce your need for induction! So don’t be afraid to see what approach works best for you when it comes to managing your blood sugars and gestational diabetes. It may even benefit your birth experience!

3. Can improve postpartum body image, fasting glucose, and more

Having gestational diabetes during pregnancy can increase your chances of developing diabetes after pregnancy. A clinical cohort study investigated the association between intuitive eating and metabolic health during pregnancy and in the early postpartum period among folks with gestational diabetes. Their research found that adhering to intuitive eating guidelines could represent a novel approach to weight and glucose control during and after pregnancy in folks with gestational diabetes.

They also conducted a study in folks with gestational diabetes and those who are at higher risk for gestational diabetes to evaluate the associations between intuitive eating during and after pregnancy with metabolic health at 1-year postpartum. One hundred seventeen women who consented and completed the French intuitive eating questionnaire during and after pregnancy were included. 

Their research found an association between intuitive eating during and after pregnancy with lower body mass index, weight retention, fasting glucose, and HbA1c at 1-year postpartum in women with gestational diabetes mellitus and in high-risk gestational diabetes mellitus in the postpartum period. They said “our results suggest that intuitive eating could be an effective intervention for weight and glucose control in women with gestational diabetes mellitus.” GREAT NEWS!

So why might intuitive eating present these benefits? For starters, intuitive eating is a more holistic, sustainable approach to eating. While traditional diets and restrictive behaviors can lead to things like binge eating, weight-cycle, and poor body image (which all have their own negative impact on your health), intuitive eating focuses on incorporating foods you enjoy and foods that nourish your body. 

TLDR:

Gestational diabetes, pregnancy, and intuitive eating are all very nuanced topics that require careful attention and a lot of self-compassion. BUT, if you are feeling frustrated by “traditional” gestational diabetes advice and are wondering if intuitive eating could work, I hope this article assures you that intuitive eating is showing positive outcomes AND there is research supporting this approach.

As a gestational diabetes dietitian and doula, I can also assure you that this is the method I follow with almost all of my clients. My goal is to help you have a pregnancy that feels good both physically and mentally, and for you to be able to sustain a healthy relationship with food beyond pregnancy.

If you’d like support as you implement the intuitive eating principles and work to have a healthy pregnancy with gestational diabetes, I’d love to support you. Click here to book a free call to chat more about my approach and services.

Emily Piazza, MS, RDN, CD Gestational Diabetes Dietitian & Doula

I’m Emily, an anti-diet registered dietitian, nutrition therapist and doula. I love working with people who want to feel great in their bodies, ditch diet culture, be their own advocate and can listen to and follow their own intuition. You deserve to have an empowering journey through pregnancy, birth and postpartum and I’m here to help.

Sources: 

Kim, S. Y., England, L., Wilson, H. G., et al. (2010). Percentage of Gestational Diabetes Mellitus Attributable to Overweight and Obesity. American Journal of Public Health; Vol. 1, No. 6: 1047-1052.

Leahy K, Berlin KS, Banks GG, Bachman J. The Relationship Between Intuitive Eating and Postpartum Weight Loss. Matern Child Health J. 2017 Aug;21(8):1591-1597. doi: 10.1007/s10995-017-2281-4. PMID: 28176035.

Lee, Megan; Williams, Susan; Burke Karena  (2020) Striving for the thin ideal post-pregnancy: a cross-sectional study of intuitive eating in postpartum women, Journal of Reproductive and Infant Psychology, 38:2, 127-138, DOI: 10.1080/02646838.2019.1607968

Adewumi,Opeyemi; Knol, Linda;  Douglas, Joy. Relationship Between Mindful or Intuitive Eating and Gestational Weight Gain: A Systematic Review, Current Developments in Nutrition, Volume 5, Issue Supplement_2, June 2021, Page 705, https://doi.org/10.1093/cdn/nzab046_002

Quansah DY, Gross J, Gilbert L, Helbling C, Horsch A, Puder JJ. Intuitive eating is associated with weight and glucose control during pregnancy and in the early postpartum period in women with gestational diabetes mellitus (GDM): A clinical cohort study. Eat Behav. 2019 Aug;34:101304. doi: 10.1016/j.eatbeh.2019.101304. Epub 2019 May 25. PMID: 31154153.

Paterson H, Treharne GJ, Horwath C, Haszard JJ, Herbison P, Hay-Smith EJC. Intuitive eating and gestational weight gain. Eat Behav. 2019 Aug;34:101311. doi: 10.1016/j.eatbeh.2019.101311. Epub 2019 Jul 9. PMID: 31330479.