As a women's health dietitian specializing in endometriosis and fertility, I see many clients struggling with the overwhelming and often conflicting information on the best endometriosis diet plan. You've likely read about eliminating sugar, gluten, dairy, and red meat – a restrictive approach promising to heal your symptoms. But what if this restrictive endometriosis diet plan does more harm than good?

How a Restrictive Endometriosis Diet Plan Can be Harmful:

Let's be honest: strict diets are hard to maintain. People who follow strict diets that are not medically necessary (due to allergies or intolerances) are more likely to experience:

Bingeing: Feeling deprived sets you up for uncontrolled eating later, leaving you feeling worse physically and emotionally.

Guilt: Constant restriction breeds negative self-talk and guilt around food, creating a strained relationship with a basic human need.

Loss of Joy: Food becomes a battleground, stealing the pleasure of eating and adding stress to one's life. Avoiding specific food groups and joyful foods can lead to social withdrawal and missing out on connections with friends and loved ones.

Weight Cycling: Restrictive diets often lead to yo-yo dieting, which impacts metabolism and hormones and could potentially worsen endometriosis symptoms. Research indicates that dieting is a long-term predictor of weight gain. Furthermore, weight cycling is an independent risk factor for cardiovascular disease, inflammation, high blood pressure, and insulin resistance. 

Disordered Eating: Restrictive practices can develop into unhealthy eating patterns and body relationship issues that are difficult to break free from. Research shows that 35 percent of dieters will progress into disordered eating and some into a total eating disorder. 

Restrictive dieting for chronic pain like endometriosis can be particularly counterproductive. Here's why:

Stress: Dieting itself is stressful. When you add calorie and nutrient deprivation, it can compound those stress hormones and chronic stress is known to worsen pain perception. Not only that, but it can be challenging to cook and plan meals when you cut out processed foods, dairy, gluten, red meat and other nutrients.

Shrinking the Body: Chasing a smaller body size removes the focus from overall well-being and pain management. It can also fuel negative body image, impacting your mental health. For those who have had unintentional weight loss related to endometriosis, following a strict elimination diet can make it challenging to eat enough to regain weight.

Nutrient Deficiencies: Restriction can lead to missing essential nutrients needed for healing, immune function, and overall health. For example, many people with heavy bleeding have iron deficiency. Completely eliminating red meat may make it more difficult to meet iron needs. 

So, what's a better approach that empowers you and prioritizes your well-being? Intuitive Eating!

Intuitive Eating: Reconnecting with Your Body's Wisdom

Intuitive eating is about reconnecting with your body's natural hunger and fullness cues. Its philosophy goes beyond just food choices and fosters a more mindful and positive relationship with your body and health. Here are the core principles of intuitive eating:

Reject the Diet Mentality: Ditch the "good" vs. "bad" food labels and focus on nourishment. Intuitive eating encourages you to see all foods as neutral and allows you to make choices based on your body's needs and desires.

Honor Your Hunger: Eat when your body is hungry and stop when comfortably full. Learn to recognize your body's hunger cues (growling stomach, irritability, low energy) and fullness cues (satisfied feeling, reduced appetite) to create a natural rhythm of eating.

Make Peace with Food: Allow yourself to enjoy all foods without guilt. Intuitive eating encourages you to move away from restriction and embrace the joy of eating a variety of foods.

Body Positivity: Respect your body and its needs. Intuitive eating fosters self-compassion and acceptance, promoting a healthy body image.

Discover the Joy of Movement: Focus on activities you enjoy, not just burning calories. Move your body in ways that feel good, celebrate its strength and resilience, and prioritize activities that bring you joy.

Intuitive Eating and Endometriosis: A Powerful Combination

By prioritizing intuitive eating within your endometriosis nutrition plan, you can experience a multitude of benefits:

Reduce Stress: A positive relationship between food and the body lowers stress hormones, potentially improving symptoms and overall well-being. Eating intuitively can make meal planning and preparation a lot less stressful.

Support Hormone Balance: Nourishing your body with a wide variety of foods and eating regularly promotes hormonal well-being, potentially reducing endometriosis symptoms. Learn more about how you can support hormone balance here.

Improve Overall Health: Intuitive eating fosters a balanced, nutrient-rich diet that provides your body with the building blocks for healing and resilience. 

Tuning into Your Body: Food as Information

One of the most powerful aspects of intuitive eating is learning to tune into your body's signals. Intuitive eating for endometriosis goes beyond just hunger and fullness cues. As you practice intuitive eating, you'll become more aware of how certain foods affect you. This eating style can be particularly helpful in managing endometriosis symptoms.

Here's how:

Identify Food Triggers: Some people find that certain foods worsen their endometriosis symptoms, such as bloating, constipation, or pain. By paying attention to how you feel after eating, you can identify potential food triggers and make informed choices. Some people may find benefits in trying an elimination diet. Still, it is important to reintroduce foods and listen to the body to see which foods actually cause discomfort. 

Add nutrients rather than eliminate: Add anti-inflammatory foods like fruits, vegetables, whole grains, and healthy fats (think omega-3s!) rather than cutting specific inflammatory foods. This way, you naturally crowd out less nutritious options without feeling deprived. Discover which nutrients have been shown to improve and worsen endometriosis symptoms here.

Recognize Emotional Eating Patterns: Stress and other emotions can sometimes lead to emotional eating. Intuitive eating helps you recognize these patterns and develop healthier coping mechanisms to manage difficult feelings.

Track Your Cycle: Endometriosis symptoms can fluctuate throughout your cycle. By tracking your cycle and how you feel, you can anticipate potential symptom flares and adjust your diet or self-care routine. Some people only have to eliminate specific foods and certain times of their cycle (such as ovulation and menstruation). 

Get Support

You don't have to go it alone. A registered dietitian nutritionist specializing in endometriosis and women's health can help you navigate creating an endometriosis diet plan that works for you, focusing on nourishment, reducing inflammation, and improving your overall well-being.

By focusing on intuitive eating and a positive relationship with food, you can manage your endometriosis symptoms and reclaim your health and happiness.

When choosing a provider for your endometriosis care team, finding someone who understands and treats the disease with evidence-based guidance is important. I Care Better is a great resource for finding specialists in your area.

Sources:

Tribole, E., & Resch, E. (2020). Intuitive Eating: A Revolutionary Anti-Diet Approach (4th ed.). St. Martin's Essentials.