Twenty-four cross-sectional studies, published between 2006 and September 2015, met eligibility criteria for systematic review. Intuitive eating was associated with less disordered eating, a more positive body image, greater emotional functioning, and a number of other psychosocial correlates that have been examined less extensively. Participants in the majority of studies were university students in the USA so findings cannot be generalised to wider population of female adults. Prospective studies are now needed to verify these cross-sectional findings, and show if intuitive eating may reduce disordered eating and body image concerns, and promote women's psychological health and well-being.
Ellis J1, Galloway AT, Webb RM, Martz DM, Farrow CV (2016). Recollections of pressure to eat during childhood, but not picky eating, predict young adult eating behavior. Appetite. 97:58-63. doi: 10.1016/j.appet.2015.11.020.Current adult intuitive eating and disordered eating behaviors were self-reported by 170 college students, along with childhood picky eating and pressure through retrospective self- and parent reports. Anlayses revealed that childhood parental pressure to eat, but not picky eating, predicted intuitive eating and disordered eating symptoms in college students. These findings suggest that parental pressure in childhood is associated with problematic eating patterns in young adulthood.
Webb J.B., and Hardin A.S. (2016). An integrative affect regulation process model of internalized weight bias and Intuitive Eating in college women. Appetite. doi: 10.1016/j.appet.2016.02.024.
A weight diverse sample of 333 college women completed an online survey assessing internalized weight stigma, intuitive eating, body shame, body image flexibility, and self-compassion. Internalized weight bias is a potential driving force behind myriad negative health and quality of life complications for individuals traversing the weight continuum. Subscribing to internalized weight stigma was marked by declines in a healthy intuitive approach to eating for young women traversing the weight spectrum. Mindfulness, acceptance and compassion may be a helpful way to transform self-critical weight bias.
Anderson LM, Reilly EE, Schaumberg K, Dmochowski S, Anderson DA. (2015). Contributions of mindful eating, intuitive eating, and restraint to BMI, disordered eating, and meal consumption in college students. Eat Weight Disord. Aug 5.
This is the first study to compare intuitive eating, mindful eating, and restraint in college students. Higher restraint was associated with increased BMI and disordered eating. Whereas, intuitive eating was associated with decreased BMI and disordered eating. Mindful eating was not related to outcome variables.
The main purpose of this research was to examine the role played by both the mother and the romantic partner in predicting women's intuitive eating. Overall, these results attest to the importance of considering women's social environment (i.e., mother and romantic partner) for a better understanding of their eating regulation and ability to eat intuitively.
Flexible control strategies include monitoring portion sizes, eating smaller amounts and lower calorie versions of comfort foods, staying within a predetermined daily calorie range, and self-monitoring weight. Flexible control have been touted by certain scholars as adaptive approaches to eating that stand in contrast to rigid restriction of food intake. This is the first study to compare Intuitive Eating with flexible control. Results indicate 1) Intuitive Eating was found to be related to well-being as well as a lower BMI. 2) Intuitive Eating is an adaptive and distinct construct from flexible control. 3) Flexible control was found to overlap with rigid control. The researchers concluded that flexible control eating strategies should not be adopted by health professionals or health organizations.
Tylka TL, Homan KJ. (2015). Exercise motives and positive body image in physically active college women and men: Exploring an expanded acceptance model of intuitive eating. Body Image. Aug;15:90-97..
To improve positive body image and intuitive eating, efforts should encourage body acceptance by others and emphasize functional, rather appearance motives for exercise.
Tylka TL, Lumeng JC, Eneli IU. (2015). Maternal intuitive eating as a moderator of the association between concern about child weight and restrictive child feeding.Appetite. Dec 1;95:158-65.
Mothers who are concerned about their young child's weight are more likely to use restrictive feeding, which has been associated with increased food seeking behaviors, emotional eating, and overeating in young children across multiple studies. Researchers examined whether mothers' intuitive eating behaviors would moderate the association between their concern about their child's weight and their use of restrictive feeding. Their findings indicate that it may be important address maternal intuitive eating within interventions designed to improve self-regulated eating in children, as mothers who attend these interventions tend to be highly concerned about their child's weight and, if also low in intuitive eating, may be at risk for using restrictive feeding behaviors that interfere with children's self-regulated eating.
In adolescents with type 1 diabetes mellitus, there appears to be a strong association between intuitive eating, in particular the effect of emotion on eating, and glycaemic control. Higher values of both total Intuitive Eating Scale and the Eating for physical rather than emotional reasons subscale were associated with lower HbA1c.
Bush H, Rossy L, Mintz L, & Schopp (2014). Eat for Life: A Worksite Feasibility Study of a Novel Mindfulness-based Intuitive Eating Intervention. Am J Health Promotion (July/Aug):380-388.
A 10-week intervention combining Intuitive Eating and mindfulness, is more effective than traditional weight-loss programs in improving individuals' views of their bodies and decreasing problematic eating behaviors.
Camilleri GM et al (2014). Cross-cultural validity of the Intuitive Eating Scale-2. Psychometric evaluation in a sample of the general French population. Appetite.Sept 17 2014 (online).
The Intuitive Eating Scale-2 was adapted in French & validated for assessing adult IE behaviors in France.
Gast J, et al (2014). Intuitive Eating:Associations with Physical Activity Motivation and BMI Am J Health Promotion .Jan 24. [Epub ahead of print]
Peole who were internally motivated to engage in physical activity were 1) less likely to engage in restrictive eating behaviors 2) more like to practice self-care 3) enjoy physical actiivty. In contrast, those who reported guilt as a motivator to exercise, were at risk for eating emotionally or in response to social cues. Intuitive eaters had lower BMI..
Gravel K, St-Hilaire G, Deslauriers A, Watiez M, Dumont M, Dufour Bouchard AA, Provencher V. (March 2014).Effect of sensory-based intervention on the increased use of food-related descriptive terms among restrained eaters. Food Quality & Preference. 32:271-276.
A sensory-based intervention may help restrained women (those with concerns about dieting and weight) to become more objective, and to enjoyably connect to food and their own bodies,which may promote a more intuitive approach to eating.
Gravel K, Deslauriers A, Watiez M, Dumont M, Dufour Bouchard AA, Provencher V. ( Jan 2014). Sensory-Based Nutrition Pilot Intervention for Women. J Acad Nutr Diet.114:99-106 xxx
A sensory-based intervention, taught women how to experience eating based on 1) hunger & fullness cues 2) eating sensations based on the senses (taste, touch, hearing, smell and sight) and 3) pleasurable associations with eating. Women in the intervention group scored higher on the Intuitive Eating Scale. Researchers concluded that this is a promising strategy that, if implemented in clinical practice, can promote healthy eating in a positive way rather than through restrictive strategies that focus mainly on weight and calories. Such intervention seems to effectively reduce overeating episodes and promote the eating of desired foods when hungry.
Weigenberg,M.J.et al (2014). Imagine HEALTH: results from a randomized pilot lifestyle intervention for obese Latino adolescents using Interactive Guided ImagerySM. BMC Complementary & Alternative Med. 14:28. http://www.biomedcentral.com/1472-6882/14/28 [accessed 4-28‐2014.]
Consistent with adult findings showing cross sectional relationships between intuitive eating practices and health markers [66,67], our findings suggest that intuitive eating can be safely used in obese adolescents without fear of sustained consumption of unhealthy foods. In other words, no sustained increases in calories, sugars or fats were seen despite the curriculum suggesting all foods are allowable, dieting is counterproductive, and portion size should be addressed using awareness of internal satiety and hunger signals rather than external rules.
Denny KN, Loth K, Eisenberg ME, Neumark-Sztainer D (2013). Intuitive eating in young adults. Who is doing it, and how is it related to disordered eating behaviors? Appetite.Jan;60(1):13-9.
Large study evaluated Intuitive Eating as a possible healthier, more effective, and more innate alternative to current strategies of weight management among 2,287 young adults from Project EAT-III. Intuitive eating practices were inversely associated with a number of harmful outcomes, including binge eating and eating disorders behaviors. Researchers concluded that clinicians should discuss the concept of intuitive eating with their young adult patients to promote healthier weight-related outcomes.
Herbert BL, Blechert J, Hautzinger M, Matthias E., Herbert C.(2013). Intuitive eating is associated with interoceptive sensitivity. Effects on body mass index. Appetite, 70(Nov):22–30.
This is the first study to demonstrate that relevant role of interoceptive sensitivity and the appraisal of bodily signals for Intuitive Eating. Interoceptive sensitivity was a positive and significant predictor for Intuitive Eating and BMI.
Moy J, Petrie TA, Dockendorff S, Greenleaf C, Martin S (2013). Dieting, exercise, and intuitive eating among early adolescents. Eat Behav.14(4):529-32. doi: 10.1016/j.eatbeh.2013.06.014.
Dieting to lose weight, with its focus on restriction of caloric intake, may disrupt intuitive eating processes, though other forms of weight loss, such as exercising, which do not emphasize food may not. This study on nearly 1400 middle school boys and girls, found that regardless of sex or exercising, dieting was related to feeling less free to eat what was wanted and to eating more to soothe emotions than to satisfy actual physical hunger. Exercising, independent of dieting, was associated with feeling less permission to eat what was wanted, but also eating to satisfy physical hunger as opposed to coping with emotional distress. Overall, girls were more aware and trusting of their bodily hunger and satiety cues than boys, but when boys were exercising, they scored similarly to girls on this dimension. These findings suggest that different weight loss approaches - dieting vs. exercising - have unique relationships to young adolescents' intuitive eating and these associations tend to be stable across sex. Longitudinal studies now are needed to examine how dieting that begins in childhood or early adolescence might have long-term effects on the progression of intuitive eating.
Tylka TL, & Kroon Van Diest AM. (2013) The Intuitive Eating Scale-2: Item refinement and psychometric evaluation with college women and men. J Couns Psychol. Jan;60(1):137-53.
Largest study to date on Intuitive Eating, on 1405 women and 1195 men, which updates and validates the new Intuitive Eating assessment scale (IE-2). The IE-2 has a new category, Body-Food Choice congruence, which reflects the principle of Gentle Nutrition. Intuitive eating scores were positively related to body appreciation, self-esteem, and satisfaction with life; and were inversely related to eating disorder symptomatology, poor interoceptive awareness, body surveillance, body shame, body mass index, and internalization of media appearance ideals. IES-2 scores also predicted psychological well-being above and beyond eating disorder symptomatology.
Schoenefeld SJ, & Webb JB. (2013). Self-compassion and intuitive eating in college women: Examining the contributions of distress tolerance and body image acceptance and action. Eat Behav. 2013 Dec;14(4):493-6.
Self-compassion has been linked to higher levels of psychological well-being. Results provide preliminary support for a complementary perspective on the role of acceptance in the context of intuitive eating.
Gast, J., Madanat H., & Nielson A. (2012). Are Men More Intuitive When It Comes to Eating and Physical Activity? Am J Mens Health, vol. 6 no. 2 164-17.
Men scoring high on Hawks’ Intuitive Eating scale, was associated with lower body mass index. Men placed value on being physically fit and healthy, rather than on an ideal weight.
Madden C.E., Leong, S.L., Gray A., and Horwath C.C. ( 2012). Eating in response to hunger and satiety signals is related to BMI in a nationwide sample of 1601 mid-age New Zealand women. Public Health Nutrition. Mar 23:1-8. [Epub ahead of print].
Women with high Intuitive Eating Scale (IES) scores had significantly lower body mass index, which suggests that people who eat in response to hunger and satiety cues, have unconditional permission to eat, and cope with feelings without food, are less likely to engage in eating behaviors that lead to weight gain.
Augustus-Horvath CL and Tylka T. (2011) The Acceptance Model of Intuitive Eating: A Comparison of Women in Emerging Adulthood, Early Adulthood, and Middle Adulthood. J Counseling Psychology 2011 (Jan ) 58:110-125.
The acceptance model of intuitive eating posits that body acceptance by others helps women appreciate their body and resist adopting an observer's perspective of their body, which contribute to their eating intuitively/adaptively. We extended this model by integrating body mass index (BMI) into its structure and investigating it with emerging age, in adult women from ages 18–65 years old.
Heileson J.L., & R. Cole (2011). Assessing Motivation for Eating and Intuitive Eating in Military Service Members. Journal of the American Dietetic Association, 111 (9 Supplement), Page A26.
Intuitive Eating was associated with lower body mass index levels in 100 active military troops.
Dockendorff, S. A., Petrie, T. A., Greenleaf, C., & Martin, S. (2011, August).Intuitive Eating Scale for Adolescents: Factorial and construct validity. Paper presented at the 119th annual American Psychological Association conference, Washington, DC.
Tylka’s Intuitive Eating scale was adopted for adolescents and Intuitive Eating was associated with health benefits including lower body mass index, without internalizing the thin ideal, positive mood, and greater life satisfaction.
Sarah H. Shouse S. J. & Nilsson, J. (2011). Self-Silencing, Emotional Awareness, and Eating Behaviors in College Women. Psychology of Women Quarterly, 35: 451-457.
Expression of thoughts, feelings, or needs seems to be a critical aspect of healthy eating behaviors. The suppression of voice, combined with high levels of emotional awareness, may decrease trust of internal signals of hunger and satiation and disrupt Intuitive Eating. Intuitive eating is maximized when a woman has high levels of emotional awareness and low levels of self-silencing. Conversely, intuitive eating is disrupted.
Young, S. Promoting healthy eating among college women: Effectiveness of an intuitive eating intervention. Iowa State University, 2011, Dissertation 147 pages; AAT 3418683.
This is the first experimental study to test the effectiveness of an intuitive eating intervention designed to increase adaptive eating practices and reduce eating disorder risk factors. Overall these results present empirical evidence that the intuitive eating model can be a promising approach to disordered eating prevention in a variety of service delivery modalities.
Cole RE and Horacek T. Effectiveness of the “My Body Knows When” Intuitive-eating Pilot Program. Am J Health Behavior 2010; (May-June):286-297.
The objective of this study was to evaluate the effectiveness of the “My Body Knows When” Intuitive Eating program tailored to assist Fort Drum military spouses in rejecting the dieting mentality.The intuitive-eating program was able to significantly transition participants away from a dieting mentality towards intuitive-eating lifestyle behaviors. Overall, Intuitive Eating is a holist approach to long-term healthy behavior change and would benefit from an extended support system to improve effectiveness.
Galloway A.T., Farrow, C.V., & Martz DM. (2010). Retrospective Reports of Child Feeding Practices, Current Eating Behaviors, and BMI in College Students. Behavior and Psychology (formerly Obesity), 18(7):1330-1335.
Nearly 100 college-aged students and their parents completed retrospective questionnaires of parental feeding practices regarding the college students’ childhood. The results showed that parental monitoring and restriction of food intake had a significant impact on their college student’s body mass index, emotional eating, and Intuitive Eating Scale scores.
MacDougall EC. An Examination of a Culturally Relevant Model of Intuitive Eating with African American College Women. University of Akron, 2010. Dissertation 218 pages.
The present study explores the model intuitive eating with African American college women. Results of the present study provide empirical support for several propositions underlying a model of intuitive eating that suggests several, but not all, model paths may extend and generalize to more diverse samples of women.
Special thanks to Steven R. Hawks of BYU; Tracy L. Tylka of OSU; and Lori Smitham of Univ Notre Dame for advancing and validating the Intuitive Eating process and allowing their research to be shared on this site.
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