Learning to eat intuitively: A qualitative exploration of the experience of mid-age women

Challenges and opportunities for conceptualizing intuitive eating in autistic people

Although intuitive eating (IE) has become an increasingly adopted intervention target, current conceptualisations of IE have yet to pivot away from (neuro)normative physiology and phenomenology. Autistic individuals commonly report disordered eating behaviours and/or poorer well-being but appear to benefit from adaptive interventions using an affirmative approach. This article uses autism as a case example to summarise challenges related to IE's prevailing conceptualisation, before proposing how future research and current practice can be extended to the autistic population. Scholars are encouraged to evaluate the full 10-principal IE framework while utilising a participatory-led approach. We argue that research using a mixed methods design is urgently needed to comprehensively explore the (re)conceptualisation of IE in autistic people. While IE shows promise for producing positive outcomes in the autistic population, we discuss the potential challenges for research and practice due to its current emphasis on accurate interoception, emotional awareness and processing, and executive functioning. This suggests the need for research and practice to integrate autistic needs and experiences into future developments with an affirmative approach. Public Significance: IE is an effective intervention for reducing disordered eating behaviours. Autistic individuals commonly present disordered eating behaviours and have unique nutritional needs which often require intervention. However, there is limited understanding of IE among the autistic population. Research-informed definitions involving autistic perspectives will support translating the IE framework to this underrepresented population.

Sex and ethnic/racial differences in disordered eating behaviors and intuitive eating among college student

Introduction

Eating behaviors encompass disordered eating behaviors (e.g., overeating, binge eating, and associated symptoms of binge eating) and intuitive eating. Certain disordered eating behaviors, including binge eating, are more prevalent among female and ethnic/racial-minority college students than male and/or non-Hispanic White college students. However, sex and ethnic/racial differences among college students with other disordered eating (e.g., associated symptoms of binge eating) and intuitive eating behaviors remain unclear.

Methods

In 2022, 887 college students (Mage = 20.9 ± 2.6 years) self-reported their sex, ethnicity/race, disordered eating behaviors (e.g., overeating, binge eating, associated symptoms of binge eating), and intuitive eating. To examine sex and ethnic/racial differences among these students, we used modified Poisson regressions for students who reported disordered eating and linear regressions for students who reported intuitive eating.

Results

Except for overeating, disordered eating behaviors were more prevalent among female [adjusted prevalence ratio (aPR) = 1.3-1.8] than male college students after adjusting for sociodemographic variables, whereas intuitive eating scores did not differ by sex. Across ethnic/racial groups, disordered eating was more prevalent among all ethnic/racial-minority college students (aPR = 1.2-2.3) than non-Hispanic White college students after adjusting for sociodemographic variables. Moreover, non-Hispanic Black or African American college students had higher intuitive eating scores than non-Hispanic White college students (adjusted β = 0.7, 95% CI = -0.2, 1.6).

Conclusion

In our sample, notable differences emerged in the prevalence of disordered eating behaviors and mean scores by sex and ethnicity/race, while differences in intuitive eating scores emerged based on ethnicity/race.

What do people think of intuitive eating? A qualitative exploration with rural Australians

Evidence supports that intuitive eating is associated with many indicators of positive physical and mental health, with more recent longitudinal studies establishing causality. Most research, however, comprises either survey data or clinical trials. This study attempts to fill this evidentiary gap by using a qualitative methodology to explore people's understandings and reactions to intuitive eating, including perceived barriers and enablers to implementation. Three focus group discussions were conducted in a non-metropolitan region of Victoria, Australia, with a total of 23 participants. Focus group transcripts were thematically analysed using an inductive descriptive approach within a constructionist perspective. Findings indicate that the concept of intuitive eating was either unknown or misunderstood. Once intuitive eating was explained, most responses to implementing intuitive eating were negative. Participants felt that having complete choice around what they ate was unlikely to equate to a healthy or balanced diet, at least in the short term. They also argued that because everyday life was not intuitive in its structures, it would be difficult to eat intuitively. Despite these difficulties, participants appreciated that if they were able to overcome the various barriers and achieve a state of intuitive eating, they anticipated a range of long-term benefits to health and weight management. For intuitive eating to become a viable public health approach, this research suggests that intuitive eating needs to be much more widely publicised and better explained, and perhaps renamed. More significantly, people would need assistance with how to eat intuitively given the barriers identified.

Effectiveness of a text-messaging intervention on intuitive eating: a randomised controlled trial

Intuitive eating (IE) is a concept based on mind-body integration of instinct, emotion and rational thought, to improve eating behaviours, physical and mental health. Several attempts were developed to teach IE principles including text-messaging interventions given that they are easy to implement and low cost.

OBJECTIVE

The present study aimed to assess the effectiveness of a 5-week text message-based IE intervention on IE, while correcting for perceived stress (PS) and self-compassion (SC).

DESIGN

A randomised controlled trial.

SETTING

Online, in Lebanon.

PARTICIPANTS

Adults (n 195) were randomised into one of three groups: the active IE group receiving IE-related messages with a practice exercise, the passive IE group receiving only IE-related messages and the control group receiving general health-related tips. Ten messages were delivered over 5 weeks. Two follow-ups were made: directly post-intervention and 7 weeks later. Baseline data and follow-ups included demographics, nutrition-related variables and measures of IE, SC and PS.

RESULTS

Results indicated improvements in IE scores in the two intervention groups (P = 0·05), with the passive IE group showing the most improvement. Also, a significant improvement in SC (Λ = 0·88, F (2, 63) = 4·40, P = 0·01) and reduction in PS (Λ = 0·86, F (2, 63) = 5·21, P = 0·008) were observed in the active IE group.

CONCLUSION

Text-messaging interventions might be efficient in enhancing IE. Results shed light on the need for further large-scale interventions that use visual aids and provide practical guidance to teach IE, while further characterising the relation between IE, SC and stress.

A qualitative exploration of perceived barriers and facilitators to following an intuitive eating style

BACKGROUND

Intuitive eating involves following internal cues of hunger and satiety to guide eating choices as opposed to responding to external signals, strong emotions, or dietary rules. This style of eating has consistently been shown to be related to better physical and psychological health indicators, and more interventions are being designed and studied to promote this eating style. The current study aimed to identify anticipated facilitators and barriers to following this style of eating among a group of college students enrolled in a larger study of intuitive eating.

METHOD

Following a week of tracking their current eating as part of a larger study, college students read a description of intuitive eating. They then answered three open-ended questions about following intuitive eating including facilitators, barriers, and perceived ability to follow long term. Responses were coded using thematic analysis to identify themes across responses.

RESULTS

Among 100 participants, 86 % were female, 46 % were Hispanic (41 % non-Hispanic White, 13 % other race/ethnicity), mean age was 24.3 years, and mean body mass index was 26.2. The most commonly anticipated participant-reported facilitators of intuitive eating were being in touch with the body's needs and hunger cues, positive perceptions of intuitive eating, and health considerations. The most commonly anticipated barriers were logistical constraints (e.g., busyness and mealtimes), difficulty with hunger cues and reactions to food, and negative perceptions of intuitive eating. The majority of participants (64 %) would consider following this style of eating long term.

DISCUSSION

This study provides information that can be used to improve efforts aimed at promoting intuitive eating to college students, including marketing intuitive eating interventions, and clarifying misunderstandings of its key tenets that might serve as barriers.

Barriers and facilitators of intuitive eating in postmenopausal women: A qualitative study

This qualitative descriptive research explored barriers and facilitators of the intuitive eating (IE) implementation process, as experienced by six postmenopausal women classified as 'overweight' or 'obese'. The data was analysed using deductive and inductive thematic analysis and six themes were identified. IE implementation included developing scepticism about weight loss diets, dealing with hunger and satiety cues, making nutritious food choices for one's body, struggling with emotional eating, learning to accept one's body and challenging weight stigma and sociocultural norms of beauty and thinness. IE allowed women to develop a more peaceful relationship with their diet, and was accepted as a welcome alternative to dieting.

Outcomes of intuitive eating interventions: a systematic review and meta-analysis

Intuitive eating (IE) is an approach to health promotion that fosters a positive relationship with food and the body. The objective of this review was to aggregate and analyse the literature on IE interventions, thereby offering an early investigation of methodological approaches to intervention. This review was conducted in accordance with the preferred reporting items for systematic review and meta-analysis protocols (PRISMA) guidelines. Searching was conducted in four electronic databases. Studies were eligible for inclusion if they delivered an IE intervention and used the Intuitive Eating Scale (IES). Nine studies were included in this review. Six were eligible for meta-analysis, though only outcomes on the IES were examined; all other measures were examined individually. All interventions led to improvements on measures of IE, with a large pooled effect size (1.50 [1.15, 1.85]) and positive changes on a variety of other outcomes relating to health. This pattern preliminarily suggests that IE interventions change psychological processes as intended and can be useful in promoting health behaviour. The present review offers a synthesis of existing approaches to IE interventions and an evaluation of which specific variants appear to be more effective. This paper provides a basis upon which future interventions can be developed to improve approaches to psychoeducation.Clinical ImplicationsInterventions contributed to improvements in measures of IE lasting up to 6 months.Interventions contributed to positive changes on outcomes such as quality of life, body image, and body appreciation.Self-management through IE-based interventions may be feasible and effective.

Eating Competence, Food Consumption and Health Outcomes: An Overview

Eating Competence (EC) is one behavioral perspective of eating practices that has been associated with a healthy lifestyle. It emphasizes eating pleasure, self-regulation of eating, body weight satisfaction, and regular meal frequency that includes food variety without focusing on dietary guidelines. EC is composed of four components (Eating Attitude, Food Acceptance, Internal Regulation, and Contextual Skill), and its assessment is performed using the Eating Competence Satter Inventory (ecSI2.0™), developed and validated in English for an adult population. EC has been associated with diet quality and health indicators for various population groups and the development of skills that increase EC might be a strategy to improve nutritional health, and prevent obesity and other chronic diseases. In this sense, this study presents an overview of the background, concepts, features, and possible associations among EC, food consumption, and health outcomes. The high prevalence of diseases associated with food/nutrition draws attention to the necessity to broaden the view on food and its relationship with health and well-being, considering not only nutrients and food combinations but also the behavioral dimensions of eating practices. Healthy nutritional recommendations that take into account attitudes and behaviors are in accordance with the EC behavioral model. Studies on eating behavior emphasize the need to better understand attitudes towards food and eating in the general population using validated instruments. In this context, measuring EC and its association with health outcomes seems to be relevant to nutritional health. The complexity of food choices has been examined in social, behavioral, and biological sciences, representing a great challenge for applying unique and simple theoretical models. Multiple methods are required, as no single theory can fully explain food selection.

Intuitive eating as a counter-cultural process towards self-actualisation: An interpretative phenomenological analysis of experiences of learning to eat intuitively

This research presents an in-depth idiographic study that illustrates how learning to eat intuitively involves socio-cultural challenges, strategies of resistance and self-actualising processes. Interviews were conducted with eight women who had been practising intuitive eating (IE) for at least 1.5 years. Data was analysed using IPA and four themes were drawn inductively from the data: IE as an ongoing process, perceived judgement of others, strategies of resistance and processes of self-actualisation. Further research is needed to explore experiences of learning to eat intuitively amongst different samples and with different cultures, and to further investigate the relationship between IE and the actualising tendency.