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Abstract

This article describes the development and validation of an instrument designed to measure the concept of intuitive eating. To ensure face and content validity for items used in the Likert-type Intuitive Eating Scale (IES), content domain was clearly specified and a panel of experts assessed the validity of each item. Based on responses from 391 university students in the United States, the IES was evaluated for internal consistency and reliability using cross-tabulations, factor analysis, test-retest correlation coefficients, and logistic regression techniques. The factor solution isolated four factors that replicated scale construction, including intrinsic eating, extrinsic eating, antidieting, and self-care with alpha coefficients ranging from 0.42 to 0.93. Retesting after 4 weeks (N = 285) yielded correlation coefficients that ranged between 0.56 and 0.87. The presence of theorized relationships between IES scores and certain demographic and lifestyle variables (obesity, presence of an eating disorder, gender, and restrictive dieting) adds support for concurrent validity. IES subscales also correlated significantly with the Cognitive Behavioral Dieting Scale in predicted directions, suggesting convergent validity. Findings provide tentative support for the use of the IES in identifying intuitive eating attitudes and behaviors among college populations. Implications for practice, theory, and future research are discussed. (Contains 3 tables.)

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... 6 Intuitive eating has been shown to be negatively associated with eating disorder symptomatology and positively associated with psychological constructs such as body appreciation and self-esteem. 7,8 In addition, associations between intuitive eating behaviors and health outcomes as diverse as dietary intake, 2,9,10 body mass index, 1,9,11 blood pressure, 5 cholesterol levels, 5 and inflammatory markers 5 have been studied. ...
... Since the term intuitive eating was coined in 1995, 3 intuitive eating scales were developed. 6,8,12 The most recent version, the Intuitive Eating Scale-2 (IES-2), is a 23-item questionnaire validated in male and female college students. 6 A higher score indicates higher adherence to the behavior. ...
... In contrast, females may tend to exhibit more dieting behaviors and regulate their own eating behaviors by external cues, rather than hunger and satiety. 8,9 A limitation of this study is that it was completed at a single university with a convenience sample of students and therefore is not generalizable to all populations of university students. Another limitation is the lack of data collection involving ethnicity or race, which was shown to be associated with intuitive eating behaviors. ...
Article
Objective: To assess associations between intuitive eating behaviors and fruit and vegetable intake among college students. Methods: Intuitive eating behaviors were measured with the Intuitive Eating Scale-2 (IES-2), which reports a total and 4 subscale scores. Fruit and vegetable intake was measured with the National Institutes of Health Eating at America's Table Fruit and Vegetable screener. Questionnaires were completed online. Results: Median age of participants was 20 years (n = 293; n = 72 male). Total IES-2 score was not correlated with fruit and vegetable intake. Body-Food Choice Congruence and Eating for Physical Rather Than Emotional Reasons subscales were positively associated with fruit and vegetable intake (r = .462, P < .001 and r = .177, P = .002, respectively). The Unconditional Permission to Eat subscale was negatively associated with fruit and vegetable intake (r = -.308, P < .001). Conclusions and implications: Correlations between fruit and vegetable intake and intuitive eating behaviors differed by IES-2 subscale scores. If IES-2 is used in nutrition research, education, or counseling with the aim of increasing fruit and vegetable intake, addressing subscale behaviors individually might be considered.
... In contrast, intuitive eating offers a non diet approach to weight management by eating according to physiological hunger and satiety cues (Augustus-Horvath & Tylka, 2011;Gast, Madanat, & Nielson, 2012;Hawks, Merrill, & Madanat, 2004;Tylka & Kroon Van Diest, 2013;Wirtz & Madanat, 2013). Intuitive eating posits that the body can self-regulate caloric need by sending signals to eat the types and quantities of food to maintain health and weight; these physiological cues are commonly referred to as eat when you are hungry and stop when you are full (Van Dyke & Drinkwater, 2014). ...
... Both of the questionnaires are referred to as Intuitive Eating Scale (IES). The first of these was developed by Steven Hawks et al., in 2004(Hawks et al., 2004. And the latest scale was developed by Tracy Tylka in 2006(Tylka, 2006. ...
... Both of the questionnaires are referred to as Intuitive Eating Scale (IES). The first of these was developed by Steven Hawks et al., in 2004(Hawks et al., 2004. And the latest scale was developed by Tracy Tylka in 2006(Tylka, 2006. ...
Article
Intuitive Eating is defined as "the dynamic process-integrating attunement of mind, body, and food". The purpose of this study was, therefore, adapt the IES-2 to the Turkish language and reliability and validity of IES-2 among Turkish populations. We also examined the instrument's internal consistency and test-retest reliability and analysed the relationships between the IES-2 and several variables so as to evaluate the convergent and discriminant validity. Three hundred seventy-seven undergraduate and postgraduate women and men between the ages of 19–31 years (mean 22.3, SD = 3.53) attending two large private universities in Istanbul, Turkey. The best solution from the principal factors analysis of the 23 items of the IES-2 revealed four factors corresponding to the four subscales (F1: Eating for physical rather than emotional reasons; F2: Unconditional permission to eat; F3: Reliance on hunger and satiety cues; F4: Body-food choice congruence), as reported by the authors of the questionnaire. Bartlett's test of sphericity gave X² = 9043.49 (p < 0.001), while the Kaiser-Meyer-Olkin index was 0.87 (KMO were 0.89 for women and 0.83 for men). The test-retest reliability of the IES-2 was 0.88 for the IES-2 total score. The IES-2 had a = 0.82. These findings support the notion that intuitive eating is a viable concept for university students and the IES can be used to examine adaptive eating behaviors in this population.
... Numerous questionnaires have been developed and validated in order to assess and identify symptoms or traits associated with maladaptive eating behaviors, such as the Three-Factor Eating Questionnaire (Stunkard & Messick, 1985), the Dutch Eating Behavior Questionnaire (van Strien, Frijters, Bergers, & Defares, 1986), the Eating Disorder Inventory (Garner, 1991;Garner, Olmstead, & Polivy, 1983), the Eating Attitudes Test (Garner, Olmsted, Bohr, & Garfinkel, 1982), and the Restraint Scale (Herman & Mack, 1975), to name only a few. Questionnaires assessing healthy adaptive eating behaviors are far fewer, the Mindful Eating Questionnaire (Framson et al., 2009), the ecSatter Inventory (Lohse, Satter, Horacek, Gebreselassie, & Oakland, 2007), and intuitive eating questionnaires (Hawks, Merrill, & Madanat, 2004;Tylka & Kroon Van Diest, 2013;Tylka, 2006) being among the only ones, to our knowledge. ...
... Instruments have been developed in order to reflect the degree of adherence to intuitive eating principles. Hawks et al. (2004) have created a 27-item scale measuring intuitive eating through four subscales: intrinsic eating, extrinsic eating, antidieting, and selfcare. Their scale showed overall good psychometrics properties, but the intrinsic eating subscale showed both low internal consistency and test-retest reliability, while the self-care subscale did not demonstrate the construct and concurrent validity expected by the authors (Hawks et al., 2004). ...
... Hawks et al. (2004) have created a 27-item scale measuring intuitive eating through four subscales: intrinsic eating, extrinsic eating, antidieting, and selfcare. Their scale showed overall good psychometrics properties, but the intrinsic eating subscale showed both low internal consistency and test-retest reliability, while the self-care subscale did not demonstrate the construct and concurrent validity expected by the authors (Hawks et al., 2004). ...
Article
Intuitive eating is an adaptive eating style based on the reliance on physiological cues to determine when, what, and how much to eat. The Intuitive Eating Scale-2 (IES-2) is a validated four subscale tool measuring the degree of adherence to intuitive eating principles. The present series of studies aimed at evaluating the psychometric properties of a French-Canadian adaptation of the IES-2 for the adult population. The factor structure, the reliability (internal consistency and test-retest), the construct validity, and the discriminant validity were evaluated in 334 women and 75 men from the Province of Québec, Canada, across two studies. A confirmatory factor analysis upheld that the four-factor structure of the original IES-2 was adequate for the present sample of French-Canadians. The scale demonstrated adequate internal consistency and test-retest reliability. Construct validity evidence was obtained with the significant associations between intuitive eating and psychological and eating-related variables. Intuitive eating was negatively associated with eating disorder symptomatology and with food- and weight-preoccupation, and positively associated with body-esteem and well-being. The French-Canadian IES-2 was also able to discriminate between genders and body mass index categories. The properties of this new version of the IES-2 are demonstrative of a reliable and valid tool to assess intuitive eating in the French-Canadian adult population of the Province of Québec.
... The IES is a 27-item pen-and-paper survey developed to measure various levels of intuitive eating behaviors and cognitions present in an individual's eating style and has established validity and reliability (Hawks, Madanat, & Merrill, 2004). The responses range from strongly agree to strongly disagree on a 5-point Likert-type scale. ...
... Descriptive statistics were used to describe the demographics of the respondents, their IES total and subscales scores, and BREQ subscale scores. To classify respondents into intuitive and nonintuitive eaters, we used the criterion previously reported by Hawks et al. (2004), which indicates that samples may be split into intuitive and nonintuitive eaters based on the median IES total score. In the current study, the median IES total score was 102. ...
... Past research in female samples has reported that as IES scores increase, BMI decreases (Hawks et al., 2004;Smith & Hawks, 2006). Smith and Hawks (2006) also discovered this pattern with college male participants. ...
Article
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Purpose: To determine whether university women who demonstrated internal motivation related to eating behavior may also be internally motivated to participate in regular physical activity (PA) and have a lower body mass index (BMI) when controlling for age. Traditional approaches for health promotion related to healthy weight include restrictive eating and exercise prescription. Examining motivation for eating and PA may prove an effective alternative for achieving or maintaining healthy weight for university women. Design: Design was a cross-sectional study. Setting: Study setting was a large, public university in the western United States. Subjects . Study subjects were 200 undergraduate women with a mean age of 19 years, mostly white (90%) and of healthy weight (69%, with a BMI range of 18.5-24.9). Measures: Study measures were the Intuitive Eating Scale and the Behavioral Regulation in Exercise Questionnaire. Analysis: Correlations and regression models were used. Intuitive eating was examined in the sample as a whole and among subgroups of respondents grouped based on tertile rankings of intuitive eating scores. Results: There was evidence that women who demonstrated internal motivation related to eating were also internally motivated to participate in regular PA. Women who reported being internally motivated to eat were significantly more likely to engage in PA for pleasure and to view PA as part of their self-concept. Women who reported high levels of intuitive eating had significantly lower BMI scores than those reporting medium or low levels when controlling for age. Conclusion: For women to achieve or maintain a healthy weight, it may be best for health professionals to examine motivation for eating and PA rather than the encouragement of restrictive eating and exercise prescriptions.
... The concept of "intuitive eating" emerged in the 1980s with the anti-diet movement based on the hypothesis that restrictive diets cannot be sustained throughout life [16] and was evaluated by the scale developed by Hawks et al. (2004) [17]. The scale was later revised by Tylka (2006) to better reflect intuitive eating behavior [18,19]. ...
... The concept of "intuitive eating" emerged in the 1980s with the anti-diet movement based on the hypothesis that restrictive diets cannot be sustained throughout life [16] and was evaluated by the scale developed by Hawks et al. (2004) [17]. The scale was later revised by Tylka (2006) to better reflect intuitive eating behavior [18,19]. ...
Article
Full-text available
BACKGROUND: The term intuitive eating is a new concept that has emerged in recent years. It is a way of eating that is based on responding to the body’s natural signals of hunger and satiety. OBJECTIVE: The study was conducted to evaluate the relationship between intuitive eating and eating disorders and body image perception in young adult women. METHODS: The study was conducted with 400 women aged 19–35 years. The data were collected with the Figure Rating Scale, the Intuitive Eating Scale-2 (IES-2), and the Eating Attitude Test-26. RESULTS: The mean body mass index was significantly higher in individuals who misperceived their body image. While 51.4% of the participants with normal eating behavior had appropriate body image perception, 38.8% of the participants with abnormal eating behavior had appropriate body image perception. The IES-2 total score was significantly lower in women with abnormal eating behavior and overweight/obese women. CONCLUSIONS: Our findings showed that intuitive eating is negatively associated with abnormal eating behavior and obesity in young adult women and that women with low intuitive eating inclinations misperceived their body image.
... Finally, the fourth domain, Body-Food Choice Congruence, refers to the extent individuals match their food choices to align with their bodies' nutritional needs to promote healthy physical functioning. The first three domains were included as individual subscales within the original Intuitive Eating Scale developed to measure IE as a latent construct [8], and more recently a revised version of the measure, the Intuitive Eating Scale-2 (IES-2), was created to incorporate the additional Body-Food Choice Congruence domain [8]. ...
... Finally, the fourth domain, Body-Food Choice Congruence, refers to the extent individuals match their food choices to align with their bodies' nutritional needs to promote healthy physical functioning. The first three domains were included as individual subscales within the original Intuitive Eating Scale developed to measure IE as a latent construct [8], and more recently a revised version of the measure, the Intuitive Eating Scale-2 (IES-2), was created to incorporate the additional Body-Food Choice Congruence domain [8]. ...
Article
Full-text available
Purpose This study sought to explore the associations between Intuitive Eating (IE), eating disorder (ED) symptom severity, and body image-related cognitive fusion within a clinical sample. IE was also examined as a possible mediator in the relationship between body image-related fusion and ED symptoms. Methods This study includes cross-sectional analyses with data from 100 adult females and 75 adolescent females seeking residential treatment for an ED. Self-reported demographic information, ED symptoms, IE behaviors, and body image-related cognitive fusion were collected from participants within the first week of treatment following admission to the same residential ED treatment facility. Results ED symptom severity was significantly negatively associated with three of the four domains of IE; unconditional permission to eat, reliance on hunger and satiety cues, and body-food choice congruence. A significant mediational effect of IE on the relationship between body image-related fusion and ED symptoms through IE behaviors was observed (β = 11.3, SE = 0.003, p < 0.001). This effect was only observed for the unconditional permission to eat (β = 0.13, p = 0.003) and reliance on hunger and satiety cues (β = 0.10, p = 0.005) domains of IE when the domains were subsequently analyzed individually. Conclusion Unconditional permission to eat and reliance on hunger and satiety cues appear to be particularly influential domains of IE in the relationship between body image-related fusion and ED symptom severity. It is possible that changes in these IE domains may be mechanisms through which body image-related fusion influences ED symptoms. Future longitudinal research is needed to better understand the relationship between body image-related cognitive fusion and IE and the potential for targeting these constructs specifically in the context of ED treatment. Level of evidence Level V, cross-sectional analysis from descriptive study.
... In terzo luogo, per l'intuitive eater gli effetti fisici dell'assunzione di cibo sono accuratamente e costantemente monitorati in termini di soddisfazione e di sazietà: lui o lei non mangia distrattamente mentre continua a lavorare o sta guidando, ma apprezza e gusta il cibo che soddisfa le sue necessità di nutrimento, fino a che non percepisce chiaramente di averne mangiato abbastanza. In quarto luogo, l'intuitive eater è molto più concentrato sui benefici a livello generale di un'alimentazione basata sulle proprie necessità fisiche, indipendentemente dalle conseguenze di questa sul suo aspetto fisico (Hawks et al., 2004a). ...
... Mediante analisi fattoriale, Hawks e collaboratori (2004a) hanno mostrato che gli item, tranne tre che non danno punteggio, possono essere raggruppati in quattro sottoscale: (i) Intrinsic Eating (4 item, esempio di item "I seldom eat unless I notice that I am physically hungry"), (ii) Extrinsic Eating (6 item, "I often turn to food when I feel sad, anxious, lonely, or stressed out"), (iii) Antidieting (13 item, esempio di item "I generally count calories before deciding if something is OK to eat") e (iv) Self-Care (4 item, esempio di item "The health and strength of my body is more important to me than how much I weigh"). I punteggi hanno mostrato stabilità temporale in somministrazioni a distanza di 4 settimane e adeguate validità di costrutto, di criterio e cross-culturale (Hawks, et al., 2004a(Hawks, et al., , 2004b(Hawks, et al., , 2005(Hawks, et al., , 2008Smith & Hawks, 2006). ...
... The ability to sense/perceive and interpret the signals that the body generates in response to hunger and satiation is a central characteristic of the internally regulated eating style. Existing conceptualisations of internally regulated eating refer to this as 'the ability to clearly recognise the physical signs of hunger, satisfaction, and fullness' (54) , 'differentiation of physiological (stomach) hunger and psychological (mouth) hunger signals' (50) , 'sensitivity to hunger and satiety cues' (39) and 'bringing awareness to sensations of physical hunger and different types of satiety (stomach fullness and sensory-specific satiety)' (38) . We use the term sensitivity to physiological signals of hunger and satiation to refer to this competence. ...
... Food legalising has been conceptualised in various ways in previous research. For example, some refer to it as 'there are no taboo foods or restrictions on eating' (54) , 'refusal to label certain foods as forbidden' (33) and 'be "given permission" to eat previously forbidden foods' (19) , while others use more general terms such as 'being comfortable with food behaviors' (35) and 'spontaneity and the enjoyment of food without anxiety, guilt or concerns about compulsive or "out-of-control" eating' (50) . ...
Article
Internally regulated eating style, the eating style that is driven by internal bodily sensations of hunger and satiation, is a concept that has received increasing attention in the literature and health practice over the last decades. The various attempts that have been made so far to conceptualize internally regulated eating have taken place independently of one another and each sheds light on only parts of the total picture of what defines internally regulated eating. This has resulted in a literature that is rather fragmented. More importantly, it is not yet clear which are the characteristics that comprise this eating style. In this paper, we identify and describe the full spectrum of these characteristics, namely, sensitivity to internal hunger and satiation signals, self-efficacy in using internal hunger and satiation signals, self-trusting attitude for the regulation of eating, relaxed relationship with food, and tendency to savor the food while eating. With this research, we introduce a common language to the field and we present a new theoretical framework that does justice not just to the full breadth of characteristics that are necessary for the internally regulated eating style but also to the associations between them and the potential mechanisms by which they contribute to this eating style.
... Intuitive eating. The Intuitive Eating Scale (IES; Hawks, Merrill, & Madanat, 2004) was developed to measure orientation towards eating based on physiological hunger cues rather than emotional or external cues. The IES contains 27 items on a 5-point Likert scale (ranging from 1 = "strongly disagree" to 5 = "strongly agree"); higher scores indicate greater endorsement of intuitive eating. ...
... The IES yields four subscales: intrinsic (eating that is guided by internal hunger cues), extrinsic (eating that is cued by environmental or emotional factors), antidieting (lack of dieting attitudes), and self-care (prioritization of self-care over weight). The IES total score and subscales show adequate to good 4week test-retest reliability (rs = 0.56 -0.85) and evidence of construct validity (Hawks et al., 2004). In this study, the subscales varied in Cronbach's alphas, from poor (intrinsic: 0.26 -0.41), to adequate (extrinsic: 0.77 -0.79 and self-care: 0.64 -0.76), to good (antidieting: 0.87 -0.90). ...
Article
This study developed and examined a brief dissonance-based non-dieting intervention designed to help college women reject unhealthy dieting behaviors, accept their bodies, and increase healthy eating. Participants included 94 female university students (mean age = 20.6 years; mean BMI = 23.8 kg/m2), randomly assigned either to the non-dieting intervention condition or a brochure control condition. The intervention consisted of two 90-120 min interactive group sessions designed to engender the rejection of dieting, increase body acceptance, and develop healthy eating skills. Assessment measures were collected at baseline, post-treatment, and one-month follow-up. The group sessions produced significant improvements in the intervention group compared to the control group on measures of dieting intention, intuitive eating, body image dissatisfaction, eating concerns, and anti-fat attitudes. These effects were sustained at one-month follow-up. There were also overall improvements over time in dietary intake and mental health-related quality of life across conditions. This study extends the research on non-dieting approaches by using a brief, dissonance-based structure and by applying the intervention to a young adult sample that included participants of normal weight. The findings here indicate that a non-dieting approach is acceptable and feasible, and can result in improvements in eating and weight-related behaviors, in young adult women.
... The ability to sense/perceive and interpret the signals that the body generates in response to hunger and satiation is a central characteristic of the internally regulated eating style. Existing conceptualisations of internally regulated eating refer to this as 'the ability to clearly recognise the physical signs of hunger, satisfaction, and fullness' (54) , 'differentiation of physiological (stomach) hunger and psychological (mouth) hunger signals' (50) , 'sensitivity to hunger and satiety cues' (39) and 'bringing awareness to sensations of physical hunger and different types of satiety (stomach fullness and sensory-specific satiety)' (38) . We use the term sensitivity to physiological signals of hunger and satiation to refer to this competence. ...
... Food legalising has been conceptualised in various ways in previous research. For example, some refer to it as 'there are no taboo foods or restrictions on eating' (54) , 'refusal to label certain foods as forbidden' (33) and 'be "given permission" to eat previously forbidden foods' (19) , while others use more general terms such as 'being comfortable with food behaviors' (35) and 'spontaneity and the enjoyment of food without anxiety, guilt or concerns about compulsive or "out-of-control" eating' (50) . ...
Preprint
The concept of internally regulated eating has been explored along several, distinct research lines. The most prominent are those on intuitive eating, eating competence, and mindful eating, but there are also several independent intervention programs that promote eating by internal hunger and satiation cues (i.e., bodily sensations of hunger and satiation). Although these paradigms have certain key elements in common, they also differ in various respects. As a result, there is no consensus regarding the key features that compose the internally regulated eating style. In the present paper, we synthesize the underlying concepts that bind together the various research lines on internally regulated eating. We do this by delineating the individual-difference characteristics that form the tendency towards engaging in internally regulated eating. These include the sensitivity to and self-efficacy in using internal hunger and satiation signals, a self-trusting attitude for the regulation of eating, a relaxed relationship with food, and the tendency to savor the food while eating. Building on earlier work, we propose an inclusive definition for the internally regulated eating style, we embody this eating style in an existing, well-known model of eating behavior (the boundary model of eating), and we present a comprehensive theoretical framework with its key defining features, antecedents, and consequences, which can be used to drive future research.
... Intuitive Eating (IE) is a relatively recent concept that looks at the degree to which individuals rely on innate signals/satiety cues to determine when, what, and how much to eat (Hawks, Merrill, & Madanat, 2004;Tylka, 2006). These innate satiety signals relate to hunger, fullness, and taste. ...
... IE and the IES have not previously been studied in the T1DM, and existing literature in the wider adolescent population remains scarce. However, in the non-T1DM population, higher levels of intuitive eating have been associated with a range of positive findings, including: lower weight (Hawks et al., 2004); fewer disordered eating behaviours; an increased pleasure in consuming food; and fewer food anxieties (Denny, Neumark-Sztainer, Loth, & Eisenberg, 2012;Smith & Hawks, 2006). This makes IE potentially relevant to the T1DM population; who are at risk of developing certain chronic eating disorders/behaviours (Colton, Olmsted, Daneman, Rydall, & Rodin, 2004;Mannucci et al., 2005), that in turn have been negatively associated with adherence and glycaemic control (Affenito & Adams, 2001;Rodin et al., 2002). ...
Article
Background: While there have been considerable advances in the medical management of Type 1 Diabetes Mellitus (T1DM), for many, glycaemic control remains substandard. Nutrition and eating behaviour are important additional factors to consider with regards to T1DM management and outcomes. Intuitive eating is one such factor, and has not previously been investigated in T1DM. With this in mind, we undertook a study examining the relationship between intuitive eating and glycaemic control in adolescents with T1DM. Methods: A case-control study of adolescents with established T1DM, and age/sex matched controls was conducted. Demographic information, the Intuitive Eating Scale (IES), and HbA1c were collected. Statistical analysis was undertaken to explore associations between the IES and HbA1c as a marker of glycaemic control. Results: Data on 38 adolescents with T1DM, and 39 age/sex matched controls were obtained. Those with T1DM had significantly lower (by 0.5 SD) IES scores compared to controls (p=0.009). Higher values of both total IES and the Eating for physical rather than emotional reasons subscale were associated with lower HbA1c: HbA1c 22% lower/whole unit increase in total IES mean score, HbA1c 11% lower/whole unit increase in Eating for physical rather than emotional reasons mean score, p=0.017 and p=0.009 respectively. Conclusion: In adolescents with T1DM, there appears to be a strong association between intuitive eating, in particular the effect of emotion on eating, and glycaemic control. In addition, those with T1DM have lower scores for their intuitive eating behaviour compared to controls. Emotional eating could be a future target for screening and potentially intervening in those with T1DM, as part of a wider treatment package to improve glycaemic control. Continuing efforts are needed to fully understand the important dynamics of diabetes, adolescence, diet, emotion, and how these factors affect long term outcomes in those with T1DM.
... In the following analyses, hunger was entered as a covariate, IES, MEQ, and TFEQ-R scores were entered as exposure variables, and BMI, EDDS scores, and pasta consumption were identified as the outcome variables. Because prior research has demonstrated gender differences on various measures of interest, including lower scores on eating disorder risk factors such as the TFEQ-R subscale [35] and higher levels of intuitive eating in men, as compared to women [36], analyses controlled for potential gender differences within our mixed-gender sample. Prior to analyses, data were screened to ensure adherence to homogeneity and normality assumptions; no variables warranted transformation. ...
... DR 2 = . 36 The third subscale, Reliance on Internal Hunger/Satiety Cues, did not account for statistically significant variance in EDDS scores. Notably, results suggest that a one-unit decrease in Unconditional Permission to Eat, and Eating for Physical Reasons Subscales accounted for a .50 ...
Article
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Mindful eating and intuitive eating are promoted as means to circumvent potentially maladaptive dietary restraint while maintaining a healthy weight. Although theoretically related, no studies have examined the correlations between intuitive eating, mindful eating, and restraint in the same sample. This study sought to examine these constructs and their correlations with body mass index (BMI), eating-disordered behaviors, and meal consumption in a college sample. Participants (N = 125) completed a laboratory taste-test meal and measures of each eating-related construct using the EDDS, IES, MEQ, and TFEQ-Restraint Subscale. Mindful eating, intuitive eating, and restraint were not strongly correlated. Hierarchical multiple regression analyses indicated that restraint and intuitive eating accounted for significant variance in disordered eating and BMI. Elevated restraint was associated with increased BMI and disordered eating; elevated intuitive eating was associated with decreased BMI and disordered eating. Mindful eating did not correlate with any outcome variables. Follow-up analyses suggested that specific intuitive eating subscales accounted for unique variance in the relation between intuitive eating and disordered eating. Intuitive eating was the only construct that was significantly associated with meal consumption. Intuitive eating and restraint appear to be only weakly correlated, and each is differentially associated with meal consumption. Mindful eating does not appear to relate to outcome variables.
... Intuitive eating programs have also achieved long-term weight maintenance in overweight or obese women (Bacon et al., 2005;Hawley et al., 2008;Provencher et al., 2009). In cross-sectional studies, intuitive eating has been associated with improved psychological health measures such as self-esteem or reduced negative affect (Tylka, 2006;Tylka & Kroon Van Diest, 2013;Tylka & Wilcox, 2006), and with reduced eating disorder symptomatology (Denny, Loth, Eisenberg, & Neumark-Sztainer, 2013;Madden, Leong, Gray, & Horwath, 2012;Tylka, 2006;Tylka & Kroon Van Diest, 2013) as well as lower body mass index (BMI) (Denny et al., 2013;Hawks, Merill, & Madanat, 2004;Madden et al., 2012;Tylka, 2006;Tylka & Kroon Van Diest, 2013;Webb & Hardin, 2012), lower triglyceride levels and cardiovascular risk (Hawks, Madanat, & Harris, 2005). There is also some evidence that intuitive eating is associated with a healthier diet, especially vegetable intake and time taken to eat a meal (Madden et al., 2012). ...
... To our knowledge, two instruments have been developed to measure intuitive eating. The first one was developed by Hawks et al. (2004) and consisted of 27 items assessing four dimensions of the behavior: 1/intrinsic eating, 2/extrinsic eating, 3/anti-dieting, and 4/self-care. Shortly afterwards, Tylka's original 21-item Intuitive Eating Scale (IES) (Tylka, 2006) was published, identifying three central features of this behavior: 1/unconditional permission to eat, 2/eating for physical rather than emotional reasons, and 3/reliance on hunger and satiety cues. ...
Article
Intuitive eating is an adaptive dietary behavior that emphasizes eating in response to physiological hunger and satiety cues. The Intuitive Eating Scale-2 (IES-2) measures such attitudes and behaviors. The aim of the present study was to adapt the IES-2 to the French context and to test its psychometric properties in 335 women and 297 men participating in the NutriNet-Sante study. We evaluated the construct validity of the IES-2 by testing hypotheses with regard to its factor structure, relationships with scores of the revised 21-item Three Factor Eating Questionnaire and the Center for Epidemiologic Studies Depression scale, and differences between "a priori" relevant subgroups. First, the exploratory factor analysis revealed three main dimensions: Eating for Physical Rather than Emotional Reasons, Reliance on Hunger and Satiety Cues, and Unconditional Permission to Eat. Second-order confirmatory factor analysis upheld the 3-factor solution influenced by a broader intuitive eating dimension. IES-2 total score was negatively related to cognitive restraint (r = -031, P < 0.0001), emotional eating (r =-0.58, P < 0.0001), uncontrolled eating (r = -0.40, P < 0.0001), and depressive symptoms (r = -0.20, P <0.0001). IES-2 subscales showed similar correlations. Women had lower scores than did men for the IES-2 total scale (3.3 in women vs. 3.5 in men, P < 0.0001), Eating for Physical Reasons, and Unconditional Permission to Eat subscales. Current or former dieters had lower scores on the IES-2 total scale and on all subscales than did those who had never dieted (all P < 0.01). Finally, results showed satisfactory reliability for the IES-2 total scores (internal consistency = 0.85 and test-retest reliability = 0.79 over a mean 8-week period) and for its subscales. Thus, the French IES-2 can be considered a useful instrument for assessing adult intuitive eating behaviors in empirical and epidemiological studies in the general population.
... The didactic lifestyle education curriculum was based on 2 major components: 1) intuitive eating; and 2) modification of dietary carbohydrate intake. Intuitive eating is a non-dieting philosophy which emphasizes five major principles: 1) unconditional permission to eat when hungry, and to eat whatever food is desired; 2) eating for physical rather than emotional reasons; 3) reliance on internal hunger and satiety cues to determine when and how much to eat; 4) seeking satisfaction in eating; and 5) incorporating movement/physical activity to promote physical well-being [44][45][46]. Intuitive eating supports autonomy in eating and physical activity decision-making, and is therefore a developmentally ideal paradigm for adolescents, for whom the pursuit of autonomy is a critical developmental milestone [47]. The rationale for education about modifying the quality of carbohydrate intake, i.e. increasing whole grain and fiber while reducing refined and added sugar intake, relates to the consistent link between increased sugar-sweetened beverage consumption and poor metabolic health [48]. ...
... Intuitive Eating was assessed using Hawks' Intuitive Eating Scale, a 27-item, 4-point Likert scale survey [45] that consists of 4 subscales: 1) Intrinsic eating (4 items), relating to reliance on physical cues to start and stop eating; 2) Extrinsic eating (6 items), relating to avoidance of emotional or external prompts for eating decisions; 3) Anti-dieting (13 items) measuring disagreement with dieting behaviors; and, 4) Self-care (4 items), assessing an orientation that favors health & fitness over fashion or beauty. Higher scores for all subscales and total score indicate more intuitive eating. ...
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There is an urgent need for innovative and developmentally appropriate lifestyle interventions to promote healthy lifestyle behaviors and to prevent the early onset of type 2 diabetes and cardiovascular disease risk in obese Latino adolescents. Guided imagery offers promise to reduce stress and promote lifestyle behavior change to reduce disease risk in obese adolescents. Our objectives were: 1) To pilot test a new 12-wk lifestyle intervention using a randomized trial design in obese Latino adolescents, in order to determine the effects of the mind-body modality of Interactive Guided ImagerySM (IGI), over and above those of a didactic lifestyle education, on insulin resistance, eating and physical activity behaviors, stress and stress biomarkers; and 2) To explore the role of intervention-related changes in stress and stress biomarkers on changes in metabolic outcomes, particularly insulin resistance. Obese (BMI > 95th percentile), Latino adolescents (n = 35, age 14-17) were randomized to receive either 12 weekly sessions of a lifestyle education plus guided imagery program (GI), or lifestyle education plus a digital storytelling computer program (DS). Between-group differences in behavioral, biological, and psychological outcomes were assessed using unpaired T-tests and ANCOVA in the 29 subjects who completed the intervention. The GI group demonstrated significant reductions in leisure sedentary behavior (p < .05) and increases in moderate physical activity (p < .05) compared to DS group, and a trend toward reduced caloric intake in GI vs DS (p = .09). Salivary cortisol was acutely reduced by stress-reduction guided imagery (p < .01). There were no group differences in adiposity, insulin resistance, perceived stress, or stress biomarkers across the 12-week intervention, though decrease in serum cortisol over the course of the intervention was associated with improved insulin sensitivity (p = .03) independent of intervention group and other relevant co-variates. The improvements in physical activity and stress biomarkers following this pilot intervention support the role of guided imagery in promoting healthy lifestyle behavior change and reducing metabolic disease risk in obese Latino adolescent populations. Future investigations will be needed to determine the full effects of the Imagine HEALTH intervention on insulin resistance, stress, and stress biomarkers.Trial registration: Clinicaltrials.gov Registry #: NCT01895595.
... There is no restriction on the types of food one can eat, unless dictated by specific health issues (e.g. diabetes, food allergies), because the body will instinctively choose a variety of foods that provide nutritional balance (13,(16)(17)(18)(19) . ...
... Intuitive eating and health indicators non-intuitive eaters. The only exceptions were 18-25year-old women in the study by Augustus-Horvath and Tylka (2011) (22) and Chinese students in the study by (17) ; in both cases no association between the two measures was found. In all of the crosssectional studies, height and weight are self-reported. ...
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To review the peer-reviewed literature on relationships between intuitive eating and health indicators and suggest areas of inquiry for future research. We define the fundamental principles of intuitive eating as: (i) eating when hungry; (ii) stopping eating when no longer hungry/full; and (iii) no restrictions on types of food eaten unless for medical reasons. We include articles cited by PubMed, PsycInfo and Science Direct published in peer-reviewed journals or theses that include 'intuitive eating' or related concepts in the title or abstract and that test relationships between intuitive eating and physical or mental health indicators. We found twenty-six articles that met our criteria: seventeen cross-sectional survey studies and nine clinical studies, eight of which were randomised controlled trials. The cross-sectional surveys indicate that intuitive eating is negatively associated with BMI, positively associated with various psychological health indicators, and possibly positively associated with improved dietary intake and/or eating behaviours, but not associated with higher levels of physical activity. From the clinical studies, we conclude that the implementation of intuitive eating results in weight maintenance but perhaps not weight loss, improved psychological health, possibly improved physical health indicators other than BMI (e.g. blood pressure; cholesterol levels) and dietary intake and/or eating behaviours, but probably not higher levels of physical activity. Research on intuitive eating has increased in recent years. Extant research demonstrates substantial and consistent associations between intuitive eating and both lower BMI and better psychological health. Additional research can add to the breadth and depth of these findings. The article concludes with several suggestions for future research.
... e.g. Carlsson, Mehta and Pettinger, 2019;Hawks, Merrill and Madanat, 2004;Tylka and Kroon Van Diest, 2013). ...
Article
The article presents the procedure for the construction of the Concise Scale of Eating Attitudes, which is intended for the study of attitudes towards nutrition in the social sciences. This novel tool is the result of research work on diagnosing eating attitudes, the source of which is an individual’s world view. The six-component structure of the scale was verified using confirmatory factor analysis (RMSEA = 0.059; CMIN/DF = 1.629; CFI = 0.929). Internal reliability of sub-scales was tested by calculating Cronbach’s Alpha coefficients: Factor 1 (anorectic attitude) - α = 0.779; Factor 2 (religious attitude) - α = 0.844; Factor 3 (vegetarian attitude) - α = 0.890; Factor 4 (hedonistic attitude) - α = 0.654; Factor 5 (orthorectic attitude) - α = 0.655; Factor 6 (experimental attitude) - α = 0.842. The result is a concise scale made up of six factors built using a total of 16 items. Criterion relevance was established on the basis of correlation with other tools measuring similar structures, including the Three-Factor Eating Questionnaire (Polish adaptation of TFEQ-13), the Eating Behaviour Questionnaire (KZZJ), the Eating Preoccupation Scale (SZJ), and the Diet Self-Efficacy Scale (Polish adaptation of DIET-SE). Satisfactory psychometric properties were obtained based on a study involving 184 adults aged 18-35 years.
... However, it did not provide sufficient reliability in his retests. 6 In the original intuitive eating scale, Tylka collected 21 items in three subgroups. 7 Tylka and Kroon developed the Van Diest intuitive eating scale-1 and created the Intuitive Eating Scale-2. ...
Article
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Objective: This study was conducted to examine the relationship between intuitive eating behaviour, body mass index (BMI), and waist-hip circumference among university students. Methods: This study was conducted on 146 students studying at the Department of Nutrition and Dietetics of a foundation university on the European side of Istanbul in the 2020-2021 academic year. Socio-demographic characteristics, anthropometric measurements, and intuitive eating habits of the students were taken through an online questionnaire. Intuitive Eating Scale-2 (IES-2) was used to determine students’ intuitive eating behaviour. Results: 146 students with a mean age of 20.64±1.69 participated in the study. 62.3% of the students were female and 37.7% were male. Intuitive eating scale total score mean ± standard deviation values were found to be 3.40±0.55. BMI mean ± standard deviation values were found to be 21.89 ± 3.94 kg / m2 while waist circumference mean ± standard deviation values were 69.78±9.32 cm. eating due to physical rather than emotional causes sub-dimension has a positive and significant correlation with the eating sub-dimension related to hunger and fullness signals, body-food choice congruity, and intuitive eating scale-total score. There is a significant and positive relationship between the eating sub-dimension related to hunger and fullness signals and the body-food choice congruity sub-dimension and the total score of the intuitive eating scale. A significant and positive correlation was found between the body-food choice congruity sub-dimension and the total score of the intuitive eating scale. Comparing the intuitive eating scale total scores and sub-dimensions according to BMI groups, there is a significant difference in the mean score of the body-food choice congruity sub-dimension according to the BMI classification. Conclusion: As intuitive eating increases in university students, the body mass index decreases.
... ng principle of Gentle Nutrition. Total scores and most sub-scale scores in the sample were positively associated with body appreciation, self-esteem, psychological wellbeing and high interoceptive awareness, and inversely related to disordered eating, body shame and poor interoceptive awareness, amongst other factorsTylka & Kroon Van Diest, 2013).Hawks et al. (2004) have also developed their own Intuitive Eating Scale using a four-factor model to measure IE (intrinsic and extrinsic eating, anti-dieting and self-care). Although both measures are validated, the IES-2 appears to be preferred and widely used in IE research studies, perhaps due to refinements made over time to the scale and its reported ...
Conference Paper
Aims: There is a lack of qualitative research examining the experiences of learning to eat intuitively. This paper aims to present an in-depth exploration of the experiences of individuals undertaking an Intuitive Eating (IE) intervention during the COVID-19 pandemic, exploring the experiences of IE principles, facilitators and barriers to implementing IE and the impacts of COVID. Methods: Interviews were conducted with 11 women who had undertaken an IE intervention, which they received at least partly during the pandemic. Semi-structured interviews were conducted and analysed using thematic analysis (Braun & Clarke, 2006). Results: 13 themes and five overarching domains were identified from the data: the experience of Intuitive Eating intervention was described as life-altering and a process of self-exploration. Participants described their experiences of finding liberation through lockdown and the challenges of COVID and discussed the societal impacts on their IE experience (‘not operating in a vacuum’). Conclusions: The study is the first to examine experiences of an IE intervention during a pandemic, providing novel insights. Findings suggest that overall the IE model was experienced favourably, with some respondents describing the principles as life-altering and challenging, such as developing unconditional permission to eat. It highlighted that the pandemic had both positive and negative impacts on IE, such as increased time to focus on treatment and fears of missing out on ‘in vivo’ learning due to the pandemic. Societal and social impacts were also discussed, including external pressures on body image and the role of support from others in treatment.
... Many cross-sectional studies have shown that intuitive eaters have lower BMI than those who do not intuitively eat. 3,6,7 This relationship could not be shown only in the studies of Augustus-Horvath and Tylka and Hawks et al. [23][24] In addition, it was found that the intuitive eating approach helped maintain weight in overweight and obese women. 3 There is evidence that an intuitive eating program can help maintain weight, although the traditional diet can initially lead to weight loss and then regain weight 3,25 and, completing an intuitive eating program can result in weight loss. ...
Article
INTRODUCTION: Intuitive eating is identified as eating by hearing to and adapting to the physical hunger, satiety and satisfaction reactions given by the body naturally. The aim of this study was to research the effects of intuitive eating on mental well-being and eating behaviors in healthcare workers. METHODS: The plan of this study included all health workers in the state hospital in Edirne. The questionnaires were filled by the researchers according to the answers given by the participants to the questions. The five sections in the questionnaire consist of demographic information, anthropometric measurements, Beck Depression Inventory (BDI), The SCOFF Questionnaire to screen for eating disorders and the Intuitive Eating Scale-2 (IES-2). Health workers were separated into two groups according to the intuitive eating scale-2 median score (Group 1: below 3.60; Group 2: 3.60 and above). RESULTS: The participants' IES-2 mean score was 3.50 +- 0.59 (1.50 - 4.80). The BDI mean score of the participants in Group 1 was higher than that of those in Group 2. The number of participants with normal mental well-being according to the BDI score was lower in Group 1 than in Group 2. The number of participants exhibiting risky eating behavior according to the SCOFF score was higher in Group 1 than in Group 2. DISCUSSION AND CONCLUSION: The health workers who ate intuitively had better mental well-being and fewer eating disorders than those who did not intuitively eat.
... We developed the intuitive exercise scale (IEXS) for the purpose of this study. Existing intuitive eating scales (Hawks, Merrill, & Madanat, 2004;Tylka, 2006) and exercise constructs (e.g., exercise dependency, obligatory exercise, and exercise motives) informed the development of themes (i.e., unconditional permission to regulate exercising, exercising for health or other positive reasons, reliance on internal body cues, and mindful exercising), and 32 initial items measured on a 5-point scale (i.e., Strongly Disagree to Strongly Agree). An interdisciplinary expert panel reviewed and recommended modifying 16, dropping three, and adding 21 items. ...
Article
Unhealthy cognitive–emotional relationships with exercise can hinder positive treatment outcomes when left unaddressed. However, clinicians lack validated tools to monitor this aspect of treatment. This study examined the 14-item Intuitive Exercise Scale with 165 patients in the United States ( M age = 26.48 years) who were receiving treatment for an eating disorder. The original factor structure was inadequate for the current sample, and exploratory factor analysis generated three factors—emotional exercise, body intuition, and exercise variety. The three-factor solution yielded strong internal consistency and partial support for the scale’s validity. Furthermore, patients scored lowest in body intuition, confirming low awareness of bodily cues common in patients with eating disorders. This study informs how clinicians may integrate and monitor patients’ cognitive–emotional relationship with exercise as part of holistic and intuitive eating disorder treatment approaches.
... 13 Intuitive eating promotes a healthy nonrestrictive relationship with food through the utilization of hunger and fullness cues and promoting eating satisfaction, 20 and studies have linked it to good health outcomes in young adults. 18,19 To the best of the authors' knowledge, this is the first time intuitive eating has been used in a specific lifestyle intervention, although the similar concept of mindfulness-based eating has been used successfully in dietary interventions in adults. 38 specific intervention components mediated the change seen in the HEI, but supports future research to determine the specific effects of these approaches to healthy eating in adolescent populations. ...
Article
Introduction: To determine the effects of a novel lifestyle intervention combining lifestyle behavioral education with the complementary-integrative health modality of guided imagery (GI) on dietary and physical activity behaviors in adolescents. The primary aim of this study was to determine the incremental effects of the lifestyle education, stress reduction GI (SRGI), and lifestyle behavior GI (LBGI) components of the intervention on the primary outcome of physical activity lifestyle behaviors (sedentary behavior, light, moderate, and vigorous physical activity), as well as dietary intake behaviors, at the completion of the 12-week intervention. The authors hypothesized that the intervention would improve obesity-related lifestyle behaviors. Materials and Methods: Two hundred and thirty-two adolescent participants (aged 14-17 years, sophomore or junior year of high school) were cluster randomized by school into one of four intervention arms: nonintervention Control (C), Lifestyle education (LS), SRGI, and LBGI. After-school intervention sessions were held two (LS) or three (SRGI, LBGI) times weekly for 12 weeks. Physical activity (accelerometry) and dietary intake (multiple diet recalls) outcomes were assessed pre- and postintervention. Primary analysis: intention-to-treat (ITT) mixed-effects modeling with diagonal covariance matrices; secondary analysis: ad hoc subgroup sensitivity analysis using only those participants adherent to protocol. Results: ITT analysis showed that the Healthy Eating Index (HEI) increased in the LS group compared with C (p = 0.02), but there was no additional effect of GI. Among adherent participants, sedentary behavior was decreased stepwise relative to C in SRGI (d = -0.73, p = 0.004) > LBGI (d = -0.59, p = 0.04) > LS (d = -0.41, p = 0.07), and moderate + vigorous physical activity was increased in SRGI (d = 0.58, p = 0.001). Among adherent participants, the HEI was increased in LS and SRGI, and glycemic index reduced in LBGI. Conclusions: While ITT analysis was negative, among adherent participants, the Imagine HEALTH lifestyle intervention improved eating habits, reduced sedentary activity, and increased physical activity, suggesting that GI may amplify the role of lifestyle education alone for some key outcomes. CTR #NCT02088294.
... Intuitive eating quartiles were derived separately for men and women, and all analyses were stratified by gender on the basis of reported gender differences in awareness of the concept of intuitive eating 17 and the relationships between engagement in intuitive eating and health behaviors. 11,18 Gender-specific analyses also allowed for alignment with daily dietary intake guidelines, which differ by gender. 14 Dietary outcomes were selected on the basis of key components of the 2015−2020 DGA 14 and the consumer-facing tool, MyPlate. ...
Article
Objective Assess how intuitive eating relates to dietary intake. Methods Survey data were collected in Project Eating and Activity in Teens and Young Adults, the fourth wave of a longitudinal cohort study (weighted n = 1,830, 49% women; mean age = 31 years). Intuitive eating was assessed using a 7-item scale adapted from the Intuitive Eating Scale and Intuitive Eating Scale-2. Dietary intake was measured via a semiquantitative food frequency questionnaire. Mean servings were stratified by gender and intuitive eating quartiles and adjusted for sociodemographic characteristics and caloric intake. Results Women and men in the top intuitive eating quartile consumed 0.6–0.3 servings more fruit and 0.4–0.6 servings more vegetables daily, respectively, compared with the bottom quartile, whereas men in the top quartile also consumed 0.6 servings fewer whole grains (all P < 0.05) than the bottom quartile. Conclusions and Implications Intuitive eating shows promise as a healthier alternative to practices such as dieting.
... Through interactive discussions within the author team, we generated a pool of 103 items, which were purported to measure the individual-difference characteristics of the IRE style. Existing measures of intuitive eating [11,19], eating competence [12], mindful eating [13,14], and interoceptive awareness [20] were used for inspiration during item generation. Researchers in the field of nutrition and experts evaluated and enriched the content of the initial item pool, which then underwent two rounds of pretesting with college samples. ...
Article
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In this paper, we describe the systematic development and validation of the Multidimensional Internally Regulated Eating Scale (MIRES), a new self-report instrument that quantifies the individual-difference characteristics that together shape the inclination towards eating in response to internal bodily sensations of hunger and satiation (i.e., internally regulated eating style). MIRES is a 21-item scale consisting of seven subscales, which have high internal consistency and adequate to high two-week temporal stability. The MIRES model, as tested in community samples from the UK and US, had a very good fit to the data both at the level of individual subscales, but also as a higher-order formative model. High and significant correlations with measures of intuitive eating and eating competence lent support to the convergent validity of MIRES, while its incremental validity in relation to these measures was also upheld. MIRES as a formative construct, as well as all individual subscales, correlated negatively with eating disorder symptomatology and weight-related measures (e.g., BMI, weight cycling) and positively with adaptive behavioral and psychological outcomes (e.g., proactive coping, body appreciation, life satisfaction), supporting the criterion validity of the scale. This endeavor has resulted in a reliable and valid instrument to be used for the thorough assessment of the features that synthesize the profile of those who tend to regulate their eating internally.
... When these comparisons have been made, results mostly suggest that scores are either equal across sex or that men report higher levels of intuitive eating (Camilleri et al., 2015;Dockendorff, Petrie, Greenleaf, & Martin, 2012;Moy, Petrie, Dockendorff, Greenleaf, & Martin, 2013;Tylka & Kroon Van Diest, 2013). On other measures of intuitive eating, men also report higher levels of intuitive eating compared to women (Hawks, Merrill, & Madanat, 2004). Cultural pressures regarding thinness could be responsible for these sex differences. ...
Article
Intuitive eating involves attention to feelings putatively related to hunger and satiety to guide eating choices. This adaptive eating style has been linked to a number of positive physical and psychological outcomes. Interestingly, women tend to report lower levels of intuitive eating compared to men. It has been hypothesized that sociocultural pressures or dieting could be contributing factors to this sex discrepancy. The current study aimed to explore whether sex moderates the relationship between either dietary restraint and intuitive eating, or between emotional eating and intuitive eating. Assessments were administered to a sample of college males and females (N = 478) as part of a larger study of eating behaviors. Moderation analyses indicated that higher dietary restraint was more strongly associated with lower levels of intuitive eating in women than in men. Emotional eating also had a stronger negative association with intuitive eating in women compared to men. Additionally, relationships between dietary restraint/emotional eating and a component of intuitive eating, “eating for physical rather than emotional reasons”, was stronger for women compared to men. These findings suggest that dietary restraint and emotional eating may serve as barriers in the implementation of an intuitive eating style, especially for women. Prevention and intervention efforts should target those high in dietary restraint and emotional eating.
... Previous studies using this scale have reported reliabilities of .56 to .85 (Tylka, 2006). Construct validity can be seen in negative associations with dietary restriction, positive association with pleasure in eating, and the EAT-26 scale (Avalos & Tylka, 2006;Daundasekara et al., 2017;Hawks, Merrill, & Madanat, 2004;Tylka, 2006). Cronbach's alpha in this study was .91. ...
Article
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Objective: To conduct a cross-sectional study of women in the postpartum period to identify relationships between intuitive eating, body image satisfaction, eating attitudes and depressive symptomology. Methods: Women with at least one child born in the previous 6–48 months were recruited via Facebook to complete an online survey which included: sociodemographic and health questions, the Intuitive Eating Scale, the Body Shape Questionnaire, the Multidimensional Body-Self Relations Questionnaire, the Eating AttitudesTest-26 and the Edinburgh Postnatal Depression Scale. Descriptive statistics were calculated for all variables and hierarchical regressions used to examine associations between intuitive eating styles, body image satisfaction, eating attitudes and depressive symptomology. Results: Of the 419 women (mean age 32 ± 5.3 years), 32% were classified with intuitive eating styles and were more likely to have higher body image satisfaction (F = 476.80, p < .001), less disordered eating attitudes (F = 30.74, p < .001) and lower depressive symptomology (F = 4.14, p = .042). Conclusions: The postpartum period is a time of high risk for developing/maintaining eating styles that may negatively impact psychological health and well-being. Providing education to new mothers about the benefits of intuitive eating could positively influence their health and well-being.
... The Intuitive Eating Scale (IES) was first introduced to the scientific literature by Hawks et al. [9]. The scale was then developed and the Intuitive Eating Scale-2 (IES 2) was developed [10]. ...
Article
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Objective To determine intuitive eating in young adults and the effects of factors such as gender, Body Mass Index and dietary intake, and dietary adequacy on intuitive eating. Methods This cross-sectional study was conducted with students at Gazi University in Ankara (N=665; 17.6% men; 82.4% women). The questionnaire, including the general characteristics, anthropometric measurements, Intuitive Eating Scale-2, and 24-H Dietary Recall sections, were applied to all participants. For the evaluation of the diet, Nutrient Adequacy Ratio and Mean Adequacy Ratio were used. Results The mean Intuitive Eating Scale-2 score was 3.2±0.33; men’s and women’s scores were 3.3±0.37 and 3.2±0.32, respectively (p<0.05). According to linear regression analysis, gender, age and mean adequacy ratio had an effect on the model for the score (p<0.05). In addition, there was a negative correlation between Intuitive Eating Scale-2 scores and Body Mass Index values in women (rp=-0.095, p=0.026). Conclusion The intuitive eating scores varied according to gender, dietary adequacy and age. Intuitive eating may be effective in the formation of long-term behavioral changes, which is beneficial for the treatment of obesity. The result of this study may encourage the development of this behavior in groups (may vary according to gender), that is thought to be effective by considering the changes of intuitive eating behavior.
... We merged their lifestyle curriculum with our previously used Imagine HEALTH pilot lifestyle curriculum. The resulting Imagine HEALTH Lifestyle Curriculum used for this study fully encompasses health-promoting nutrition and physical activity practices consistent with consensus pediatric recommendations [34,78,79], emphasizing modification in quality of carbohydrate intake [73,80,81], as well as key concepts of "Intuitive Eating" [82][83][84]. a non-diet approach to healthy eating that bears many similarities to mindfulness-based eating [15]. The final lifestyle curriculum also incorporates an active mentoring component previously used by SOSMentor, whereby the high school participants receive the lifestyle education in the first 6 weeks of the program, and then deliver the intervention to students of a partnered, geographically proximate elementary school during the final 6-weeks of the program. ...
Article
Innovative lifestyle interventions are needed to reduce type 2 diabetes risk in adolescents. This report describes the protocol of the Imagine HEALTH cluster randomized control trial, that tests an intervention based in Self-Determination Theory (SDT) and uses lifestyle education combined with the mind-body, complementary health modality of guided imagery (GI), to address obesity prevention and treatment in predominantly Latino adolescents. The primary aim is to determine the unique effects of each of the three major components of the 12-week lifestyle intervention (lifestyle education, stress reduction guided imagery, and lifestyle behavior guided imagery) compared to control on primary outcomes of physical activity (accelerometry), dietary intake (3-day recall), and stress biomarker levels (salivary cortisol). Secondary aims assess changes compared to controls in psychosocial outcomes (stress, well-being, depression), diabetes-related metabolic outcomes (adiposity, insulin resistance), maintenance of outcome changes for one year post-intervention, and SDT-based mediation of intervention effects. The development and rationale for each of the intervention components, study design, and outcome measurement processes are described. Adolescent participants recruited from four urban schools are cluster randomized by school into one of four arms of the 12-week (3-month) intervention, followed by 6 months of maintenance and 6 months of no contact. Outcome measures are assessed at the end of each period (3-, 9-, and 15-months). Results to date show successful recruitment of 97% of the target study population. Future results will demonstrate the effects of this integrative intervention on primary and secondary outcome measures in adolescents at risk for lifestyle-related metabolic disease.
... One diet-related measure that has not been explored extensively is emotion regulation associated with eating behaviors [56,57]. Such measures were not collected in the studies reviewed for this paper, aside from one [36] which assessed emotional and physical associations to eating via an Intuitive Eating Scale [58]. Stress and negative emotions increase the risk of obesity, and it has been hypothesized that emotion regulation (defined as strategies to maintain positive affect or improve negative affect) is associated with obesity-related eating behaviors, and thus childhood obesity risk [59]. ...
Article
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Childhood obesity remains a significant public health issue in the U.S. and globally. Rates are disproportionately higher in Latinos than other ethnic groups. This review provides a qualitative synthesis of the current evidence for childhood obesity treatment interventions among Latino children. A systematic search was performed in PubMed, Web of Science and Google Scholar for articles published from September 2010 to December 2015. Randomized controlled trials treating childhood overweight/obesity in Latino children ages 5-19 focused on diet and/or physical activity (PA) behaviors were included. Of the records initially identified (n=1,592), 11 studies met the inclusionary criteria. The majority included a family-based component (n=8; 73%). Nearly half (n=5) focused on children ages 5-12, with three specifically developed for the pre-adolescence stage (ages 8-12). Nine studies acknowledged cultural tailoring, most frequently by seeking input from their intended population and utilizing bilingual delivery staff. Improvements in anthropometric measures (e.g. body mass index (BMI) z-score) were observed in 55% of the studies (n=6). Many interventions with a combined focus of diet and PA, in the form of nutrition education in a group setting and in-person activity/exercise sessions and incorporated a parent/family component reported positive anthropometric results. Three (27%) studies included a follow-up period, all of which observed a sustained decrease in BMI over time. Overall, family-based interventions focusing on both diet and PA demonstrated promising results. However, additional research incorporating a follow-up period is warranted to assess sustainability of these outcomes. Additionally, more interventions could be developed specifically for the critical developmental stage of pre-adolescence.
... Intuitive eating is typically assessed using self-report questionnaires. The first instrument measuring intuitive eating has been developed by Hawks, Merrill, and Madanat (2004) and consists of 27 items clustered into four dimensions: intrinsic eating, extrinsic eating, anti-dieting, and self-care. Two years later, Tylka published the initial "Intuitive Eating Scale" (IES-1; Tylka, 2006), which was developed based on the ten principles of intuitive eating by Tribole and Resch (1995). ...
Article
Intuitive eating has been described to represent an adaptive eating behaviour that is characterised by eating in response to physiological hunger and satiety cues, rather than situational and emotional stimuli. The Intuitive Eating Scale-2 (IES-2) has been developed to measure such attitudes and behaviours on four subscales: unconditional permission to eat (UPE), eating for physical rather than emotional reasons (EPR), reliance on internal hunger and satiety cues (RHSC), and body-food choice congruence (B-FCC). The present study aimed at validating the psychometric properties of the German translation of the IES-2 in a large German-speaking sample. A second objective was to assess levels of intuitive eating in participants with an eating disorder diagnosis (anorexia nervosa, bulimia nervosa, or binge eating disorder). The proposed factor structure of the IES-2 could be confirmed for the German translation of the questionnaire. The total score and most subscale scores were negatively related to eating disorder symptomatology, problems in appetite and emotional awareness, body dissatisfaction, and self-objectification. Women with eating disorders had significantly lower values on all IES-2 subscale scores and the total score than women without an eating disorder diagnosis. Women with a binge eating disorder (BED) diagnosis had higher scores on the UPE subscale compared to participants with anorexia nervosa (AN) or bulimia nervosa (BN), and those diagnosed with AN had higher scores on the EPR subscale than individuals with BN or BED. We conclude that the German IES-2 constitutes a useful self-report instrument for the assessment of intuitive eating in German-speaking samples. Further studies are warranted to evaluate psychometric properties of the IES-2 in different samples, and to investigate its application in a clinical setting.
... We developed the intuitive exercise scale (IEXS) for the purpose of this study. Existing intuitive eating scales (Hawks, Merrill, & Madanat, 2004;Tylka, 2006) and exercise constructs (e.g., exercise dependency, obligatory exercise, and exercise motives) informed the development of themes (i.e., unconditional permission to regulate exercising, exercising for health or other positive reasons, reliance on internal body cues, and mindful exercising), and 32 initial items measured on a 5-point scale (i.e., Strongly Disagree to Strongly Agree). An interdisciplinary expert panel reviewed and recommended modifying 16, dropping three, and adding 21 items. ...
Article
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Up to 80% of individuals with eating disorders engage in dysfunctional exercise, which is characterized by exercising in excessive quantities often past the point of pain as well as compulsive feelings and negative affect when exercise is disrupted (Cook, Hausenblas, Crosby, Cao, & Wonderlich, 2015). Intuitive exercise involves an awareness of the senses while moving and attending to one's bodily cues for when to start and stop exercise, rather than feeling compelled to adhere to a rigid program (Reel, 2015). The purpose of this study was to design a measurement tool to evaluate the construct of intuitive exercise in research, treatment, and prevention settings. The 14-item Intuitive Exercise Scale (IEXS) was developed and validated in the current study with completed surveys from 518 female and male adult participants. Exploratory factor analysis was used to identify four latent constructs, including emotional exercise, exercise rigidity, body trust, and mindful exercise, which were supported via confirmatory factor analysis (CFI = 0.96; SRMR = 0.06). The IEXS demonstrated configural, metric, and scalar invariance across women and men. Correlations with measures of intuitive eating, exercise dependence, and exercise motivation supported convergent and discriminant validity.
... While two valid and reliable measures are available to capture individuals' intuitive eating behaviour, the more frequently used Tylka and Kroon van Diest's Intuitive Eating Scale-2 (9,15) and the less common, Hawks and colleagues' Intuitive Eating Scale (42) , no such measure has been validated to gauge health professionals' knowledge, attitudes and practices regarding this approach. To date, only qualitative research has examined dietitians' knowledge of non-dieting and size acceptance approaches (43) . ...
Article
Objective The purpose of the present study was to develop and assess the construct validity of a tool to measure knowledge, attitudes and practices of registered dietitians/nutritionists (RD/N) regarding an intuitive eating lifestyle. Design Cross-sectional study design that utilized a survey administered to a random sample and remaining full population of RD/N. Setting A national survey conducted via online survey software. Subjects A random sample of 10 % of all RD/N in the USA ( n 8834) was invited to participate. Survey completion rate was 22·2 % ( n 1897). After initial validation, the survey was distributed to the remaining 90 % of RD/N to confirm validation. Results After removing items with insufficient factor loadings, results were consistent with a four-factor solution: (i) knowledge of intuitive eating; (ii) attitudes towards intuitive eating; (iii) traditional and restrictive practices; and (iv) non-restrictive and intuitive eating practices. Confirmatory factor analysis provided further evidence of the validity of the four factors and the factors had strong reliability. Conclusions Unlike the hypothesized three-factor solution (knowledge, attitudes and practices), validation analysis revealed that the survey measures knowledge of intuitive eating, attitudes towards intuitive eating, use of traditional and restrictive weight-management practices, and use of non-restrictive and intuitive eating practices. With the landscape of weight management and health promotion undergoing a shift towards a health centred, size acceptance approach, this instrument will provide valuable information regarding the current knowledge, attitudes and practices of RD/N and other health promotion professionals.
... Both are referred to as Intuitive Eating Scale (IES). The first one was developed by Steven Hawks and cols. in 2004, and the other one by Tracy Tylka in 2006 32,33 . Despite the fact that both seem to measure intuitive eating features, they do not share the same factor structure. ...
Article
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Introduction: In an effort to treat obesity, health care professionals pursue, by means of dieting and exercise interventions, weight loss as a primary goal of treatment. Although in few cases these interventions induce shortterm moderate weight loss, in the long-term, the efficacy of these treatments is at least questionable. Weight-loss interventions based on restrictive diets may be associated to adverse health and well-being. In this regard, some researchers have considered shifting the focus of obesity treatment into a health-centered paradigm. Among the models derived from this new paradigm, Health at Every Size (HAES) is one of the most referenced. HAES has enhanced intuitive eating as a core component of the paradigm, which refers to the reliance on biological mechanisms to regulate food intake (i.e., internal hunger and satiety cues). Recently, intuitive eating has been winning recognition since it have been associated with numerous indices of physical and psychological well-being, and noteworthy, it have not been related to any adverse effects. Objective: The present paper reviews the concept of intuitive eating, as well as the existing evidence that upholds this emerging approach. Also, it discusses the implication of shifting the focus of dietetic interventions into a health-centered paradigm. Design: Narrative Review. Conclusions: Although it is certain there is a need to extend current research on health-centered interventions, this approach may be a more promising and realistic alternative to address overweight and obesity than the conventional weight-loss treatments. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
... Intuitive eating is defined as a strong connection with, understanding of, and eating in response to, internal physiological hunger and satiety cues coupled with low preoccupation with food (Hawks, Merrill, & Madanat, 2004;Tribole & Resch, 1995;Tylka, 2006). Scholars posit that intuitive eating is comprised of three central and interrelated components of intuitive eating: unconditional permission to eat when hungry and what food is desired, eating for physical rather than emotional reasons, and reliance on internal hunger and satiety cues to determine timing and amount of food to consume (Tribole & Resch, 1995;Tylka, 2006). ...
... Because it is a combination of attitudes and behaviors, intuitive eating cannot be simply measured by one distinct behavior. 52 Two validated intuitive eating scales currently exist, 18,78 one of which has been recently updated. 19 No study in our review used these scales to assess to what degree participants actually changed their behaviors. ...
Article
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Traditional diet programs that encourage individuals to consciously restrict their dietary intake have not only been ineffective in terms of weight outcomes, but have also been counterproductive, promoting psychological distress and unhealthy eating behaviors. Nondiet approaches shift the focus away from weight outcomes to the improvement of health outcomes and psychological well-being. One such approach, intuitive eating, promotes dietary intake based on internal cues of hunger and fullness, body acceptance, and making behavior choices based on health as well as enjoyment. Several studies have implemented such ideas into intervention programs. The purpose of our review was to examine the physical and psychological effects of these programs. Twenty interventions were identified. Overall, studies had positive results, demonstrating improvements in eating habits, lifestyle, and body image as measured by dietary restraint, restrictive dieting, physical activity, body satisfaction, and drive for thinness. Participants also experienced improved psychological health as measured by depression, ineffectiveness, anxiety, self-esteem, negative affect, and quality of life. Several improvements were sustained through follow-up periods as long as 2 years. Completion rates were as high as 92% in nondieting groups. In addition, improvements in eating behaviors and maintaining a nondiet approach, increased self-esteem, and decreased body dissatisfaction were sustained long-term. Overall, studies that encourage individuals to eat intuitively help participants abandon unhealthy weight control behaviors, improve metabolic fitness, increase body satisfaction, and improve psychological distress. Results from our review favor the promotion of programs that emphasize a nonrestrictive pattern of eating, body acceptance, and health rather than weight loss.
Article
BACKGROUND: Intuitive eating is defined by eating response to physiological hunger and satiety cues rather than situational or emotional cues and it has been linked to psychological well-being. The 23-item Intuitive Eating Scale-2 (IES-2) is commonly used to assess the concept of intuitive eating. OBJECTIVE: To develop the Greek version of the IES-2 questionnaire and to test its psychometric qualities. METHODS: Forward and backward translations into Greek and English were completed. Exploratory Factor Analysis (EFA) was applied to understand the underlying factor structure of the IES-2, whilst internal consistency was assessed by Cronbach’s alpha test. The concurrent validity was assessed by evaluating the correlation among the IES-2 and the Eating Attitudes Test-26 Item (EAT-26) questionnaire. RESULTS: A total of 379 adults (mean age = 34 years) participated. EFA gave a three-factor structure with the total variance explained being 54.4% . Cronbach’s alpha was 0.87 for the IES-2 total score, as well as 0.90, 0.84 and 0.70 for the IES-2 subscales. The revised IES-2 total score was significantly correlated with EAT-26 total score (rs = –0.46, p < 0.01) and BMI (rs = –0.46, p < 0.01). CONCLUSION: In this sample, the Greek version of the IES-2 showed good psychometric qualities and can be regarded a helpful tool for examining adult intuitive eating behaviours.
Article
Aim: This systematic review explored the feasibility, acceptability and effect on health outcomes of weight-neutral interventions in health improvement-seeking young people with overweight/obesity. Methods: Six databases were searched to March 2021 for health, but not weight, focused interventions (PROSPERO, CRD42020152671). Eligible studies recruited young people (10-24 years) with overweight/obesity. The studies were described using narrative synthesis, with numerical results summarised. The quality of included studies was assessed using the Joanna Briggs Institute critical appraisal tools. Results: Six articles were included, representing three pilot studies. Study 1 (n = 37, 14-17 years) compared a 6-week mindful eating program with single-session lifestyle education; Study 2 (n = 35, 14-17 years) compared 12-week weight-neutral lifestyle education focused on intuitive eating and carbohydrate quality, with/without guided imagery; and Study 3 (n = 33, 12-17 years) compared a 6-week mindfulness intervention with cognitive behavioural therapy in adolescents with depressive symptoms at risk of type 2 diabetes. All interventions explored feasibility (intervention group retention 57%-88%, attendance >80%) and reported interventions were acceptable. Studies 1 and 3 reported no change in mindfulness. Study 2 reported an increase (p < 0.05) in intuitive eating following weight-neutral plus guided imagery (0.32 ± 0.36, Hawks' Scale, score 1-4), compared with weight-neutral alone (0.15 ± 0.29). Study 1 reported decreased body mass index (p < 0.001) following mindful eating (-1.1 kg/m2 ), compared with single-session lifestyle education (+0.7 kg/m2 ); Studies 2 and 3 found no change in body mass index or body mass index z-score. Conclusions: Weight-neutral interventions may be feasible and acceptable in adolescents with overweight/obesity in the short term (≤12 weeks), but data are limited.
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Purpose: Previous studies examining the appropriateness of the 4-factor model of Intuitive Eating Scale-2 (IES-2) scores have returned equivocal results, which may reflect methodological limitations in the way IES-2 scores are modelled. Here, we applied a bifactor-exploratory structural equation modelling (B-ESEM) framework to better understand IES-2 multidimensionality. Methods: A total of 603 participants from the United States completed the IES-2, alongside measures of body appreciation, body acceptance from others, and self-esteem. Our analyses compared the fit of various hypothesised models of IES-2 scores. Results: Models of IES-2 scores based on confirmatory factor analysis (CFA) uniformly showed poor fit. ESEM models showed superior fit to CFA representations and a B-ESEM model showed improved fit over higher-order CFA and B-CFA representations of IES-2 scores. The optimal model was a B-ESEM model that accounted for, through correlated uniqueness (CU), the methodological artefact introduced by negatively-worded IES-2 items. This B-ESEM-CU model was fully invariant across gender and showed adequate construct validity. Conclusion: The B-ESEM-CU framework appears well-suited to understand the multidimensionality of IES-2 scores. A model of IES-2 scores that yields a reliable latent indicator of global intuitive eating while allowing for simultaneous consideration of additional specific factors will likely provide more accurate accounting of the nature and outcomes of intuitive eating.
Article
Objective: Intuitive eating is an adaptive style of eating that has generated significant research attention. Theoretically, intuitive eating is a core construct that features prominently in the Acceptance Model of Intuitive Eating, a framework that explains how positive environmental influences can foster intuitive eating practices via body appreciation. Empirically, intuitive eating has been connected to a broad range of adaptive mental health indices. At present, a quantitative synthesis of intuitive eating and its correlates has yet to be conducted. This was the objective of the current meta-analysis. Method: Ninety-seven studies (89% cross-sectional) were included. Random effects meta-analyses were conducted on 23 psychological correlates, divided into three clusters: eating behavior and body image disturbances, positive body image and other adaptive factors, and general psychopathology. Meta-analytic path analyses were also computed to test the validity of the Acceptance Model. Results: Intuitive eating was inversely associated with multiple indices of eating pathology, body image disturbances, and psychopathology (rs = -.23 to -.58). Intuitive eating was positively associated with numerous positive psychological constructs, such as positive body image, self-esteem, and wellbeing (rs = .20 to .58). Men reported higher levels of intuitive eating than women (d = 0.39), with differences being largest in Caucasian samples. Meta-analytic path analyses strongly supported the hypothesized pathways specified in the Acceptance Model of Intuitive Eating. Conclusions: There is a strong evidence base for intuitive eating's connection to numerous adaptive psychological constructs. Attention should now shift toward prospective and experimental designs so that the temporal nature of these relationships can be identified.
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Intuitive eating is a form of eating behavior characterized by a strong connection to the physiological cues of hunger and satiety, taking into account the amount of body needs and the type of food to eat to maintain the nutritional and body health. The sampling technique is non probability sampling. A total of 263 adolescents aged 15 years to 19 years with the criteria of high school students who live in Malang, East Java and have got balanced nutrition education program be sample of this study. The results of this study show significant influence of personality extraversion, personality agreeableness, personality conscientiousness, personality neuroticism, personality openness to experiences of big five personality, healthy life behavior, and body mass index (IMT) on intuitive eating in high school students in Malang regency. (R-square = 0.066, sig = 0.032). Hypothesis test results show that neuroticism of big five personality and body mass index (IMT) have significant influence to intuitive eating. Abstrak Intuitive eating adalah suatu bentuk perilaku makan yang ditandai dengan hubungan yang kuat pada isyarat-isyarat fisiologis dari rasa lapar dan kenyang, dengan memperhatikan jumlah kebutuhan tubuh dan jenis makanan yang harus dimakan untuk menjaga kesehatan gizi dan bentuk tubuh. Teknik pengambilan sampel yang digunakan adalah non probability sampling. Sebanyak 263 remaja berusia 15 tahun sampai dengan 19 tahun dengan kriteria siswa SMA yang berdomisili di Kabupaten Malang, Jawa Timur. Dan sudah mendapat program pendidikan gizi seimbang. Hasil penelitian ini menunjukkan adanya pengaruh yang signifikan personality extraversion, personality agreeableness, personality conscientiousness, personality neuroticism, personality openness to experiences dari big five personality, perilaku hidup sehat, dan indeks massa tubuh (IMT) terhadap intuitive eating pada siswa SMA di Kabupaten Malang. (R-square = 0.066, sig = 0.032). Hasil uji hipotesis menunjukkan bahwa neuroticism dari big five personality dan indeks massa tubuh (IMT) mempunyai pengaruh signifikan terhadap intuitive eating. DOI : 10.15408/jp3i.v6i2.9170
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Intuicyjne jedzenie (intuitive eating) to filozofia odżywiania się propagująca rezygnację z ograniczeń dietetycznych przy jednoczesnym uwrażliwieniu na fizjologiczne wskaźniki głodu i sytości, dostosowaniu się do nich, a co za tym idzie-kierowaniu się nimi w swoich zachowaniach żywieniowych (Lewandowska, 2015). W badaniach (Tylka, 2006) dowiedziono, że intuicyjne jedzenie wiąże się z dobrostanem psychologicznym, czyli poczuciem szczęścia, a koreluje negatywnie z zaburzeniami odżywiania. To "antydietetyczne" podejście staje się coraz bardziej popularne wśród specjalistów z zakresu nawyków żywieniowych. Wzrasta świadomość, że diety restrykcyjne przynoszą paradoksalne efekty-powodują narastającą frustrację i poczucie głodu oraz nie są dostosowane do potrzeb organizmu, co prowadzi do częstego łamania sztywnych reguł diety czy epizodów objadania się (Lewandowska, 2015). Wstęp Założenia Skuteczność interwencji Według badań (Hawks i in., 2005; Tylka, Wilcox, 2006; Denny i in., 2013; Cadena-Schlam, Lopez-Guimera, 2015; Linardon, Mitchell, 2017), argumenty przemawiające za wykorzystaniem interwencji opartych na intuicyjnym jedzeniu są liczne: 1. Osoby jedzące intuicyjnie mają mniejsze BMI 2. Mają także niższą tendencję do rozwoju zaburzonego odżywiania niż osoby, które używają wskaźników zewnętrznych do kontroli własnych posiłków 3. Efekty są długoterminowe i służą poprawieniu dobrostanu psychicznego i fizjologicznego. 4. Taki sposób odżywiania pozwala utrzymać odpowiednią masę ciała, bez konieczności restrykcji żywieniowych. Sposoby kontroli Wnioski Intuicyjne jedzenie stanowi bardziej realistyczną i obiecującą alternatywę dla profilaktyki i leczenia nadwagi oraz zaburzonych nawyków żywieniowych niż konwencjonalne metody (Cadena-Schlam, Lopez-Guimera, 2015). Tylka nazwała intuicyjne jedzenie wysoce adaptacyjną postawą obecną w populacji z różnym nasileniem (Tylka, 2006). Rodzi się pytanie czy autorka ma rację w swoich przewidywaniach. Czy intuicyjne jedzenie jest tak bardzo efektywne podczas walki z otyłością i nadwagą? Ze względu na rosnącą liczbę światowych specjalistów zwracającą się ku temu podejściu i najnowsze doniesienia o jego skuteczności, jawi się potrzeba przeprowadzenia badań i podjęcia dyskusji w polskich środowiskach akademickich. To innowacyjne podejście zostało przedstawione jako podstawa profilaktyki otyłości przez dietetyczki Tribole i Resch już w 1995 roku (za: Lewandowska, 2015). Sformułowały 10 reguł intuicyjnego odżywiania: 1. Porzuć wiarę w diety oferujące szybką, łatwą i trwałą utratę wagi. 2. Nie tłum swojego głodu, naucz się rozpoznawać nawet małe jego przejawy i szybko reagować na nie. 3. Przestań wyrzekać się swojej potrzeby jedzenia. 4. Przestań oceniać swoje wybory żywieniowe jako 'dobre' i 'złe' oraz siebie po ich spożyciu 5. Doceniaj poczucie sytości-sygnały odprężenia, pełności, mniejszą przyjemność ze spożycia kolejnych rzeczy 6. Odkrywaj co w jedzeniu przynosi Ci satysfakcję. To wpłynie na spożycie bardziej świadome i powolne. 7. Zaspokajaj swoje potrzeby emocjonalne bez użycia jedzenia. 8. Szanuj swoje ciało, akceptuj to czego nie możesz zmienić i nie przyjmuj nierealistycznych standardów. 9. Jeżeli ćwiczysz, to nie uzasadniaj tego odchudzaniem. Rób to tylko by uzyskać poczucie energii i przyjemności płynące z aktywności fizycznej. 10. Szanuj swoje zdrowie. Twoje wybory żywieniowe powinny być racjonalne, stanowić umiarkowanie między tym co smaczne, a tym co zdrowe. Tylka (2006; Tylka i in., 2013) zoperacjonalizowała to w czterech czynnikach: Intuicyjne odżywianie się jako innowacyjna metoda leczenia i prewencji otyłości oraz zaburzonych zachowań jedzeniowych
Article
The present article reports on a 2-year pilot study that evaluated the effectiveness of an intuitive eating program for patients in an eating disorder treatment center. Standardized measures of intuitive eating and eating disorder and psychological symptoms were administered. Psychotherapists and dietitians rated patients on the healthiness of their eating attitudes and behaviors. Preliminary findings indicated that patients can develop the skills of intuitive eating, and that the ability to eat intuitively is associated with positive treatment outcomes for each diagnostic category (i.e., anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified). We conclude by offering recommendations about how to implement intuitive eating training safely and effectively in inpatient and residential treatment programs.
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div class="title">Eating behaviours, genetic influence and dietary intake of Irish twins - Volume 75 Issue OCE3 - R. Barron, K. Bermingham, L. Brennan, E. Gibney, M. Ryan, A. O’ Sullivan
Article
Objective: To examine the relationship between intuitive eating (IE), which includes eating in response to hunger and satiety cues rather than emotional cues and without having forbidden foods, and weight status in a large sample of adults. Methods: A total of 11,774 men and 40,389 women aged ≥18 years participating in the NutriNet-Santé cohort were included in this cross-sectional analysis. Self-reported weight and height were collected as well as IE levels using the validated French version of the Intuitive Eating Scale-2. The association between IE and weight status was assessed using multinomial logistic regression models. Results: A higher IE score was strongly associated with lower odds of overweight or obesity in both men and women. The strongest associations were observed in women for both overweight [quartile 4 vs. 1 of IE: odds ratio, 95% confidence interval: (0.19, 0.17-0.20)] and obesity (0.09, 0.08-0.10). Associations in men were as follows: for overweight (0.43, 0.38-0.48) and obesity (0.14, 0.11-0.18). Conclusions: IE is inversely associated with overweight and obesity which supports its importance. Although no causality can be inferred from the reported associations, these data suggest that IE might be relevant for obesity prevention and treatment.
Article
Intuitive eating has been proposed as an eating style that fosters a positive attitude towards food, the body, and physical activity. A systematic review of the literature was undertaken to examine intuitive eating in relation to disordered eating, body image, emotional functioning, and other psychosocial correlates in adult women. Articles were identified through Academic Search Complete, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Health Source (Nursing and Academic Edition), Medline Complete, PsycINFO, PsycArticles, Psychology and Behavioral Sciences Collection, PubMed and Scopus. Eligible studies were those that examined women aged 18 years and older, measured intuitive eating, and assessed a psychosocial correlate of intuitive eating. Twenty-four cross-sectional studies, published between 2006 and September 2015, met eligibility criteria. 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. However, given that all studies used cross-sectional designs, no conclusions regarding the direction of the relationship between intuitive eating and psychosocial correlates can be drawn. Participants in the majority of studies were university students in the United States 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.
Article
Epidemic levels of obesity represent a growing public health problem associated with a variety of negative health outcomes. Population level interventions that aim to moderate obesigenic environments have been proposed but remain largely unimplemented. Standard individual level interventions that focus on dietary restraint have been ineffective and in some cases harmful. Intuitive eating, an anti-dieting strategy that relies on recognizing and responding to internal hunger and satiation cues, has been proposed as an alternative approach to healthy weight management at the individual level—but it remains largely untested. This study evaluated the relationship between intuitive eating and various health indicators among female college students. As measured by the Intuitive Eating Scale (IES), it was found that intuitive eating was significantly correlated with lower body mass index (r = -.576), lower triglyceride levels (r = -.408), higher levels of high density lipoproteins (.437), and improved cardiovascular risk (r = .425). Findings provide tentative support for intuitive eating as a positive approach to healthy weight management at the individual level. Implications and future research needs are discussed.
Article
The purpose of this study was to validate the Arabic-version of the adapted Marin Bidimensional Acculturation Scale and investigate the relationship between Westernization, intuitive eating, and body mass index (BMI) in a sample of Jordanian female adolescents. A total of 199 subjects between the ages of 11-18 were surveyed. Participants who scored higher on the Arabic domain exhibited higher Intuitive Eating Scale (IES) intrinsic subscale scores (r = 0.147, P = 0.048) suggesting that those who are more orientated toward Arabic culture may respond more naturally to physical hunger cues than their more Westernized counterparts. Reinforcing intuitive eating attitudes and behaviors and emphasizing body ideals resonant with the Arabic culture may propagate the continuation of intuitive eating in this population, potentially reducing the risk of obesity and other nutrition-related non-communicable diseases.
Article
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Intuitive eating (an anti-dieting, hunger-based approach to eating) has been popularized as a viable approach to healthy weight management. The purpose of this study was to evaluate the relationship between intuitive eating, diet composition, and the meaning of food. The convenience sample included 343 students enrolled in a general education course at a Western university. Participants were given paper-and-pencil surveys containing the Intuitive Eating Scale and a variety of diet-related scales adapted from other studies. Each scale/subscale was evaluated for internal consistency and deemed acceptable. Those scoring high in intuitive eating had lower BMI scores (r=-.327, p<.001), less health-consciousness in relation to food (r=-.209, p<.001), and higher levels of pleasure associated with food and eating (r=.484, p<.001). No negative aspect of diet composition was correlated with intuitive eating or any of its sub-scales. Mean comparisons showed a significant difference between males and females in intuitive eating, dieting, health consciousness, and eating for pleasure (p<.001). In general, high intuitive eating scores were associated with an increase in the enjoyment and pleasure of food, lower BMI scores, and fewer dieting behaviors and food anxieties. The promotion of intuitive eating as one approach to healthy weight management should continue to be explored.
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The purpose of this research was to assess the frequency of nutrition label use among college students and its relationship to nutrition and label knowledge, attitudes, and beliefs regarding diet-disease relationships, and to determine factors predictive of frequent or infrequent label use. This study utilized a cross-sectional design. Volunteer participants included a convenience sample of 1,294 students from a large university in Texas. A 57-item survey instrument was used to assess nutrition label knowledge, attitudes, behaviors, and beliefs about diet-disease relationships. Open-ended items were included to capture reasons for frequent/infrequent label use. Statistical analyses included frequency distributions, Pearson's correlations, independent sample t-tests, and binary logistic regression. Label users had greater knowledge, more favorable attitudes, and more accurate perceptions of diet-disease relationships than nonusers. Females exhibited greater knowledge, more favorable attitudes, and more frequent label use than males. Health reasons, looking for specific information, weight control, and knowledge predicted frequent label use. Desire for certain foods, time constraints, and "don't care" attitudes predicted infrequent use. These predictors of frequent/infrequent use suggest important points of intervention for increasing label use among selected groups of college students.
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This article reviews recent research on the prevalence and virulence of obesity as a causal risk factor for mortality and morbidity. The prevailing assumption that obesity, by itself, is a chronic disease or a primary risk factor for health is challenged. A historical perspective is used to analyze the efficacy of various medical and educational approaches that have attempted to alter body size in the pursuit of enhanced physical health. The motivational discrepancies between society's media-induced desire for thinness and the health field's risk reduction approach to weight loss are outlined. Finally, ethical issues are raised in relation to current weight control measures, implications for future educational efforts are discussed, and potential guidelines for future weight management programs are presented.
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Health educators and others typically rely on three weight loss strategies to combat obesity. These include (1) medical intervention, (2) caloric restriction, and (3) fat gram restriction. The empirical evidence for these approaches in producing long-term weight loss is weak. However, much media attention has been given to a weight loss paradigm that seemingly does not fall into the aforementioned categories, which has been called the intuitive eating paradigm. Currently there is no empirical evidence to validate this paradigm. The focus of this article is to present an overview of this weight loss paradigm, discuss its potential benefits for health education in relation to current weight loss paradigms, and critically evaluate it in terms of the usefulness and ethical appropriateness for health education.
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The increasing prevalence of obesity is a major public health concern, since obesity is associated with several chronic diseases. To monitor trends in state-specific data and to examine changes in the prevalence of obesity among adults. Cross-sectional random-digit telephone survey (Behavioral Risk Factor Surveillance System) of noninstitutionalized adults aged 18 years or older conducted by the Centers for Disease Control and Prevention and state health departments from 1991 to 1998. States that participated in the Behavioral Risk Factor Surveillance System. Body mass index calculated from self-reported weight and height. The prevalence of obesity (defined as a body mass index > or =30 kg/m2) increased from 12.0% in 1991 to 17.9% in 1998. A steady increase was observed in all states; in both sexes; across age groups, races, educational levels; and occurred regardless of smoking status. The greatest magnitude of increase was found in the following groups: 18- to 29-year-olds (7.1% to 12.1%), those with some college education (10.6% to 17.8%), and those of Hispanic ethnicity (11.6% to 20.8%). The magnitude of the increased prevalence varied by region (ranging from 31.9% for mid Atlantic to 67.2% for South Atlantic, the area with the greatest increases) and by state (ranging from 11.3% for Delaware to 101.8% for Georgia, the state with the greatest increases). Obesity continues to increase rapidly in the United States. To alter this trend, strategies and programs for weight maintenance as well as weight reduction must become a higher public health priority.
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To conduct separate factor analyses of the Three Factor Eating Questionnaire (TFEQ-R, TFEQ-D and TFEQ-H) scales and provide initial evidence of the construct validity of the obtained solutions. A cross-sectional survey with a 12 month retest of a subsample of subjects. A total of 553 undergraduate university women with a mean age of 25.0 y. The retest sample comprised 64 subjects with a mean age at retest of 25.7 y. In addition to the TFEQ, age, body mass index (BMI), satisfaction with current weight, nutrition knowledge and current exercise level were recorded. Three restraint (strategic dieting behaviour, attitude to self-regulation, avoidance of fattening foods), three disinhibition (habitual susceptibility, emotional susceptibility, situational susceptibility) and two hunger constructs (internal locus for hunger, external locus for hunger) were identified. Initial evidence of the validity of these constructs was provided. The explanation of disordered eating behaviour is likely to be refined more by specific constructs, such as those presented, rather than by the more general constructs measured by the original TFEQ-R, TFEQ-D and TFEQ-H scales. Further examination of the factor structures presented is therefore encouraged.
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This study was performed to examine changes in eating behaviors as assessed by the three-factor eating questionnaire (TFEQ) and to quantify the potential associations between these eating behaviors and body weight changes in a 6-follow-up study. Prospective study performed in men and women who were tested twice (Visit 1=1989-1995 and Visit 2=6 y later) in the Québec Family Study (QFS). Women were more restrained and less hungry than men. To reduce food intake, women relied more on strategic dieting behavior and avoided more fattening food. However, they had higher emotional and situational susceptibility to eat than men. Significant decreases in the disinhibition score were noted over time in women (P<0.01), which resulted from a decrease in habitual susceptibility behavior to increase food intake. In men, we observed an increase in the avoidance of fattening food (P<0.05). In both genders, we found that the 6-y change in restraint behavior was negatively correlated with body weight changes (P<0.05). In women, a high restraint behavior seems to promote weight gain, whereas in men, it is associated with the opposite trend. These results suggest that variables reflecting some eating behaviors are associated with body weight changes in a free-living context. However, these behaviors are expressed differently between men and women. These behaviors should be considered in clinical interventions for individuals seeking a better body weight control.
Objective The study objectives were to assess (1) the prevalence of dieting and disordered eating among adolescents; (2) the sociodemographic, anthropometric, psychosocial, and behavioral correlates of dieting and disordered eating; and (3) whether adolescents report having discussed weight-related issues with their health care providers. Design Cross-sectional school-based survey. Study Population A nationally representative sample of 6728 adolescents in grades 5 to 12 who completed the Commonwealth Fund surveys of the health of adolescent girls and boys. Main Outcome Measures Dieting and disordered eating (binge-purge cycling). Results Approximately 24% of the population was overweight. Almost half of the girls (45%) reported that they had at some point been on a diet, compared with 20% of the boys. Disordered eating was reported by 13% of the girls and 7% of the boys. Strong correlates of these behaviors included overweight status, low self-esteem, depression, suicidal ideation, and substance use. Almost half of the adolescents (38%-53%) reported that a health care provider had at some point discussed nutrition or weight with them. Discussions on eating disorders were reported by lower percentages of girls (24%) and boys (15%). Conclusions The high prevalence of weight-related concerns suggests that all youth should be reached with appropriate interventions. Special attention needs to be directed toward youth at greatest risk for disordered eating behaviors, such as overweight youth, youth engaging in substance use behaviors, and youth with psychological concerns such as low self-esteem and depressive symptoms.
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The development of the Dutch Eating Behaviour Questionnaire (DEBQ) with scales for restrained, emotional, and external eating is described. Factor analyses have shown that all items on restrained and external eating each have high loadings on one factor, but items on emotional eating have two dimensions, one dealing with eating in response to diffuse emotions, and the other with eating in response to clearly labelled emotions. The pattern of corrected item-total correlation coefficients and of the factors was very similar for various subsamples, which indicates a high degree of stability of dimensions on the eating behavior scales. The norms and Cronbach's alpha coefficients of the scales and also the Pearson's correlation coefficients to assess interrelationships between scales indicate that the scales have a high internal consistency and factorial validity. However, their external validity has yet to be investigated.
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