Research: Intuitive Eating predicts better psychological health and lower use of disordered eating behaviours long-term
Context:
Cross-sectional studies have shown that Intuitive Eating (IE) is associated with higher self-esteem, higher body satisfaction, less disordered eating and lower depressive symptoms. However, this relationship has not been examined longitudinally.
Study Aim:
This study aimed to look at longitudinal associations of Intuitive Eating (IE) with psychological health outcomes and disordered eating behaviours from adolescence into young adulthood.
Method:
Longitudinal data (repeated data collected over a prolonged period of time) looking at IE, depression, self-esteem, body dissatisfaction and unhealthy and extreme weight control behaviours were taken from 1491 participants at two-time points (adolescence ~14.5 years old (baseline) and young adulthood ~22.2 years old (follow-up)).
The sample (45.9% male, 54.1% female) were diverse with regard to race/ethnicity (19.7% non-Hispanic white, 28.6% non-Hispanic black, 17.1% Hispanic, 19.5% Asian, 15.1% other race/ethnicity) and socioeconomic status (39.8% low, 21.9% low middle, 17.5% middle, 13.4% high middle, 7.4% high).
Markers of IE were assessed using questions from the Intuitive Eating Scale (IES), depressive symptoms were assessed using the six-item Kandel and Davies Depressive Mood Scale, self-esteem was assessed using the Rosenberg Self-Esteem Scale, Body dissatisfaction was assessed with a Body Shape Satisfaction Scale and unhealthy weight control behaviours were categorised as fasting, eating very little food, using a food substitute, skipping meals, smoking more cigarettes and extreme weight control behaviours were categorised as diet pills, induced vomiting, using laxatives and using diuretics.
All of these are self-report methods and data was collected at baseline (roughly 14 years) and follow-up (roughly 22 yrs, 8 years later).
Results:
Researchers found that the following prevalences increased from baseline to follow-up:
High depressive symptoms (20.1% to 30.8%).
Low self-esteem (26.6% to 32.7%).
High body dissatisfaction (23.7% to 26%).
Unhealthy weight control behaviours (43.1% to 51.9%).
Extreme weight control behaviours (4.2% to 13.1%).
Binge eating (7.8% to 11.6%).
Increases in these factors may help to illustrate the challenges faced by young people as they move from early adolescence to early adulthood. Interestingly, the prevalence of high body, dissatisfaction did not significantly change from baseline to follow-up perhaps reflecting socio-cultural pressures to achieve the thin-deal from a very young age with subsequent negative impacts including unhealthy and extreme weight control behaviours coming later.
Moreover, in the sample, greater IE in adolescence and greater increases in IE over the 8-year study period were associated with lower odds of high depressive symptoms, low self-esteem, high body dissatisfaction, unhealthy and extreme weight control behaviours, and binge eating in young adulthood. In other words, Intuitive eating seems to be a major protective factor against these outcomes.
The strongest protective associations were observed for binge eating, such that scoring one point higher on IE at baseline was associated with 74% lower odds of binge eating at follow-up.
These results indicate that IE longitudinally predicts better psychological and behavioural health across a range of outcomes.
Strengths:
Strengths of the study include the longitudinal design and the large, racially/ethnically and socioeconomically diverse sample of males and females. The inclusion of racial/ethnic minorities and males in this sample is particularly notable, as the vast majority of research on IE to date has been conducted in predominantly white, female samples.
Limitations:
Limitations of the study include the self-report nature of the measures as this could have led to response bias from the participants, i.e. meaning they may have responded in ways to reflect what they “should” be doing rather than their actual behaviours. Also, participants may have interpreted the questions differently, therefore, resulting in different responses.
Conclusion:
Findings from this study suggest that IE may be a valuable intervention target for improving psychological health and reducing disordered eating behaviours, particularly binge eating.
Integrating IE approaches into clinical practice and school-based nutrition education interventions may, therefore, help promote psychological well-being and mitigate risk for future disordered eating behaviours.
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