Intuitive eating longitudinally predicts better psychological health and lower use of disordered eating behaviors: findings from EAT 2010–2018

Purpose: To examine longitudinal associations of intuitive eating (IE), defined as eating according to internal hunger and satiety cues, with psychological health outcomes and disordered eating behaviors. Methods: Data from a diverse sample of 1491 participants (54.1% female, 19.7% non-Hispanic white) followed from adolescence (baseline; M_age= 14.5 years) into young adulthood (follow-up; M_age = 22.2 years) came from the population-based EAT 2010–2018 (Eating and Activity over Time) study. Logistic regression models predicting psychological health outcomes and disordered eating behaviors at follow-up simultaneously included baseline IE and change in IE from baseline to follow-up as predictors, adjusting for demographic covariates, body mass index, and outcome at baseline. Results: Greater baseline IE and increases in IE from baseline to follow-up were both associated with lower odds of high depressive symptoms, low self-esteem, high body dissatisfaction, unhealthy weight control behaviors (e.g., fasting, skipping meals), extreme weight control behaviors (e.g., taking diet pills, vomiting), and binge eating at 8-year follow-up. Particularly strong protective associations were observed for binge eating, such that a one-point higher IE score at baseline was associated with 74% lower odds of binge eating at follow-up, and a one-point higher increase in IE score from baseline to follow-up was associated with 71% lower odds of binge eating at follow-up. Conclusions: These results indicate that IE longitudinally predicts better psychological and behavioral health across a range of outcomes and suggest that IE may be a valuable intervention target for improving psychological health and reducing disordered eating behaviors, particularly binge eating. Level of evidence: Level III, cohort study.