RESUMO
INTRODUCTION: Intuitive eating (IE) has emerged as a weight-neutral approach to health promotion for those with overweight/obesity. This weight-neutral paradigm has some support, although research thus far has often neglected to control for potential confounds (i.e. objective weight status and demographics) and foundational studies are lacking. The objective of the current study was to observe the unique association of IE with physical health indicators in a sample of adults, independent of objective weight status. METHODS: Participants were 248 adults (32 ± 14 years old, 73% female, 64% White) of all weight categories (18.2-55.3 kg m-2), with an average body mass index (BMI) of 30 ± 8 kg m-2. IE was measured with the Intuitive Eating Scale-2 (IES-2). BMI was objectively measured in-lab. Health indicators included blood pressure (BP) and fasting glucose. RESULTS: A series of hierarchical linear regressions revealed no significant associations between IE and systolic BP (ß = -0.076, P = 0.256), diastolic BP (DBP; ß = -0.122, P = 0.073) or fasting glucose (ß = 0.047, P = 0.500) after controlling for BMI. All effects sizes were small or below (f 2 = 0.00 to -0.04). Sensitivity analyses revealed significantly lower DBP in high intuitive eaters versus low when analysed with a t-test, t(111.651) = 3.602, P < 0.001, Levene corrected; however, after controlling for relevant covariates (i.e. BMI and demographics), analysis of covariance revealed no difference in DBP between groups, F(1, 116) = 0.330, P = 0.567. No significant differences in systolic BP or fasting glucose were observed between low and high intuitive eaters before or after considering covariates. CONCLUSIONS: In sum, this study investigated associations between IE and common indicators of physical health after controlling for objective weight status. Findings revealed no unique relationship between IE and physical health, and any IE-physical health relationships that were observed were accounted for BMI and/or demographic factors.
RESUMO
Obesity is a global epidemic, yet successful interventions are rare. Up to 60% of people fail to achieve clinically meaningful, short-term weight loss (5-10% of start weight), whereas up to 72% are unsuccessful at achieving long-term weight loss (5-10% loss for ≥5years). Understanding how biological, cognitive, and self-regulatory factors work together to promote or to impede weight loss is clearly needed to optimize obesity treatment. This paper describes the methodology of the Cognitive and Self-regulatory Mechanisms of Obesity Study (the COSMOS trial). COSMOS is the first randomized controlled trial to investigate how changes in multiple biopsychosocial and cognitive factors relate to weight loss and one another across two weight loss treatments. The specific aims are to: 1) Confirm that baseline obesity-related physiological dysregulation is linked to cognitive deficits and poorer self-regulation, 2) Evaluate pre- to post-treatment change across time to assess individual differences in biomarkers, cognition, and self-regulation, and 3) Evaluate whether the acceptance-based treatment (ABT) group has greater improvements in outcomes (e.g., greater weight loss and less weight regain, improvements in biomarkers, cognition, and self-regulation), than the standard behavioral treatment group (SBT) from pre- to post-treatment and 1-year follow-up. The results of COSMOS will provide critical information about how dysregulation in biomarkers, cognition, and/or self-regulation is related to weight loss and whether weight loss treatments are differentially associated with these factors. This information will be used to identify promising treatment targets that are informed by biological, cognitive, and self-regulatory factors in order to advance obesity treatment.
