Abstract
Monitoring blood glucose prior to eating can teach individuals to eat only when truly hungry, but how adherence to ‘hunger training’ influences weight loss and eating behaviour is uncertain. This exploratory, secondary analysis from a larger randomized controlled trial examined five indices of adherence to ‘hunger training’, chosen a priori, to examine which adherence measure best predicted weight loss over 6 months. We subsequently explored how the best measure of adherence influenced eating behavior in terms of intuitive and emotional eating. Retention was 72% (n = 36/50) at 6 months. Frequency of hunger training booklet entry most strongly predicted weight loss, followed by frequency of blood glucose measurements. Participants who completed at least 60 days of booklet entry (of recommended 63 days) lost 6.8 kg (95% CI: 2.6, 11.0; p < 0.001) more weight than those who completed fewer days. They also had significantly higher intuitive eating scores than those who completed 30 days or less of booklet entry; a difference (95% CI) of 0.73 (0.12, 1.35) in body-food choice congruence and 0.79 (0.06, 1.51) for eating for physical rather than emotional reasons. Adherent participants also reported significantly lower scores for emotional eating of −0.70 (−1.13, −0.27). Following hunger training and focusing on simply recording ratings of hunger on a regular basis can produce clinically significant weight loss and clinically relevant improvements in eating behaviour.
Highlights
Why we eat, as well as what we eat, influences body weight [1]
Intuitive eating, where an individual tends to eat in response to their appetite cues may be an effective way of managing body weight, in the face of societal and environmental pressures to eat in the absence of hunger
In our subsequent randomized controlled trial (RCT), we examined the efficacy of this modified protocol for producing weight loss over 12 months in conjunction with diet and exercise advice [21]
Summary
Emotional eating or eating in response to negative emotions has been found to predict later obesity [1,2]. Intuitive eating, where an individual tends to eat in response to their appetite cues may be an effective way of managing body weight, in the face of societal and environmental pressures to eat in the absence of hunger. Interventions that teach intuitive eating and appetite awareness have generally not resulted in weight loss to date [7,8,9,10,11]. One possible explanation may be that some overweight and obese individuals have blunted sensations of hunger and satiety [12,13,14], which may lead to difficulties in learning to Nutrients 2017, 9, 1260; doi:10.3390/nu9111260 www.mdpi.com/journal/nutrients
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