Intersecting Approaches to the Study of Eating: A Focus on Intuitive, Mindful, Emotional, and External Eating

Abstract

The proportion of individuals deemed overweight or obese has reached an all-time high globally, and eating disorder rates are also on the rise. These statistics make it even more important to understand eating beliefs and behaviours and some of their covariates that could be addressed with interventions. However, past research has tended to focus on eating motivations, beliefs, or styles that could lead to overweight and obesity, rather than focussing on those expected to be important to eating regulation and weight management, such as intuitive or mindful eating. Intuitive and mindful eating are expected to be beneficial because they are believed to be motivated by hunger and satiety cues and a respect and appreciation for the body, its needs, and how it functions. Related to these concepts, overeating regulation has also been described in other literature, which refers to an ability to minimise overeating specifically. The first general aim of this thesis was to understand whether these “adaptive” eating patterns were more than merely the absence, or lower levels of, maladaptive eating. Before this could be achieved, a measure of overeating regulation had to be created and examined for its component structure and validity. In addition, a second general aim was to investigate the correlates and predictors of intuitive and mindful eating. These aims were met by conducting four studies. Study 1 included 312 Australian university students (68% women; Mage = 22 years), whereas Studies 2-4 were drawn from a large independent sample of 2,018 women aged between 16 and 81 years (Mage = 23.1 years), with the majority (86.7%) age 30 or younger, and most (87%) university students. Study 3 limited the sample to young women between the ages of 16 and 30 years with complete data, resulting in 1,663 participants (82.4% of the full sample; Mage = 20.2 years). In Study 1, an existing eating behaviour measure (i.e., the Weight Efficacy Life-Style Questionnaire; Clark et. al., 1991) was modified with the aim of directly assessing regulation of overeating. This study involved tests of this measures’ structure and convergence with emotion regulation, mindfulness, eating pathology, gender, and age. Study 2 examined the interrelations between, and the core components of, multiple measures of adaptive and maladaptive eating approaches. Study 3 examined whether intuitive and mindful eating were uniquely associated with three disordered and restrictive weight management behaviours of dieting, bulimic symptomology, and exercise for weight or shape control, as well as a fourth outcome of general psychological well-being, beyond any effects of external and emotional eating, body dissatisfaction, and BMI on each outcome. Study 3 also assessed whether intuitive and mindful eating were indirectly associated with each outcome via lower levels of external and emotional eating. Study 4 tested an expanded acceptance model of intuitive eating which incorporated two internal sources of acceptance or personal strengths, namely self-concept clarity and self-compassion, to complement the original interpersonal or external sources of acceptance of general unconditional acceptance by others and perceived body acceptance by others. This model was also tested in relation to mindful eating. The results from the four studies suggest that (1) there is considerable covariation between operationalisations of intuitive and mindful eating, and similarity in the correlates and predictors of intuitive and mindful eating; and (2) it may be too reductionistic to view adaptive and maladaptive eating as opposite ends of the same continuum because although multiple adaptive eating measures were highly negatively correlated with several maladaptive eating measures, several other adaptive and maladaptive eating measures are better described as tapping somewhat unique attitudes, beliefs, motivations, and behaviours regarding food and eating. Implications for research, theory, and clinical practice are discussed. The current program of research highlights the complexity of eating behaviour, warranting further integration of multiple measures of eating beliefs, processes, and patterns at the conceptual and measurement levels. In particular, longitudinal research is required to determine the nuanced relationships between different eating behaviours, and the core superordinate eating styles that they may represent, as well as their impact on health and well-being, and the underlying mechanisms involved in such ways of eating. The current research findings also provide a foundation for considering how to integrate multiple fields of study related to eating, which may assist with the identification of the most critical eating behaviours or styles that will promote optimal health and well-being.