Intuitive eating, binge eating and BMI: Results of the three-year follow-up of a prospective survey of midlife New Zealand women.

Background: Non-dieting approaches to weight loss and the prevention of weight gain are becoming an increasingly popular solution to increasing obesity rates and the poor long-term success of traditional dieting methods. One non-dieting approach, Intuitive Eating (IE), has been shown to be associated with lower body mass index (BMI) and a range of positive psychological indices. However, the long-term associations of IE with BMI and binge eating in a large representative sample of mid-life women have not previously been investigated. Objectives: To examine: 1) The degree of stability of IE over a period of three years. 2) Whether BMI at baseline is a moderator of IE change over three years. 3) The relationship between change in IE over three years and its effect on BMI at three years. 4) Whether weight loss attempt at baseline moderates the relationship between change in IE over three years and BMI change at three years. 5) The relationship between binge eating and IE scores at three years. 6) Whether binge eating moderates the relationship between change in IE over three years and BMI at three years. Design: Longitudinal, observational study design. A nationwide sample of 2500 randomly selected New Zealand women, aged 40-50 years at baseline. The study involved self-administered questionnaires being sent to participants at baseline, two year follow up, three year follow up and five years. Results: IE scores had a high degree of stability over a period of three years, with 87% of the sample remaining within 0.5 (1SD) of their original scores. When results were stratified by baseline BMI category, it was found that baseline BMI was a significant moderator of the change in only one IE subscale score between baseline and three years, that being reliance on internal hunger and satiety cues. A 1-point increase in total IE score between baseline and three years, was related to a 2.6% lower BMI at three years (p=0.001). For those attempting to lose weight at baseline, an increase of 1 point in total IE score was associated with a 5.4% lower BMI over three years (p=