Piloting a Novel Intuitive Eating Intervention for College Women With Disordered Eating

Study Overview
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Brief Summary
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The purpose of this research study is to pilot test a new intervention that helps young adult women learn adaptive eating and exercise strategies, increase their body acceptance, decrease unhealthy weight control behaviors and prevent future eating and problems. This intervention is experimental, and the study will test its feasibility, acceptability, and effectiveness.

Detailed Description
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The intervention, Intuitive Eating, is an eating approach that addresses important risk factors and promotes adaptive eating attitudes and behaviors. It has three central tenets: 1) unconditional permission to eat when hungry, 2) eating for physical rather than emotional reasons, and 3) eating according to hunger and satiety cues. Intuitive Eating has ten principles that focus on rejecting the dieting mentality, honoring hunger cues, decreasing restrictive behaviors that lead to deprivation and bingeing, challenging rigid food rules, increasing awareness of satiety, discovering the satisfaction of food, coping with emotions without food, respecting and accepting one's body, using exercise as self-care, and balancing nutrition with satisfaction.

Official Title
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Piloting a Novel Intuitive Eating Intervention for College Women With Disordered Eating

Conditions
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Disordered Eating Behaviors

Intervention / Treatment
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* Behavioral: Group Intervention
* Behavioral: Guided Self-Help


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Not currently pregnant Enrolled in postsecondary education at VCU Have body image or eating concerns Exclusion Criteria: Eating disorder threshold risk Men Pregnant women

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 25 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Participants will be randomized to either a group or guided self-help condition, of the same intervention, intuitive eating, of the same duration (8 weeks).
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intuitive Eating Group Intervention<br>Intuitive eating intervention delivered in a group format with 8-10 women, led by 2 facilitators. | Behavioral: Group Intervention<br>* Participants in the group intervention will attend eight weekly, 90-minute sessions involving group activities and discussions. They will complete homework between sessions to reinforce learning. The intervention focuses on cultivating attunement to bodily sensations and fostering self-compassion to improve physical and mental health.<br>|
| Experimental: Intuitive Eating Guided Self-Help<br>Participants in this condition engage in 8 weeks of self-study of the intuitive eating intervention have  20 minute weekly phone call with a study interventionist. | Behavioral: Guided Self-Help<br>* Participants in the GSH condition will follow the intuitive eating content through self-guided study, with eight weekly scheduled phone calls with an interventionist ( 20 minutes each). Interventionists will review homework assignments, answer questions, and reinforce adherence. The intervention materials are the same as the group and also focus on cultivating attunement to bodily sensations and fostering self-compassion to improve physical and mental health.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in diagnostic eating disorder symptoms | The Eating Disorder Diagnostic Scale (EDDS) is a brief self-report measure that screens for the presence of subthreshold or threshold levels of ED symptoms. It yields a symptom composite score, to be used as the primary outcome measure. Items assessing body dissatisfaction, overvaluation of shape/weight, and impairment are measured on a 0 to 6-point scale with higher ratings indicating greater body dissatisfaction. Items evaluating the presence of compensatory behaviors and binge eating are rated yes/no and participants indicate the frequency these behaviors have occurred in the prior 3 months. | Baseline to 16 weeks | 
| Change in global eating disorder symptoms | The EDE-Q is a 28-item self-report version of the Eating Disorder Examination that measures frequency of disordered eating cognitions and behaviors experienced in the previous 28 days. Participants rate the number of days behaviors have occurred in the last 28 days, with 0 = no days and 6 = every day. Yes/no questions identify the presence of compensatory and binge behaviors and participants indicate the frequency of these behaviors over the last 28 days. Higher EDE-Q scores indicate greater eating pathology. | Baseline to 16 weeks | 
| Changes in intuitive eating | The Intuitive Eating Scale-2 (IES-2) is a 23-item self-report measure of intuitive eating with three subscales: Unconditional Permission to Eat, Eating for Physical Rather Than Emotional Reasons, and Reliance on Hunger and Satiety Cues. Items are rated on a 1 to 5-point scale with higher scores indicating higher levels of intuitive eating. | Baseline to 16 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in body appreciation | The Body Appreciation Scale-2 (BAS-2) is a 10-item measure of positive body image. Specifically, it assesses body appreciation, which reflects acceptance of and favorable opinions and respect towards one's body and a rejection of the narrow beauty ideals promoted through mass media. Items are rated on a 5-point scale with higher scores indicating greater body appreciation. | Baseline to 16 weeks | 
| Changes in dietary restraint | The Dutch Restrained Eating Scale (DRES) contains 10 items that measure dietary restraint for the purpose of weight loss. Items are rated on a 5-point scale with higher scores reflecting greater dietary restraint. | Baseline to 16 weeks | 
| Changes in body functionality appreciation | The Functionality Appreciation Scale (FAS) is a 7-item scale that measures appreciation for the functionality of one's body, which is believed to help offset appearance concerns. Items are rated on a 5-point scale with higher scores reflecting greater appreciation for the functionality of one's body. | Baseline to 16 weeks | 
| Changes in interoceptive awareness | The Interoceptive Awareness subscale of the EDI-3 has 10 items that measure an individual's attunement to their internal state, including perceptions of emotions, hunger, and satiety. Items are rated on a 6-point scale, with higher scores reflecting greater deficits in interoceptive awareness. | Baseline to 16 weeks | 
| Changes in intuitive exercise | The Intuitive Exercise Scale (IEXS) measures adaptive exercise behaviors that are guided by physical cues and flexibility rather than rigid rules or feelings of obligation. Items are rated on a 5-point scale, with higher scores reflecting more intuitive exercise behaviors. | Baseline to 16 weeks | 
| Changes in weight bias internalization | The Modified Weight Bias Internalization Scale (WBIS-M) is a modified version of the Weight Bias Internalization Scale that was adapted for use with individuals across the weight spectrum. The WBIS-M measures the degree to which individuals apply weight-based stereotypes to themselves and use those to guide their weight self-evaluations. Items are rated on a 7-point scale, with higher scores reflecting greater degrees of weight bias internalization. | Baseline to 16 weeks | 
| Changes in satisfaction with life | The Satisfaction with Life Scale (SWLS) is a 5-item scale that assesses global life satisfaction. Items are scored on a 7-point scale, with higher scores reflecting greater life satisfaction. | Baseline to 16 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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disordered eating, body image, intuitive eating, undergraduates, college, unhealthy weight control behaviors, eating disorders, weight stigma, weight bias