A review of interventions that promote eating by internal cues.

Traditional diet programs that encourage individuals to consciously restrict their dietary intake have not only been ineffective in terms of weight outcomes, but have also been counterproductive, promoting psychological distress and unhealthy eating behaviors. Nondiet approaches shift the focus away from weight outcomes to the improvement of health outcomes and psychological well-being. One such approach, intuitive eating, promotes dietary intake based on internal cues of hunger and fullness, body acceptance, and making behavior choices based on health as well as enjoyment. Several studies have implemented such ideas into intervention programs. The purpose of our review was to examine the physical and psychological effects of these programs. Twenty interventions were identified. Overall, studies had positive results, demonstrating improvements in eating habits, lifestyle, and body image as measured by dietary restraint, restrictive dieting, physical activity, body satisfaction, and drive for thinness. Participants also experienced improved psychological health as measured by depression, ineffectiveness, anxiety, self-esteem, negative affect, and quality of life. Several improvements were sustained through follow-up periods as long as 2 years. Completion rates were as high as 92% in nondieting groups. In addition, improvements in eating behaviors and maintaining a nondiet approach, increased self-esteem, and decreased body dissatisfaction were sustained long-term. Overall, studies that encourage individuals to eat intuitively help participants abandon unhealthy weight control behaviors, improve metabolic fitness, increase body satisfaction, and improve psychological distress. Results from our review favor the promotion of programs that emphasize a nonrestrictive pattern of eating, body acceptance, and health rather than weight loss.