Do interoceptive awareness and interoceptive responsiveness mediate the relationship between body appreciation and intuitive eating in young women?

Interoceptive awareness in a Southeastern US college sample: validation of the multidimensional assessment of interoceptive awareness - version 2

OBJECTIVE

The Multidimensional Assessment of Interoceptive Awareness, version 2 (MAIA-2) is a commonly utilized self-report instrument to assess individuals' ability to perceive bodily sensations. The MAIA-2 has displayed variable psychometric properties across samples. Thus, we examine the psychometric properties of the MAIA-2 in a Southeastern United States college sample.

PARTICIPANTS

Our studies consisted of 710 (study 1) and 66 (study 2) college students.

METHODS

Study 1 used a cross-sectional research design where we investigated the factor structure, and measurement invariance (e.g., measured similarly across genders). Study 2 examined the test-retest reliability across a three-week period.

RESULTS

The MAIA-2 displayed adequate to good internal consistencies and factor loadings, strict invariance, and questionable temporal stability.

CONCLUSION

The MAIA-2 demonstrates adequate psychometric properties in this college sample that were similar to the original MAIA sample characteristics. Contextual and cultural factors may influence the subjective experience of interpreting bodily sensations.

Are you how you eat? Aspects of self-awareness in eating disorders

Eating disorders (ED) are severe psychiatric disorders characterized by dysfunctional behaviors related to eating or weight control, with profound impacts on health, quality of life, and the financial burden of affected individuals and society at large. Given that these disorders involve disturbances in self-perception, it is crucial to comprehend the role of self-awareness in their prevalence and maintenance. This literature review presents different self-awareness processes, discussing their functioning across different levels of complexity. By deconstructing this concept, we can gain a better understanding of how each facet of self and personality relates to the symptoms of these disorders. Understanding the absence or impairment of self-awareness in ED holds significant implications for diagnosis, treatment, and overall management. By recognizing and comprehending the characteristics of self-awareness, clinicians can develop tailored interventions and evidence-based treatments for individuals with ED. Furthermore, this narrative review underscores the importance of considering temperament and personality factors in the context of ED, as temperament traits and personality characteristics may interact with self-awareness processes, influencing the development and maintenance of ED. Ultimately, the results highlight the pressing need for further research on the development of effective interventions and support strategies grounded in the aspects of self-awareness mechanisms for individuals affected by these disorders.

The causal associations between interoception, self-regulation, non-purposeful eating behaviors, and weight status in college women: a longitudinal cross-lagged model analysis

AIMS

Excessive weight gain has led to increased obesity and mortality risk among college students. Issues with maintaining a healthy weight may be attributed to poor internal awareness and unhealthy eating behaviors. The study's purpose was to determine the longitudinal effects among interoception, self-regulation, nonpurposeful eating behaviors, and weight status (BMI) among college women.

METHODS

Data from 103 females were collected via Qualtrics over 3 timepoints (T1, T2, T3) during an academic semester. Repeated measures ANOVA and cross-lagged model analyses were used. Significant changes were found in interoceptive responsiveness, external, and uncontrolled eating throughout 3 timepoints.

RESULTS

Longitudinally, significant causal effects were found among the study measures. Among all models, higher interoceptive responsiveness (T1) predicted increased self-regulation (T2). Higher non-purposeful eating behaviors (T1) predicted reduced self-regulation (T2). Higher BMI (T1) predicted reduced non-purposeful eating behaviors (T2), however higher BMI (T2) predicted increased non-purposeful eating (T3) and reduced interoceptive responsiveness (T3). Significant causal effects were found within each non-purposeful eating behavior models.

CONCLUSION

Overall, the research study provided foundational evidence of the importance of self-regulatory skills to help prevent unhealthy eating behaviors and increased weight status in college women. Future interventions educating college women to become more internally aware and better self-regulate are needed.

Profiles of intuitive eating in adults: the role of self-esteem, interoceptive awareness, and motivation for healthy eating

OBJECTIVE

Intuitive eating is an eating behavior that has recently come to use mainly in the young population. Knowing that the Lebanese cultural diet differs from other countries, the purpose of this study was to investigate if there is a relationship between self-esteem, interoceptive awareness, and motivation for healthy eating in a sample of Lebanese adults using a Latent Profile Analysis approach.

DESIGN

Cross-sectional study.

SETTING

Lebanese governorates.

PARTICIPANTS

359 Lebanese participants enrolled in this study (mean age: 22.75 ± 7.04 years, 40.1% males), through convenience sampling in several Lebanese governorates. Participants were asked to fill anonymously the following scales: The Intuitive Eating Scale (IES-2), the Rosenberg Self-Esteem Scale, the Multidimensional Assessment of Interoceptive Awareness Scale (MAIA), and the Motivation for Healthy Eating Scale (MHES).

RESULTS

Our findings revealed four profiles: profile 1 (n = 67; 18.66%) characterized by high SE and intermediate interoceptive awareness and motivation for healthy eating; profile 2 (n = 86; 23.97%) presented high SE, interoceptive awareness, and motivation for healthy eating; profile 3 (n = 86; 23.96%) characterized by high SE, interoceptive awareness, and motivation for healthy eating; class 4 (n = 108; 30.08) described by low SE, intermediate interoceptive awareness, and motivation for healthy eating One-way analysis of variance did not observe a significant difference between the four profiles based on intuitive eating (F = 1.810; p = 0.145; ɳp2 = 0.015).

CONCLUSIONS

Among a sample of Lebanese people, four profiles of interoceptive awareness, motivation for healthy eating, and self-esteem were observed, with no difference concerning intuitive eating.

Interoception and self-regulation of eating behaviors and weight status in college students

OBJECTIVE

To determine the associations between interoception, self-regulation, eating behaviors, and weight status among college students.

PARTICIPANTS

229 female undergraduates, predominantly classified as Juniors (51.1%) and identified as Hispanic/Latinx (75%) with a mean age of 23.4 (SD = 6.3), were examined.

METHODS

Cross-sectional data using baseline measures from a larger, longitudinal study, were examined. Confirmatory factor analyses and structural equation modeling were conducted to test hypotheses.

RESULTS

Interoception was directly associated to self-regulation. Interoception and self-regulation were inversely associated with non-purposeful eating. Non-purposeful eating was directly associated with weight status.

CONCLUSION

This study provided empirical evidence on the associations between interoception, self-regulation, eating behaviors, and weight status. Our results support the need for programs that target college students' cognitive skills to reduce unhealthy eating behaviors and optimize weight status. Future interventions are needed to enhance interoception and self-regulation skills so that college students can be more purposeful in their eating habits.

"There's No Separating My View of My Body from My Autism": A qualitative study of positive body image in autistic individuals

While scholars have investigated positive body image across diverse populations, extant theory largely excludes those with differing socio-cognitive experiences, such as autistic individuals. Using constructivist grounded theory, this study sought to develop a grounded theory of positive body image in autistic individuals. One-to-one interviews with photo-elicitation were conducted with 20 autistic adults (7 women, 8 men, 5 non-binary/agender; aged 18-53 years) from the United Kingdom. Through a process of open, axial, and focused coding, a grounded theory was developed around a core category of positive body image in autistic adults and was found to comprise six themes: body connection, body acceptance, appreciating body functionality and neurodivergent strengths, having a body-positive protective filter, taking care of the body, and body and appearance neutrality. Our findings suggest that some aspects of positive body image in autistic individuals are consistent with those found in neurotypical adults. However, positive body image in autistic individuals further encompasses both the sensory (i.e., how the body is felt) and aesthetic (i.e., how the body is seen) body. These findings may stimulate research aimed at improving positive body image in autistic populations.

Psychometric analysis of the body responsiveness questionnaire in the Portuguese population

Body responsiveness refers to the tendency to be attuned to the body's needs and use interoceptive information to guide behavior. Despite its potential beneficial effect on the development of positive body image, this construct is currently understudied. To boost research in this area, we examined the factor structure, gender invariance, and psychometric properties of a Portuguese translation of the Body Responsiveness Questionnaire (BRQ). A total of 650 men and women (aged 18-80 years) completed the Portuguese BRQ. To assess its convergent validity, participants also completed measures of body appreciation, emotion regulation, depression symptoms, and psychological quality of life. Exploratory factor analysis indicated a two-factor structure of the BRQ, which was upheld using confirmatory factor analysis: "Importance of Interoceptive Awareness" (ω = .85-.87) and "Perceived Connection" between body and mind (ω = .71-.74). BRQ scores had partial scalar invariance across gender, and no significant gender differences. Convergent and known-groups validity was supported. Participants with overweight/obesity (vs. normal weight) and middle-aged adults (vs. young adults) assigned higher importance to body signals to guide behavior. The Portuguese version of the BRQ is a psychometrically sound measure of body responsiveness and it may contribute to a comprehensive assessment of positive body image to guide intervention.

Challenges and opportunities for conceptualizing intuitive eating in autistic people

Although intuitive eating (IE) has become an increasingly adopted intervention target, current conceptualisations of IE have yet to pivot away from (neuro)normative physiology and phenomenology. Autistic individuals commonly report disordered eating behaviours and/or poorer well-being but appear to benefit from adaptive interventions using an affirmative approach. This article uses autism as a case example to summarise challenges related to IE's prevailing conceptualisation, before proposing how future research and current practice can be extended to the autistic population. Scholars are encouraged to evaluate the full 10-principal IE framework while utilising a participatory-led approach. We argue that research using a mixed methods design is urgently needed to comprehensively explore the (re)conceptualisation of IE in autistic people. While IE shows promise for producing positive outcomes in the autistic population, we discuss the potential challenges for research and practice due to its current emphasis on accurate interoception, emotional awareness and processing, and executive functioning. This suggests the need for research and practice to integrate autistic needs and experiences into future developments with an affirmative approach. Public Significance: IE is an effective intervention for reducing disordered eating behaviours. Autistic individuals commonly present disordered eating behaviours and have unique nutritional needs which often require intervention. However, there is limited understanding of IE among the autistic population. Research-informed definitions involving autistic perspectives will support translating the IE framework to this underrepresented population.

Family cohesion and intuitive eating in Chinese college students: A serial mediation model

Improving intuitive eating can effectively prevent emotional eating, restrained eating, and overeating, and help improve people's physical and mental health. Based on the acceptance model of intuitive eating, ecological systems theory, family stress model, and transactional model of stress and coping, the present study aimed to explore the relationship between family cohesion and intuitive eating and its underlying mechanisms through a cross-sectional study design. A random sample of 702 college students from 29 provinces in China, aged from 18 to 26 years (54.56% male, M age = 21.12 years), voluntarily participated in the survey. Demographic variables, family cohesion, intuitive eating, perceived stress, and coping style were measured. The results indicated that family cohesion was significantly positively correlated with intuitive eating and the direct effect between them was significant. Meanwhile, there was a significant indirect effect of family cohesion on intuitive eating through perceived stress and positive coping styles. Moreover, perceived stress and positive coping styles, rather than negative coping styles, acted as serial mediators in the association between family cohesion and intuitive eating. The findings shed light on the prevention and intervention for disordered eating and obesity and provided a new theoretical perspective for the mental health education of college students. In addition, implications and directions for future research were also discussed.

Psychometric properties of an Arabic translation of the multidimensional assessment of interoceptive awareness (MAIA-2) questionnaire in a non-clinical sample of Arabic-speaking adults

BACKGROUND

Interoception refers to processes through which the nervous system identifies, analyzes, and integrates the information generated by the physiological state of the body (e.g., from internal organs such as the stomach, heart, or lungs). Despite its potential interest for clinical research and its wide use globally, no Arabic adaptation and validation of the Multidimensional Assessment of Interoceptive Awareness (MAIA-2) questionnaire exists to date. The goal of this study was to examine the psychometric properties of an Arabic translation of the MAIA-2 in a sample of Arabic-speaking community adults from Lebanon. We hypothesized that the Arabic version of the MAIA-2 would yield adequate internal consistency coefficients; the 8-factor structure model would show a good fit to our data, with measurement invariance and good convergent validity.

METHOD

The Arabic adaptation of the MAIA-2 was developed using the forward-backward translation method. A non-clinical sample of Arabic-speaking adults (n = 359, 59.9% females, mean age = 22.75 years (SD = 7.04)) took part of this validation study. To check if the model was adequate, several fit indices were calculated: the normed model chi-square (χ²/df), the Steiger-Lind root mean square error of approximation (RMSEA), the Tucker-Lewis Index (TLI) and the comparative fit index (CFI). Values ≤ 3 for χ²/df, and ≤ 0.08 for RMSEA, and 0.90 for CFI and TLI indicate good fit of the model to the data.

RESULTS

Confirmatory Factor Analyses corroborated the validity of the original 8-factor structure of the MAIA-2 [χ2/df = 1603.86/601 = 2.67, RMSEA = 0.068 (90% CI 0.064, 0.072), SRMR = 0.058, CFI = 0.903, TLI = 0.892]. Reliability estimates in our sample revealed good internal consistency, with McDonald's ω coefficients for the subscales ranging from 0.86 to 0.93. Our analyses also revealed measurement invariance of the Arabic MAIA-2 for gender. No statistically significant difference between men and women in all dimensions, except for the not worrying and attention regulation subscales where men scored significantly higher than women. Finally, the Arabic MAIA-2 dimensions showed positive correlations with the intuitive eating dimension "Reliance on Hunger and Satiety Cues", thus providing support for convergent validity.

CONCLUSION

We contribute the literature by providing the first Arabic adaptation and validation of a measure assessing the multidimensional construct of self-reported interoception. The Arabic MAIA-2 demonstrated good psychometric properties. We thus preliminarily recommend its use to measure the interoceptive awareness construct among Arabic-speaking communities worldwide.

When Eating Intuitively Is Not Always a Positive Response: Using Machine Learning to Better Unravel Eaters Profiles

BACKGROUND

The aim of the present study was to identify eaters profiles using the latest advantages of Machine Learning approach to cluster analysis.

METHODS

A total of 317 participants completed an online-based survey including self-reported measures of body image dissatisfaction, bulimia, restraint, and intuitive eating. Analyses were conducted in two steps: (a) identifying an optimal number of clusters, and (b) validating the clustering model of eaters profile using a procedure inspired by the Causal Reasoning approach.

RESULTS

This study reveals a 7-cluster model of eaters profiles. The characteristics, needs, and strengths of each eater profile are discussed along with the presentation of a continuum of eaters profiles.

CONCLUSIONS

This conceptualization of eaters profiles could guide the direction of health education and treatment interventions targeting perceptual and eating dimensions.

Outcomes for binge eating disorder in a remote weight-inclusive treatment program: a case report

BACKGROUND

There are no known published reports on outcomes for medically and psychiatrically compromised patients with binge eating disorder (BED) treated remotely in higher level of care settings. This case report presents outcomes of an intentionally remote weight-inclusive partial hospitalization and intensive outpatient program based on Health at Every Size® and intuitive eating principles.

CASE PRESENTATION

The patient presented with an extensive trauma background and long history of disturbed eating and body image. She was diagnosed with BED along with several comorbidities, most notably major depressive disorder with suicidality and non-insulin dependent diabetes mellitus. She completed a total of 186 days in the comprehensive, multidisciplinary treatment program encompassing individual and group therapy, as well as other supportive services such as meal support and in vivo exposure sessions. Upon discharge, her BED was in remission, her major depressive disorder was in partial remission, and she no longer exhibited signs of suicidality. Overall, she showed decreases in eating disorder, depressive, and anxiety symptoms as well as increases in quality of life and intuitive eating throughout treatment, which were largely maintained after one year.

CONCLUSIONS

This case highlights the potential of remote treatment as an option for individuals with BED, especially in cases where access to higher levels of care might be limited. These findings exemplify how a weight-inclusive approach can be effectively applied when working with this population.

Feeling difficult to identify: Alexithymia is inversely associated with positive body image in adults from the United Kingdom

BACKGROUND

Research has increasingly examined the ways in which internal bodily experiences influence body image, including the relationship between alexithymia - the reduced ability to identify and describe one's own emotional feelings and bodily sensations - and negative body image. However, relationships between facets of alexithymia and positive body image remain unexplored.

METHODS

To bridge this gap in the literature, we assessed relationships between facets of alexithymia and multiple, core indices of positive body image in an online sample of adults from the United Kingdom. A total of 395 participants (226 women, 169 men) aged 18 to 84 years completed measures of alexithymia, body appreciation, functionality appreciation, body image flexibility, body acceptance by others, and positive rational acceptance.

RESULTS

Once the effects of age had been accounted for, alexithymia was significantly and negatively associated with all five body image constructs in hierarchical multiple regressions. In the final models, the alexithymia facet of Difficulties Identifying Feeling emerged as a significant and negative predictor of all indices of positive body image.

LIMITATIONS

The use of cross-sectional data limits the causal conclusions that can be drawn.

CONCLUSIONS

These findings extend previous work by demonstrating the unique relationship between alexithymia and positive body image, providing important implications for body image research and practice.

Body perceptions, occupations, eating attitudes, and behaviors emerged during the pandemic: An exploratory cluster analysis of eaters profiles

Introduction

COVID-19 pandemic negatively impacted people's mental and physical health. Three areas have been significantly impacted, among others: eating-related behaviors, occupational balance, and exposure to self-image due to videoconferencing. This study aims to explore and document eaters profiles that were reported during the pandemic in the general Canadian population using a holistic perspective, including body perceptions, attitudes, and eating behaviors (i.e., body image, behaviors, attitudes, and motivations regarding food), and occupations (i.e., physical activity and cooking).

Methods

This cross-sectional study was conducted from May to September 2020. Two hundred and seventy-three Canada's residents, French speaking of 18 years of age and older, participated in an online survey on behaviors, attitudes, and motivations regarding food and eating as well as body image and occupations during the COVID-19 pandemic. A hierarchical cluster analysis was used to determine the eaters profiles. One-way ANOVA and Chi-square test were conducted to differentiate occupational characteristics between eaters profiles.

Results

Three distinctive profiles were found during the COVID-19 pandemic and could be placed on a continuum: the Congruent-driven eater is at the functional pole of the continuum, whereas the Incongruent-driven eater is at the dysfunctional pole of the eaters continuum. In the middle of the continuum, the Incongruent-perceptual eater is at a critical crossing point. Significant differences were reported between eaters profiles.

Discussion

The empirical results based on an eaters continuum conceptualization highlight the importance of understanding how people perceive their body to assess and promote food well-being.

Healthy orthorexia vs orthorexia nervosa: associations with body appreciation, functionality appreciation, intuitive eating and embodiment

PURPOSE

Current conceptualizations and measures of orthorexia nervosa may not be accurately distinguishing between the healthy vs pathological pursuit of a healthy diet, leading to very high prevalence rates and risking the pathologizing and stigmatizing of healthy eating more generally. Recent research has identified healthy orthorexia as a novel construct conceptually distinct from orthorexia nervosa, which represents the non-pathological pursuit of a healthy diet. In light of the strong body of evidence supporting the role of positive body image in eating behavior, the current study aimed to examine the associations between healthy orthorexia, orthorexia nervosa, intuitive eating and indices of positive body image.

METHODS

The current study employed a cross-sectional design. An online community sample (N = 835; 62% women; M_age = 40.24, SD = 14.45) completed self-report questionnaires including the Teruel Orthorexia Scale, Body Appreciation Scale-2, Functionality Appreciation Scale, Intuitive Eating Scale-2, and Experience of Embodiment Scale.

RESULTS

Intuitive eating and indices of positive body image were significantly positively associated with healthy orthorexia and inversely associated with orthorexia nervosa. A hierarchical multiple regression analysis found that intuitive eating and indices of body image were uniquely associated with 13.3% of the variance of healthy orthorexia above and beyond that accounted for by orthorexia nervosa. Intuitive eating moderated the relationship between healthy orthorexia and orthorexia nervosa.

CONCLUSION

The findings of this study provide support for intuitive eating and indices of positive body image as worthy of further exploration as important factors which distinguish between healthy orthorexia and orthorexia nervosa.

LEVEL OF EVIDENCE

V, descriptive study.

A snapshot of eating behaviors in undergraduate college students living in South Florida

Objective: To examine a) whether college students' eating behaviors are different by students' sex and/or body mass index (BMI) categories and b) the correlations between college students' eating behaviors and the degree to which they rely on internal bodily signals for food intake. Participants: Undergraduate college students 18-24 years old at a public university located in South Florida. Methods: Eligible students answered questionnaires to examine interoception, intuitive eating, and eating behaviors including emotional eating, restrained eating, cognitive restraint, external eating, and uncontrolled eating. Pearson correlation and independent t test were used (significance: p < 0.05). Results: Females reported lower interoception, intuitive eating, and higher emotional eating than males. Students with lower BMI had higher intuitive eating and lower restrained eating. Interoception was positively correlated with intuitive eating and negatively correlated with emotional, uncontrolled, restrained, and external eating. Conclusion: College students who have a better connection with their bodily signals have healthier eating behaviors and lower BMI.

Dissonance-based eating disorder prevention improves intuitive eating: a randomized controlled trial for Brazilian women with body dissatisfaction

PURPOSE

Investigate the efficacy of a dissonance-based (DB) intervention (i.e., the Body Project), during which some examples of intuitive eating were provided by peer leaders, in improving intuitive eating and targeting risk and protective factors for eating disorders (ED) among Brazilian women with body dissatisfaction.

METHODS

Participants were randomized to a four-session DB intervention (n = 38) or assessment-only control (AOC) (n = 36), and completed validated measures assessing intuitive eating, body appreciation, self-esteem, body-ideal internalization, body dissatisfaction, negative affect, and disordered eating pre-intervention, post-intervention, and at 4- and 24-week follow-ups.

RESULTS

The DB condition demonstrated significantly greater increases in intuitive eating, body appreciation and self-esteem scores compared to AOC from pre-intervention to post-intervention (between-condition Cohen's d = 0.73-0.98), 4-week (between-condition Cohen's d = 1.25-1.87) and 24-week follow-up (between-condition Cohen's d = 0.82-1.38). Also, the DB condition showed significantly greater decreases in body-ideal internalization, body dissatisfaction and disordered eating scores from pre-intervention to post-intervention (between-condition Cohen's d = 0.76-1.04), 4-week (between-condition Cohen's d = 1.27-1.71) and 24-week follow-up (between-condition Cohen's d = 1.04-1.19). Regarding negative affect, DB condition showed significantly greater reduction only at 24-week follow-up (between-condition Cohen's d = 0.60).

CONCLUSION

Results reinforce the efficacy of DB interventions in reducing ED risk factors for young women and support the preliminary efficacy of these programs in improving intuitive eating, body appreciation, and self-esteem.

LEVEL OF EVIDENCE

Level I, randomized controlled trial. ReBEC (Brazilian Registry of Clinical Trials; available at http://www.ensaiosclinicos.gov.br/ ) number of registration: RBR-2f57cs. Date of registration: June 1, 2020.

The relationship between intuitive eating, eating disorders, and body image perceptions in young adult women

BACKGROUND: The term intuitive eating is a new concept that has emerged in recent years. It is a way of eating that is based on responding to the body’s natural signals of hunger and satiety. OBJECTIVE: The study was conducted to evaluate the relationship between intuitive eating and eating disorders and body image perception in young adult women. METHODS: The study was conducted with 400 women aged 19–35 years. The data were collected with the Figure Rating Scale, the Intuitive Eating Scale-2 (IES-2), and the Eating Attitude Test-26. RESULTS: The mean body mass index was significantly higher in individuals who misperceived their body image. While 51.4% of the participants with normal eating behavior had appropriate body image perception, 38.8% of the participants with abnormal eating behavior had appropriate body image perception. The IES-2 total score was significantly lower in women with abnormal eating behavior and overweight/obese women. CONCLUSIONS: Our findings showed that intuitive eating is negatively associated with abnormal eating behavior and obesity in young adult women and that women with low intuitive eating inclinations misperceived their body image.

eLoriCorps Immersive Body Rating Scale and eLoriCorps Mobile Versions: Validation to Assess Body Image Disturbances from Allocentric and Egocentric Perspectives in a Nonclinical Sample of Adolescents

A growing number of studies have used virtual reality (VR) for the assessment and treatment of body image disturbances (BIDs). This study, conducted in a community sample of adolescents, documents the convergent and discriminant validity between (a) the traditional paper-based Figure Rating Scale (paper-based FRS), (b) the VR-based Body Rating Scale (eLoriCorps-IBRS 1.1), and (c) the mobile app-based Body Rating Scale (eLoriCorps-IBRS 1.1-Mobile). A total of 93 adolescents (14 to 18 years old) participated in the study. Body dissatisfaction and body distortion were assessed through the paper-based FRS, the eLoriCorps-IBRS 1.1 and the eLoriCorps-IBRS 1.1-Mobile. Eating disorder symptoms, body image avoidance, and social physique anxiety were also measured. Correlation analyses were performed. Overall, the results showed a good and statistically significant convergence between allocentric perspectives as measured by the paper-based FRS, the eLoriCorps-IBRS 1.1 and the eLoriCorps-IBRS 1.1-Mobile. As expected, the egocentric perspective measured in VR produced different results from the allocentric perspective, and from cognitive–attitudinal–affective dimensions of BIDs, with the exception of body distortion. These differences support the discriminant validity of the egocentric perspective of eLoriCorps-IBRS 1.1 and are consistent with emerging evidence, highlighting a difference between experiencing the body from an egocentric (i.e., the body as a subject) and allocentric (i.e., the body as an object) perspective. The egocentric perspective could reflect a perceptual–sensory–affective construction of BIDs, whereas allocentric measures seem to be more related to a cognitive–affective–attitudinal construction of BIDs. Moreover, the results support the validity of the eLoriCorps-IBRS 1.1-Mobile with promising perspectives of implementation among young populations.

Modeling the associations between internal body orientation, body appreciation, and intuitive eating among early-adult and middle-adult men and women: A multigroup structural invariance analysis

This cross-sectional study investigated the associations among internal body orientation, body appreciation, intuitive eating, age, and BMI in men and women between 30 and 70 years old as delineated in the acceptance model of intuitive eating. Self-report measures were administered to a final sample of 522 individuals consisting of early-adult men (ages 30-44; n = 153), middle-adult men (ages 45-70; n = 108), early-adult women (ages 30-44; n = 135), and middle-adult women (ages 45-70; n = 126). Overall mean age was 45.03 (SD = 10.95). Structural equation modeling evidenced that, for both age groups of men and women, internal body orientation was positively associated with body appreciation and body appreciation was positively associated with intuitive eating. Internal body orientation was positively associated with intuitive eating in each group, except early-adult women. The associations among age and BMI with the aforementioned variables were inconsistent. Although evidencing measurement non-invariance among a number of parameters, multigroup structural invariance analyses showed that the associations among internal body orientation, body appreciation, intuitive eating, age, and BMI were invariant across each gender and age. These results further confirm components of the acceptance model of intuitive eating among men and women in early-adulthood and middle-adulthood.

Intuitive eating and its psychological correlates: A meta-analysis

OBJECTIVE

Intuitive eating is an adaptive style of eating that has generated significant research attention. Theoretically, intuitive eating is a core construct that features prominently in the Acceptance Model of Intuitive Eating, a framework that explains how positive environmental influences can foster intuitive eating practices via body appreciation. Empirically, intuitive eating has been connected to a broad range of adaptive mental health indices. At present, a quantitative synthesis of intuitive eating and its correlates has yet to be conducted. This was the objective of the current meta-analysis.

METHOD

Ninety-seven studies (89% cross-sectional) were included. Random effects meta-analyses were conducted on 23 psychological correlates, divided into three clusters: eating behavior and body image disturbances, positive body image and other adaptive factors, and general psychopathology. Meta-analytic path analyses were also computed to test the validity of the Acceptance Model.

RESULTS

Intuitive eating was inversely associated with multiple indices of eating pathology, body image disturbances, and psychopathology (rs = -.23 to -.58). Intuitive eating was positively associated with numerous positive psychological constructs, such as positive body image, self-esteem, and wellbeing (rs = .20 to .58). Men reported higher levels of intuitive eating than women (d = 0.39), with differences being largest in Caucasian samples. Meta-analytic path analyses strongly supported the hypothesized pathways specified in the Acceptance Model of Intuitive Eating.

CONCLUSIONS

There is a strong evidence base for intuitive eating's connection to numerous adaptive psychological constructs. Attention should now shift toward prospective and experimental designs so that the temporal nature of these relationships can be identified.

Emotional Regulation and Overeating Behaviors in Children and Adolescents: A Systematic Review

The worldwide prevalence of obesity has dramatically increased, mostly in children and adolescents. The Emotional Eating theoretical model has proposed that the failure in emotional regulation could represent a risk factor for establishing maladaptive overeating behavior that represents an inadequate response to negative emotions and allows increasing body-weight. This systematic review investigates the relationship between overeating and both emotional regulation and emotional intelligence in childhood and adolescence, considering both cross-sectional and longitudinal studies. Moreover, another goal of the review is evaluating whether emotional regulation and emotional intelligence can cause overeating behaviors. The systematic search was conducted according to the PRISMA-statement in the databases Medline, PsychArtcles, PsychInfo, PubMed, Scopus, and Web of Sciences, and allows 484 records to be extracted. Twenty-six studies were selected according to inclusion (e.g., studies focused on children and adolescents without clinical conditions; groups of participants overweight or with obesity) and exclusion (e.g., studies that adopted qualitative assessment or cognitive-affective tasks to measure emotional variables; reviews, commentary, or brief reports) criteria detailed in the methods. Cross-sectional studies showed a negative association between emotional regulation and overeating behavior that was confirmed by longitudinal studies. These findings highlighted the role of maladaptive emotion regulation on overeating and being overweight. The relationship between these constructs in children and adolescents was consistent. The results indicated the complexity of this association, which would be influenced by many physiological, psychological, and social factors. These findings underline the need for further studies focused on emotion regulation in the development of overeating. They should analyze the mediation role of other variables (e.g., attachment style, peer pressure) and identify interventions to prevent and reduce worldwide overweight prevalence.

Living in a Larger Body: Do Exercise Motives Influence Associations between Body Image and Exercise Avoidance Motivation?

The study explored reasons for exercise as possible mediators of the relationship between body appreciation and exercise avoidance motivation and between body surveillance and exercise avoidance motivation. Using a cross-sectional design, 131 women with a body mass index (BMI) of 25 or higher completed measures of body surveillance, body appreciation, reasons for exercise, and exercise avoidance motivation. Mediation analyses indicated that appearance-oriented reasons for exercise partially mediated the body surveillance–exercise avoidance motivation relationship. Health and fitness professionals, organizations, and environments should avoid reinforcing appearance-oriented reasons for exercise. Rather, empowering exercise experiences and environments should be created as they seem to benefit women regardless of reasons for exercise.

Examining the association between body trust and body mass index with quantile regression

PURPOSE

Schachter's externality theory posits a connection between the inability to eat according to internal cues and higher body mass index (BMI); however, related work has not investigated associations between body trust and the wide range of BMIs found in general samples. This study examined the association between body trust and BMI across levels of BMI to determine whether this relationship differed as a function of BMI level.

METHODS

Participants were 534 adults (55.4% female), mean age 36 years, BMIs 15.13-67.90 (M = 27.89, SD = 7.25), recruited via MTurk. They completed self-report assessments of body trust, height, and weight. Quantile regression was utilized to estimate effects of body trust on BMI at five equidistant quantiles of BMI.

RESULTS

Overall linear regression analyses indicated that body trust was significantly negatively associated with BMI. Quantile regression revealed a significant negative relationship at each quantile of BMI, and Wald tests indicated the association was significantly stronger at the 0.7 and 0.9 quantiles than at the 0.1, 0.3, and 0.5 quantiles, which did not differ.

CONCLUSIONS

Quantile regression identified a stronger relationship between body trust and BMI at 0.7 and 0.9 quantiles than at 0.1, 0.3, and 0.5 quantiles of BMI. Results align with the externality hypothesis, which suggests those at higher weights experience difficulty using internal cues to guide eating. A weaker-than-expected association between body trust and low BMI may be due to restricted range (few low-BMI participants). Replication in eating disorder samples is merited.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

Improving interoception and self-disgust in the treatment of patients with anorexia nervosa

Anorexia nervosa (AN) is a mental disorder in which sufficient evidence points towards the presence of a high level of disturbed interoception and self-disgust. High arousal mood induction is a therapeutic technique that helps improve a patient's interoceptive capacities. With some adjustments to this technique such as adding a challenging behavior that induces a "flow" state or a mindfulness component such as in mindful awareness in body-oriented therapy (MABT), it is expected that patients with AN may benefit from an integrative treatment strategy that helps them improve their symptoms of high self-disgust and low interoception.

Greater gastric interoception is associated with more positive body image: Evidence from adults in Malaysia and the United Kingdom

Gastric interoception refers to the processing of sensory stimuli originating in the gut. Previous research has found that gastric interoception (measured using a water load task) is associated with drive for thinness in young Western women. However, associations with broader facets of body image and in diverse national groups have not been previously investigated. To address these issues, we asked samples of adults in the United Kingdom (UK; N = 91, women n = 54) and Malaysia (N = 100, women n = 50) to complete a 2-stage water load task (WLT) and measures of positive body image (i.e., body appreciation, functionality appreciation). The results indicated that a greater change in the intensity of self-reported WLT-related sensations was associated with significantly higher body appreciation and functionality appreciation after accounting for gender identity, body mass index, and national group. Behavioural performance on the WLT was significantly associated with body appreciation and functionality appreciation for the Malaysian sample, but not the UK adults, after accounting for gender identity and body mass index. These findings extend previous research by demonstrating that there are significant associations between facets of gastric interoception and previously unexplored facets of body image in both Western and non-Western settings.

Intuitive eating and body appreciation in type 2 diabetes

Our objective was to explore the socio-demographic, clinical, and nutritional factors of body appreciation in type 2 diabetics. This is a cross-sectional observational study with 179 adults and older adults (60 ± 10 years old). Most of the sample was female (n = 133; 74.3%). Through logistic regression analysis, it was observed that being perceived as overweight was associated with a 91.6% lower chance of being satisfied with one's body. Trusting hunger and satiety cues doubled the chances of body satisfaction. Thus, eating more intuitively, attending to the signs of hunger and satiety, is associated with greater body satisfaction in type 2 diabetics.

A conceptual model describing mechanisms for how yoga practice may support positive embodiment

Yoga practice has been associated with various indices of positive embodiment in correlational and intervention studies. Yet, systematic, theoretically-grounded models detailing specific mechanisms by which yoga supports positive embodiment are lacking. In this article, we present a conceptual model that describes mechanisms (i.e., mediators and moderators) that can be used to guide research to help answer how, for whom, and under what conditions yoga practice may promote positive embodiment. Based on existing theoretical frameworks and empirical findings, this model suggests that (a) yoga practice may cultivate embodying experiences during yoga (e.g., state mindfulness), (b) these embodying experiences may build stable embodying experiences that generalize beyond the yoga context (e.g., trait mindfulness), and (c) these stable embodying experiences may then promote embodying practices (e.g., mindful self-care). This mediational chain is likely moderated by the yoga context (e.g., instructional focus, presence of mirrors, diversity of bodies represented) and yoga practitioners' social identities (e.g., body size, physical limitations), social and personal histories (e.g., experiences with weight stigma and trauma), and personality traits and motives (e.g., body comparison, appearance-focused motives to practice yoga). Using the structure of this conceptual model, we offer researchers ideas for testable models and study designs that can support them.

Prediction of the Influential Factors on Eating Behaviors: A Hybrid Model of Structural Equation Modelling-Artificial Neural Networks

The importance of eating behavior risk factors in the primary prevention of obesity has been established. Researchers mostly use the linear model to determine associations among these risk factors. However, in reality, the presence of nonlinearity among these factors causes a bias in the prediction models. The aim of this study was to explore the potential of a hybrid model to predict the eating behaviors. The hybrid model of structural equation modelling (SEM) and artificial neural networks (ANN) was applied to evaluate the prediction model. The SEM analysis was used to check the relationship of the emotional eating scale (EES), body shape concern (BSC), and body appreciation scale (BAS) and their effect on different categories of eating behavior patterns (EBP). In the second step, the input and output required for ANN analysis were obtained from SEM analysis and were applied in the neural network model. 340 university students participated in this study. The hybrid model (SEM-ANN) was conducted using multilayer perceptron (MLP) with feed-forward network topology. Moreover, Levenberg–Marquardt, which is a supervised learning model, was applied as a learning method for MLP training. The tangent/sigmoid function was used for the input layer, while the linear function was applied for the output layer. The coefficient of determination (R²) and mean square error (MSE) were calculated. Using the hybrid model, the optimal network happened at MLP 3-17-8. It was proved that the hybrid model was superior to SEM methods because the R² of the model was increased by 27%, while the MSE was decreased by 9.6%. Moreover, it was found that BSC, BAS, and EES significantly affected healthy and unhealthy eating behavior patterns. Thus, a hybrid approach could be suggested as a significant methodological contribution from a machine learning standpoint, and it can be implemented as software to predict models with the highest accuracy.

Interoceptive reliance as a major determinant of emotional eating in adult obesity

This study examined the association between emotional eating, emotion dysregulations, and interoceptive sensibility in 116 patients with obesity by distinguishing an “awareness” and a “reliance” component of interoceptive sensibility. Deficits in interoceptive awareness were only associated with more emotional eating in obesity through less interoceptive reliance and more emotion dysregulations. The results suggest that good interoceptive awareness can increase the risk of emotional eating if not supported by good interoceptive reliance. Interoceptive reliance, like the ability to trust, positively consider, and positively use inner sensations, should be a privileged target of psychotherapeutic interventions in obesity.

An exploration of the associations between facets of interoceptive awareness and body image in adolescents

Previous research suggests that lower interoceptive awareness is associated with more negative body image during adolescence. However, studies have not distinguished between adaptive and maladaptive modes of attention toward interoceptive signals, and relationships between interoceptive awareness and positive body image remain unexplored. To address these issues, a sample of 265 British adolescents (140 girls, 125 boys) aged 13-16 years completed measures of interoceptive awareness, body appreciation, functionality appreciation, body pride, body shame, and body surveillance. Correlational analyses broadly indicated that greater interoceptive awareness was significantly associated with more positive body image. Multiple regressions revealed significant predictive relationships between interoceptive awareness and all facets of body image in both girls and boys, except body surveillance, which was not statistically significant for girls. At the univariate level, the interoceptive awareness facets of Attention Regulation, Body Listening, Self-Regulation, and Trusting emerged as significant predictors for at least one facet of positive body image, whilst the Noticing and Emotional Awareness facets did not. These findings broadly align with previous research with adults, which has indicated that the way interoceptive stimuli are appraised and responded to might be more closely associated with facets of body image than the tendency to notice interoceptive stimuli.

Difficulties in emotion regulation and deficits in interoceptive awareness in moderate and severe obesity

PURPOSE

Difficulties in emotion regulation and deficits in interoceptive awareness may be responsible for overeating and weight gain in obesity by increasing the risks of problematic eating behaviors. This study aimed to: (1) examine emotion regulation difficulties and interoceptive deficits in obesity; (2) compare the emotion regulation and interoceptive abilities of moderately and severely obese patients.

METHODS

Participants were recruited through the university, diabetology centers and bariatric surgery departments. A total of 165 participants were categorized in three groups, matched by age and gender, according to their Body Mass Index (BMI). The severely obese (SO), moderately obese (MO) and normal weight (NW) groups were constituted of 55 participants each. Self-report questionnaires were used to assess emotion regulation difficulties (CERQ-DERS) and interoceptive awareness (MAIA-FFMQ).

RESULTS

Overall, obese participants reported more emotion regulation difficulties and less interoceptive awareness than NW participants did. They also reported a lack of planning strategies and emotional awareness, as well as less ability to observe, notice and trust body sensations. No differences in emotion regulation and interoceptive abilities were found between MO and SO participants.

CONCLUSIONS

Emotion regulation and interoceptive awareness should be targeted in the psychotherapeutic care of obese people, regardless of their BMI.

LEVEL OF EVIDENCE

Level III, case-control analytic study.

Multiple dimensions of interoceptive awareness are associated with facets of body image in British adults

Previous research has identified a relationship between interoception and body image, where lower interoceptive awareness (IA) is associated with negative body image. However, relationships between facets of interoception and positive body image remain unexplored, and men and older adults remain underrepresented. To overcome these limitations, we assessed relationships between multiple dimensions of interoceptive awareness (IA) and multiple facets of body image in community adults. An online sample of 646 British adults (447 women) aged 18-76 years completed the Multidimensional Assessment of Interoceptive Awareness (MAIA), the Body Appreciation Scale-2, the Functionality Appreciation Scale, the Authentic Pride subscale from the Body and Appearance Self-Conscious Emotions Scale, and the Appearance Orientation and Overweight Preoccupation subscales from the Multidimensional Body-Self Relations Questionnaire. Hierarchical regressions revealed significant predictive relationships between IA and all five facets of body image after controlling for sex, body mass index, and age. In the final models, the MAIA subscales emerged as significant predictors for at least one facet of body image, with the exception of the MAIA Body Listening subscale. These findings extend previous work by demonstrating significant relationships between IA and previously unexplored facets of body image, which may hold promise for practitioner-based interventions.