Intuitive eating practices among African-American women living with type 2 diabetes: a qualitative study

Intuitive eating programs that improve self-efficacy and dietary habits could enhance glycemic control in African-American women with type 2 diabetes. The goal of our study was to investigate how current eating practices and beliefs of African-American women living with diabetes aligned with intuitive eating concepts. African-American women with type 2 diabetes referred for diabetes education class during 2009-2012 were recruited for a qualitative study using focus groups for data collection. Verbatim group transcriptions were analyzed by two independent reviewers for themes using a combined inductive-deductive approach. Participants (n=35) had an average age 52±9 years, mean body mass index 39±7, and mean time with a type 2 diabetes diagnosis of 10±10 years. Participants' self-reported dietary practices were poorly aligned with intuitive eating concepts. The women reported a lack of self-control with food and regularly eating in the absence of hunger, yet stated that the determinant factor for when to stop eating was to recognize a feeling of fullness. Participants reported knowing they were full when they felt physically uncomfortable or actually became sick. Women frequently cited the belief that individuals with diabetes have to follow a different diet than that recommended for the general public. Many women also discussed diabetes-related stigma from family/friends, and often did not tell others about their diabetes diagnosis. These findings demonstrate that intuitive eating techniques are not currently applied by the women in this sample. Future studies should assess the influence of intuitive eating interventions on dietary habits among low-income African-American women with type 2 diabetes.