The ecological validity of the Intuitive Eating Scale-2 among adults with binge-eating disorder

This study examined the ecological validity of the Intuitive Eating Scale-2 (IES-2) facets among adults with binge-eating disorder (BED) and subthreshold BED (SBED) by assessing how IES-2 subscales predict positive and negative affect, body satisfaction, hunger and satiety sensitivity, eating self-efficacy, and binge-eating symptoms measured via ecological momentary assessment (EMA).

The sample included 50 adults with BED/SBED who completed the IES-2 and 14 days of EMA data collection. Generalized linear mixed models examined IES-2 subscales (eating for physical rather than emotional reasons, reliance on hunger and satiety cues, unconditional permission to eat, body food choice congruence) as predictors of EMA-measured outcomes.

Participants who reported greater reliance on hunger and satiety cues evidenced greater EMA-measured satiety sensitivity (B = 0.13, p = .003), less binge-eating symptoms (B = -0.19, p = .007), and less positive affect (B = -0.30, p = .042). Participants reporting greater eating for physical rather than emotional reasons reported greater EMA-measured eating self-efficacy (B = 0.47, p = .006) and body satisfaction (B = 0.46, p = .030). Participants who reported greater unconditional permission to eat evidenced greater EMA-measured binge-eating symptoms (B = 0.15, p = .048). No other effects were significant.

Results generally supported the ecological validity of the IES-2 among those with BED, particularly the reliance on hunger and satiety cues and eating for physical rather than emotional reasons subscales. Findings align with prior research that indicates trusting physiological rather than emotional or external cues to guide eating is important for adaptive eating regulation in BED. Results also highlighted the importance of further research to understand the unconditional permission to eat construct in BED.