Weight-inclusive intuitive eating course associated with reductions in disordered eating in adults: a mixed methods...

Many employee health promotion programs encourage lifestyle changes such as eating more fruits and vegetables or getting more physical activity. Most of these programs operate from a weight-normative lens, meaning they encourage such changes with the primary goal of weight change (typically weight loss). However, research indicates that weight-inclusive programs - programs that focus on health behaviors alone, regardless of weight change - may be just as effective at promoting better health and also feel less stigmatizing for participants. The purpose of this study was to test the effects of a weight-inclusive employee wellness program (Intuitive Eating, or IE) and a weight-normative program (Intensive Lifestyle Program, or ILP) on disordered eating, intuitive eating, weight bias internalization, weight bias, weight/shape concerns, and body appreciation of adults working in a university setting.

This study utilized a quasi-experimental, mixed-methods approach and employed 8- (IE) and 12-week (ILP) interventions with validated pre and post questionnaires and semi-structured interviews. Quantitative data was analyzed using two-way repeated measures ANOVAs and qualitative data was analyzed using interpretive phenomenological analysis (IPA).

Participants (n = 42) were 95% white and 98% female. 26 in the IE group and 16 in the ILP group enrolled in the study. Of that sample, 13 participants were interviewed (IE = 6; ILP = 7). The IE program was associated with significantly greater reductions in disordered eating from pre- to post-course compared to the ILP program. There were no statistically significant improvements in weight/shape concerns, IE levels, body appreciation, and weight bias between groups from pre- to post-course. Qualitative analysis found 5 main themes: 1) Influences on Body Image, 2) Diet Culture, 3) Forms of Eating and Exercise, 4) Mental and Emotional Wellbeing, and 5) Self-Care.

Qualitative analysis provided richer detail from in-depth individual perspectives of participants' attitudes in both groups about eating attitudes/behaviors, body image, and weight bias. Employee wellness programs grounded in weight-inclusive approaches such as intuitive eating may be associated with reductions in disordered eating and provide a non-stigmatizing approach to health promotion in a homogenous employee wellness setting.