Intuitive Eating and Eating Disorders Among Adults: A Relationship AnalysisYetişkinlerde Sezgisel Yeme ve Yeme Bozuklukları: Bir İlişki Analizi

Abstract

Aim: We aimed to investigate the relationship between eating disorders (EDs) and intuitive eating (IE) in adults. Material and Method: In this cross-sectional study, a total of 200 adults aged 25-55 years were randomly selected. The Eating Attitude Test 40 (EAT 40) and the Intuitive Eating Scale-2 (IES-2) were used to evaluate eating attitudes and IE, respectively. Sociodemographic characteristics were also recorded. Results: We found 38 participants with EDs and 162 participants without EDs. The IES-2 and its sub-dimensions scores did not differ significantly between participants with and without EDs. No significant correlation was observed between EAT-40 and IES-2 scores or IES-2 sub-dimensions scores. However, a significant negative correlation was found between Unconditional Permission to Eat (UPE) scores and age (r=-0.170, p

Full text

BANÜ Sağlık Bilimleri ve Araştırmaları Dergisi 2023;5(2)
151
Sağlık Bilimleri ve Araştırmaları Dergisi / Journal of Health Science and Research ● 3(1) ● 2021
e-ISSN:2687-2145
DOI: 10.46413/boneyusbad.1280046 zgn Aratırma / Original Research
Intuitive Eating and Eating Disorders Among Adults: A Relationship Analysis
Yetişkinlerde Sezgisel Yeme ve Yeme Bozuklukları: Bir İlişki Analizi
Seda ÇİFTÇİ 1 Hülya DEMİR 2 Tansu ÇALIM 3
1 Assist. Prof., İzmir Democracy
University, Faculty of Health
Sciences, Department of Nutrition
and Dietetics, İzmir
2 Assos. Prof., Yeditepe
University, Faculty of Health
Science, Department of
Nutrition and Dietetics, İstanbul
3 MSc, Yeditepe University,
Faculty of Health Science,
Department of Nutrition and
Dietetics, İstanbul
Sorumlu yazar / Corresponding
author
Seda ÇİFTÇİ
seda.ciftci@idu.edu.tr
Geli tarihi / Date of
receipt: 09.04.2023
Kabul tarihi / Date of
acceptance: 02.07.2023
Atıf/Citation: Çiftci, S., Demir,
H., Çalım, T. (2023). Intuitive
eating and eating disorders
among adults: a relationship
analysis. BANÜ Sağlık Bilimleri
ve Araştırmaları Dergisi, 5(2),
151-161. doi: 10.46413/
boneyusbad.1280046
ABSTRACT
Aim: We aimed to investigate the relationship between eating disorders (EDs) and intuitive
eating (IE) in adults.
Material and Method: In this cross-sectional study, a total of 200 adults aged 25-55 years were
randomly selected. The Eating Attitude Test 40 (EAT 40) and the Intuitive Eating Scale-2 (IES-
2) were used to evaluate eating attitudes and IE, respectively. Sociodemographic characteristics
were also recorded.
Results: We found 38 participants with EDs and 162 participants without EDs. The IES-2 and
its sub-dimensions scores did not differ significantly between participants with and without EDs.
No significant correlation was observed between EAT-40 and IES-2 scores or IES-2 sub-
dimensions scores. However, a significant negative correlation was found between
Unconditional Permission to Eat (UPE) scores and age (r=-0.170, p<0.05).
Conclusion: The study suggests that EDs are not a cause or effect of IE. Participants with EDs
did not tend towards IE, and IE scores were not lower in individuals prone to EDs. The lack of
significant differences in IE and its sub-dimensions between the two groups suggests that IE may
be a promising approach for individuals with or without EDs to improve their eating attitudes
and behaviors.
Keywords: Body mass index, Eating disorders, Intuitive eating
ZET
Amaç: Bu çalışmanın amacı yetişkinlerde yeme bozukluğu (YB) ve sezgisel yeme (SY) arasındaki
ilişkinin saptanmasıdır.
Gereç ve Yöntem: Bu kesitsel çalışmada, 25-55 yaş arası 200 yetişkin rastgele seçildi. Yeme
tutumlarını ve sezgisel yeme durumlarını değerlendirmek için Yeme Tutum Testi-40 (YTT-40) ve
Sezgisel Yeme Ölçeği-2 (SYÖ-2) kullanıldı. Sosyodemografik özellikler de kaydedildi.
Bulgular: YB olan 38 katılımcı ve YB olmayan 162 katılımcı vardı. SYÖ-2 ve alt boyutları
puanları, YB olan ve olmayan katılımcılar arasında anlamlı farklılık göstermedi. YTT-40 ve
SYÖ-2 puanları veya SYÖ-2 alt boyutları puanları arasında anlamlı bir ilişki gözlenmedi.
Bununla birlikte, Yemeğe Şartsız İzin Verme puanları ile yaş arasında anlamlı negatif bir ilişki
bulundu (r=-0.170, p<0.05).
Sonuç: Çalışma, YB'nin SY'nin nedeni veya sonucu olmadığını öne sürmektedir. YB olan
katılımcılar SY'ye eğilimli değildi ve SY puanları YB eğilimli bireylerde düşük değildi. İki grup
arasındaki SY ve alt boyutlarındaki anlamlı farklılıkların olmaması, SY'nin, YB'si olan veya
olmayan bireylerin yeme tutumlarını ve davranışlarını iyileştirmek için umut verici bir yaklaşım
olabileceğini düşündürmektedir.
Anahtar Kelimeler: Beden kütle indeksi, Yeme bozuklukları, Sezgisel yeme
BANDIRMA ONYEDİ EYLÜL ÜNİVERSİTESİ
SAĞLIK BİLİMLERİ VE ARAŞTIRMALARI
DERGİSİ
BANU Journal of Health Science and Research

BANÜ Sağlık Bilimleri ve Araştırmaları Dergisi 2023;5(2)
152
BANÜ Sağlık Bilimleri ve Araştırmaları Dergisi / BANU Journal of Health Science and Research ● 5(2) ● 2023
INTRODUCTION
Intuitive eating (IE) is characterized by a reliance
on physical cues to guide eating behavior,
including when, what, and how much to eat. It
entails fostering a healthy relationship between
food, cognition, and the body, where individuals
actively attend to the sensations and enjoyment
derived from their meals. Intuitive eaters possess
an innate skill of tuning into their body's signals
and making food choices based on internal cues,
prioritizing their physiological needs and
preferences. (Barraclough, Hay-Smith, Boucher,
Tylka, & Horwath, 2019). Maintaining
mindfulness in eating habits and proactively
managing one's health are vital considerations. By
being mindful, individuals can develop a
heightened awareness of their eating behavior,
enabling them to make conscious choices that
support their overall health and well-being.
Taking proactive action empowers individuals to
actively engage in behaviors that contribute to the
management and improvement of their health
(Bray, Frühbeck, Ryan, & Wilding, 2016).
Intuitive eating is a philosophy that promotes the
practice of attuning to the body's natural hunger
and fullness cues when making food choices.
Instead of rigid rules or strict guidelines, intuitive
eaters develop trust in their bodies to guide them
toward nourishing foods that support their overall
health. Central to intuitive eating is the recognition
and response to physical sensations of hunger and
fullness, achieved by attentively listening to the
body's signals while disregarding external cues
like time or portion size that may override these
cues. Another significant aspect involves
cultivating a positive relationship with food,
releasing feelings of guilt and shame often
associated with eating. Intuitive eaters embrace all
types of food without judgment, focusing on the
pleasure and satisfaction that comes from
nourishing themselves. Ultimately, intuitive
eating encompasses a holistic approach to well-
being, prioritizing the nourishment of the body,
mind, and spirit through food and self-care
practices. (Van Dyke & Drinkwater, 2014). The
principle of unconditional permission to eat
promotes the idea that individuals should honor
their body's physical cues of hunger and food
cravings. It encourages people to grant themselves
permission to enjoy the foods they desire in the
present moment, without imposing judgment or
restrictions. By embracing unconditional
permission to eat, individuals can foster a healthier
relationship with food, allowing themselves to
fully satisfy their cravings and nourish their bodies
without feelings of guilt or deprivation. This
principle emphasizes the importance of trusting
one's internal cues and honoring their body's
unique needs and preferences when it comes to
eating. (Keirns & Hawkins, 2019). According to
research, individuals who engage in food
restriction tend to exhibit heightened sensitivity to
food-related stimuli, such as smell and taste. This
increased sensitivity can result in a greater desire
for and consumption of food. In essence, when
people limit their food intake, they become more
attuned to cues associated with food, potentially
leading to overeating and a loss of control around
food. This phenomenon highlights the potential
unintended consequences of restrictive eating
behaviors, as it can trigger a heightened focus on
and preoccupation with food, ultimately
undermining efforts to maintain a balanced and
healthy approach to eating. (Reichenberger,
Schnepper, Arend, & Blechert, 2020). Dietary
restriction further increases the nutritional effort.
This is because people who limit their food intake
consume more food than people who are
unconditionally allowed to eat (Brytek-Matera,
Czepczor-Bernat, Jurzak, Kornacka, &
Kołodziejczyk, 2019). Eating disorders (EDs) can
impact individuals of all ages, ethnic backgrounds,
body weights, and genders. These disorders are
characterized by a complex interplay of
psychological, emotional, and social factors.
People with eating disorders often utilize food and
control overeating as a coping mechanism to deal
with emotions and various situations in their lives.
The three most prevalent types of eating disorders
are anorexia nervosa, bulimia nervosa, and binge
eating disorder. Anorexia nervosa is characterized
by severe food restriction and an intense fear of
gaining weight. Bulimia nervosa involves
episodes of binge eating followed by
compensatory behaviors such as purging or
excessive exercise. Binge eating disorder entails
recurring episodes of consuming large quantities
of food accompanied by a sense of loss of control.
It is important to recognize that eating disorders
can have serious physical and psychological
consequences, requiring comprehensive treatment
and support for individuals affected by these
conditions. (Park & Kim, 2022).
The objective of this study was to assess the
connections between intuitive eating (IE) and
eating disorders (EDs) in relation to participants'
sociodemographic characteristics. We formulated
the hypothesis that there would be no significant

BANÜ Sağlık Bilimleri ve Araştırmaları Dergisi 2023;5(2)
153
BANÜ Sağlık Bilimleri ve Araştırmaları Dergisi / BANU Journal of Health Science and Research ● 5(2) ● 2023
association between IE and eating disorders.
Conversely, we anticipated that eating disorders
would be correlated with body mass index (BMI),
physical activity levels, and daily water
consumption. The study aimed to explore these
relationships and shed light on the potential
interplay between IE, EDs, and various
sociodemographic factors. Moreover, this study's
importance for Turkey lies in its exploration of the
connections between intuitive eating, eating
disorders, and sociodemographic factors. And the
academic importance of this study for Turkey lies
in its contribution to filling the knowledge gap,
which may help its implications for policy and
interventions, its support for health promotion
efforts, and its advancement of the academic field
of eating behavior research.
MATERIAL AND METHOD
Research Type
To gather data, this study employed an
observational, cross-sectional research design.
Face-to-face interviews were conducted with
participants over a specified timeframe, which
spanned from April to June 2021. The use of face-
to-face interviews allowed for direct interaction
and engagement with participants, facilitating a
more in-depth exploration of the research topic.
The cross-sectional design enabled the collection
of data at a single point in time, providing a
snapshot of the participants' characteristics,
behaviors, and perceptions during the specific
period of the study.
Study Population and Sample
This study was conducted on individuals who
received by a dietitian or did not receive any
regular nutritional counselling in Bayrampaşa
Municipality Health Affairs Directorate. The
study in question determined a minimum sample
size of 170 participants, calculated to achieve
90% statistical power at a significance level of
α=0.05. Eligibility criteria for participation
required individuals to be between the ages of 25-
55 and to not have alcohol/drug dependence or a
mental disorder. Exclusion criteria were (1) less
than 25 years old, older than 55 years; (2) being
addicted to alcohol; (3) having a mental disorder
that prevents them from completing the
questionnaire. The study enrolled a total of 200
eligible participants, surpassing the minimum
sample size requirement.
Data Collection Tools
The information form utilized three instruments,
including the Intuitive Eating Scale-2 (IES-2), the
Eating Attitude Test 40 (EAT-40), and
anthropometric measurements to assess the study
participants. In addition to these instruments,
participants' sociodemographic characteristics
were also recorded. Specifically, data were
collected on age, gender, marital status,
occupation status, education level, and other
relevant sociodemographic factors.
Anthropometric measurements: Anthropometric
measurements, including body height, body
weight, waist circumference, and hip
circumference, were collected by the researcher
following standardized procedures. Subsequently,
the body mass index (BMI) [body weight (kg) /
body height* body height (m2)] and waist-to-hip
ratio were calculated based on the criteria
established by the World Health Organization
(WHO) (Casadei & Kiel, 2022). These
anthropometric measurements and derived
indices provide objective indicators of body
composition and distribution, which are crucial in
assessing and analyzing participants' physical
characteristics within the research context.
Intuitive Eating Scale -2: The Intuitive Eating
Scale -2 was adapted into Turkish which was
developed by Tylka and Kroon Van Diest (Bas et
al., 2017; Tracy L Tylka & Kroon Van Diest,
2013), it consists of twenty-three questions and
examines intuitive eating in four sub-dimensions.
The first subdimension is unconditional
permission to eat (UPE). It has 6 items; (items
one, three, four, nine, sixteen, and seventeen). 2.
Eating for Physical Rather Than Emotional
Reasons (EPR): Eight items in the sub-dimension
of food related to physical rather than emotional
reasons; Under this factor; Items two, five, ten,
eleven, twelve, thirteen, fourteen, and fifteen are
evaluated. 3. Reliance on Hunger and Satiety
Cues (RHSC): Six items in the sub-dimension of
consumption based on hunger and satiety signals;
Under this factor; Items six, seven, eight, twenty-
one, twenty-two, and twenty-three are evaluated.
4. Body-Food Choice Congruence (B-FCC):
Three items in the body-food choice compatibility
sub-dimension; Under this factor; Items eighteen,
nineteen, and twenty are being evaluated.
The IES 2 is evaluated due to a five-point Likert
scale. To evaluate the responses provided to the
questions, a Likert scale was utilized, wherein
participants rated their agreement or disagreement

BANÜ Sağlık Bilimleri ve Araştırmaları Dergisi 2023;5(2)
154
BANÜ Sağlık Bilimleri ve Araştırmaları Dergisi / BANU Journal of Health Science and Research ● 5(2) ● 2023
on a scale of one to five. Specifically, the rating
options were as follows: one denoted "I do not
agree," two represented "I am undecided," three
indicated "I agree," and four signified "I strongly
agree." For the purpose of analysis, seven items,
namely item one, two, three, seven, eight, nine,
and ten, were reverse coded, where higher scores
indicated stronger disagreement.
The median value of the individuals' intuitive
eating total score was taken as a basis to sort them
as intuitive eaters and non-intuitive eaters. Those
with values higher than the median and median
were evaluated as intuitive eaters and those with
values below the median were evaluated as
individuals who did not eat intuitively. This
method was applied to other sub-dimensions of
the IES 2 scale (Hawks, Merrill, & Madanat,
2004). In this particular research study, the
participant's scores on the IES-2 were used to
classify them as either intuitive eaters or non-
intuitive eaters. The median score on the IES-2
was used as a cut-off point to make this
classification. Participants with scores above the
median were categorized as intuitive eaters, while
those with scores below the median were
categorized as non-intuitive eaters. This approach
allowed the researchers to divide the participants
into two groups based on their level of adherence
to the principles of intuitive eating, and to
compare the outcomes between these groups
(Hawks et al., 2004). In the Turkish version of the
study, the Cronbach’s alpha was 0.81. In
comparison, the original version of the scale had
Cronbach’s coefficient alphas were 0.87 for the
total 23-item (Bas et al., 2017; Tracy L Tylka &
Kroon Van Diest, 2013). We found Cronbach
alphas coefficient for the IES-2s as 0.81. The
median of the IES-2 was found to be 3.48.
Eating Attitude Test 40 (EAT-40): The Eating
Attitude Test (EAT-40) is a self-report
questionnaire developed to assess symptoms and
attitudes related to anorexia nervosa (Garner &
Garfinkel, 1979). It consists of forty items that are
rated on a six-point Likert-type scale, with higher
scores indicating more severe eating-related
pathology. The original version of the EAT-40
has a cut-off score of 30 points, which is used to
indicate the presence of significant eating disorder
symptoms. The EAT-40 has been translated and
adapted into several languages, including Turkish
(Savaşır & Testi, 1989). The Turkish version of
the EAT-40 is a widely used tool for assessing
eating disorder symptoms and attitudes among
Turkish populations. By adapting the EAT-40 to
Turkish, researchers and clinicians can better
assess the prevalence and severity of eating
disorders in Turkish communities and develop
targeted interventions to address these issues. The
EAT-40 consists of forty items, with different
scoring options depending on the item. For items
1, 18, 19, 23, 27, and 39, participants can receive
one point for sometimes exhibiting a particular
behavior or thought, two points for rarely
exhibiting the behavior or thought, and zero
points for never exhibiting it. For the other items
on the scale, participants receive three points for
always exhibiting a particular behavior or
thought, two points for very often exhibiting it,
one point for often exhibiting it, and zero points
for not exhibiting it. To determine the overall
score on the EAT-40, the scores for each item are
added up. In the evaluation scale used in the study,
participants who scored thirty or higher on the
EAT-40 were considered to be at risk for
disordered eating behavior. This cut-off score is
commonly used in clinical and research settings
to identify individuals who may need further
evaluation and treatment for eating disorder
symptoms. The Turkish version of the EAT-40
Cronbach’s alpha was 0.70 (Savaşır & Testi,
1989). However, in our study, we calculated the
Cronbach's alpha to be 0.78, indicating a higher
level of internal consistency.
Research Process
The research process for this study lunched by
clearly defining the research objective and
formulating research questions that will guide the
study. This was followed by a thorough review of
existing literature and studies related to the
research topic, which helps to identify the current
knowledge and gaps in the field. Based on this
understanding, we developed a set of hypotheses
to provide a framework for the study. The next
step involved designing the survey instrument,
carefully selecting appropriate survey items or
questions that align with the research objectives
and hypotheses. Necessary approvals and
permissions, such as ethical clearance, were
obtained. After collecting and compiling the
survey data, we used appropriate statistical
techniques to test hypotheses, and derive
meaningful insights. We interpreted the findings
in relation to the research objectives and existing
literature, and conclusions are drawn based on the
data analysis.
Ethical Consideration
This study was performed in line with the

BANÜ Sağlık Bilimleri ve Araştırmaları Dergisi 2023;5(2)
155
BANÜ Sağlık Bilimleri ve Araştırmaları Dergisi / BANU Journal of Health Science and Research ● 5(2) ● 2023
principles of the Declaration of Helsinki.
Approval was granted by the Ethics Committee of
the University of Yeditepe University Ethics
Committee (Date: July 05, 2020 and Approval no:
1218).
Data analysis
We analysed the data in the SPSS package
program and tested the data normalization by
Kolmogorov-Smirnov analysis. For the non-
parametric data, we gave the median and
interquartile range [IQR]. When data showed
normal distribution, we used parametric tests and
mean ± standard deviation. Descriptive statistics
of data were given. And we performed Mann
Whitney U, Kruskal Wallis, and Spearman
correlation. P value <0.05 was considered
statistically significant.
RESULTS
Table 1 presents the sociodemographic and
anthropometric characteristics of the study
participants, encompassing variables such as
gender, marital status, working status, education
level, body weight, height, waist circumference,
and hip circumference. Body mass index (BMI)
was calculated using the formula weight (kg) /
height (m)2. Out of the 200 participants enrolled
in the study, 139 (69.5%) were identified as
female, while 61 (30.5%) were male. The mean
age of the participants was 34.24 ± 11.03 years.
The participants' BMI measurements ranged from
16.0 to 43.1 kg/m2. In terms of marital status,
more than half of the participants (107
individuals, accounting for 53.5%) reported being
unmarried. Furthermore, 129 participants (64.5%)
were employed based on their working status.
Table 2 displays the correlations between various
variables, including age, BMI, W/H ratio, EAT-
40, IES-2, EPR, UPE, RHSC, and B-FCC. The
correlation analyses revealed several significant
findings. Firstly, there was a weak but significant
positive correlation between age and BMI (r =
0.105, p < 0.05), as well as age and W/H ratio (r
= 0.118, p < 0.05). Additionally, there was a
moderate positive correlation between BMI and
W/H ratio (r = 0.472, p < 0.01). Furthermore, IES-
2 demonstrated a high positive correlation with
RHSC (r = 0.675, p < 0.01), a moderate positive
correlation with UPE (r = 0.597, p < 0.01), and B-
FCC (r = 0.413, p < 0.01), and a weak positive
correlation with EPR (r = 0.196, p < 0.01). RHSC
exhibited a moderate positive correlation with B-
FCC (r= 0.416, p<0.01), while UPE demonstrated
a moderate positive correlation with RHSC (r =
0.400, p < 0.01). These findings indicate the
relationships between different variables within
the study, highlighting the strengths and
directions of their associations.
Table 1. Characteristics and Anthropometric
Measurements of Participants (n=200)
Variable
n
%
Gender
Male
61
30.5
Female
139
69.5
Marital status
Single
107
53.5
Married
93
46.5
Working Status
Yes
129
64.5
No
71
35.5
Education Status
≤12 years
173
86.5
12 years <
27
13.5
Total
200
100
Variable
x
 ± SD
Min - Max
Weight (kg)
69.77 ± 16.54
41.0 - 132.0
Height (m)
1.66 ± 0.09
1.47 - 1.88
BMI (kg/m2)
25.2 ± 4.9
16.0 - 43.1
WC (cm)
82.3 ± 16.5
50 - 133
HC (cm)
96.2 ± 10.5
60 - 130
W/C ratio
0.9 ± 0.1
0.60 - 1.5
BMI: Body Mass Index; WC: Waist circumference, HC: Hip
circumference, W/C ratio: Waist / Hip ratio
In our study, out of the total participants, 38
individuals were identified as being prone to
eating disorders (EDs), while 162 participants
were not prone to EDs. We found that there was
no significant difference in the total scores of IES-
2, EPR, UPE, RHSC, and B-FCC between
participants who were prone to EDs and those
who were not (p > 0.05). Factors such as
education level, BMI, income, presence of
medical disorders, meal skipping status, daily
water intake, and physical activity level did not
have a significant impact on participants EAT-40
scores (p > 0.05).
However, we did observe that participants with an
education level of over 12 years had higher UPE
scores (p = 0.021). Additionally, participants who
reported not engaging in physical activity or
performing physical activity once or twice a week
had higher EPR scores compared to those who
engaged in physical activity every day or three to
four times a week (p < 0.05).

BANÜ Sağlık Bilimleri ve Araştırmaları Dergisi 2023;5(2)
156
BANÜ Sağlık Bilimleri ve Araştırmaları Dergisi / BANU Journal of Health Science and Research ● 5(2) ● 2023
Table 2. The Correlations Between Age, BMI, W/H Ratio, EAT-40, IES-2, and Sub-Dimensions
Of IES-2
Variables
Age
BMI
W/H
EAT-40
IES-2
EPR
UPE
RHSC
B-FCC
Age
r
-
BMI
r
0.105*
-
W/H
r
0.118*
0.472**
-
EAT-40
r
- 0.028
- 0.033
- 0.074
-
IES-2
r
0.002
0.046
0.064
- 0,020
-
EPR
r
- 0.089
- 0.058
- 0.069
0.045
0.196**
-
UPE
r
0.021
0.056
0.063
- 0.036
0.597**
- 0,081
-
RHSC
r
0.043
0.083
0.082
0.004
0.675**
0.006
0.400**
-
B-FCC
r
0.047
- 0,021
0.049
- 0.038
0.413**
- 0.144**
0.257**
0.416**
-
Kendall's Tau b correlation coefficient *p<0.05, **p<0.01; BMI: Body Mass Index; W/C: Waist / Hip ratio
Daily water intake had an effect on participants
who were not prone to EDs. Higher EPR scores
were observed among participants who consumed
2400 ml or more of water daily compared to those
who consumed 401-1000 ml (p = 0.012).
Similarly, participants with a daily water intake of
2400 ml or more had lower B-FCC scores
compared to those consuming 401-1000 ml (p =
0.009). Additionally, participants with a daily
water intake of 2400 ml or more had higher B-
FCC scores compared to those consuming less
than 400 ml (p = 0.048).
DISCUSSION
Existing studies have consistently shown a
negative relationship between body mass index
(BMI) and intuitive eating (Herbert, Blechert,
Hautzinger, Matthias, & Herbert, 2013; T. L.
Tylka, Calogero, & Daníelsdóttir, 2015). The
negative relationship between BMI and intuitive
eating can be attributed, in part, to the rejection of
dieting and the adoption of unconditional
permission to eat. Intuitive eating involves
honouring the body's hunger and fullness cues and
allowing oneself to eat all types of food without
judgment or restriction. This stands in contrast to
traditional diets that impose strict rules and
limitations on food intake. When individuals
embrace intuitive eating, they may initially
experience an increase in food consumption as
they learn to trust and respond to their body's
signals. This can result in temporary weight gain,
especially for those who have previously engaged
in food restriction or followed strict diets.
However, over the long term, intuitive eating has
been associated with more stable and healthy
weight outcomes. By fostering a positive and
balanced relationship with food and their bodies,
intuitive eating helps individuals develop
sustainable habits that support overall well-being.
As mentioned earlier, the power of diets as
predictors of weight gain has been well-
documented. This further highlights the
importance of shifting focus towards intuitive
eating as a beneficial approach for promoting
positive eating behaviors and maintaining a
healthy weight (Keirns & Hawkins, 2019).
It was stated that the restrictive eating attitude that
did not allow food similarly causes weight gain
(van Strien, Herman, & Verheijden, 2014). The
intuitive eating model, which focuses on rejecting
diet culture and encouraging individuals to listen
to their bodies hunger and fullness cues, has been
associated with positive outcomes in weight
management. This approach helps individuals
develop a healthier relationship with food and
their bodies, which can lead to more sustainable,
long-term weight management. In contrast, eating
without consciousness, or mindless eating, can
lead to overeating and weight gain. Existing
studies have reported a negative correlation
between the increase in IES-2 scores and BMI,
indicating that higher IES scores are associated
with a decrease in BMI (Van Dyke & Drinkwater,
2014; Gast, 2015). However, the relationship
between BMI and intuitive eating may vary based
on gender. A study indicated that there was no
relationship discovered between BMI and
intuitive eating in young adult women (Horwath,
Hagmann, & Hartmann, 2019). On the other hand,
a study had found no significant relationship
between BMI and IES-2 scores in males, unlike in
females (Özkan & Bilici, 2021). This may be due
to differences in social and cultural expectations
around body size and eating behaviors for men
and women. Further research is needed to fully
understand the relationship between gender and
intuitive eating outcomes. Nonetheless, intuitive
eating is generally recognized as a positive

BANÜ Sağlık Bilimleri ve Araştırmaları Dergisi 2023;5(2)
157
BANÜ Sağlık Bilimleri ve Araştırmaları Dergisi / BANU Journal of Health Science and Research ● 5(2) ● 2023
Table 3. The Relationship Between the Characteristic and EAT-40, IES-2, and IES-2 Sub-
Dimensions
*Mann-Whitney U test (p<0.05), **Kruskal Wallis test (p<0.05). M: Median; IQR: Interquartile range; EAT-40: Eating attitude test-40; IES-2: Intuitive Eating
Scale-2; EPR: Eating for Physical Rather Than Emotional Reasons; UPE: Unconditional permission to eat; RHSC; Reliance on Hunger and Satiety Cues; BFCC:
Body-Food Choice Congruence. P1: Indicates the relation between EAT-401 (n=38) prone to EDs and EAT-401 (n=162)
≥30 Yes (n=38)
<30 No (n=162)
Variables
EAT-
401
(n=38)
Prone
to EDs
IES-2
M
[IQR]
3.48
[0.70]
EPR
M
[IQR]
3.00
[1.17]
UPE
M
[IQR]
3.38
[1.13]
RHSC
M
[IQR]
3.83
[1.00]
B-FCC
M
[IQR]
3.67
[1.33]
EAT-
401
(n=162
)
IES-2
M
[IQR]
3.48
[0.70]
EPR
M
[IQR]
3.00
[1.17]
UPE
M
[IQR]
3.38
[1.13]
RHSC
M
[IQR]
3.83
[1.00]
B-FCC
M [IQR]
3.67
[1.33]
p1 value
Total
37.00
[13]
3.39
[0.58]
3.08
[1.09]
3.38
[1.25]
3.75
[0.83]
3.67
[1.41]
17.00
[10]
3.48
[0.71]
3.00
[1.00]
3.44
[1.13]
3.83
[1.00]
3.83
[1.33]
0.001*
Education
< 12 years (n=173)
37.00
[15]
3.39
[0.48]
3.00
[0.92]
3.25
[1.01]
3.67
[0.83]
3.67
[1.50]
17.00
[10]
3.48
[0.68]
3.00
[1.13]
3.50
[1.00]
3.83
[0.96]
3.83
[1.33]
0.001*
>12years (n=27)
41.00
[25]
3.70
[1.02]
3.33
[2.26]
4.00
[0.69]
3.83
[2.00]
3.67
[1.67]
16.5
[8.75]
3.39
[1.21]
3.17
[0.71]
3.13
[1.43]
3.83
[2.13]
3.83
[1.42]
0.001*
p-value
0.218*
0.187*
0.738*
0.021*
0.933*
0.867*
0.294*
0.874*
0.810*
0.523*
0.774*
0.969*
BMI (kg/m2)
<18.5 (n=8)
44.5
[-]
4.00
[-]
-
4.06
[-]
4.41
[-]
4.50
[-]
13
[4]
3.06
[1.65]
2.50
[0.84]
3.44
[1.69]
3.08
[1.92]
3.66
[1.92]
0.071*
18.5-24.99 (n=103)
37.00
[9]
3.30
[0.61]
3.25
[1.25]
3.25
[0.96]
3.66
[0.96]
3.67
[1.42]
17
[9]
3.43
[0.70]
3.17
[1.00]
3.25
[1.25]
3.83
[1.17]
4.00
[1.17]
0.001*
25.0-29.9 (n=57)
36.00
[16]
3.45
[0.54]
2.66
[1.42]
3.38
[1.19]
3.58
[0.79]
3.83
[1.08]
18
[12]
3.43
[0.74]
3.00
[1.00]
3.38
[1.13]
3.83
[0.83]
3.67 [1.0]
0.001*
≥30.0 (n=32)
42.00
[21]
3.11
[1.30]
3.16
[1.71]
3.25
[1.65]
3.16
[2.05]
3.00
[2.17]
15.5
[11]
3.67
[0.43]
3.00
[1.29]
3.75
[0.72]
4.00
[0.79]
4.00
[1.25]
0.001*
p-value
0.621**
0.298**
0.457**
0.437**
0.393**
0.235**
0.089**
0.062**
0.205**
0.078**
0.041**
0.0853**
Income Status
Low (n=19)
31
[-]
-
-
-
-
-
18
[9]
3.34
[0.80]
3.33
[0.54]
2.94
[0.84]
3.58
[1.25]
3.66
[1.42]
0.105*
Middle (n=161)
37
[14]
3.43
[0.57]
3.33
[1.42]
3.38
[1.25]
4.00
[1.16]
3.67
[0.84]
17
[17]
3.48
[0.70]
3.00
[1.17]
3.50
[1.00]
3.83
[1.00]
3.67
[1.33]
0.001*
High (n=20)
36
[11]
3.02
[1.22]
2.47
[1.29]
3.44
[1.38]
3.41
[1.96]
3.33
[1.66]
9.5
[10]
3.59
[0.77]
3.00
[0.46]
3.88
[0.91]
3.75
[2.17]
4.00
[1.92]
0.001*
p-value
0.338**
0.169**
0.337**
0.961**
0.128**
0.545**
0.065**
0.587**
0.369**
0.040**
0.634**
0.697**
Medical Disorder
No (n=156)
37
[14]
3.39
[0.52]
3.00
[1.67]
3.38
[0.87]
3.67
[0.83]
3.67
[1.33]
17
[10]
3.48
[0.79]
3.00
[1.09]
3.50
[1.07]
3.83
[1.09]
3.67
[1.33]
0.001*
Yes (n=44)
36
[14]
3.39
[0.96]
3.17
[0.50]
3.25
[1.63]
4.00
[0.83]
4.00
[2.0]
14
[11]
3.84
[0.59]
3.17
[1.25]
3.13
[1.25]
3.83
[0.83]
4.00
[1.00]
0.001*
p-value
0.446*
0.949*
0.775*
0.568*
0.924*
0.308*
0.073*
0.816*
0.184*
0.467*
0.844*
0.931*
Meal Skipped Status
No (n=43)
38
[23]
3.52
[0.83]
2.83
[2.0]
3.75
[0.87]
3.50
[1.33]
3.67
[1.0]
15
[14]
3.54
[0.81]
3.17
[1.25]
3.56
[1.16]
3.83
[0.83]
4.0
[1.34]
0.001*
Yes (n=157)
37
[13]
3.39
[0.52]
3.17
[1.0]
3.25
[0.88]
3.83
[0.83]
3.67
[1.66]
17
[10]
3.48
[0.75]
3.00
[1.0]
3.38
[1.13]
3.83
[1.04]
3.67
[1.33]
0.001*
p-value
0.124*
0.568*
0.590*
0.251*
0.568*
0.775*
0.338*
0.583*
0.564*
0.719*
0.936*
0.321*
Daily Water Intake (ml)
400  (n=13)
36.5
[-]
3.19
[-]
3.08
[-]
3.19
[-]
3.41
[-]
3.00
[-]
16
[8]
3.52
[0.31]
3.67
[1.17]
3.75
[0.75]
3.67
[1.83]
3.33
[1.34]
0.026*
401-1000 (n=54)
36
[4]
3.13
[0.61]
3.33
[1.34]
3.25
[1.38]
3.33
[1.33]
3.00
[1.33]
18
[9]
3.23
[0.74]
3.33
[1.00]
3.13
[1.00]
3.33
[1.00]
3.33
[1.00]
0.001*
1001-1800 (n=50)
41
[33]
3.50
[0.41]
3.33
[1.00]
3.31
[0.97]
3.91
[1.08]
3.50
[0.59]
17
[9]
3.48
[0.80]
3.00
[1.17]
3.38
[1.13]
3.83
[1.66]
4.00
[1.00]
0.001*
1801-2400 (n=51)
38
[20]
3.54
[0.80]
3.00
[1.17]
3.87
[1.03]
3.83
[1.08]
4.33
[2.42]
15
[12]
3.52
[0.61]
3.00
[0.83]
3.25
[1.07]
4.00
[0.84]
4.00
[1.50]
0.001*
2400  (n=32)
36
[17]
3.17
[0.35]
2.17
[0.67]
3.38
[0.94]
4.00
[0.50]
4.00
[0.67]
23
[12]
3.65
[0.92]
2.67
[1.00]
3.63
[1.00]
4.00
[2.00]
4.00
[1.00]
0.001*
p-value
0.457**
0.463**
0.141**
0.549**
0.920**
0.142**
0.099**
0.530**
0.012**
0.139**
0.197**
0.002**
Physical Activity
I don't do (n=81)
37.5
[16]
3.39
[1.00]
3.25
[0.75] a
3.25
[1.56]
3.25
[1.29]
3.16
[1.17]
16
[10]
3.48
[0.79]
3.17
[1.17]
3.50
[1.13]
3.83
[0.83]
3.67
[1.00]
0.001*
1-2/week (n=71)
37
[13]
3.52
[0.73]
3.33
[1.30] a
3.31
[1.28]
4.00
[0.79]
3.67
[1.50]
18
[10]
3.52
[0.80]
3.17
[0.92]
3.25
[1.31]
3.83
[1.34]
4.00
[1.50]
0.001*
3-4/week (n=30)
35
[18]
3.13
[0.23]
2.16
[1.13] b
3.38
[0.62]
3.41
[1.04]
3.83
[1.42]
17
[11]
3.61
[0.85]
2.75
[0.83]
3.62
[1.07]
3.91
[1.75]
4.00
[1.33]
0.001*
Every day (n=18)
36.5
[22]
3.30
[0.30]
2.08
[0.67] b
3.31
[0.66]
4.16
[0.95]
4.00
[0.50]
16.5
[14]
3.24
[0.49]
2.58
[0.83]
3.31
[0.63]
3.50
[1.13]
4.16
[1.17]
0.001*
p-value
0.846**
0.220**
0.008**
0.905**
0.285**
0.345**
0.743**
0.244**
0.001**
0.499**
0.378**
0.065**

BANÜ Sağlık Bilimleri ve Araştırmaları Dergisi 2023;5(2)
158
BANÜ Sağlık Bilimleri ve Araştırmaları Dergisi / BANU Journal of Health Science and Research ● 5(2) ● 2023
approach to improving overall health and well-
being, regardless of gender (Augustus-Horvath &
Tylka, 2011; Bilici, Kocaadam-Bozkurt, Mortaş,
Kucukerdonmez, & Koksal, 2018). We did not
find a significant correlation between BMI and
IES-2 and subdimensions. In our study, the
average BMI was in the normal range so this may
affect participants’ nutritional habits and food
preferences. Madden et al. stated that more
advanced research is needed to clearly understand
the relationship between intuitive eating and BMI
(Madden, Leong, Gray, & Horwath, 2012).
As another variable, considering education status,
significant differentiation was observed in the
sub-dimensions of unconditional consent to eat.
The Unconditional Permission to Eat (UPE) score
was higher in participants over 12 years. It is
important to emphasize the importance of
education on eating attitudes, in addition to formal
education, to promote healthy eating behaviors
and prevent disordered eating patterns. Education
on eating attitudes can include information on
nutrition and the importance of a balanced diet, as
well as strategies for listening to and responding
to hunger and fullness cues. This type of
education can be provided through a variety of
channels, such as community workshops, online
resources, or support groups. It is important to
ensure that this education is accessible to
individuals of all ages, genders, and
socioeconomic backgrounds. By promoting
education on eating attitudes, we can empower
individuals to make informed choices about their
eating behaviors and cultivate a positive
relationship with food and their bodies. This, in
turn, can lead to improved overall health and well-
being. The current data show that awareness of
intuitive eating has many benefits. Firstly, it was
stated that intuitive eating training has a long-term
effect on restoring physiological and
psychological state over conventional weight loss
aids (Gagnon-Girouard et al., 2010; Provencher et
al., 2009). The intuitive eating approach has a
holistic expansion in terms of promoting overall
health and well-being, beyond just nutrition. By
incorporating techniques that increase
interoceptive sensitivity (i.e., the ability to
recognize and respond to internal body signals
such as hunger and fullness), individuals are
better able to make informed choices about their
eating behaviors and improve their overall health
outcomes. In addition to reducing the risk of
malnutrition, the intuitive eating approach can
also improve physiological and psychological
outcomes, such as reducing stress and anxiety
related to food and body image. This, in turn, can
help prevent the onset of chronic diet-related
disorders such as obesity, diabetes, and
cardiovascular disease (Cadena-Schlam & López-
Guimerà, 2014). While studies had shown
intuitive eating had significant positive
associations with disordered eating (Lee, Madsen,
Williams, Browne, & Burke, 2022; Rodgers,
O'Flynn, Bourdeau, & Zimmerman, 2018), Bruce
et all. (Bruce Ricciardelli, 2016) had shown that
intuitive eating was inversely associated with
symptoms of eating disorders and was negatively
related to food occupation and binge eating
behaviors. We found a negative association
between IES-2 and EAT-40 scores. Differences
may be caused by cultural differences. For
instance, Akırmak et al. (Akırmak, Bakıner,
Boratav, & Güneri, 2021) recommended that
Turkish IES-2 total scores be computed without
the UPE items. Would like to clarify that the
statement "intuitive eating relates to eating
disorders" may not be accurate. Intuitive eating is
often seen as a potential treatment for disordered
eating patterns, as it promotes a more balanced
and positive relationship with food and the body.
I need, individuals who have a history of
disordered eating or are prone to eating disorders
may initially struggle with adopting intuitive
eating habits. This may be due to a variety of
factors, including a history of dieting, body image
concerns, or a lack of trust in their own hunger
and fullness cues. However, with guidance and
support, many individuals with a history of
disordered eating have been able to successfully
adopt intuitive eating habits and improve their
overall health and well-being. It is important to
note that intuitive eating is not a cure-all for eating
disorders and that individuals with severe or
chronic eating disorders may require specialized
treatment from a qualified healthcare
professional. In summary, while there may be
some initial challenges for individuals with a
history of disordered eating in adopting intuitive
eating habits, it is generally seen as a positive and
effective approach to promoting overall health
and well-being.
Integrating intuitive eating, physical activity
levels, and daily water consumption into one's
lifestyle constitutes vital elements of physical
self-care. Research suggests that individuals who
engage in regular physical exercise tend to exhibit
higher levels of total daily fluid intake and water
consumption (San Mauro Martín et al., 2019).

BANÜ Sağlık Bilimleri ve Araştırmaları Dergisi 2023;5(2)
159
BANÜ Sağlık Bilimleri ve Araştırmaları Dergisi / BANU Journal of Health Science and Research ● 5(2) ● 2023
Mindful eating, characterized by utilizing
physical and emotional senses to fully experience
and enjoy food choices, fosters an increased
awareness of hunger and fullness, consequently
promoting healthier eating habits. A structured
literature review conducted by Warren (2017)
revealed that mindfulness, mindful eating, and
intuitive eating interventions have the potential to
effectively modify eating behaviors and
encourage the adoption of healthy dietary
practices (Warren et al., 2017). Furthermore, our
study identified a significant association between
the subdimension of IES-2, specifically "Eating
for Physical Rather Than Emotional Reasons,"
and physical activity levels. Specifically, a higher
level of self-determined eating behavior was
positively correlated with a greater dose of
physical activity (Fernandes et al., 2023). These
findings contribute to the growing body of
academic knowledge, highlighting the importance
of incorporating mindful and intuitive eating
practices and engaging in regular physical activity
for promoting healthy eating behaviors and
overall well-being.
Strengths and limitations of the study
The statement effectively acknowledges both the
strengths and limitations of the study. It
recognizes that the predominance of female
participants may restrict the generalizability of the
findings, while also acknowledging that this
gender bias is common in studies on eating
behaviors and eating disorders. The omission of
24-hour dietary recall data is acknowledged as a
limitation, as it could have provided valuable
insights into participants' eating patterns and
nutritional intake. However, it clarifies that
intuitive eating and eating disorders cannot be
adequately assessed based solely on one day of
dietary data, emphasizing the need for a
comprehensive approach to understanding these
complex issues. Despite its limitations, the study
is acknowledged for contributing to the existing
literature on intuitive eating and its potential
benefits for individuals with a history of
disordered eating.
CONCLUSION
The present study focused exclusively on adults
between the ages of 25 and 55. However, future
research endeavours could encompass children
and adolescents to obtain a more comprehensive
understanding of the topic. Additionally,
conducting additional cross-sectional and
descriptive studies would be valuable in
establishing causal relationships between
intuitive eating behavior, eating attitudes, dieting,
and anthropometric measurements. Policymakers
could consider implementing holistic approaches,
such as psycho-diet programs, which incorporate
practices related to intuitive eating behavior and
eating attitudes. These initiatives have the
potential to mitigate overweight/obesity issues
and support sustainable weight management.
While the current study did not find any
significant effects of sex on the dependent
variables, it would be beneficial for future
investigations to explore different sample groups
to acquire comparable data and gain a deeper
understanding of potential sex-related influences.
It is crucial to acknowledge that the relationship
between intuitive eating and eating attitudes in
Turkey has not been extensively researched.
Therefore, the meaningful results obtained from
this study can contribute to the existing literature
and hold original value in advancing our
knowledge in this domain.
Ethics Committe Approval
Ethics committee approval was received for this study
from the Yeditepe University Ethics Committee (Date:
27.03.2020 and No: 1218)
Author Contributions
Idea/Concept: H.D., T.N.S.; Design: H.D., T.N.S.;
Supervision/Consultancy: H.D., T.N.S.; Analysis
and/or Interpretation: S.Ç., H.D., T.N.S.; Literature
Review: S.Ç., H.D., T.N.S.; Writing the Article: S.Ç.,
H.D., T.N.S.; Critical Review: S.Ç., H.D., T.N.S.
Peer-review
Externally peer-reviewed.
Conflict of Interest
The authors have no conflict of interest to declare.
Financial Disclosure
The authors declared that this study has received no
financial support.
Acknowledgments
We are grateful to Bayrampaşa Municipality Health
Affairs Directorate for Nutritional Counseling, where
the study was carried out, and finally thank the
participating parents who volunteered for the study.
REFERENCES
Akırmak, Ü., Bakıner, E., Boratav, H. B., Güneri, G.
(2021). Cross-cultural adaptation of the intuitive
eating scale-2: psychometric evaluation in a sample
in Turkey. Current Psychology, 40(3), 1083-1093.
doi: 10.1007/s12144-018-0024-3

BANÜ Sağlık Bilimleri ve Araştırmaları Dergisi 2023;5(2)
160
BANÜ Sağlık Bilimleri ve Araştırmaları Dergisi / BANU Journal of Health Science and Research ● 5(2) ● 2023
Augustus-Horvath, C. L., Tylka, T. L. (2011). The
acceptance model of intuitive eating: a comparison
of women in emerging adulthood, early adulthood,
and middle adulthood. Journal Of Counseling
Psychology, 58(1), 110-125. doi:
10.1037/a0022129
Barraclough, E. L., Hay-Smith, E. J. C., Boucher, S. E.,
Tylka, T. L., Horwath, C. C. (2019). Learning to eat
intuitively: A qualitative exploration of the
experience of mid-age women. Health Psychology
Open, 6(1), 2055102918824064.
doi:10.1177/2055102918824064
Bas, M., Karaca, K. E., Saglam, D., Arıtıcı, G., Cengiz,
E., Köksal, S., … Buyukkaragoz, A. H. (2017).
Turkish version of the Intuitive Eating Scale-2:
validity and reliability among university students.
Appetite, 114, 391-397. doi:
10.1016/j.appet.2017.04.017
Bilici, S., Kocaadam-Bozkurt, B., Mortaş, H.,
Kucukerdonmez, O., Koksal, E. (2018). Intuitive
eating in youth: Its relationship with nutritional
status. Revista de Nutrição, 31, 557-565. doi:
10.1590/1678-98652018000600005
Bray, G. A., Frühbeck, G., Ryan, D. H., Wilding, J. P.
H. (2016). Management of obesity. The Lancet,
387(10031), 1947-1956. doi: 10.1016/S0140-
6736(16)00271-3
Bruce, L. J., Ricciardelli, L. A. (2016). A systematic
review of the psychosocial correlates of intuitive
eating among adult women. Appetite, 96, 454-472.
doi: 10.1016/j.appet.2015.10.012
Brytek-Matera, A., Czepczor-Bernat, K., Jurzak, H.,
Kornacka, M., Kołodziejczyk, N. (2019). Strict
health-oriented eating patterns (orthorexic eating
behaviours) and their connection with a vegetarian
and vegan diet. Eating Weight Disords, 24(3), 441-
452. doi:10.1007/s40519-018-0563-5
Cadena-Schlam, L., López-Guimerà, G. (2014).
Intuitive eating: an emerging approach to eating
behavior. Nutrition Hospitalaria, 31(3), 995-1002.
doi: 10.3305/nh.2015.31.3.7980
Casadei, K., Kiel, J. (2022). Anthropometric
Measurement. In StatPearls. Treasure Island (FL):
StatPearls Publishing LLC.
Fernandes, V., Rodrigues, F., Jacinto, M., Teixeira, D.,
Cid, L., Antunes, R., . . . Monteiro, D. (2023). How
does the level of physical activity influence eating
behavior? a self-determination theory approach.
Life, 13(2), 298.
Gagnon-Girouard, M. P., Bégin, C., Provencher, V.,
Tremblay, A., Mongeau, L., Boivin, S., …
Lemieux, S. (2010). Psychological impact of a
"health-at-every-size" intervention on weight-
preoccupied overweight/obese women.
International Journal of Obesity, 2010.
doi:10.1155/2010/928097
Garner, D. M., Garfinkel, P. E. (1979). The Eating
Attitudes Test: an index of the symptoms of
anorexia nervosa. Psychological Medicine, 9(2),
273-279. doi:10.1017/s0033291700030762
Gast J, Campbell Nielson A, Hunt A, Leiker JJ.
Intuitive eating: associations with physical activity
motivation and BMI. American Journal of Health
Promotion. 2015 Jan-Feb;29(3):e91-9. doi:
10.4278/ajhp.130305-QUAN-97.
Hawks, S., Merrill, R. M., Madanat, H. N. (2004). The
Intuitive Eating Scale: Development and
Preliminary Validation. American Journal of
Health Education, 35(2), 90-99. doi:
10.1080/19325037.2004.10603615
Herbert, B. M., Blechert, J., Hautzinger, M., Matthias,
E., Herbert, C. (2013). Intuitive eating is associated
with interoceptive sensitivity. Effects on body mass
index. Appetite, 70, 22-30. doi:
10.1016/j.appet.2013.06.082
Horwath, C., Hagmann, D., and Hartmann, C. (2019).
Intuitive eating and food intake in men and women:
Results from the Swiss food panel study. Appetite,
135, 61-71.
Keirns, N. G., Hawkins, M. A. W. (2019). The
relationship between intuitive eating and body
image is moderated by measured body mass index.
Eating Behaviour, 33, 91-96. doi:
10.1016/j.eatbeh.2019.04.004
Lee, M. F., Madsen, J., Williams, S. L., Browne, M.,
Burke, K. J. (2022). Differential effects of intuitive
and disordered eating on physical and
psychological outcomes for women with young
children. Maternal And Child Health Journal,
26(2), 407-414. doi: 10.1007/s10995-021-03251-y
Madden, C. E. L., Leong, S. L., Gray, A., Horwath, C.
C. (2012). Eating in response to hunger and satiety
signals is related to BMI in a nationwide sample of
1601 mid-age New Zealand women. Public Health
Nutrition, 15(12), 2272-2279. doi:
10.1017/S1368980012000882
Özkan, N. and Bilici, S. (2021). Are anthropometric
measurements an indicator of intuitive and mindful
eating? Eating and Weight Disorders - Studies on
Anorexia, Bulimia and Obesity, 26.
doi:10.1007/s40519-020-00904-9
Park, E., Kim, W. H. (2022). A retrospective literature
review of eating disorder research: application of
bibliometrics and topical trends. International
Journal of Environmental Research and Public
Health, 19(13), 7710.
Provencher, V., Bégin, C., Tremblay, A., Mongeau, L.,
Corneau, L., Dodin, S., . . . Lemieux, S. (2009).
Health-At-Every-Size and eating behaviors: 1-year

BANÜ Sağlık Bilimleri ve Araştırmaları Dergisi 2023;5(2)
161
BANÜ Sağlık Bilimleri ve Araştırmaları Dergisi / BANU Journal of Health Science and Research ● 5(2) ● 2023
follow-up results of a size acceptance intervention.
Journal of American Dieteteics Association,
109(11), 1854-1861. doi:
10.1016/j.jada.2009.08.017
Reichenberger, J., Schnepper, R., Arend, A. K.,
Blechert, J. (2020). Emotional eating in healthy
individuals and patients with an eating disorder:
evidence from psychometric, experimental and
naturalistic studies. Proceedings of the Nutrition
Society, 79(3), 290-299. doi:
10.1017/s0029665120007004
Rodgers, R. F., O'Flynn, J. L., Bourdeau, A.,
Zimmerman, E. (2018). A biopsychosocial model
of body image, disordered eating, and breastfeeding
among postpartum women. Appetite, 126, 163-168.
doi: 10.1016/j.appet.2018.04.007
San Mauro Martín, I., Garicano Vilar, E., Romo
Orozco, D. A., Mendive Dubourdieu, P., Paredes
Barato, V., Rincón Barrado, M., . . . Garagarza, C.
(2019). Hydration status: influence of exercise and
diet quality. American Journal of Lifestyle
Medicine, 13(4), 414-423.
doi:10.1177/1559827617711906
Savaşır, I., Testi, E. (1989). Anoreksi Nervoza
belirtileri indeksi. Psikoloji Dergisi, 7(23), 19-25.
Tylka, T. L., Calogero, R. M., Daníelsdóttir, S. (2015).
Is intuitive eating the same as flexible dietary
control? Their links to each other and well-being
could provide an answer. Appetite, 95, 166-175.
doi: 10.1016/j.appet.2015.07.004
Tylka, T. L., Kroon Van Diest, A. M. (2013). The
Intuitive Eating Scale–2: Item refinement and
psychometric evaluation with college women and
men. Journal of Counseling Psychology, 60(1),
137.
Van Dyke, N., Drinkwater, E. J. (2014). Relationships
between intuitive eating and health indicators:
literature review. Public Health Nutrition, 17(8),
1757-1766. doi: 10.1017/s1368980013002139
van Strien, T., Herman, C. P., Verheijden, M. W.
(2014). Dietary restraint and body mass change. A
3-year follow up study in a representative Dutch
sample. Appetite, 76, 44-49. doi:
10.1016/j.appet.2014.01.015
Warren, N., Smith, M., Ashwell. (2017). A structured
literature review on the role of mindfulness,
mindful eating and intuitive eating in changing
eating behaviours: effectiveness and associated
potential mechanisms. Nutrition Research Reviews
30 (2) 272-283. doi: 10.1017/s0954422417000154