Intervention based on the intuitive eating technique under nutritional counseling: metabolic and behavioral responses in overweight and obese adults

Overweight and obesity are health problems all over the world, and conventional treatment based on restrictive diets has been ineffective in the long term. Strategies that use the assessment of feelings of hunger and satiety to guide eating have been effective in promoting health. The objective of the research was to evaluate the effects of an intervention based on eating guided by nutritional counseling on behavioral, physical and metabolic responses in overweight and obese adults. A pilot study of a randomized clinical trial with pre (T0) and post-test (T1) was carried out. The sample consisted of 18 women and 3 men with a BMI >25 kg/m2, between 24 and 55 years old, randomized into two groups: control (n=11; nutritional counseling) and intuitive eating (n=10; nutritional counseling + intuitive eating) - the closed group format followed. The sample was homogeneous for age, BMI and sociodemographic characteristics. The Dutch Eating Behavior Questionnaire (DEBQ), Intuitive Eating Scale (IES-2), Depression, Anxiety and Stress Scale (DASS-21), Satisfaction with Life Scale (SWLS), International Physical Activity Questionnaire (IPAQ) and the 3-day food diary. Anthropometric and laboratory evaluations were performed to analyze the anthropometric and metabolic profile before and after the intervention. The intervention consisted of 8 weekly sessions in remote and synchronous format, lasting a maximum of 1 hour and a half. There were 9 weeks of intervention and 3 weeks of follow-up, totaling 14 weeks. There were no significant intergroup differences in eating styles, subscales, and total intuitive eating scores. Intragroup variations were similar, with a reduction in emotional (control=19.5%; intuitive eating=10.9%) and external (control=17.7%; intuitive eating=12%) eating styles. The control group increased the frequency of restrictive eating behavior by 27% and reduced the score on the “unconditional permission to eat” subscale by 9.4 %. However, both groups showed an increase in the level of intuitive eating, showing that the interventions had similar effects on eating behavior. Inverse and significant associations were observed between the emotional style and the subscale “eating for physical and non-emotional reasons”, and between these and the psychological variables, evidencing the relationship with emotional eating. The dietary assessment showed a 10% reduction in the consumption of ultra-processed foods in both groups. There was no significant effect of the interventions on measures of weight, BMI, waist and hip circumferences (between 0.5% and 1.9%), and physical activity level, with modest and similar differences between groups. However, there was a significant effect on blood glucose reduction (P=0.004) through both interventions. C-reactive protein had no significant reduction and was similar between groups (~35 %). Both showed a modest reduction in HDL. The intuitive eating group had a concomitant reduction in triglycerides and VLDL, while the control group increased VLDL values by 17.7%. It is concluded that both interventions showed benefits to participants with overweight or obesity in behavioral, anthropometric and metabolic responses. Due to the complexity and multifactorial nature of obesity, more research is needed to clarify the effectiveness of intuitive eating in the treatment of obesity and its possible associations with other behavioral and metabolic variables.