A Current Approach to Body Weight Control: Intuitive Eating

Yıl 2024, Cilt: 13 Sayı: 2, 974 - 983, 29.06.2024

Gökçe Sueda Aydoğdu , Gamze Akbulut

https://doi.org/10.37989/gumussagbil.1367380

Öz

The prevalence of obesity is increasing worldwide and many different treatment approaches for obesity have been proposed. One of these important approaches is "Intuitive Eating" which rejects the diet mentality and emphasizes nutrition according to the individual's physiological hunger and satiety signals. Obesogenic environment of individuals, and external cues may lead to obesity by decreasing intuitive eating behavior. Therefore, increasing the awareness of intuitive eating may be protective against obesity. There is a negative relationship between intuitive eating and body mass index. However, clinical studies have found that intuitive eating intervention is more effective in maintaining body weight rather than body weight loss. Moreover, relying on hunger and satiety signals and unconditional permission to eat, which are sub-dimensions of intuitive eating, have been associated with individuals' tendency towards unhealthy foods. Even if the obese individual can be directed to internal hunger and satiety signals with the intuitive eating intervention, the changes in hunger-satiety hormones that occur with obesity and the disruption of the balance between the homeostatic and hedonic systems may cause a decrease in the effectiveness of the intuitive eating intervention in body weight loss. In addition, changes in hunger and satiety signaling may differ according to the degree of obesity of the individual, which may change the effectiveness of the intuitive eating intervention. In this direction, more clinical studies are needed to evaluate whether intuitive eating can be used as a treatment approach, in which individuals with large sample sizes and different degrees of obesity are evaluated.

Anahtar Kelimeler

Hunger-satiety hormones, Obesity, Intuitive eating, Body weight

Vücut Ağırlığı Denetiminde Güncel Bir Yaklaşım: Sezgisel Yeme

Öz

Obezite prevalansı dünya çapında giderek artmaktadır ve obeziteye yönelik birçok farklı tedavi yaklaşımı ileri sürülmüştür. Diyet zihniyetini reddeden, bireyin fizyolojik açlık ve tokluk sinyallerine göre beslenmesini vurgulayan “Sezgisel Yeme” bu önemli yaklaşımlardan bir tanesidir. Bireylerin bulundukları obezojenik çevre, dışsal ipuçları sezgisel yeme davranışının azalmasına neden olarak obeziteye yol açabilir. Bu nedenle bireylerin sezgisel yeme farkındalığının artırılması obeziteye karşı koruyucu olabilir. Sezgisel yeme durumu ile beden kütle indeksi arasında negatif bir ilişki bulunmaktadır. Ancak yapılan klinik çalışmalarda sezgisel yeme müdahalesinin vücut ağırlığı kaybından daha çok vücut ağırlığının korunmasında daha etkin olduğunu bulunmuştur. Bununla birlikte sezgisel yemenin alt boyutu olan açlık ve tokluk sinyallerine güvenme ve koşulsuz yeme izni bireylerin sağlıksız besinlere yönelmesiyle ilişkilendirilmiştir. Sezgisel yeme müdahalesiyle birlikte obez bireyin içsel açlık ve tokluk sinyallerine yönelmesi sağlanabilse bile obezite ile birlikte ortaya çıkan açlık-tokluk hormonlarındaki değişiklikler ve homeostatik ve hedonik sistemler arasındaki dengenin bozulması vücut ağırlığı kaybında sezgisel yeme müdahalesinin etkinliğinin azalmasına sebep olabilir. Ek olarak bireyin obezite derecesine göre açlık tokluk sinyallerindeki değişiklikler farklılık gösterebilir bu da sezgisel yeme müdahalesinin etkinliğini değiştirebilir. Bu doğrultuda sezgisel yemenin tedavi yaklaşımı olarak kullanılıp kullanılamayacağına yönelik örneklem sayısı fazla, farklı obezite derecelerine sahip bireylerin değerlendirildiği daha fazla klinik çalışma yapılmasına ihtiyaç vardır.

Anahtar Kelimeler

Açlık-tokluk hormonları, Obezite, Sezgisel yeme, Vücut ağırlığı

Kaynakça

• 1. İnternet: WHO. “Obesity”. Erişim adresi: https://wwwwhoint/health-topics/obesity#tab=tab_1 (Erişim Tarihi: 30.05.2023)
• 2. Russell, S.J. and Kahn, C.R. (2007). “Endocrine Regulation of Ageing”. Nature Reviews Molecular Cell Biology, 8 (9), 681-691.
• 3. Sandalcı, U. ve Tuncer, G. (2020). “Obezitenin Doğrudan ve Dolaylı Maliyetlerine İlişkin Bir Değerlendirme”. Aksaray Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi, 12 (2), 29-44.
• 4. González-Muniesa, P, Mártinez-González, M.A, Hu, F.B, Després, J.P, Matsuzawa, Y, Loos, R.J. and Martinez, J.A. (2017). “Obesity (Primer)”. Nature Reviews: Disease Primers, 3 (1), 1-18. https://doi.org/10.1038/nrdp.2017.34
• 5. Hall, K.D. and Kahan, S. (2018). “Maintenance of Lost Weight and Long-Term Management of Obesity”. Medical Clinics, 102 (1), 183-197.
• 6. Cadena-Schlam, L. and López-Guimerà, G. (2015). “Intuitive Eating: an Emerging Approach to Eating Behavior”. Nutrición Hospitalaria, 31 (3), 995-1002. https://doi.org/10.3305/nh.2015.31.3.7980
• 7. Tylka, T.L. (2006). “Development and Psychometric Evaluation of a Measure of İntuitive Eating”. Journal of Counseling Psychology, 53 (2), 226. https://psycnet.apa.org/doi/10.1037/0022-0167.53.2.226
• 8. Van Diest, A.M. and Tylka, T.L. (2010). “The Caregiver Eating Messages Scale: Development and Psychometric İnvestigation”. Body Image, 7 (4), 317-326. https://doi.org/10.1016/j.bodyim.2010.06.002
• 9. Badman, M.K. and Flier, J.S. (2005). “The Gut and Energy Balance: Visceral Allies İn The Obesity Wars”. Science, 307 (5717), 1909-1914. https://doi.org/10.1126/science.1109951
• 10. Cui, H, López, M. and Rahmouni, K. (2017). “The Cellular And Molecular Bases Of Leptin And Ghrelin Resistance İn Obesity”. Nature Reviews Endocrinology, 13 (6), 338-351. https://doi.org/10.1038/nrendo.2016.222
• 11. Gast, J, Nielson, A.C, Hunt, A. and Leiker, J.J. (2015). “Intuitive Eating: Associations with Physical Activity Motivation and BMI”. American Journal of Health Promotion, 29 (3), e91-e99. https://doi.org/10.4278/ajhp.130305-QUAN-97
• 12. Tribole, E. and Resch, E. (1995). “Intuitive Eating: a Recovery Book for The Chronic Dieter: Rediscover The Pleasures of Eating and Rebuild Your Body İmage”.
• 13. Linardon, J, Tylka, T.L. and Fuller‐Tyszkiewicz, M. (2021). “Intuitive Eating and İts Psychological Correlates: a Meta‐Analysis. International Journal of Eating Disorders”. 54 (7), 1073-1098. https://doi.org/10.1002/eat.23509
• 14. Tylka, T.L. and 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. https://psycnet.apa.org/doi/10.1037/a0030893
• 15. Li, Y. (2018). “Using a Non-Diet Approach to Prevent Overweight and Obesity Among 6 Th To 8 Th Grade Youth İn a Low-İncome Racial/Ethnic Community İn Kansas”. Kansas State University.
• 16. Tribole, E. and Resch, E. (2017). “The İntuitive Eating Workbook: Ten Principles for Nourishing a Healthy Relationship With Food”. New Harbinger Publications.
• 17. Gibson‐Moore, H. (2009). “Satiation, Satiety and Their Effects On Eating Behaviour”. Nutrition Bulletin, 34 (4), 412-416. https://doi.org/10.1111/j.1467-3010.2009.01777.x
• 18. Benelam, B. (2009). “Satiation, Satiety and Their Effects on Eating Behaviour”. Nutrition Bulletin, 34 (2), 126-173. https://doi.org/10.1111/j.1467-3010.2009.01753.x
• 19. Hawks, S, Merrill, R.M. and Madanat, H.N. (2004). “The İntuitive Eating Scale: Development and Preliminary Validation”. American Journal of Health Education, 35 (2), 90-99. https://doi.org/10.1080/19325037.2004.10603615
• 20. Hensley-Hackett, K, Bosker, J, Keefe, A, Reidlinger, D, Warner, M, D’Arcy, A. and Utter, J. (2022). “Intuitive Eating Intervention and Diet Quality in Adults: A Systematic Literature Review”. Journal of Nutrition Education and Behavior. 54 (12), 1099-1115. https://doi.org/10.1016/j.jneb.2022.08.008
• 21. Carbonneau, E, Bégin, C, Lemieux, S, Mongeau, L, Paquette, M.C, Turcotte, M. ... and Provencher, V. (2017). “A Health at Every Size İntervention İmproves İntuitive Eating and Diet Quality in Canadian Women”. Clinical Nutrition, 36 (3), 747-754. https://doi.org/10.1016/j.clnu.2016.06.008
• 22. Christoph, M.J, Hazzard, V.M, Järvelä-Reijonen, E, Hooper, L, Larson, N. and Neumark-Sztainer, D. (2021). “Intuitive Eating is Associated with Higher Fruit and Vegetable İntake Among Adults”. Journal of Nutrition Education and Behavior, 53 (3), 240-245. https://doi.org/10.1016/j.jneb.2020.11.015
• 23. Barad, A, Cartledge, A, Gemmill, K, Misner, N.M, Santiago, C.E, Yavelow, M. and Langkamp-Henken, B. (2019). “Associations Between İntuitive Eating Behaviors and Fruit and Vegetable İntake Among College Students”. Journal of Nutrition Education and Behavior, 51 (6), 758-762. https://doi.org/10.1016/j.jneb.2019.03.010
• 24. Małachowska, A. and Jeżewska-Zychowicz, M. (2022). “Polish Adaptation and Validation of The Intuitive (IES-2) and Mindful (MES) Eating Scales-The Relationship of The Concepts with Healthy and Unhealthy Food İntake (A Cross-Sectional Study)”. Nutrients, 14 (5), 1109. https://doi.org/10.3390/nu14051109
• 25. Camilleri, G.M, Méjean, C, Bellisle, F, Andreeva, V.A, Kesse-Guyot, E, Hercberg, S. and Péneau, S. (2017). “Intuitive Eating Dimensions were Differently Associated with Food İntake in The General Population–Based Nutrinet-Santé Study”. The Journal of Nutrition, 147 (1), 61-69. https://doi.org/10.3945/jn.116.234088
• 26. Hagan, S. and Niswender, K.D. (2012). “Neuroendocrine Regulation of Food İntake”. Pediatric Blood & Cancer, 58 (1), 149-153. https://doi.org/10.1002/pbc.23376
• 27. Weltens, N, Zhao, D. and Van Oudenhove, L. (2014). “Where İs The Comfort İn Comfort Foods? Mechanisms Linking Fat Signaling, Reward, and Emotion”. Neurogastroenterology & Motility, 26 (3), 303-315. https://doi.org/10.1111/nmo.12309
• 28. Suzuki, K, Jayasena, C.N. and Bloom, S.R. (2012). “Obesity and Appetite Control”. Journal of Diabetes Research, 2012. https://doi.org/10.1155/2012/824305
• 29. Aukan, M.I, Nymo, S, Ollestad, K.H, Boyesen, G.A, DeBenedictis, J.N, Rehfeld, J.F, ... and Martins, C. (2022). “Differences in Gastrointestinal Hormones and Appetite Ratings Among Obesity Classes”. Appetite, 171, 105940. https://doi.org/10.1016/j.appet.2022.105940
• 30. Aukan, M.I, Coutinho, S, Pedersen, S.A, Simpson, M.R. and Martins, C. (2023). “Differences in Gastrointestinal Hormones and Appetite Ratings Between İndividuals With and Without Obesity-A Systematic Review and Meta‐Analysis”. Obesity Reviews, 24 (2), e13531. https://doi.org/10.1111/obr.13531
• 31. Ahmed, B, Sultana, R. and Greene, M.W. (2021). “Adipose Tissue and İnsulin Resistance in Obese”. Biomedicine & Pharmacotherapy, 137, 111315. https://doi.org/10.1016/j.biopha.2021.111315
• 32. Obradovic, M, Sudar-Milovanovic, E, Soskic, S, Essack, M, Arya, S, Stewart, A.J. ... and Isenovic, E.R. (2021). “Leptin And Obesity: Role and Clinical İmplication”. Frontiers in Endocrinology, 12, 585887. https://doi.org/10.3389/fendo.2021.585887
• 33. Bogdanov, V.B, Bogdanova, O.V, Dexpert, S, Delgado, I, Beyer, H, Aubert, A. ... and Capuron, L. (2020). “Reward-Related Brain Activity and Behavior are Associated with Peripheral Ghrelin Levels in Obesity”. Psychoneuroendocrinology, 112, 104520.
• 34. Zigman, J.M, Bouret, S.G. and Andrews, Z.B. (2016). “Obesity İmpairs The Action of The Neuroendocrine Ghrelin System”. Trends in Endocrinology & Metabolism, 27 (1), 54-63. https://doi.org/10.1016/j.tem.2015.09.010
• 35. Fittipaldi, A.S, Hernández, J, Castrogiovanni, D, Lufrano, D, De Francesco, P.N, Garrido, V. ... and Perello, M. (2020). “Plasma Levels of Ghrelin, Des-Acyl Ghrelin and LEAP2 in Children with Obesity: Correlation with Age and İnsulin Resistance”. European Journal of Endocrinology, 182 (2), 165-175. https://doi.org/10.1530/eje-19-0684
• 36. Berthoud, H.R. (2011). “Metabolic and Hedonic Drives in The Neural Control of Appetite: Who İs The Boss?”. Current Opinion in Neurobiology, 21 (6), 888-896. https://doi.org/10.1016/j.conb.2011.09.004
• 37. Cushing, C.C, Benoit, S.C, Peugh, J.L, Reiter-Purtill, J, Inge, T. H, and Zeller, M.H. (2014). “Longitudinal Trends in Hedonic Hunger after Roux-En-Y Gastric Bypass in Adolescents”. Surgery For Obesity and Related Diseases, 10 (1), 125-130. https://doi.org/10.1016/j.soard.2013.05.009
• 38. Egecioglu, E, Skibicka, K.P, Hansson, C, Alvarez-Crespo, M, Friberg, P.A, Jerlhag, E, ... and Dickson, S.L. (2011). “Hedonic and İncentive Signals for Body Weight Control”. Reviews in Endocrine and Metabolic Disorders, 12, 141-151. https://doi.org/10.1007/s11154-011-9166-4
• 39. Schultes, B, Ernst, B, Wilms, B, Thurnheer, M. and Hallschmid, M. (2010). “Hedonic Hunger is İncreased in Severely Obese Patients and is Reduced After Gastric Bypass Surgery”. The American Journal of Clinical Nutrition, 92 (2), 277-283. https://doi.org/10.3945/ajcn.2009.29007
• 40. Ullrich, J, Ernst, B, Wilms, B, Thurnheer, M, Hallschmid, M. and Schultes, B. (2013). “The Hedonic Drive to Consume Palatable Foods Appears to be Lower in Gastric Band Carriers Than in Severely Obese Patients Who Have Not Undergone a Bariatric Surgery". Obesity Surgery, 23, 474-479. https://doi.org/10.1007/s11695-012-0818-6
• 41. Aydoğdu, G.S, ve Köksal, E. (2021). “Hedonik Açlık ve Makro Besin Öğeleri ile İlişkisi”. Gazi Sağlık Bilimleri Dergisi, 7 (1), 154-163. https://doi.org/10.52881/gsbdergi.958923
• 42. Coutinho, S.R, Halset, E.H, Gåsbakk, S, Rehfeld, J.F, Kulseng, B, Truby, H. and Martins, C. (2018). “Compensatory Mechanisms Activated With İntermittent Energy Restriction: a Randomized Control Trial”. Clinical Nutrition, 37 (3), 815-823. https://doi.org/10.1016/j.clnu.2017.04.002
• 43. Ayyıldız, F, Akbulut, G, Ermumcu, M.Ş.K. and Tek, N.A. (2023). “Emotional and İntuitive Eating: an Emerging Approach to Eating Behaviours Related to Obesity”. Journal of Nutritional Science, 12, e19. https://doi.org/10.1017/jns.2023.11
• 44. Horwath, C, Hagmann, D. and Hartmann, C. (2019). “Intuitive Eating and Food İntake in Men and Women: Results From The Swiss Food Panel Study”. Appetite, 135, 61-71. https://doi.org/10.1016/j.appet.2018.12.036
• 45. Robinson, E, Marty, L, Higgs, S. and Jones, A. (2021). “Interoception, eating behaviour and body weight”. Physiology & behavior, 237, 113434. https://doi.org/10.1016/j.physbeh.2021.113434
• 46. Nogué, M, Nogué, E, Molinari, N, Macioce, V, Avignon, A. and Sultan, A. (2019). “Intuitive Eating is Associated with Weight Loss After Bariatric Surgery in Women”. The American Journal of Clinical Nutrition, 110 (1), 10-15. https://doi.org/10.1093/ajcn/nqz046
• 47. Camilleri, G.M, Méjean, C, Bellisle, F, Andreeva, V.A, Kesse‐Guyot, E, Hercberg, S. and Péneau, S. (2016). “Intuitive Eating is İnversely Associated with Body Weight Status in The General Population‐Based Nutrinet‐Santé Study”. Obesity, 24 (5), 1154-1161. https://doi.org/10.1002/oby.21440
• 48. Özkan, N. and Bilici, S. (2021). “Are Anthropometric Measurements an İndicator of İntuitive and Mindful Eating?”. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 26, 639-648.
• 49. Romano, K.A, Swanbrow Becker, M.A, Colgary, C.D. and Magnuson, A. (2018). “Helpful or Harmful? The Comparative Value of Self-Weighing and Calorie Counting versus İntuitive Eating on The Eating Disorder Symptomology of College Students”. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 23, 841-848. https://doi.org/10.1007/s40519-018-0562-6
• 50. Ruzanska, U.A. and Warschburger, P. (2017). “Psychometric Evaluation of the German Version of the Intuitive Eating Scale-2 in a Community Sample”. Appetite, 117, 126-134. https://doi.org/10.1016/j.appet.2017.06.018
• 51. Caferoglu, Z. and Toklu, H. (2022). “Intuitive Eating: Associations with Body Weight Status and Eating Attitudes in Dietetic Majors”. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 27 (2), 683-692. https://doi.org/10.1007/s40519-021-01206-4
• 52. Teas, E, Kimiecik, J, Ward, R.M, and Timmerman, K. (2022). “Intuitive Eating and Biomarkers Related to Cardiovascular Disease in Older Adults”. Journal of Nutrition Education and Behavior, 54 (5), 412-421. https://doi.org/10.1016/j.jneb.2022.01.010
• 53. Van Dyke, N. and Drinkwater, E.J. (2014). “Review Article Relationships Between İntuitive Eating and Health İndicators: Literature Review”. Public Health Nutrition, 17 (8), 1757-1766. https://doi.org/10.1017/S1368980013002139
• 54. Campos, M.B, Menezes, I.H.C.F, Peixoto, M.D.R.G. and Schincaglia, R.M. (2022). “Intuitive Eating in General Aspects Of Eating Behaviors in İndividuals With Obesity: Randomized Clinical Trial”. Clinical Nutrition ESPEN, 50, 24-32. https://doi.org/10.1016/j.clnesp.2022.06.002
• 55. Anglin, J.C, Borchardt, N, Ramos, E. and Mhoon, K. (2013). “Diet Quality of Adults Using İntuitive Eating for Weight Loss–Pilot Study”. Nutrition and Health, 22 (3-4), 255-264. https://doi.org/10.1177/0260106015601943
• 56. Cloutier-Bergeron, A, Provencher, V, Mongeau, L, Paquette, M.C, Carbonneau, É, Turcotte, M. and Bégin, C. (2019). “Does Health At Every Size® Fit All? A Group-Based Trajectory Modeling of a Non-Diet İntervention”. Appetite, 143, 104403. https://doi.org/10.1016/j.appet.2019.104403
• 57. Bacon, L, Stern, J.S, Van Loan, M.D. and Keim, N.L. (2005). “Size Acceptance And İntuitive Eating İmprove Health for Obese, Female Chronic Dieters”. Journal of the American Dietetic Association, 105 (6), 929-936. https://doi.org/10.1016/j.jada.2005.03.011