Tracy L. Tylka, Ph.D., FAED ohio state university Rachel M. Calogero, Ph.D., FAED Western University Janell L. Mensinger, Ph.D., FAED Drexel University Higher BMI, Lower Intuitive Eating: Could Weight Stigma Explain this Association?

I, Tracy Tylka, have no commercial relationships to disclose. I, Rachel Calogero, have no commercial relationships to disclose. I, Janell Mensinger, have no commercial relationships to disclose.

What is Intuitive Eating? Listening to, trusting, and largely relying on internal hunger and satiety cues Using these cues to determine when, what, and how much to eat Flexible (not rigid adherence) Innate (but can be masked) Positively linked to well-being Inversely linked to psychological distress

Intuitive eating is consistently linked to lower BMI Study Intuitive Eating Tylka et al. (2015) -.40*** / -.28*** Tylka & Kroon Van Diest (2013) -.27*** / -.31*** Horwath et al. (2019) -.34*** / -.30*** Herbert et al. (2013) -.29*** / xxx Schoenefeld & Webb (2013) -.27*** / xxx Augustus-Horvath & Tylka (2011) -.34*** / xxx Note. Women’s correlations / Men’s correlations.

Further support of the inverse link between intuitive eating and BMI: Denny et al. (2013); young adults (1257 women, 1030 men) from the U.S. part of Project EAT (3rd wave) Madden et al. (2012); 1601 middle-age New Zealand women Camilleri et al. (2016); 11,774 men and 40,389 women in the French Nutri-Net-Santé study

Camilleri et al. (2016) suggest that higher IE predicts lower BMI over time. Accurate? Evidence suggests that intuitive eating is linked to weight stability rather than weight loss. (e.g., Bacon et al., 2002, 2005; Mensinger, Calogero, & Tylka, 2016; Tylka, Calogero, & Danielsdottir, 2019)

An Alternative Interpretation: What if higher BMI predicts lower intuitive eating over time? ….and this connection is due to encounters with weight stigma?

Present Study

Purpose To determine whether weight stigma mediates the association between BMI and intuitive eating among women and men. Weight stigma in the forms of: pressure to be thin (lean) lack of body acceptance by others

Hypotheses H1: There will be an inverse association between BMI and intuitive eating for both women and men. H2: This association will be mediated by sociocultural pressures to be thin (lean) and lack of body acceptance by others. Exploratory: gender differences?

Body Acceptance by Others Pressure to be Thin (Lean) BMI Intuitive Eating Body Acceptance by Others Hypothesized Model

Method Participants and Procedure College women (n = 305) and men (n = 364) Mean age of 20.62 (SD = 5.47) Predominantly White (85%) Completed measures online Received course credit

Measures Self-reported height and weight to calculate BMI Intuitive Eating Scale-2 (IES-2; Tylka & Kroon Van Diest, 2013). α = .89 Perceived Sociocultural Pressures Scale (PSPS; Stice, Ziemba, Margolis, & Flick, 1996). α = .85 Body Acceptance by Others Scale (BAOS; Avalos & Tylka, 2006). α = .91

Perceived Sociocultural Pressures Scale “I feel pressure from to lose weight” “I feel pressure from to have a thin (or lean) body” Complete these 2 items for: Family Friends Dating Partners Media

Body Acceptance by Others Scale “I’ve felt acceptance from regarding my body shape and/or weight” “ has sent me the message that my body shape and/or weight are fine” Complete these 2 items for: Family Friends Dating partners Media Society

Results H1: Supported There was an inverse association between BMI and intuitive eating. Women r = -.38, p < .001 Men r = -.28, p < .001

H2: Supported Both pressure to be thin (lean) and body acceptance by others mediated this link. Indirect effects: Pressure to be thin (lean): β = -.066 b = -.006 (90%CI = -.011, -.003) Body acceptance by others: β = -.098 b = -.010 (90%CI = -.015, -.005)

Body Acceptance by Others Pressure to be Thin (Lean) -.24*** .27*** BMI -.11* Intuitive Eating Body Acceptance by Others -.40*** .25*** Figure 1. Standardized path values shown.

Exploratory Analyses: Gender differences? Women: Both pressure to be thin and body acceptance by others mediated the association between BMI and intuitive eating. Men: Only body acceptance by others mediated the association between BMI and intuitive eating.

Body Acceptance by Others Pressure to be Thin / Lean .39*** / .13* -.38*** / -.24*** BMI -.13* / -.18*** Intuitive Eating Body Acceptance by Others -.47*** / -.36*** .20*** / .18*** Figure 1. Women’s path values / Men’s path values (standardized).

Discussion BMI and intuitive eating are connected due to weight stigma. Weight stigma in the forms of pressures to be thin and lack of body acceptance by others are relevant for women. Weight stigma in the form of lack of body acceptance by others is relevant for men.

Implications Those with lower BMI are more likely to be “left alone” in terms of changing their weight, which allows them to remain connected to their internal hunger and satiety cues (i.e., intuitively eat). Those with higher BMI are likely pressured to be thin and not granted body acceptance, which may direct them away from listening to and trusting their bodies’ internal hunger and satiety cues.

Limitations  Future Research Cross-sectional study; causal conclusions cannot be made. Prospective studies are needed. College student convenience sample. Sampling diverse community samples (in terms of age, race, sexual orientation, gender identity, SES, etc.) is needed. Alternative forms of weight stigma, and internalized weight stigma, should be considered.

Conclusions Lower BMI represents a privilege that maintains individuals’ connection to, trust in, and reliance on their internal hunger and satiety cues to determine when, what, and how much to eat. Findings illustrate an additional way that weight stigma is detrimental and how it may disrupt connection to the body.

For slides, go to my website: https://u.osu.edu/tracyltylka/ Thank you! For slides, go to my website: https://u.osu.edu/tracyltylka/