Intuitive eating predictors and outcomes in people with severe mental illness participating in a lifestyle intervention

Issue addressed: People with severe mental illness (SMI) are at higher risk of preventable diseases than the general population; poor diet contributes to heightened risk. Adaptive approaches designed to improve intuitive eating may improve dietary behaviours in people with SMI. Aims of this study were to investigate predictors of, and assess the impact of a nutrition program on, intuitive eating in people with SMI.

Methods: This was a retrospective analysis of an exercise and nutrition program for people with SMI. The primary outcome was intuitive eating assessed using the Intuitive Eating Scale 2 (IES2); psychological distress was measured using the Kessler-6 scale. Regression analyses were conducted on baseline data; change in intuitive eating was assessed using Wilcoxon tests.

Results: A total of 93 participants had complete data for regression analyses, and 32 completed pre/post-assessments. The most common mental health diagnosis was psychotic disorder (35%); 74% had BMI > 25 kg/m². The regression model significantly predicted total IES2 score and three intuitive eating domains. Body mass index (BMI) was negatively associated with these outcomes (β = -0.234 to -0.248; p < 0.05). Both BMI and psychological distress were negatively associated with body-food choice congruence (B-FCC), and only B-FCC was improved at post-intervention.

Conclusions: Higher BMI and psychological distress were associated with lower intuitive eating in people with SMI. Nutrition interventions may improve B-FCC in people with SMI. SO WHAT?: Given the interrelatedness of BMI and psychological distress with psychosocial stressors, nutritional interventions should be implemented alongside holistic approaches to improve health equality.