“Effectiveness of Text Messaging Intervention on Intuitive Eating

Abstract

Intuitive eating (IE) is a concept based on mind-body integration of instinct, emotion and rationale thought, to improve eating behaviors and benefit physical and mental health. Several attempts were developed to teach IE principles such as structured face-to-face interviews, web-based interventions as well as text messaging interventions, being easy to implement and low-cost. Despite that, studies assessing the short and long-term effectiveness of active text messaging intervention on IE while correcting for stress and self-compassion are minimal. The present study aimed to assess the effectiveness of a five-week text-message-based IE intervention on IE, while correcting for self-compassion and perceived stress level, and to examine the serial mediation model; linking self-compassion with IE via perceived stress and BMI. An online-randomized control trial design was used. Adults (n=195) were randomized into one of three groups: the Active intuitive eating (IE) group receiving IE-related messages with a practice exercise, the Passive IE group receiving only IE related messages and the control group receiving general health-related tips. Ten messages were delivered over five weeks. Two follow-ups were made, one directly post-intervention and another one five weeks later. The baseline data and follow-ups included demographic and nutrition-related variables and measures of IE, self-compassion and perceived stress. In total, 177 subjects completed the study. Results indicated a significant improvement in IE scores in the two intervention groups, with the passive IE group showing the most improvement. In addition, a significant improvement in self-compassion and reduction in perceived stress were observed in the active IE group. There was no significant change in BMI post-intervention. A significant positive correlation was detected between IE and self-compassion, and significant negative correlations were observed between IE, perceived stress and BMI at all assessment points. Finally, self-compassion was the strongest predictor of IE at follow-up. The present study revealed that text-messaging interventions might be efficient and cost-effective in enhancing IE. The results shed light on the need for further large-scale interventions that use visual aids and provide practical guidance to teach IE, while further characterizing the relation between IE, self-compassion, stress and BMI.