LAUSR

For a subset of dieters, the pursuit of thinness may be harmful. In contrast, eating competence is associated with positive physical and mental health outcomes. This single-arm, pilot intervention study evaluated changes in eating competence and symptoms of eating disorders among previous dieters employed in a metropolitan hospital system who participated in the How to Eat program. Participants were adult employees of the hospital system who self-identified as previous dieters, and voluntarily enrolled in How to Eat on a rolling basis over a six-year period during employee health promotion offerings. How to Eat, offered weekly in a group setting over 10 sessions, is grounded in the validated Eating Competence model, and measured by the ecSI 2.0™, which defines eating competence as comprised of four domains: 1) eating attitudes; 2) food acceptance; 3) food management/contextual skills; and 4) internal regulation of eating based on hunger, appetite and satisfaction. A total score on the ecSI 2.0™ of at least 32 (of 48 possible) indicates eating competence. Symptoms of eating disorders were evaluated with the Eating Attitudes Test-26 (EAT-26). Paired t-Tests and Wilcoxon signed-rank tests were used for analyses. 43 adults participated, averaged 47.5 years (SD = 10.7), 210 lbs. (SD = 30.9), and were primarily female (95.3%) and white (90.7%). From pre- to post-program, How to Eat was associated with significant changes in scores on the total ecSI 2.0™ (t(42) = 12.20, P < 0.001), each of its subscales, and the EAT-26 (t(42) = 6.53, P < 0.001). Pre-program, the mean ecSI 2.0™ total score was 22.8 (SD = 6.5) and 9.3% (N = 4) of participants were considered eating competent. Post-program, the mean ecSI 2.0™ total score was 34.3 (SD = 4.9) and 100% (N = 43) of participants were classified as eating competent. Mean EAT-26 total scores decreased from 10.7 (SD = 8.1) to 3.7 (SD = 2.9). Body weight was not significantly influenced by the intervention (t(21) = 0.314, P = 0.757). How to Eat may be associated with improvements in measures of eating competence and eating disorder symptoms among previous dieters participating in an employee health program despite no significant change in body weight. Experimental research is needed to evaluate the efficacy and additional health-related outcomes of How to Eat among diverse populations and other settings. None.