Public Health Nutrition

Nutrition and health

Eating in response to hunger and satiety signals is related to BMI in a nationwide sample of 1601 mid-age New Zealand women

Clara EL Maddena1, Sook Ling Leonga1, Andrew Graya2 and Caroline C Horwatha1 c1

a1 Department of Human Nutrition, University of Otago, Dunedin 9054, New Zealand

a2 Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand


To examine the association between eating in response to hunger and satiety signals (intuitive eating) and BMI. A second objective was to determine whether the hypothesized higher BMI in less intuitive eaters could be explained by the intake of specific foods, speed of eating or binge eating.

Cross-sectional survey. Participants were randomly selected from a nationally representative sampling frame. Eating in response to hunger and satiety signals (termed ‘intuitive eating’), self-reported height and weight, frequency of binge eating, speed of eating and usual intakes of fruits, vegetables and selected high-fat and/or high-sugar foods were measured.

Nationwide study, New Zealand.

Women (n 2500) aged 40–50 years randomly selected from New Zealand electoral rolls, including Māori rolls (66 % response rate; n 1601).

Intuitive Eating Scale (IES) scores were significantly associated with BMI in an inverse direction, after adjusting for potential confounding variables. When controlling for confounding variables, as well as potential mediators, the inverse association between intuitive eating (potential range of IES score: 21–105) and BMI was only slightly attenuated and remained statistically significant (5·1 % decrease in BMI for every 10-unit increase in intuitive eating; 95 % CI 4·2, 6·1 %; P < 0·0 0 1). The relationship between intuitive eating and BMI was partially mediated by frequency of binge eating.

Eating in response to hunger and satiety signals is strongly associated with lower BMI in mid-age women. The direction of causality needs to be investigated in longitudinal studies and randomized controlled trials.

(Received May 30 2011)

(Revised February 06 2012)

(Accepted February 10 2012)

(Online publication March 23 2012)


  • Hunger and satiety;
  • Intuitive eating;
  • Mid-age;
  • Women;
  • BMI;
  • Obesity


c1 Corresponding author: Email