# Exploring the Relationship Between the How to Eat Intervention and Eating Competence Among Repeat Dieters

## TL;DR

A 10-session eating intervention improved eating competence and reduced disordered eating behaviors in repeat dieters without affecting body weight.

## Contribution

Demonstrates the effectiveness of the How to Eat intervention in improving eating attitudes and competence in repeat dieters.

## Key findings

- How to Eat significantly increased Eating Competence scores in both hospital and university participants.
- The intervention led to significant decreases in eating disturbance scores (EAT-26) in both settings.
- There was no significant change in body weight despite improvements in eating behaviors.

## Abstract

Background/Objectives: The 10-session How to Eat intervention was developed to institute Eating Competence (EatC) and repair distorted eating attitudes and behaviors growing out of chronically restrained eating and/or repeated weight reduction dieting. How to Eat was conducted over a 12-year period as an employee wellness option at two locations in the midwestern United States. Methods: Participants in How to Eat were adult employees of their respective hospital or university who voluntarily enrolled after screening and assessment by each site facilitator. Pre- and post-measures were the 16-item EatC measure, the 26-item Eating Attitudes Test (EAT-26), and body weight. Results: In the hospital setting, a total of 43 adults participated, with a mean (±SD) age of 47.5 ± 10.7 years, primarily female (95.3%) and white (90.7%). How to Eat was associated with a significant increase in EatC total scores (22.8 ± 6.5 to 34.3 ± 4.9) and a decrease in EAT-26 scores (10.7 ± 8.1 to 3.7 ± 2.9), both p < 0.001. In the university setting, a total of 52 adults participated, 89.4% female, with a mean (±SD) age of 39.3 ± 11.4 years. University participants were significantly younger, p < 0.001. How to Eat was also associated with a significant increase in EatC total scores (24.1 ± 7.0 to 36.6 ± 6.9) and EAT-26 scores (13.9 ± 8.8 to 3.2 ± 4.2), both p < 0.001. At both sites, changes in total EatC, Contextual skills, and EAT-26 scores had strong effect sizes. Mean body weight was ±5% pre/post-intervention at either site. Conclusions: How to Eat is associated with clinically significant improvements in measures of EatC and a decrease in eating disturbances among repeat dieters without significantly impacting body weight. Positive results from employee wellness settings support future experimental studies with more diverse samples and additional outcome measures.