Development and efficacy of a cognitive dissonance-based intervention program for intuitive eating: A randomized controlled clinical trial

Intuitive eating is an approach that encourages individuals to eat according to their body's hunger and satiety cues. Intuitive eating interventions vary in methodology, lack time-based monitoring, and are often not based on all intuitive eating principles. Therefore, this study aimed to develop and evaluate the efficacy of an intuitive eating intervention using cognitive dissonance strategies to increase intuitive eating, positive body image, and health-related motivation for physical exercise, as well as to reduce disordered eating behaviors. Brazilian women ( n = 110) aged 18–35 were randomly assigned to one of three groups: cognitive dissonance, educational, and passive control. Intention-to-treat analysis was performed using the mixed-effects models to assess the efficacy of the cognitive dissonance intuitive eating intervention, comparing effects between groups and each outcome over time (baseline, post-intervention, four-, 24-, and 48-weeks of follow-up). The cognitive dissonance intervention showed increases in body appreciation, internal body orientation, health motivation for physical exercise, and a reduction in restrictive eating post-intervention. At 24- and 48-week follow-ups, there were increases in all outcomes and reductions in scores for restrictive, uncontrolled, and emotional eating. Overall, the cognitive dissonance group showed statistically significant differences compared to the other groups in most outcomes. Effect sizes ranged from small to large. The results showed the efficacy of the cognitive dissonance intervention in promoting intuitive eating and positive body image, as well as reducing disordered eating behaviors. It can be used to prevent body image disturbances and disordered eating, constituting an important additional tool for addressing these issues.