(PS7-44) Exploring Psychometric Properties of the Intuitive Eating Scale (IES-2) in a Residential Eating Disorder Treatment Sample

Intuitive eating is characterized by promoting sensitivity to hunger and satiety cues, honoring the body’s nutritional requirements, mindful eating, and prioritizing health over appearance. This holistic approach to diet and eating is gaining traction as a promising intervention target in eating disorder (ED) treatment. However, its application and efficacy within residential treatment settings remain relatively unexplored. To advance our understanding in this area, it is important to validate measures such as the Intuitive Eating Scale (IES-2) within clinical ED populations, given its widespread use in assessing intuitive eating behaviors. Moreover, understanding how the IES-2 performs across ED subtypes (i.e., restrictive vs. binge/purge) can offer valuable insights for tailoring interventions to meet the diverse needs of EDs. Thus, this study aimed to evaluate the psychometric properties of the IES-2 within a residential ED sample and to understand its performance across various ED subtypes. The sample consisted of 177 adult and adolescent women presenting to a residential ED treatment center who completed the IES-2 and eating disorder pathology surveys as part of a larger assessment battery. The IES-2 maps onto four factors, including unconditional permission to eat, eating for physical rather than emotional reasons, reliance on hunger and satiety cues, and body-food choice congruence. Confirmatory factor analysis supported this same four-factor structure showing a good yet imperfect fit. Comparative Fit Index and the Tucker-Lewis Index, with robust adjustments, produced values of 0.90 and 0.89, respectively. The Root Mean Square Error of Approximation was 0.10, 90% CI [0.09 to 0.11], suggesting a moderate fit, while the Standardized Root Mean Square Residual was < 0.08, indicating good fit. Configural, metric, and scalar invariance were not supported across ED subtypes, indicating the measure performs differently across ED subtypes. For both the restrictive and binge/purge subtypes, specific IES-2 subscales were negatively associated with ED symptoms, although eating for physical rather than emotional reasons showed no significant relationship with ED symptoms. The binge/purge group reported significantly lower scores for eating for physical rather than emotional reasons and reliance on hunger/satiety cues compared to the restrictive group. These findings contribute to a deeper understanding of how the IES-2 performs within a residential ED treatment sample. While support for the four-factor structure highlights its relevance for assessing various dimensions of intuitive eating in clinical settings, the imperfect fit suggests the need for further refinement of the scale within this population. Further, understanding differences in the IES-2 subscales across ED subtypes can inform tailored treatment strategies. For example, addressing underlying emotional triggers and promoting awareness of hunger and satiety cues may be crucial for the binge/purge subtype. Targeting specific aspects of intuitive eating behavior relevant to each subtype can optimize treatment approaches and facilitate ED recovery.