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.