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Hoare JK, Lister NB, Garnett SP, Baur LA, Jebeile H. Weight-neutral interventions in young people with high body mass index: A systematic review. Nutr Diet 2023; 80:8-20. [PMID: 35411702 PMCID: PMC10084274 DOI: 10.1111/1747-0080.12729] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 01/09/2022] [Accepted: 01/24/2022] [Indexed: 01/10/2023]
Abstract
AIM This systematic review explored the feasibility, acceptability and effect on health outcomes of weight-neutral interventions in health improvement-seeking young people with overweight/obesity. METHODS Six databases were searched to March 2021 for health, but not weight, focused interventions (PROSPERO, CRD42020152671). Eligible studies recruited young people (10-24 years) with overweight/obesity. The studies were described using narrative synthesis, with numerical results summarised. The quality of included studies was assessed using the Joanna Briggs Institute critical appraisal tools. RESULTS Six articles were included, representing three pilot studies. Study 1 (n = 37, 14-17 years) compared a 6-week mindful eating program with single-session lifestyle education; Study 2 (n = 35, 14-17 years) compared 12-week weight-neutral lifestyle education focused on intuitive eating and carbohydrate quality, with/without guided imagery; and Study 3 (n = 33, 12-17 years) compared a 6-week mindfulness intervention with cognitive behavioural therapy in adolescents with depressive symptoms at risk of type 2 diabetes. All interventions explored feasibility (intervention group retention 57%-88%, attendance >80%) and reported interventions were acceptable. Studies 1 and 3 reported no change in mindfulness. Study 2 reported an increase (p < 0.05) in intuitive eating following weight-neutral plus guided imagery (0.32 ± 0.36, Hawks' Scale, score 1-4), compared with weight-neutral alone (0.15 ± 0.29). Study 1 reported decreased body mass index (p < 0.001) following mindful eating (-1.1 kg/m2 ), compared with single-session lifestyle education (+0.7 kg/m2 ); Studies 2 and 3 found no change in body mass index or body mass index z-score. CONCLUSIONS Weight-neutral interventions may be feasible and acceptable in adolescents with overweight/obesity in the short term (≤12 weeks), but data are limited.
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Affiliation(s)
- Johanna K Hoare
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Natalie B Lister
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Sarah P Garnett
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Kids Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Louise A Baur
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.,Kids Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Weight Management Services, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Hiba Jebeile
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
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2
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Cloutier-Bergeron A, Samson A, Provencher V, Mongeau L, Paquette MC, Turcotte M, Bégin C. Health At Every Size intervention® under real-world conditions: the rights and wrongs of program implementation. Health Psychol Behav Med 2022; 10:935-955. [PMID: 36210868 PMCID: PMC9543046 DOI: 10.1080/21642850.2022.2128357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Implementation integrity is known to be critical to the success of interventions. The Health At Every Size® (HAES®) approach is deemed to be a sustainable intervention on weight-related issues. However, no study in the field has yet investigated the effects of implementation on outcomes in a real-world setting.
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Affiliation(s)
| | - Amélie Samson
- Centre de recherche Nutrition, santé et société (NUTRISS), INAF, Université Laval, Québec, Canada
- Ministère de la santé et des services sociaux, Québec, Canada
| | - Véronique Provencher
- Centre de recherche Nutrition, santé et société (NUTRISS), INAF, Université Laval, Québec, Canada
- School of Nutrition, Université Laval, Québec, Canada
| | - Lyne Mongeau
- School of Public Health, Université de Montréal, Montréal, Canada
| | - Marie-Claude Paquette
- Institut national de santé publique du Québec, Québec, Canada
- Department of Nutrition, Université de Montréal, Montréal, Canada
| | - Mylène Turcotte
- Centre de recherche Nutrition, santé et société (NUTRISS), INAF, Université Laval, Québec, Canada
| | - Catherine Bégin
- School of Psychology, Université Laval, Québec, Canada
- Centre de recherche Nutrition, santé et société (NUTRISS), INAF, Université Laval, Québec, Canada
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3
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Harris LM, Broshek CE, Ribeiro JD. Does Body Mass Index Confer Risk for Future Suicidal Thoughts and Behaviors? A Meta-analysis of Longitudinal Studies. Curr Obes Rep 2022; 11:45-54. [PMID: 35174455 DOI: 10.1007/s13679-022-00468-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/23/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Body mass index (BMI) outside of the "normal" range is commonly cited as a predictor of adverse health outcomes and has been identified as a potential risk factor for suicidal thoughts and behaviors (STBs). This meta-analysis provides a descriptive and quantitative summary of the literature evaluating the longitudinal relationship between BMI/weight status and STBs. RECENT FINDINGS The longitudinal literature examining the relationship between BMI/weight status and STBs is small and methodologically constrained. Within the existing literature, BMI and weight status are generally weak or nonsignificant risk factors for STBs. It is possible that body weight has a complex relationship with physical and mental health, including STBs, which may not be possible to accurately capture with a singular metric such as BMI. BMI and weight status do not appear to robustly predict STBs, at least within the methodological constraints of the existing literature.
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4
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Ning C, Wu J, Ye Y, Yang N, Pei H, Gao H. How Media Use Influences the Fertility Intentions Among Chinese Women of Reproductive Age: A Perspective of Social Trust. Front Public Health 2022; 10:882009. [PMID: 35619808 PMCID: PMC9127136 DOI: 10.3389/fpubh.2022.882009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 04/19/2022] [Indexed: 11/17/2022] Open
Abstract
Background The low fertility level has become a serious social problem in China. Previous research has argued the significant influence of media use and social trust on fertility intentions, but the interaction between the two variables and how they influence fertility intentions remain further investigation. This study explored the influence mechanism of media use on Chinese women's fertility intentions from the perspective of social trust. Methods This study collected data from the 2017 China General Social Survey, investigated the relationships between variables through bivariate correlation coefficients, and explored the differences in fertility intentions among women of reproductive age (20–49). Also, this paper examined the influence of media use and social trust by regression analysis and tested the mediating role of social trust between media use and fertility intentions with Bootstrap sampling. Results Women with different media use preferences, education levels, and family incomes have significant differences (p < 0.01) in fertility intentions. New media use negatively influences women's fertility intentions, while traditional media use has no significant influence on women's fertility intentions. Social trust significantly influenced women's fertility intentions and partially mediated the impact of new media use on fertility intentions. Conclusion Online communication influences fertility intentions among Chinese women of reproductive age. It tends to influence their social trust by amplifying negative social news, affecting their fertility intentions further. This paper suggests the importance of strengthening social trust and online agenda-setting to improve women's fertility intentions that strategic information communication can change their perceptions of social trust.
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Affiliation(s)
- Chuanlin Ning
- School of Media and Communication, Shanghai Jiao Tong University, Shanghai, China
| | - Jing Wu
- Faculty of Social Sciences, University of Ljubljana, Ljubljana, Slovenia
| | - Yijie Ye
- School of Economics and Finance, Shanghai International Studies University, Shanghai, China
| | - Nan Yang
- School of Economics and Finance, Shanghai International Studies University, Shanghai, China
| | - Huacheng Pei
- School of Economics and Finance, Shanghai International Studies University, Shanghai, China
| | - Hao Gao
- School of Journalism and Communication, Nanjing Normal University, Nanjing, China
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5
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Dimitrov Ulian M, Pinto AJ, de Morais Sato P, Benatti FB, Lopes de Campos-Ferraz P, Coelho D, Roble OJ, Sabatini F, Perez I, Aburad L, Vessoni A, Fernandez Unsain R, Rogero MM, Sampaio G, Gualano B, Scagliusi FB. Health at Every Size®-Based Interventions May Improve Cardiometabolic Risk and Quality of Life Even in the Absence of Weight Loss: An Ancillary, Exploratory Analysis of the Health and Wellness in Obesity Study. Front Nutr 2022; 9:598920. [PMID: 35273983 PMCID: PMC8902219 DOI: 10.3389/fnut.2022.598920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 01/27/2022] [Indexed: 11/23/2022] Open
Abstract
We examined whether weight loss following HAES®-based interventions associates with changes in cardiometabolic risk factors and quality of life of women with obesity. This was an exploratory, ancillary analysis of a 7-month, mixed-method, randomized controlled trial. Fifty-five women (age: 33.0 ± 7.2; BMI: 30–39.9 kg/m2) were included in this study. Body weight, cardiovascular risk factors, clustered cardiometabolic risk, and quality of life were assessed before (Pre) and after HAES®-based interventions (Post). Delta scores (Post-Pre) were calculated for each outcome and used in linear regression models. After adjusting by potential confounders, weight loss was associated with improvements in waist circumference (β = 0.83, p <0.001), fasting glycemia (β = 0.45, p = 0.036), total cholesterol (β = 1.48, p = 0.024), LDL (β = 1.33, p = 0.012), clustered cardiometabolic risk (β = 0.18, p = 0.006), and quality of life (β = −1.05, p = 0.007). All participants but one who reduced body weight (n = 11) improved clustered cardiometabolic risk and quality of life. Of relevance, 34% and 73% of the participants who maintained or gained weight improved clustered cardiometabolic risk and quality of life, respectively, although the magnitude of improvements was lower than that among those who lose weight. Improvements in cardiovascular risk factors and quality of life following HAES®-based interventions associated with weight loss as expected. However, most of the participants who maintained or even gained weight experienced benefits to some extent. This suggests that weight-neutral, lifestyle-modification interventions may improve wellness and health-related outcomes, even in the absence of weight loss.
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Affiliation(s)
- Mariana Dimitrov Ulian
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Ana Jéssica Pinto
- Applied Physiology & Nutrition Research Group, University of São Paulo, São Paulo, Brazil
| | - Priscila de Morais Sato
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Fabiana B Benatti
- Applied Physiology & Nutrition Research Group, University of São Paulo, São Paulo, Brazil.,School of Applied Sciences, State University of Campinas, Limeira, Brazil
| | | | - Desire Coelho
- Applied Physiology & Nutrition Research Group, University of São Paulo, São Paulo, Brazil
| | - Odilon J Roble
- Faculty of Physical Education, State University of Campinas, Campinas, Brazil
| | - Fernanda Sabatini
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Isabel Perez
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Luiz Aburad
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - André Vessoni
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Ramiro Fernandez Unsain
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Marcelo Macedo Rogero
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.,Food Research Center (FoRC), CEPID-FAPESP, Research Innovation and Dissemination Centers São Paulo Research Foundation, São Paulo, Brazil
| | - Geni Sampaio
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Bruno Gualano
- Applied Physiology & Nutrition Research Group, University of São Paulo, São Paulo, Brazil
| | - Fernanda B Scagliusi
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
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6
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Zafir S, Jovanovski N. The weight of words: Discursive constructions of health in weight-neutral peer-reviewed journal articles. Body Image 2022; 40:358-369. [PMID: 35149443 DOI: 10.1016/j.bodyim.2022.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/21/2022] [Accepted: 01/22/2022] [Indexed: 11/30/2022]
Abstract
Weight-neutral approaches to health, like the Health at Every Size® (HAES®) approach arose in response to emerging evidence showing the negative health consequences of weight-focused approaches through the effects of stigma and marginalization in many settings, including healthcare. While the discourses of dominant 'weight-normative' approaches are well-researched and described, little is known about how language and discourse is creating certain 'truths' about weight-neutral approaches. The aim of this study was to explore how academic discourses create truths about weight-neutral approaches to health. A discourse analysis of 63 academic journal articles was conducted. We found that the language used in academic literature is creating confusing and contradictory messages about weight and weight-neutral approaches to health (like the HAES® approach) through: (i) the continued use of stigmatising and normative labels like 'overweight' and 'obese', (ii) paradoxical language like 'flexible restraint', and (iii) a focus on individual responsibility and blame for health and weight without acknowledgement of broader societal and systemic factors. More research is needed to characterize weight-neutral approaches and develop a clearer framework for researchers wishing to engage with the weight-neutral paradigm of health.
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Affiliation(s)
- Shoa Zafir
- Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.
| | - Natalie Jovanovski
- Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.
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7
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Chinn V, Neely E, Shultz S, Kruger R, Hughes R, Thunders M. Empowering Women in the Face of Body Ideals: A Scoping Review of Health Promotion Programs. HEALTH EDUCATION & BEHAVIOR 2021; 49:534-547. [PMID: 34628972 DOI: 10.1177/10901981211050571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Achieving women's health equity and empowerment is a global priority. In a Western context, women are often disempowered by the value society places on body size, shape or weight, which can create a barrier to health. Health promotion programs can exacerbate women's preoccupations with their bodies by focusing outcomes toward achieving an "ideal" body size. Women's health promotion activities should be empowering if the desired outcomes are to improve their health and well-being long-term. This review sought to identify key elements from health promotion programs that aimed to empower women. A search was conducted in PubMed, MEDLINE, Web of Science, Scopus, CINAHL complete, and Academic Search Premiere databases. The search yielded 27 articles that collectively reported on 10 different programs. Through thematic synthesis, each article was analyzed for (1) key program features employed to empower women and (2) how such programs evaluated women's health. Seven themes resulted, of which five describe key empowering features (active participation, social support, sustainable change, holistic health perspective, strength-based approach) and two evaluation characteristics (assessment across multiple health domains and a mixed-method design). The findings from this review can assist health promoters to design and improve initiatives that aim to empower women.
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Affiliation(s)
- Victoria Chinn
- Massey University, Wellington, New Zealand.,Victoria University of Wellington, Wellington, New Zealand
| | - Eva Neely
- Victoria University of Wellington, Wellington, New Zealand
| | - Sarah Shultz
- Seattle University, Seattle, WA, USA.,Massey University, Albany, New Zealand
| | | | - Roger Hughes
- University of Tasmania, Hobart, Tasmania, Australia
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8
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Grider HS, Douglas SM, Raynor HA. The Influence of Mindful Eating and/or Intuitive Eating Approaches on Dietary Intake: A Systematic Review. J Acad Nutr Diet 2020; 121:709-727.e1. [PMID: 33279464 DOI: 10.1016/j.jand.2020.10.019] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 10/12/2020] [Accepted: 10/16/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Stimuli that promote eating in the absence of the physiological need for food are pervasive and can facilitate excessive energy intake. The practices of mindful eating (ME) and intuitive eating (IE) have been developed to minimize external drivers of energy intake by helping individuals emphasize the sensory properties of foods and internal indicators of hunger and fullness. OBJECTIVE To enhance understanding about the effect of ME and IE interventions on dietary intake, this systematic review included randomized trials of ME and IE interventions that examined dietary intake, defined as energy intake or diet quality, in adults of varying weight status without a diagnosis of an eating disorder. METHODS The selection of literature followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses systematic review process, in which PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and PsycINFO databases were searched for studies published between January 1980 and November 2019. Studies were included if they met the following criteria: randomized trial design in which 1 arm was an intervention with an ME or IE component and there was at least 1 control or active comparison arm; enrolled participants were of a healthy weight or with overweight or obesity and reported not having an eating disorder (ie, anorexia, bulimia nervosa, or binge eating disorder) or other health conditions in which dietary restrictions were applied; were at least 18 years of age; and outcomes of energy intake or diet quality were reported at baseline and post intervention. The modified Downs and Black checklist was used to assess risk of bias for each study that met inclusion criteria. RESULTS A total of 13 studies, including 8 investigating ME interventions and 5 investigating IE interventions, represented in 14 articles, were included in the review. Seven of the 9 articles reporting on energy intake did not find significant group differences. Eight of the 12 articles reporting on diet quality did not find significant group differences. The mean bias assessment score was 13.6 out of 28, indicating poor quality. CONCLUSIONS Little evidence suggests that ME and IE interventions influence energy intake or diet quality. To draw strong conclusions about the effect of ME and IE on dietary intake, future research using study designs of high rigor are needed.
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Affiliation(s)
- Hannah S Grider
- Department of Nutrition, University of Tennessee, Knoxville, TN
| | - Steve M Douglas
- Department of Nutrition, University of Tennessee, Knoxville, TN
| | - Hollie A Raynor
- Department of Nutrition, University of Tennessee, Knoxville, TN.
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9
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Abstract
Internally regulated eating style, the eating style that is driven by internal bodily sensations of hunger and satiation, is a concept that has received increasing attention in the literature and health practice over the last decades. The various attempts that have been made so far to conceptualise internally regulated eating have taken place independently of one another, and each sheds light on only parts of the total picture of what defines internally regulated eating. This has resulted in a literature that is rather fragmented. More importantly, it is not yet clear which are the characteristics that comprise this eating style. In this paper, we identify and describe the full spectrum of these characteristics, namely, sensitivity to internal hunger and satiation signals, self-efficacy in using internal hunger and satiation signals, self-trusting attitude for the regulation of eating, relaxed relationship with food and tendency to savour the food while eating. With this research, we introduce a common language to the field and we present a new theoretical framework that does justice not just to the full breadth of characteristics that are necessary for the internally regulated eating style but also to the associations between them and the potential mechanisms by which they contribute to this eating style.
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10
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Cloutier-Bergeron A, Provencher V, Mongeau L, Paquette MC, Carbonneau É, Turcotte M, Bégin C. Does Health At Every Size® fit all? A group-based trajectory modeling of a non-diet intervention. Appetite 2019; 143:104403. [DOI: 10.1016/j.appet.2019.104403] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 08/12/2019] [Accepted: 08/13/2019] [Indexed: 11/26/2022]
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11
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Sabatini F, Ulian MD, Perez I, Pinto AJ, Vessoni A, Aburad L, Benatti FB, Lopes de Campos-Ferraz P, Coelho D, de Morais Sato P, Roble OJ, Unsain RF, Schuster RC, Gualano B, Scagliusi FB. Eating Pleasure in a Sample of Obese Brazilian Women: A Qualitative Report of an Interdisciplinary Intervention Based on the Health at Every Size Approach. J Acad Nutr Diet 2019; 119:1470-1482. [PMID: 30940423 DOI: 10.1016/j.jand.2019.01.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 12/05/2018] [Accepted: 01/10/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Health at Every Size (HAES) is a weight-neutral approach focused on promoting healthy behaviors in people with different body sizes and on enhancing pleasure derived from consuming food to achieve sustainable healthy eating outcomes. However, to the best of our knowledge, there are no studies in the literature assessing the effects of the HAES approach on perceptions of eating pleasure. OBJECTIVE We qualitatively investigated the perceptions of obese women about eating pleasure before and after a new interdisciplinary, nonprescriptive intervention based on the HAES approach. DESIGN The intervention was a randomized controlled clinical trial, designated as Health and Wellness in Obesity, conducted over 7 months at University of São Paulo (Brazil). We used a qualitative approach to data construction and analysis of perceptions about eating pleasure. Participants were randomized to either the intervention (I-HAES) group or the control (CTRL) group. The I-HAES group featured individual nutritional counseling, group practice of enjoyable physical activity, and philosophical workshops. The CTRL group was a traditional HAES intervention group (lecture-based model). Focus group discussions eliciting perceptions of pleasure around eating were conducted at baseline and post-study. Focus group transcripts were analyzed by exploratory content analysis. PARTICIPANTS Forty-three women aged 25 to 50 years with body mass index (measured in kilograms per square meter) between 30 and 39. 9 completed the intervention and the focus groups, with 32 in the I-HAES group and 11 in the CTRL group. RESULTS Lack of guilt about experiencing pleasure while eating and increased reflection on their own desires increased in participants of both groups after the study. The I-HAES group also displayed a greater sense of autonomy related to eating, increased pleasure in commensality, familiarity with the practice of cooking, and decreased automatic eating. CONCLUSION HAES-based intervention featuring nutritional counseling, appreciation for physical activity, and philosophical engagement was shown to stimulate pleasure around eating without leading to indiscriminate eating.
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12
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Ulian MD, Aburad L, da Silva Oliveira MS, Poppe ACM, Sabatini F, Perez I, Gualano B, Benatti FB, Pinto AJ, Roble OJ, Vessoni A, de Morais Sato P, Unsain RF, Baeza Scagliusi F. Effects of health at every size® interventions on health-related outcomes of people with overweight and obesity: a systematic review. Obes Rev 2018; 19:1659-1666. [PMID: 30261553 DOI: 10.1111/obr.12749] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 07/06/2018] [Accepted: 07/12/2018] [Indexed: 02/04/2023]
Abstract
CONTEXT The growing use of interventions based on the Health at Every Size® (HAES®) in obesity management. OBJECTIVE This study aimed to summarize the health-related effects of HAES®-based interventions on people with overweight and obesity. DATA SOURCES MEDLINE (via PubMed), EMBASE, Cochrane Library, LILACS, Google Scholar, OpenGrey and Grey Literature Report. STUDY SELECTION A systematic review of studies published until January 2017 reporting on HAES®-based randomized and non-randomized controlled trials in people with overweight and/or obesity. DATA EXTRACTION Fourteen papers met the inclusion criteria. The assessed studies included the following tests: blood profile, blood pressure, anthropometry, eating behaviour, energy intake, diet quality, psychological and qualitative evaluations. RESULTS The HAES® interventions benefited both the psychological and physical activity outcomes, besides promoting behavioural and qualitative changes in eating habits. On the other hand, the results regarding cardiovascular responses, body-image perception and total energy intake were inconsistent. CONCLUSIONS Despite improving the cardiovascular status, eating behaviours, quality of life and psychological well-being in participants, other large long-term clinical trials should be performed to establish the effectiveness of HAES®-based interventions in improving health for people with overweight and obesity. PROSPERO registration 2017: CRD42017054857.
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Affiliation(s)
- M D Ulian
- School of Public Health, Department of Nutrition, University of Sao Paulo, Sao Paulo, Brazil
| | - L Aburad
- School of Public Health, Department of Nutrition, University of Sao Paulo, Sao Paulo, Brazil
| | - M S da Silva Oliveira
- School of Public Health, Department of Nutrition, University of Sao Paulo, Sao Paulo, Brazil
| | - A C M Poppe
- School of Public Health, Department of Nutrition, University of Sao Paulo, Sao Paulo, Brazil
| | - F Sabatini
- School of Public Health, Department of Nutrition, University of Sao Paulo, Sao Paulo, Brazil
| | - I Perez
- School of Public Health, Department of Nutrition, University of Sao Paulo, Sao Paulo, Brazil
| | - B Gualano
- Applied Physiology & Nutrition Research Group, Laboratory of Assessment and Conditioning in Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - F B Benatti
- Applied Physiology & Nutrition Research Group, Laboratory of Assessment and Conditioning in Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil.,School of Applied Sciences, Universidade Estadual de Campinas, Limeira, Brazil
| | - A J Pinto
- Applied Physiology & Nutrition Research Group, Laboratory of Assessment and Conditioning in Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - O J Roble
- Faculty of Physical Education, Universidade Estadual de Campinas, Campinas, Brazil
| | - A Vessoni
- School of Public Health, Department of Nutrition, University of Sao Paulo, Sao Paulo, Brazil
| | - P de Morais Sato
- School of Public Health, Department of Nutrition, University of Sao Paulo, Sao Paulo, Brazil
| | - R F Unsain
- Institute of Health and Society, Federal University of Sao Paulo, Santos, Brazil
| | - F Baeza Scagliusi
- School of Public Health, Department of Nutrition, University of Sao Paulo, Sao Paulo, Brazil
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13
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Emmanouil CC, Pervanidou P, Charmandari E, Darviri C, Chrousos GP. The effectiveness of a health promotion and stress-management intervention program in a sample of obese children and adolescents. Hormones (Athens) 2018; 17:405-413. [PMID: 30099726 DOI: 10.1007/s42000-018-0052-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 05/26/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Our study aimed to evaluate the effectiveness of an 8-week stress management intervention program that included progressive muscle relaxation, diaphragmatic breathing, guided imagery, and cognitive restructuring in obese Greek children and adolescents. DESIGN Thirty-six patients were prospectively recruited to participate in this randomized controlled study. Of these, 16 participants formed the intervention group and 20 participants the control group. Anthropometric measurements and salivary cortisol, determined serially 3 times a day, were assessed at the beginning and at the end of the study. Participants also completed the state-trait anxiety in children questionnaire (STAIC), the stress in children questionnaire (SiC), and the child behavior checklist (CBCL). RESULTS The intervention resulted in a significant reduction of waist-hip ratio (p = 0.008) in the intervention group compared with the control group. Moreover, school performance was improved in the intervention group (p = 0.025), while both the intervention and the control group adopted healthier daily habits (p = 0.020 and 0.011, respectively). However, there was no statistically significant difference between body mass index (BMI) z-score, stress, anxiety, and diurnal patterns in salivary cortisol. CONCLUSIONS The present study supports the effectiveness of stress management intervention programs on waist-hip ratio reduction. Further research is required to investigate biomarkers able to predict and evaluate the effectiveness of stress management intervention programs.
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Affiliation(s)
- Chrysoula-Christina Emmanouil
- Postgraduate Course Stress Management and Health Promotion, University of Athens Medical School, 4 Soranou Ephessiou Str., GR-115-27, Athens, Greece
| | - Panagiota Pervanidou
- First Department of Pediatrics, University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Evangelia Charmandari
- First Department of Pediatrics, University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Christina Darviri
- Postgraduate Course Stress Management and Health Promotion, University of Athens Medical School, 4 Soranou Ephessiou Str., GR-115-27, Athens, Greece.
| | - George P Chrousos
- Postgraduate Course Stress Management and Health Promotion, University of Athens Medical School, 4 Soranou Ephessiou Str., GR-115-27, Athens, Greece
- First Department of Pediatrics, University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
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14
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Weigensberg MJ, Spruijt-Metz D, Wen CKF, Davis JN, Ávila Q, Juarez M, Brown-Wadé N, Lane CJ. Protocol for the Imagine HEALTH Study: Guided imagery lifestyle intervention to improve obesity-related behaviors and salivary cortisol patterns in predominantly Latino adolescents. Contemp Clin Trials 2018; 72:103-116. [PMID: 30076988 PMCID: PMC8746570 DOI: 10.1016/j.cct.2018.07.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 07/13/2018] [Accepted: 07/15/2018] [Indexed: 01/14/2023]
Abstract
Innovative lifestyle interventions are needed to reduce type 2 diabetes risk in adolescents. This report describes the protocol of the Imagine HEALTH cluster randomized control trial, that tests an intervention based in Self-Determination Theory (SDT) and uses lifestyle education combined with the mind-body, complementary health modality of guided imagery (GI), to address obesity prevention and treatment in predominantly Latino adolescents. The primary aim is to determine the unique effects of each of the three major components of the 12-week lifestyle intervention (lifestyle education, stress reduction guided imagery, and lifestyle behavior guided imagery) compared to control on primary outcomes of physical activity (accelerometry), dietary intake (3-day recall), and stress biomarker levels (salivary cortisol). Secondary aims assess changes compared to controls in psychosocial outcomes (stress, well-being, depression), diabetes-related metabolic outcomes (adiposity, insulin resistance), maintenance of outcome changes for one year post-intervention, and SDT-based mediation of intervention effects. The development and rationale for each of the intervention components, study design, and outcome measurement processes are described. Adolescent participants recruited from four urban schools are cluster randomized by school into one of four arms of the 12-week (3-month) intervention, followed by 6 months of maintenance and 6 months of no contact. Outcome measures are assessed at the end of each period (3-, 9-, and 15-months). Results to date show successful recruitment of 97% of the target study population. Future results will demonstrate the effects of this integrative intervention on primary and secondary outcome measures in adolescents at risk for lifestyle-related metabolic disease.
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Affiliation(s)
| | - Donna Spruijt-Metz
- USC Dornsife Center for Economic and Social Research, Department of Psychology, United States; USC Keck School of Medicine, Department of Preventive Medicine, United States
| | - Cheng K Fred Wen
- USC Keck School of Medicine, Department of Preventive Medicine, United States
| | - Jaimie N Davis
- University of Texas at Austin, Department of Nutritional Sciences, United States
| | - Quintilia Ávila
- USC Keck School of Medicine, Department of Pediatrics, United States
| | - Magaly Juarez
- USC Keck School of Medicine, Department of Pediatrics, United States
| | - Niquelle Brown-Wadé
- USC Keck School of Medicine, Department of Preventive Medicine, Division of Biostatistics, United States
| | - Christianne J Lane
- USC Keck School of Medicine, Department of Preventive Medicine, Division of Biostatistics, United States
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15
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Bégin C, Carbonneau E, Gagnon-Girouard MP, Mongeau L, Paquette MC, Turcotte M, Provencher V. Eating-Related and Psychological Outcomes of Health at Every Size Intervention in Health and Social Services Centers Across the Province of Québec. Am J Health Promot 2018; 33:248-258. [DOI: 10.1177/0890117118786326] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose: To report the outcomes of a Health at Every Size (HAES) intervention in a real-world setting. Design: Quasi-experimental design evaluating eating behaviors and psychological factors. Setting: The HAES intervention is offered in Health and Social Services Centers in Québec (Canada). Participants: For this study, 216 women (body mass index [BMI]: 35.76 [6.80] kg/m2) who participated to the HAES intervention were compared to 110 women (BMI: 34.56 [7.30] kg/m2) from a comparison group. Intervention: The HAES intervention is composed of 14 weekly meetings provided by health professionals. It focuses on healthy lifestyle, self-acceptance, and intuitive eating. Measures: Eating behaviors (ie, flexible restraint, rigid restraint, disinhibition, susceptibility to hunger, intuitive eating, and obsessive-compulsive eating) and psychological correlates (ie, body esteem, self-esteem, and depression) were assessed using validated questionnaires at baseline, postintervention, and 1-year follow-up. Analysis: Group, time, and interaction effects analyzed with mixed models. Results: Significant group by time interactions were found for flexible restraint ( P = .0400), disinhibition ( P < .0001), susceptibility to hunger ( P < .0001), intuitive eating ( P < .0001), obsessive–compulsive eating ( P < .0001), body-esteem ( P < .0001), depression ( P = .0057), and self-esteem ( P < .0001), where women in the HAES group showed greater improvements than women in the comparison group at short and/or long term. Conclusion: The evaluation of this HAES intervention in a real-life context showed its effectiveness in improving eating-, weight-, and psychological-related variables among women struggling with weight and body image.
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Affiliation(s)
- Catherine Bégin
- Institute of Nutrition and Functional Foods, Laval University, Québec, Canada
- School of Psychology, Laval University, Québec, Canada
| | - Elise Carbonneau
- Institute of Nutrition and Functional Foods, Laval University, Québec, Canada
- School of Nutrition, Laval University, Québec, Canada
| | | | - Lyne Mongeau
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Canada
- School of Public Health, University of Montreal, Montreal, Canada
| | - Marie-Claude Paquette
- Institut national de santé publique du Québec, Québec, Canada
- Department of Nutrition, University of Montreal, Montreal, Canada
| | - Mylène Turcotte
- Institute of Nutrition and Functional Foods, Laval University, Québec, Canada
- School of Nutrition, Laval University, Québec, Canada
| | - Véronique Provencher
- Institute of Nutrition and Functional Foods, Laval University, Québec, Canada
- School of Nutrition, Laval University, Québec, Canada
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16
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Dimitrov Ulian M, Pinto AJ, de Morais Sato P, B. Benatti F, Lopes de Campos-Ferraz P, Coelho D, Roble OJ, Sabatini F, Perez I, Aburad L, Vessoni A, Fernandez Unsain R, Macedo Rogero M, Toporcov TN, de Sá-Pinto AL, Gualano B, B. Scagliusi F. Effects of a new intervention based on the Health at Every Size approach for the management of obesity: The "Health and Wellness in Obesity" study. PLoS One 2018; 13:e0198401. [PMID: 29979699 PMCID: PMC6034785 DOI: 10.1371/journal.pone.0198401] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 05/20/2018] [Indexed: 01/08/2023] Open
Abstract
Health at Every Size® (HAES®) is a weight-neutral approach focused on promoting healthy behaviors in people with different body sizes. This study examined multiple physiological, attitudinal, nutritional, and behavioral effects of a newly developed, intensive, interdisciplinary HAES®-based intervention in obese women. This was a prospective, seven-month, randomized (2:1), controlled, mixed-method clinical trial. The intervention group (I-HAES®; n = 39) took part in an intensified HAES®-based intervention comprising a physical activity program, nutrition counseling sessions, and philosophical workshops. The control group (CTRL; n = 19) underwent a traditional HAES®-based intervention. Before and after the interventions, participants were assessed for physiological, psychological, and behavioral parameters (quantitative data) and took part in focus groups (qualitative data). Body weight, body mass index, and waist and hip circumferences did not significantly differ within or between groups (P > 0.05). I-HAES® showed increased peak oxygen uptake and improved performance in the timed-stand test (P = 0.004 and P = 0.004, between-group comparisons). No significant within- or between-group differences were observed for objectively measured physical activity levels, even though the majority of the I-HAES® participants indicated that they were engaged in or had plans to include physical activity in their routines. I-HAES® resulted in improvements in eating attitudes and practices. The I-HAES® group showed significantly improved all Body Attitude Questionnaire subscale and all Figure Rating Scale scores (P ≤ 0.05 for all parameters, within-group comparisons), whereas the CTRL group showed slight or no changes. Both groups had significant improvements in health-related quality of life parameters, although the I-HAES® group had superior gains in the "physical health," "psychological health," and "overall perception of quality of life and health" (P = 0.05, 0.03, and 0.02, respectively, between-group comparisons) domains. Finally, most of the quantitative improvements were explained by qualitative data. Our results show that this new intensified HAES®-based intervention improved participants' eating attitudes and practices, perception of body image, physical capacity, and health-related quality of life despite the lack of changes in body weight and physical activity levels, showing that our novel approach was superior to a traditional HAES®-based program.
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Affiliation(s)
- Mariana Dimitrov Ulian
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Ana Jéssica Pinto
- Applied Physiology & Nutrition Research Group, Laboratory of Assessment and Conditioning in Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Priscila de Morais Sato
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Fabiana B. Benatti
- Applied Physiology & Nutrition Research Group, Laboratory of Assessment and Conditioning in Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
- School of Applied Sciences, Universidade Estadual de Campinas, Limeira, Brazil
| | | | - Desire Coelho
- Applied Physiology & Nutrition Research Group, Laboratory of Assessment and Conditioning in Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Odilon J. Roble
- Faculty of Physical Education, Universidade Estadual de Campinas, Campinas, Brazil
| | - Fernanda Sabatini
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Isabel Perez
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Luiz Aburad
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| | - André Vessoni
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| | | | - Marcelo Macedo Rogero
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
- Food Research Center (FoRC), CEPID-FAPESP, Research Innovation and Dissemination Centers Sao Paulo Research Foundation, Sao Paulo, Brazil
| | | | - Ana Lúcia de Sá-Pinto
- Laboratory of Assessment and Conditioning in Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Bruno Gualano
- Applied Physiology & Nutrition Research Group, Laboratory of Assessment and Conditioning in Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Fernanda B. Scagliusi
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
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17
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Morin I, Bégin C, Maltais-Giguère J, Bédard A, Tchernof A, Lemieux S. Impact of Experimentally Induced Cognitive Dietary Restraint on Eating Behavior Traits, Appetite Sensations, and Markers of Stress during Energy Restriction in Overweight/Obese Women. J Obes 2018; 2018:4259389. [PMID: 30123582 PMCID: PMC6079586 DOI: 10.1155/2018/4259389] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 04/30/2018] [Accepted: 05/20/2018] [Indexed: 02/07/2023] Open
Abstract
Weight loss has been associated with changes in eating behaviors and appetite sensations that favor a regain in body weight. Since traditional weight loss approaches emphasize the importance of increasing cognitive dietary restraint (CDR) to achieve negative energy imbalance, it is difficult to untangle the respective contributions of energy restriction and increases in CDR on factors that can eventually lead to body weight regain. The present study aimed at comparing the effects of energy restriction alone or in combination with experimentally induced CDR on eating behavior traits, appetite sensations, and markers of stress in overweight and obese women. We hypothesized that the combination of energy restriction and induced CDR would lead to more prevalent food cravings, increased appetite sensations, and higher cortisol concentrations than when energy restriction is not coupled with induced CDR. A total of 60 premenopausal women (mean BMI: 32.0 kg/m2; mean age: 39.4 y) were provided with a low energy density diet corresponding to 85% of their energy needs during a 4-week fully controlled period. At the same time, women were randomized to either a condition inducing an increase in CDR (CDR+ group) or a condition in which CDR was not induced (CRD- group). Eating behavior traits (Three-Factor Eating Questionnaire and Food Craving Questionnaire), appetite sensations (after standardized breakfast), and markers of stress (Perceived Stress Scale; postawakening salivary cortisol) were measured before (T = 0 week) and after (T = 4 weeks) the 4-week energy restriction, as well as 3 months later. There was an increase in CDR in the CDR+ group while no such change was observed in the CDR- group (p=0.0037). No between-group differences were observed for disinhibition, hunger, cravings, appetite sensations, perceived stress, and cortisol concentrations. These results suggest that a slight increase in CDR has no negative impact on factors regulating energy balance in the context of energy restriction.
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Affiliation(s)
- Isabelle Morin
- Institute of Nutrition and Functional Foods (INAF), Pavillon des Services, Laval University, 2440 Boulevard Hochelaga, Québec, QC, Canada G1V 0A6
- School of Nutrition, Pavillon Paul-Comtois, Laval University, 2425 Rue de l'Agriculture, Québec, QC, Canada G1V 0A6
| | - Catherine Bégin
- School of Psychology, Pavillon Félix-Antoine-Savard, Laval University, 2325 Rue des Bibliothèques, Québec, QC, Canada G1V 0A6
| | - Julie Maltais-Giguère
- Institute of Nutrition and Functional Foods (INAF), Pavillon des Services, Laval University, 2440 Boulevard Hochelaga, Québec, QC, Canada G1V 0A6
| | - Alexandra Bédard
- Institute of Nutrition and Functional Foods (INAF), Pavillon des Services, Laval University, 2440 Boulevard Hochelaga, Québec, QC, Canada G1V 0A6
| | - André Tchernof
- School of Nutrition, Pavillon Paul-Comtois, Laval University, 2425 Rue de l'Agriculture, Québec, QC, Canada G1V 0A6
- Endocrinology and Nephrology, CHU de Québec, Laval University Medical Center, 2705 Boulevard Laurier, Québec, QC, Canada G1V 4G2
- Quebec Heart and Lung Institute, Laval University, 2725 Chemin Ste-Foy, Québec, QC, Canada G1V 4G5
| | - Simone Lemieux
- Institute of Nutrition and Functional Foods (INAF), Pavillon des Services, Laval University, 2440 Boulevard Hochelaga, Québec, QC, Canada G1V 0A6
- School of Nutrition, Pavillon Paul-Comtois, Laval University, 2425 Rue de l'Agriculture, Québec, QC, Canada G1V 0A6
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18
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Ulian MD, Gualano B, Benatti FB, de Campos-Ferraz PL, Coelho D, Roble OJ, Sabatini F, Perez I, Aburad L, Pinto AJ, Vessoni A, Victor JC, Lima VK, Unsain RF, de Morais Sato P, Rogero MM, Toporcov TN, Scagliusi FB. The design and rationale of an interdisciplinary, non-prescriptive, and Health at Every Size®-based clinical trial: The "Health and Wellness in Obesity" study. Nutr Health 2017; 23:261-270. [PMID: 29214922 DOI: 10.1177/0260106017731260] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND This manuscript describes the design and rationale of a clinical trial that aims to investigate the multiple physiological, attitudinal, nutritional, and behavioral effects of a new interdisciplinary intervention based on the Health at Every Size® (HAES®) approach in obese women. METHODS This will be a prospective, 7-month, randomized (2:1), mixed-method clinical trial. Obese women will be recruited and randomly allocated into two groups. The intervention group (I-HAES®; proposed n = 40) will undertake a novel HAES®-based intervention. Participants will take part in an exercise program, nutrition counseling sessions, and philosophical workshops, all aligned with the principles of the HAES® approach. The control group (CTRL; proposed n = 20) will participate in a program using a traditional HAES®-based group format, characterized by bimonthly lectures about the same topics offered to the experimental group, encouraging the adoption of a healthy lifestyle. The following multiple quantitative outcomes will be assessed pre and post intervention: health-related quality of life, cardiovascular risk factors, anthropometric assessments, physical activity level, physical capacity and function, and psychological and behavioral assessments. Qualitative analysis will be used to evaluate the experiences of the participants throughout the intervention, as assessed by focus groups and semi-structured interviews. CONCLUSIONS The interdisciplinary research team leading this study has varied and complementary expertise. The knowledge arising from this study will help to guide new interdisciplinary interventions with the potential to holistically improve the health of obese individuals. This trial is registered at Clinicaltrials.gov (NCT02102061).
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Affiliation(s)
- Mariana D Ulian
- 1 School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Bruno Gualano
- 2 Applied Physiology & Nutrition Research Group, University of São Paulo, Brazil
| | - Fabiana B Benatti
- 2 Applied Physiology & Nutrition Research Group, University of São Paulo, Brazil
| | | | - Desire Coelho
- 2 Applied Physiology & Nutrition Research Group, University of São Paulo, Brazil
| | - Odilon J Roble
- 4 Faculty of Physical Education, State University of Campinas, Campinas, Brazil
| | - Fernanda Sabatini
- 1 School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Isabel Perez
- 1 School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Luiz Aburad
- 1 School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Ana Jéssica Pinto
- 2 Applied Physiology & Nutrition Research Group, University of São Paulo, Brazil
| | - André Vessoni
- 1 School of Public Health, University of São Paulo, São Paulo, Brazil
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19
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Rigid dietary control, flexible dietary control, and intuitive eating: Evidence for their differential relationship to disordered eating and body image concerns. Eat Behav 2017; 26:16-22. [PMID: 28131005 DOI: 10.1016/j.eatbeh.2017.01.008] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 01/18/2017] [Accepted: 01/22/2017] [Indexed: 02/01/2023]
Abstract
This study aimed to replicate and extend from Tylka, Calogero, and Daníelsdóttir (2015) findings by examining the relationship between rigid control, flexible control, and intuitive eating on various indices of disordered eating (i.e., binge eating, disinhibition) and body image concerns (i.e., shape and weight over-evaluation, body checking, and weight-related exercise motivations). This study also examined whether the relationship between intuitive eating and outcomes was mediated by dichotomous thinking and body appreciation. Analysing data from a sample of 372 men and women recruited through the community, this study found that, in contrast to rigid dietary control, intuitive eating uniquely and consistently predicted lower levels of disordered eating and body image concerns. This intuitive eating-disordered eating relationship was mediated by low levels of dichotomous thinking and the intuitive eating-body image relationship was mediated by high levels of body appreciation. Flexible control predicted higher levels of body image concerns and lower levels of disordered eating only when rigid control was accounted for. Findings suggest that until the adaptive properties of flexible control are further elucidated, it may be beneficial to promote intuitive eating within public health approaches to eating disorder prevention. In addition to this, particular emphasis should also be made toward promoting body acceptance and eradicating a dichotomous thinking style around food and eating.
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20
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US Registered Dietitian Nutritionists' Knowledge and Attitudes of Intuitive Eating and Use of Various Weight Management Practices. J Acad Nutr Diet 2017; 117:1419-1428. [PMID: 28619668 DOI: 10.1016/j.jand.2017.04.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 04/20/2017] [Indexed: 01/02/2023]
Abstract
BACKGROUND Researchers have been advocating for a new weight-inclusive paradigm that focuses on health rather than weight. One important component of this model is intuitive eating. Although registered dietitian nutritionists (RDNs) are the nation's food and nutrition experts, RDNs' knowledge of and attitudes toward intuitive eating and use of traditional or restrictive strategies are unknown. OBJECTIVE The purpose of this study was to characterize RDNs' knowledge of and attitudes toward an intuitive eating lifestyle and describe use of traditional weight management and nonrestrictive lifestyle practices with clients. DESIGN This was a cross-sectional study. PARTICIPANTS A validated survey was distributed using online survey software to 88,834 RDNs. RESULTS There were 18,622 respondents who completed the survey (25%). The majority of RDNs were knowledgeable about intuitive eating, answering 71% of items correctly. The majority of RDNs had a positive view on each attitude item. RDNs who work in weight management reported using nonrestrictive/intuitive eating practices more than traditional/restrictive practices. RDNs who were women (P<0.001), had advanced education (P<0.001), worked in a private practice setting (P<0.001), completed at least one certificate of training in weight management (P<0.001), had more experience in weight management counseling (P<0.001), and had greater intuitive eating knowledge (P<0.001) were more likely to report greater use of nonrestrictive/intuitive eating practices. CONCLUSIONS This study provides evidence that RDNs are using an intuitive eating approach more often than traditional weight management practices.
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21
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Brevers D, Rogiers A, Defontaine A, Cheron G, Clarinval AM, Foucart J, Bouchez A, Bolly V, Tsartsafloudakis L, Jottrand P, Minner P, Bechara A, Kornreich C, Verbanck P. Implementation Intention for Initiating Intuitive Eating and Active Embodiment in Obese Patients Using a Smartphone Application. Front Psychiatry 2017; 8:243. [PMID: 29209236 PMCID: PMC5702316 DOI: 10.3389/fpsyt.2017.00243] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 11/06/2017] [Indexed: 11/13/2022] Open
Abstract
This article describes a study protocol, which aims to explore and describe the feasibility of a mobile-phone application for initiating intuitive eating and intuitive exercising in patients who are following an ambulatory treatment for obesity. Intuitive eating refers to one's ability to make food choices based on one's awareness of his/her body's response. Intuitive exercising encourages people in finding enjoyable ways of being physically active. These two components will be trained using an implementation intention procedure, that is, behavioral plans that aim at creating a strong link between a specified situation and a response. We aim to recruit up to 80 overweight and obese patients over a period of 2 years. The smartphone application will be assessed on the basis of (i) data obtained through a 4-week use period, (ii) self-report measures taken before and after the use of the mobile application, and (iii) feedbacks from participants after the use of the mobile application. This pilot study will allow us to better understand the applicability of the use of mobile application within ambulatory treatment settings, and to adapt the design of the app necessary for building cross-sectional studies investigating its efficacy.
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Affiliation(s)
- Damien Brevers
- Laboratory of Psychological Medicine and Addictology, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium.,Research in Psychology Applied to Motor Learning, Faculty of Motor Sciences, Université Libre de Bruxelles, Brussels, Belgium
| | - Anne Rogiers
- Laboratory of Psychological Medicine and Addictology, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Alexis Defontaine
- Research in Psychology Applied to Motor Learning, Faculty of Motor Sciences, Université Libre de Bruxelles, Brussels, Belgium
| | - Guy Cheron
- Laboratory of Neurophysiology and Movement Biomechanics, Faculty of Motor Sciences, Université Libre de Bruxelles, Brussels, Belgium
| | - Anne-Marie Clarinval
- Laboratory of Neurophysiology and Movement Biomechanics, Faculty of Motor Sciences, Université Libre de Bruxelles, Brussels, Belgium
| | - Jennifer Foucart
- Research in Psychology Applied to Motor Learning, Faculty of Motor Sciences, Université Libre de Bruxelles, Brussels, Belgium
| | - Anne Bouchez
- Laboratory of Psychological Medicine and Addictology, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Véronique Bolly
- Laboratory of Psychological Medicine and Addictology, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Laura Tsartsafloudakis
- Laboratory of Psychological Medicine and Addictology, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Pénélope Jottrand
- Laboratory of Psychological Medicine and Addictology, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Pierre Minner
- Laboratory of Psychological Medicine and Addictology, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Antoine Bechara
- Department of Psychology, Brain and Creativity Institute, University of Southern California, Los Angeles, CA, United States
| | - Charles Kornreich
- Laboratory of Psychological Medicine and Addictology, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Paul Verbanck
- Laboratory of Psychological Medicine and Addictology, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium.,Research in Psychology Applied to Motor Learning, Faculty of Motor Sciences, Université Libre de Bruxelles, Brussels, Belgium
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22
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Lee JA, Pausé CJ. Stigma in Practice: Barriers to Health for Fat Women. Front Psychol 2016; 7:2063. [PMID: 28090202 PMCID: PMC5201160 DOI: 10.3389/fpsyg.2016.02063] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 12/20/2016] [Indexed: 01/19/2023] Open
Abstract
In this paper, we explore barriers to health for fat people. By shifting the focus from what fat people do or do not do, neoliberal principles are replaced by a focus instead on structural and institutional policies, attitudes, and practices. This includes the impact of stigma on the health treatment and health-seeking behavior of fat people. For example, we consider the role that provider anti-fat attitudes and confirmation bias play in the failure to provide evidenced-based healthcare to fat patients. This is an autoethnographic paper, which provides the opportunity to read research from the perspective of fat scholars, framed by questions such as: can fat people have health? Is health itself a state of being, a set of behaviors, a commodity, a performance; perhaps the new social contract? As a co-written autoethnographic paper, one aspect of the evidence provided is the recorded experiences of the two fat authors. This includes writing from notes, journals, compiled and repeated experiences with medical professionals, family, and the community. Framed by feminist standpoint and supported by literature drawn from Fat Studies, Public Health, Obesity Research, and other interdisciplinary fields, this is a valuable opportunity to present an extended account of fat discrimination and the impact of the stigma fat people face through the medical profession and other sectors of the community, written by fat individuals. The paper concludes by considering the health pathways available to fat people. Special attention is paid to whether Bacon and Aphramor's Health at Every Size paradigm provides a path to health for fat individuals.
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Affiliation(s)
- Jennifer A. Lee
- College of Arts, Victoria UniversityMelbourne, VIC, Australia
| | - Cat J. Pausé
- College of Humanities and Social Sciences, Institute of Education, Massey UniversityPalmerston North, New Zealand
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Validation of an instrument to measure registered dietitians'/nutritionists' knowledge, attitudes and practices of an intuitive eating approach. Public Health Nutr 2016; 19:3114-3122. [PMID: 27246613 DOI: 10.1017/s1368980016001336] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The purpose of the present study was to develop and assess the construct validity of a tool to measure knowledge, attitudes and practices of registered dietitians/nutritionists (RD/N) regarding an intuitive eating lifestyle. DESIGN Cross-sectional study design that utilized a survey administered to a random sample and remaining full population of RD/N. SETTING A national survey conducted via online survey software. SUBJECTS A random sample of 10 % of all RD/N in the USA (n 8834) was invited to participate. Survey completion rate was 22·2 % (n 1897). After initial validation, the survey was distributed to the remaining 90 % of RD/N to confirm validation. RESULTS After removing items with insufficient factor loadings, results were consistent with a four-factor solution: (i) knowledge of intuitive eating; (ii) attitudes towards intuitive eating; (iii) traditional and restrictive practices; and (iv) non-restrictive and intuitive eating practices. Confirmatory factor analysis provided further evidence of the validity of the four factors and the factors had strong reliability. CONCLUSIONS Unlike the hypothesized three-factor solution (knowledge, attitudes and practices), validation analysis revealed that the survey measures knowledge of intuitive eating, attitudes towards intuitive eating, use of traditional and restrictive weight-management practices, and use of non-restrictive and intuitive eating practices. With the landscape of weight management and health promotion undergoing a shift towards a health centred, size acceptance approach, this instrument will provide valuable information regarding the current knowledge, attitudes and practices of RD/N and other health promotion professionals.
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Khasteganan N, Lycett D, Turner AP, Farley A, Lindson-Hawley N, Furze G. Health, not weight loss, focused programmes versus conventional weight loss programmes for cardiovascular risk factors. Hippokratia 2016. [DOI: 10.1002/14651858.cd011182.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Nazanin Khasteganan
- Coventry University; Faculty of Health and Life Sciences; Priory Street Coventry Warwickshire UK CV1 5FB
| | - Deborah Lycett
- Coventry University; Faculty of Health and Life Sciences; Priory Street Coventry Warwickshire UK CV1 5FB
| | - Andy P Turner
- Coventry University; Faculty of Health and Life Sciences; Priory Street Coventry Warwickshire UK CV1 5FB
| | - Amanda Farley
- University of Birmingham; Public Health, Epidemiology and Biostatistics; Edgbaston Birmingham West Midlands UK B15 2TT
| | - Nicola Lindson-Hawley
- University of Oxford; Nuffield Department of Primary Care Health Sciences; Radcliffe Observatory Quarter Woodstock Road Oxford Oxfordshire UK OX2 6GG
| | - Gill Furze
- Coventry University; Faculty of Health and Life Sciences; Priory Street Coventry Warwickshire UK CV1 5FB
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Spoor KD, Madanat H. Relationship Between Body Image Discrepancy and Intuitive Eating. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2016; 36:189-97. [DOI: 10.1177/0272684x16641847] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Dieting is widespread among college women despite being ineffective and harmful long term. Intuitive eating is a dieting alternative that teaches eating in response to hunger and satiety cues. It has been associated with improved physical and psychological health and studied in association with various body image dimensions. A sample of college first years completed baseline measurements during an intuitive eating intervention to test the association between intuitive eating and body image discrepancy (BID). BID represents whether a respondent believes her current body is larger or smaller than ideal. Greater BID was negatively associated with intuitive eating ( p ≤ .05); participants who believed that their current bodies were larger than ideal were less likely to attend to hunger and satiety cues than participants who expressed little or no BID. These women should be targeted in future weight management interventions in order to avoid negative health outcomes of dieting.
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Affiliation(s)
- Kesha Dorsey Spoor
- Graduate School of Public Health, San Diego State University, San Diego, CA, USA
- Institute for Behavioral and Community Health, San Diego, CA, USA
| | - Hala Madanat
- Graduate School of Public Health, San Diego State University, San Diego, CA, USA
- Institute for Behavioral and Community Health, San Diego, CA, USA
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Anderson DA, Schaumberg K, Anderson LM, Reilly EE. Is level of intuitive eating associated with plate size effects? Eat Behav 2015; 18:125-30. [PMID: 26042920 DOI: 10.1016/j.eatbeh.2015.05.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Revised: 03/20/2015] [Accepted: 05/13/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Intuitive eating is an eating approach that emphasizes increased focus on internal hunger and fullness cues to regulate eating behavior; thus, successful intuitive eating should curb the influence of environmental factors such as plate and portion size on consumption. The current study examined whether self-reported levels of intuitive eating moderated the influence of portion size on college students' food consumption during an afternoon meal of pasta and tomato sauce. METHOD Participants (N=137, 63.5% female) were randomly assigned to either a large plate (12-inch) or small plate (8-inch) external cue condition. All participants fasted for four daytime hours, completed the Intuitive Eating Scale, and then were asked to rate a meal of pasta and tomato sauce on different dimensions of taste. Participants were told that they could eat as much pasta as they would like. RESULTS Higher levels of intuitive eating were associated with greater food consumption. At the mean level of intuitive eating, participants ate more pasta in the large plate condition. Furthermore, the influence of plate size on food consumption increased as levels of intuitive eating increased. DISCUSSION Individuals who report high levels of intuitive eating may be more likely to eat an objectively larger amount of food in a permissive food environment, and may have implications for eating approaches that promote eating in response to internal hunger and fullness cues.
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Affiliation(s)
- Drew A Anderson
- University at Albany-State University of New York, Department of Psychology, 1400 Washington Avenue, Social Sciences 399, Albany, NY 12222, United States.
| | - Katherine Schaumberg
- University at Albany-State University of New York, Department of Psychology, 1400 Washington Avenue, Social Sciences 399, Albany, NY 12222, United States; Drexel University, Department of Psychology, 3141 Chestnut Street, Stratton Hall 119, Philadelphia, PA 19104, United States.
| | - Lisa M Anderson
- University at Albany-State University of New York, Department of Psychology, 1400 Washington Avenue, Social Sciences 399, Albany, NY 12222, United States.
| | - Erin E Reilly
- University at Albany-State University of New York, Department of Psychology, 1400 Washington Avenue, Social Sciences 399, Albany, NY 12222, United States.
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Penney TL, Kirk SFL. The Health at Every Size paradigm and obesity: missing empirical evidence may help push the reframing obesity debate forward. Am J Public Health 2015; 105:e38-42. [PMID: 25790393 DOI: 10.2105/ajph.2015.302552] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A Health at Every Size (HAES) approach has been proposed to address weight bias and stigma in individuals living with obesity, and more recently articulated as a promising public health approach beyond the prevailing focus on weight status as a health outcome. The purpose of this article is to examine our understanding of HAES within the context of public health approaches to obesity, and to present strengths and limitations of the available evidence. Advancing our understanding of HAES from a public health perspective requires us to move beyond an ideological debate and give greater attention to the need for empirical studies across a range of populations. Only then can the value of HAES, as a weight-neutral, public health approach for the prevention of obesity and other chronic diseases, be fully understood.
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Affiliation(s)
- Tarra L Penney
- Tarra L. Penney and Sara F. L. Kirk are with Applied Research Collaborations for Health, School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia
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Clifford D, Ozier A, Bundros J, Moore J, Kreiser A, Morris MN. Impact of non-diet approaches on attitudes, behaviors, and health outcomes: a systematic review. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2015; 47:143-55.e1. [PMID: 25754299 DOI: 10.1016/j.jneb.2014.12.002] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 12/03/2014] [Accepted: 12/03/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To determine the overall effect of non-diet, weight-neutral interventions on factors such as weight, biochemical measures, food and activity behavior, body image, and mental health. DESIGN Systematic review of intervention literature. SETTING Group classes in community and worksite settings (14 studies), and individual counseling (1) and online education (1) in college settings. PARTICIPANTS Eighteen research articles (representing 16 studies) evaluating non-diet interventions using quasi-experimental and randomized study designs with either a comparison or control group. MAIN OUTCOME MEASURES Anthropometric, physiological, psychological, and dietary intake. ANALYSIS Systematic search of 168 articles and review of 18 articles meeting inclusionary criteria. RESULTS Non-diet interventions resulted in statistically significant improvements in disordered eating patterns, self-esteem, and depression. None of the interventions resulted in significant weight gain or worsening of blood pressure, blood glucose, or cholesterol, and in 2 studies biochemical measures improved significantly compared with the control or diet group. Primary limitations were inconsistent definitions of non-diet approaches and the use of different assessment instruments for measuring outcomes. CONCLUSIONS AND IMPLICATIONS Because of the long-term ineffectiveness of weight-focused interventions, the psychological improvements seen in weight-neutral, non-diet interventions warrant further investigation.
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Affiliation(s)
- Dawn Clifford
- Department of Nutrition and Food Science, California State University, Chico, Chico, CA.
| | - Amy Ozier
- Family, Consumer & Nutrition Sciences, Northern Illinois University, DeKalb, IL
| | - Joanna Bundros
- Department of Nutrition and Food Science, California State University, Chico, Chico, CA
| | - Jeffrey Moore
- Department of Nutrition and Food Science, California State University, Chico, Chico, CA
| | - Anna Kreiser
- Family, Consumer & Nutrition Sciences, Northern Illinois University, DeKalb, IL
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Healy N, Joram E, Matvienko O, Woolf S, Knesting K. Impact of an intuitive eating education program on high school students’ eating attitudes. HEALTH EDUCATION 2015. [DOI: 10.1108/he-03-2014-0043] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– There is a growing need for school-based nutritional educational programs that promote healthy eating attitudes without increasing an unhealthy focus on restrictive eating or promoting a poor body image. Research suggests that intuitive eating (IE) approaches, which encourage individuals to focus on internal body signals as a guide for eating, have had a positive impact on eating-related psychological outcomes in adults. The purpose of this paper is to investigate the effects an IE education program on the eating attitudes of high school students.
Design/methodology/approach
– In a quasi-experimental study, 48 high school students (30 females) in a Midwest town in the USA received instruction on IE or a comparison program over seven days during health classes. Repeated measures analyses of covariance were conducted to examine changes in eating attitudes in sexes across conditions.
Findings
– Students who received the IE program made significantly greater gains in overall positive eating attitudes on the Intuitive Eating Scale than students in the comparison program (p=0.045), as well as on the Unconditional Permission to Eat subscale (p=0.02). There were no significant effects of sex on any of the analyses.
Research limitations/implications
– Because of the relatively small sample size and short duration of the program, the results should be generalized with caution.
Practical implications
– The results suggest that IE instruction may encourage the development of healthy eating attitudes in high school students, and health teachers may wish to consider including IE instruction in the health curriculum.
Originality/value
– This is the first study to examine the effectiveness of an IE program in a K-12 population, with instruction provided in the context of the school. The results are promising and suggest that this may be a fruitful area for future research in nutrition education.
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Khasteganan N, Lycett D, Turner AP, Farley AC, Lindson-Hawley N, Furze G. Health, not weight loss, focused programmes versus conventional weight loss programmes for cardiovascular risk factors. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2014. [DOI: 10.1002/14651858.cd011182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Schaefer JT, Magnuson AB. A review of interventions that promote eating by internal cues. J Acad Nutr Diet 2014; 114:734-60. [PMID: 24631111 DOI: 10.1016/j.jand.2013.12.024] [Citation(s) in RCA: 124] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Accepted: 12/22/2013] [Indexed: 11/28/2022]
Abstract
Traditional diet programs that encourage individuals to consciously restrict their dietary intake have not only been ineffective in terms of weight outcomes, but have also been counterproductive, promoting psychological distress and unhealthy eating behaviors. Nondiet approaches shift the focus away from weight outcomes to the improvement of health outcomes and psychological well-being. One such approach, intuitive eating, promotes dietary intake based on internal cues of hunger and fullness, body acceptance, and making behavior choices based on health as well as enjoyment. Several studies have implemented such ideas into intervention programs. The purpose of our review was to examine the physical and psychological effects of these programs. Twenty interventions were identified. Overall, studies had positive results, demonstrating improvements in eating habits, lifestyle, and body image as measured by dietary restraint, restrictive dieting, physical activity, body satisfaction, and drive for thinness. Participants also experienced improved psychological health as measured by depression, ineffectiveness, anxiety, self-esteem, negative affect, and quality of life. Several improvements were sustained through follow-up periods as long as 2 years. Completion rates were as high as 92% in nondieting groups. In addition, improvements in eating behaviors and maintaining a nondiet approach, increased self-esteem, and decreased body dissatisfaction were sustained long-term. Overall, studies that encourage individuals to eat intuitively help participants abandon unhealthy weight control behaviors, improve metabolic fitness, increase body satisfaction, and improve psychological distress. Results from our review favor the promotion of programs that emphasize a nonrestrictive pattern of eating, body acceptance, and health rather than weight loss.
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Carels RA, Burmeister JM, Koball AM, Oehlhof MW, Hinman N, LeRoy M, Bannon E, Ashrafioun L, Storfer-Isser A, Darby LA, Gumble A. A randomized trial comparing two approaches to weight loss: differences in weight loss maintenance. J Health Psychol 2014; 19:296-311. [PMID: 23349402 PMCID: PMC3883879 DOI: 10.1177/1359105312470156] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
This study compared treatment outcomes for a new weight loss program that emphasized reducing unhealthy relationships with food, body image dissatisfaction, and internalized weight bias (New Perspectives) to a weight loss program that emphasizes environmental modification and habit formation and disruption (Transforming Your Life). Fifty-nine overweight and obese adults (body mass index ≥ 27 kg/m(2)) were randomly assigned to either a 12-week New Perspectives or Transforming Your Life intervention. Despite equivalent outcomes at the end of treatment, the Transforming Your Life participants were significantly more effective at maintaining their weight loss than New Perspectives participants during the 6-month no-treatment follow-up period.
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Bloom L, Shelton B, Bengough M, Brennan L. Psychosocial outcomes of a non-dieting based positive body image community program for overweight adults: a pilot study. J Eat Disord 2013; 1:44. [PMID: 24999422 PMCID: PMC4081825 DOI: 10.1186/2050-2974-1-44] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Accepted: 11/30/2013] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The limited success of traditional diet focused obesity interventions has led to the development of alternative non-dieting approaches. The current study evaluated the impact of a community based non-dieting positive body image program for overweight/obese people on a range of psychosocial outcomes. The characteristics of this real-world sample presenting for a non-dieting weight management intervention are also described. METHOD Overweight and obese participants enrolled in the eight week 'No More Diets' (NMD) group program completed self-report questionnaires assessing disordered eating thoughts and behaviours, body image, motivation for exercise and psychopathology pre- and post-treatment. RESULTS Participants (n = 17; 16 female) were aged between 19 and 78 years, with a BMI ranging from 25.2 kg/m(2) (Overweight) to 55.9 kg/m(2) (Severely Obese). They reported elevated levels of eating disorder pathology, body shape preoccupation, depression, anxiety and stress compared to community norms (p < .05). Following treatment there were significant improvements in reported body shape preoccupation, shape concern and eating attitudes (p < .05), and clinically significant changes (small to medium effect sizes; 0.3-0.35) for improvements in reported weight concern, eating competence, stress and health evaluation. There were no changes in reported dietary restraint, emotional eating and uncontrolled eating, or eating concern (p > .05). CONCLUSION Individuals presenting for the NMD program demonstrated increased eating disorder pathology and more generalised psychopathology compared to community norms. The NMD program was particularly beneficial for body image and shape concern. Addressing these body image factors may help to address some of the perpetuating factors of obesity and disordered eating, which are often not addressed in the traditional diet-based weight loss interventions.
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Affiliation(s)
- Lisa Bloom
- School of Health Sciences, RMIT University, Melbourne, Australia
| | - Beth Shelton
- MonashLink Community Health Service, Melbourne, Australia
- Southern Health Wellness Recovery Adult Outpatient Eating Disorder Service, Melbourne, Australia
| | - Melissa Bengough
- Southern Health Wellness Recovery Adult Outpatient Eating Disorder Service, Melbourne, Australia
| | - Leah Brennan
- School of Psychology, Australian Catholic University, Melbourne, Australia
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Lesdéma A, Fromentin G, Daudin JJ, Arlotti A, Vinoy S, Tome D, Marsset-Baglieri A. Characterization of the Three-Factor Eating Questionnaire scores of a young French cohort. Appetite 2012; 59:385-90. [DOI: 10.1016/j.appet.2012.05.027] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Revised: 05/24/2012] [Accepted: 05/27/2012] [Indexed: 11/15/2022]
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Associations between eating patterns, dietary intakes and eating behaviors in premenopausal overweight women. Eat Behav 2012; 13:162-5. [PMID: 22365804 DOI: 10.1016/j.eatbeh.2011.12.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Revised: 11/03/2011] [Accepted: 12/22/2011] [Indexed: 11/21/2022]
Abstract
The regulation of energy intake is complex and many biological, psychosocial and environmental influences have been identified. To our knowledge, no study has yet investigated how eating patterns could mediate associations between eating behaviors and self-reported energy intake in premenopausal overweight women. Therefore, objectives of this study were to examine associations between eating behaviors and eating patterns in premenopausal overweight women and to test if eating patterns could mediate the associations between eating behaviors and self-reported energy intake. Women completed a 3-day food record and the Three-Factor Eating Questionnaire was used to assess eating behaviors (dietary restraint, disinhibition, hunger). In the total sample of women, flexible restraint was negatively (r=-0.18; p=0.03) and binge eating severity was positively (r=0.24; p=0.004) associated with self-reported energy intake. Moreover, flexible restraint was positively associated with the proportion of energy intake at breakfast (r=0.24; p=0.004), whereas disinhibition and binge eating severity were positively associated with the proportion of energy intake from snacks consumed after 5:00 pm (r=0.22, p=0.007 and r=0.22, p=0.01, respectively). In addition, mediational analyses showed that proportion of energy intake from snacks consumed after 5:00 pm explained 24.1% of the association between binge eating severity and self-reported energy intake. In conclusion, these results suggest that eating patterns are important factors to consider in order to explain the associations between eating behaviors and self-reported energy intake.
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Bryant E, Caudwell P, Hopkins M, King N, Blundell J. Psycho-markers of weight loss. The roles of TFEQ Disinhibition and Restraint in exercise-induced weight management. Appetite 2012; 58:234-41. [DOI: 10.1016/j.appet.2011.09.006] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2011] [Revised: 07/28/2011] [Accepted: 09/05/2011] [Indexed: 11/27/2022]
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Impact of a Health-At-Every-Size intervention on changes in dietary intakes and eating patterns in premenopausal overweight women: results of a randomized trial. Clin Nutr 2012; 31:481-8. [PMID: 22296874 DOI: 10.1016/j.clnu.2011.12.013] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Revised: 11/29/2011] [Accepted: 12/21/2011] [Indexed: 11/20/2022]
Abstract
BACKGROUND & AIMS Previous studies have shown improvements in eating behaviors following a Health-At-Every-Size approach (HAES). However, to our knowledge, no study has yet investigated how a HAES intervention could influence dietary intakes and eating patterns in overweight women. Therefore, objectives of this study were to determine changes in dietary intakes and eating patterns in premenopausal overweight women in response to a HAES intervention compared to a social support intervention and a control group, and then to determine whether changes in eating behaviors were associated with changes in dietary intakes and eating patterns in response to the HAES intervention. METHODS Women completed a 3-day food record and the Three-Factor Eating Questionnaire was used to assess eating behaviors. RESULTS Energy intake (main effect of time; p = 0.045) and snack frequency (main effect of time; p = 0.0004) decreased similarly over time in the three groups whereas proportion of energy intake from breakfast (main effect of time; p = 0.03) increased over time. Within HAES group, decreases in hunger and external hunger were associated with a decrease in total daily energy intake (r = 0.50, p = 0.0009 and r = 0.50, p = 0.0007, respectively). CONCLUSIONS HAES intervention has no specific impact on eating patterns. However, a decrease in hunger, which characterizes women who respond well to HAES, is associated with a decrease in overall energy intake. Clinical trial registration number (www.clinicaltrials.gov): NCT01240499.
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Bacon L, Aphramor L. Weight science: evaluating the evidence for a paradigm shift. Nutr J 2011; 10:9. [PMID: 21261939 PMCID: PMC3041737 DOI: 10.1186/1475-2891-10-9] [Citation(s) in RCA: 274] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2010] [Accepted: 01/24/2011] [Indexed: 02/07/2023] Open
Abstract
Current guidelines recommend that "overweight" and "obese" individuals lose weight through engaging in lifestyle modification involving diet, exercise and other behavior change. This approach reliably induces short term weight loss, but the majority of individuals are unable to maintain weight loss over the long term and do not achieve the putative benefits of improved morbidity and mortality. Concern has arisen that this weight focus is not only ineffective at producing thinner, healthier bodies, but may also have unintended consequences, contributing to food and body preoccupation, repeated cycles of weight loss and regain, distraction from other personal health goals and wider health determinants, reduced self-esteem, eating disorders, other health decrement, and weight stigmatization and discrimination. This concern has drawn increased attention to the ethical implications of recommending treatment that may be ineffective or damaging. A growing trans-disciplinary movement called Health at Every Size (HAES) challenges the value of promoting weight loss and dieting behavior and argues for a shift in focus to weight-neutral outcomes. Randomized controlled clinical trials indicate that a HAES approach is associated with statistically and clinically relevant improvements in physiological measures (e.g., blood pressure, blood lipids), health behaviors (e.g., eating and activity habits, dietary quality), and psychosocial outcomes (such as self-esteem and body image), and that HAES achieves these health outcomes more successfully than weight loss treatment and without the contraindications associated with a weight focus. This paper evaluates the evidence and rationale that justifies shifting the health care paradigm from a conventional weight focus to HAES.
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Gagnon-Girouard MP, Bégin C, Provencher V, Tremblay A, Mongeau L, Boivin S, Lemieux S. Psychological Impact of a "Health-at-Every-Size" Intervention on Weight-Preoccupied Overweight/Obese Women. J Obes 2010; 2010:928097. [PMID: 20798861 PMCID: PMC2925467 DOI: 10.1155/2010/928097] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2009] [Revised: 04/21/2010] [Accepted: 05/20/2010] [Indexed: 11/23/2022] Open
Abstract
The aim of the present study was to assess the impact of a "Health-at-every-size" (HAES) intervention on psychological variables and body weight the weight-preoccupied overweight/obese women. Those women were randomized into three groups (1) HAES, (2) social support (SS), (3) waiting-list (WL), and were tested at baseline, post-treatment and six-month and one-year follow-ups. All participants presented significant psychological improvement no matter if they received the HAES intervention or not. However, even if during the intervention, the three groups showed improvements, during the follow up, the HAES group continued to improve while the other groups did not, even sometimes experiencing some deterioration. Furthermore, in the HAES group only, participant's weight maintenance 12 months after the intervention was related to their psychological improvement (quality of life, body dissatisfaction, and binge eating) during the intervention. Thus, even if, in the short-term, our study did not show distinctive effects of the HAES intervention compared to SS and WL on all variables, in the long-term, HAES group seemed to present a different trajectory as psychological variables and body weight are maintained or continue to improve, which was not the case in other groups. These differential long-term effects still need to be documented and further empirically demonstrated.
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Affiliation(s)
- Marie-Pierre Gagnon-Girouard
- School of Psychology, Laval University, Pav. F-A.-Savard, local 1116, 2325 des Bibliothèques Street, QC, Canada G1V 0A6
| | - Catherine Bégin
- School of Psychology, Laval University, Pav. F-A.-Savard, local 1116, 2325 des Bibliothèques Street, QC, Canada G1V 0A6
| | - Véronique Provencher
- Department of Food Science and Nutrition, Institute of Nutraceuticals and Functional Foods, Laval University, QC, Canada G1V 0A6
| | - Angelo Tremblay
- Division of Kinesiology, Department of Preventive and Social Medicine, Laval University, QC, Canada G1K 7P4
| | - Lyne Mongeau
- Institut National de Santé Publique du Québec, Ministère de la Santé et des Services sociaux, 201, boul. Crémazie Est, office 203, Montréal, QC, Canada H2M 1L2
| | - Sonia Boivin
- Eating Disorders Treatment Program, CHUQ, Laval University, QC, Canada G1V 0A6
| | - Simone Lemieux
- Department of Food Science and Nutrition, Institute of Nutraceuticals and Functional Foods, Laval University, QC, Canada G1V 0A6
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Andrade AM, Coutinho SR, Silva MN, Mata J, Vieira PN, Minderico CS, Melanson KJ, Baptista F, Sardinha LB, Teixeira PJ. The effect of physical activity on weight loss is mediated by eating self-regulation. PATIENT EDUCATION AND COUNSELING 2010; 79:320-6. [PMID: 20149955 DOI: 10.1016/j.pec.2010.01.006] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2009] [Revised: 12/31/2009] [Accepted: 01/07/2010] [Indexed: 05/06/2023]
Abstract
OBJECTIVE This study tested whether different forms of physical activity (PA) were associated with eating self-regulation during weight control, and if changes in eating behavior mediated the relationship between PA and weight loss, in overweight/obese women. METHODS 239 women (37.6+/-7.0 years; 31.3+/-4.1kg/m(2)) participated. The intervention group received a 12-month group behavioral treatment designed to increase autonomy and self-regulation for weight control. Controls received a health education program. Assessments included body weight, structured and lifestyle exercise/PA, and eating self-regulation. RESULTS Moderate+vigorous and lifestyle PA were associated with 12-month change in most eating variables (p<0.05) and with body weight change (p<0.01). Mediation analysis showed that flexible cognitive restraint and emotional eating fully mediated the relation between lifestyle PA and weight change (effect ratio: 0.63). About 34% of the effect of moderate+vigorous PA on weight change was explained by these same mediators (partial mediation). CONCLUSION Exercise and PA may positively influence weight control through eating self-regulation. Flexible dietary control and reduced emotional overeating are mechanisms by which an active lifestyle can contribute to long-term weight management. PRACTICE IMPLICATIONS Regular exercise and PA can contribute to improved eating behaviors during weight management. This could represent an important incentive for people seeking weight control.
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Affiliation(s)
- Ana M Andrade
- Faculty of Human Kinetics, Technical University of Lisbon, Portugal
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Comparison of a dietary intervention promoting high intakes of fruits and vegetables with a low-fat approach: long-term effects on dietary intakes, eating behaviours and body weight in postmenopausal women. Br J Nutr 2010; 104:1080-90. [PMID: 20482930 DOI: 10.1017/s0007114510001716] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The aim of the present study was to compare the long-term effects of two dietary approaches on changes in dietary intakes, eating behaviours and body weight: (1) approach using restrictive messages to limit high-fat foods (low-fat intake; LOFAT); (2) approach emphasising non-restrictive messages directed towards the inclusion of fruits and vegetables (high intake of fruits and vegetables; HIFV). A total of sixty-eight overweight or obese postmenopausal women were randomly assigned to one of the two dietary approaches. The 6-month dietary intervention included three group sessions and ten individual sessions with a dietitian. Dietary intakes, eating behaviours and anthropometrics were measured at baseline, at the end of the dietary intervention (T = 6) and 6 months and 12 months after the end of the intervention (T = 12 and T = 18). In the LOFAT group, energy and fat intakes were lower at T = 6 when compared with baseline and remained lower at T = 12 and T = 18. In the HIFV group, fruit and vegetable intakes increased significantly at T = 6 but were no longer significantly different from baseline at T = 12 and T = 18. Dietary restraint increased at T = 6 and remained higher than baseline at T = 18 in the LOFAT group while no significant change was observed in the HIFV group. At T = 6, body weight was significantly lower than baseline in both groups (LOFAT: - 3.7 (SD 2.8) kg; HIFV: - 1.8 (SD 3.0) kg) and no significant difference in body-weight change from baseline was found between groups at T = 18. We concluded that weight loss was similar at 1-year follow-up in both dietary approaches. Despite relatively good improvements in the short term, the adherence to a 6-month dietary intervention promoting high intakes of fruits and vegetables was difficult to maintain.
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Impact of walking on eating behaviors and quality of life of premenopausal and early postmenopausal obese women. Menopause 2010; 17:529-38. [DOI: 10.1097/gme.0b013e3181d12361] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Teixeira PJ, Silva MN, Coutinho SR, Palmeira AL, Mata J, Vieira PN, Carraça EV, Santos TC, Sardinha LB. Mediators of weight loss and weight loss maintenance in middle-aged women. Obesity (Silver Spring) 2010; 18:725-35. [PMID: 19696752 DOI: 10.1038/oby.2009.281] [Citation(s) in RCA: 259] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Long-term behavioral self-regulation is the hallmark of successful weight control. We tested mediators of weight loss and weight loss maintenance in middle-aged women who participated in a randomized controlled 12-month weight management intervention. Overweight and obese women (N = 225, BMI = 31.3 +/- 4.1 kg/m(2)) were randomly assigned to a control or a 1-year group intervention designed to promote autonomous self-regulation of body weight. Key exercise, eating behavior, and body image variables were assessed before and after the program, and tested as mediators of weight loss (12 months, 86% retention) and weight loss maintenance (24 months, 81% retention). Multiple mediation was employed and an intention-to-treat analysis conducted. Treatment effects were observed for all putative mediators (Effect size: 0.32-0.79, P < 0.01 vs. controls). Weight change was -7.3 +/- 5.9% (12-month) and -5.5 +/- 5.0% (24-month) in the intervention group and -1.7 +/- 5.0% and -2.2 +/- 7.5% in controls. Change in most psychosocial variables was associated with 12-month weight change, but only flexible cognitive restraint (P < 0.01), disinhibition (P < 0.05), exercise self-efficacy (P < 0.001), exercise intrinsic motivation (P < 0.01), and body dissatisfaction (P < 0.05) predicted 24-month weight change. Lower emotional eating, increased flexible cognitive restraint, and fewer exercise barriers mediated 12-month weight loss (R(2) = 0.31, P < 0.001; effect ratio: 0.37), but only flexible restraint and exercise self-efficacy mediated 24-month weight loss (R(2) = 0.17, P < 0.001; effect ratio: 0.89). This is the first study to evaluate self-regulation mediators of weight loss and 2-year weight loss maintenance, in a large sample of overweight women. Results show that lowering emotional eating and adopting a flexible dietary restraint pattern are critical for sustained weight loss. For long-term success, interventions must also be effective in promoting exercise intrinsic motivation and self-efficacy.
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Affiliation(s)
- Pedro J Teixeira
- Department of Exercise and Health, Faculty of Human Kinetics, Technical University of Lisbon, Lisbon, Portugal.
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Non-dieting group interventions for overweight and obese women: what predicts non-completion and does completion improve outcomes? Public Health Nutr 2009; 13:1622-8. [DOI: 10.1017/s1368980009992977] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveTo determine factors which predict non-completion of group non-dieting interventions for overweight women, and to investigate whether completion improves outcomes.DesignFirst, baseline predictors of non-completion were identified; then changes at 10 weeks and 12 months were compared between completers and non-completers of 10-week non-dieting interventions.SettingGeneral community.SubjectsParticipants were 119 women (aged 25–65 years, BMI ≥ 28 kg/m2) with at least one cardiovascular risk factor. Participants who attended at least eight of the ten sessions were classified as completers, and non-completers were those who attended fewer than eight sessions. Measures included BMI, blood pressure, psychological distress, lifestyle behaviours and eating self-efficacy.ResultsLogistic regression analyses indicated that women were less likely to be non-completers at non-dieting group programmes if, at baseline, they were more highly educated or had healthier nutrition behaviours (controlling for education). Only healthier nutrition behaviour was negatively associated with non-completion in the final model. Twelve months after the intervention, completers showed significantly greater improvements in body weight (mean change −0·53 kg), systolic and diastolic blood pressure (−6·3 and −4·1 mmHg, respectively), stress management behaviour score (+0·5) and psychotic symptoms score (−0·1) than non-completers (all P < 0·05).ConclusionsHighly educated women already engaging in some healthier lifestyle choices were less likely to be non-completers in non-dieting group programmes. Since important treatment outcomes vary according to attendance, future trials of non-dieting interventions should report the effects of completion on outcomes.
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Provencher V, Bégin C, Tremblay A, Mongeau L, Corneau L, Dodin S, Boivin S, Lemieux S. Health-At-Every-Size and Eating Behaviors: 1-Year Follow-Up Results of a Size Acceptance Intervention. ACTA ACUST UNITED AC 2009; 109:1854-61. [DOI: 10.1016/j.jada.2009.08.017] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2009] [Accepted: 05/29/2009] [Indexed: 11/25/2022]
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Kuk JL, Ardern CI, Church TS, Hebert JR, Sui X, Blair SN. Ideal weight and weight satisfaction: association with health practices. Am J Epidemiol 2009; 170:456-63. [PMID: 19546153 DOI: 10.1093/aje/kwp135] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Evidence suggests that individuals have become more tolerant of higher body weights over time. To investigate this issue further, the authors examined cross-sectional associations among ideal weight, examination year, and obesity as well as the association of ideal weight and body weight satisfaction with health practices among 15,221 men and 4,126 women in the United States. Participants in 1987 reported higher ideal weights than participants in 2001, an effect particularly pronounced from 1987 to 2001 for younger and obese men (85.5 kg to 94.9 kg) and women (62.2 kg to 70.5 kg). For a given body mass index, higher ideal body weights were associated with greater weight satisfaction but lower intentions to lose weight. Body weight satisfaction was subsequently associated with greater walking/jogging, better diet, and lower lifetime weight loss but with less intention to change physical activity and diet or lose weight (P < 0.01). Conversely, body mass index was negatively associated with weight satisfaction (P < 0.01) and was associated with less walking/jogging, poorer diet, and greater lifetime weight loss but with greater intention to change physical activity and diet or lose weight. Although the health implications of these findings are somewhat unclear, increased weight satisfaction, in conjunction with increases in societal overweight/obesity, may result in decreased motivation to lose weight and/or adopt healthier lifestyle behaviors.
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Riesco E, Rossel N, Rusques C, Mirepoix M, Drapeau V, Sanguignol F, Mauriège P. Impact of weight reduction on eating behaviors and quality of life: Influence of the obesity degree. Obes Facts 2009; 2:87-95. [PMID: 20054211 PMCID: PMC6444470 DOI: 10.1159/000210692] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND To examine the effects of a short-term weight reducing program on body composition, eating behaviors, and health-related quality of life (HRQL) of sedentary obese women characterized by different obesity degrees. METHODS 44 women with a BMI under 34.9 kg/m(2) and 39 women with a BMI above 35 kg/m(2) were studied. Fat mass and lean mass (electrical bioimpedance), eating behaviors (Three-Factor Eating Questionnaire), and HRQL (36-item short form, SF-36, questionnaire) were determined before and after weight loss. RESULTS Disinhibition and hunger scores and their subscales decreased after weight loss in both groups (0.0001 < p < 0.04). Restriction increased after weight reduction in all women (p = 0.02). Among the five restriction subscales, flexible restriction increased in women with a BMI above 35 kg/m(2) (p = 0.008), whereas rigid restraint and avoidance of fattening foods increased in both groups (0.006 < p < 0.02). SF-36 Mental Component Score increased after weight loss in all women (p < 0.0001). CONCLUSION A 3week weight reducing program changes selected eating behaviors and components of HRQL, irrespective of women's obesity degree. Data suggest that women with a BMI above 35 kg/m(2) could have a better weight control in the long term because of their higher flexible restriction after weight loss when compared to those whose BMI was under 34.9 kg/m(2).
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Affiliation(s)
- Eléonor Riesco
- UFR S.T.A.P.S., Université Paul Sabatier, Toulouse, France
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