A weight-neutral versus weight-loss approach for health promotion in women with high BMI: A randomized-controlled trial. (1st October 2016)

• Record Type: Journal Article
• Authors: Mensinger, Janell L.; Calogero, Rachel M.; Stranges, Saverio; Tylka, Tracy L.
• Is Part Of: Appetite. Volume 105(2016)
• Page Start: 364
• Page End: 374
• Publication Date: 2016-10-01
• Subjects: Health promotion -- Intuitive eating -- Obesity -- Weight loss -- Health At Every Size; Food habits -- Periodicals; Appetite -- Periodicals; Appetite disorders -- Periodicals; Electronic journals; 306.4613
• DOI: 10.1016/j.appet.2016.06.006
• Languages: English
• ISSNs: 0195-6663

Abstract

Abstract: Weight loss is the primary recommendation for health improvement in individuals with high body mass index (BMI) despite limited evidence of long-term success. Alternatives to weight-loss approaches (such as Health At Every Size – a weight-neutral approach) have been met with their own concerns and require further empirical testing. This study compared the effectiveness of a weight-neutral versus a weight-loss program for health promotion. Eighty women, aged 30–45 years, with high body mass index (BMI ≥ 30 kg/m 2 ) were randomized to 6 months of facilitator-guided weekly group meetings using structured manuals that emphasized either a weight-loss or weight-neutral approach to health. Health measurements occurred at baseline, post-intervention, and 24-months post-randomization. Measurements included blood pressure, lipid panels, blood glucose, BMI, weight, waist circumference, hip circumference, distress, self-esteem, quality of life, dietary risk, fruit and vegetable intake, intuitive eating, and physical activity. Intention-to-treat analyses were performed using linear mixed-effects models to examine group-by-time interaction effects and between and within-group differences. Group-by-time interactions were found for LDL cholesterol, intuitive eating, BMI, weight, and dietary risk. At post-intervention, the weight-neutral program had larger reductions in LDL cholesterol and greater improvements in intuitive eating; the weight-loss program had larger reductions in BMI, weight, and larger (albeit temporary) decreases in dietary risk. Significant positive changes were observed overall between baseline and 24-month follow-up for waist-to-hip ratio, total cholesterol, physical activity, fruit and vegetable intake, self-esteem, and quality of life. These findings highlight that numerous health benefits, even in the absence of weight loss, are achievable and sustainable in the long term using a weight-neutral approach. The trial positions weight-neutral programs as a viable health promotion alternative to weight-loss programs for women of high weight.