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Health-At-Every-Size and Eating Behaviors: 1-Year Follow-Up Results of a Size Acceptance Intervention

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Abstract

Background

Poor long-term success observed with current weight-control strategies stresses the relevance to explore new weight management approaches.

Objective

To assess the effects of a Health-At-Every-Size (HAES) intervention on eating behaviors, appetite sensations, metabolic and anthropometric variables, and physical activity levels in women at 6-month and 1-year postintervention.

Design

Randomized controlled trial; measurements at baseline, at the end of the intervention period (4 months), and at 6-month and 1-year postintervention (10 months and 16 months, respectively). Intervention and testing took place from September 2003 to August 2006.

Participants/setting

Premenopausal overweight/obese women (n=144; mean age of 42.3±5.6 years), recruited from free-living, general community.

Intervention

Women were randomly assigned to: HAES group (n=48), social support group (n=48), or control group (n=48).

Main outcome measures

Eating behaviors (restraint, disinhibition, and susceptibility to hunger), appetite ratings (desire to eat, hunger, fullness, and prospective food consumption), anthropometric and metabolic variables (body mass index, waist and hip circumferences, blood lipid levels, and blood pressure), and engagement in moderate to intense physical activity (energy cost ≥1.2 kcal×kg−1×15 minutes−1 [≥4.8 metabolic equivalents]).

Statistical analyses performed

Changes for each dependent variable were assessed by linear mixed models according to a group (HAES vs social support vs control) by time (baseline vs 4 months vs 10 months vs 16 months) split-plot design.

Results

Situational susceptibility to disinhibition and susceptibility to hunger significantly decreased over time in both HAES group (−0.9±0.2 and −1.3±0.5, respectively) and the social support group (−0.4± 0.2 and −1.4±0.5, respectively). Although eating behavior scores observed at 16 months did not differ between HAES and social support groups (situational susceptibility to disinhibition: 2.5±0.2 in HAES group vs 2.7 ± 0.2 in social support group; susceptibility to hunger: 4.2±0.5 in both groups), they were lower in these groups than scores noted in the control group (3.3±0.2 for situational susceptibility to disinhibition and 5.9±0.5 for susceptibility to hunger).

Conclusions

These results suggest that, when compared to a control group, an HAES approach could have long-term beneficial effects on eating behaviors related to disinhibition and hunger. In addition, our study did not show distinctive effects of the HAES approach in comparison to a social support intervention.

Section snippets

Participants

Participants were recruited from the Quebec City metropolitan area through media advertisements. A total of 194 women were met for a screening interview and a sample of 144 premenopausal women voluntarily agreed to participate in the research project and to be randomized into one of the three groups under study. Inclusion criteria included women with overweight or obesity (body mass index [BMI] between 25 to 35), with a stable body weight for at least 2 months (±2.5 kg). All women were also

Results

Women who participated in the study had a mean age of 42.3±5.6 years. Almost all (99.3%) women of the total sample were white, and 23% were taking medication (the most common being thyroid agents [n=8]). However, these medications had no potential effects on dependent variables measured. Baseline comparisons between completers and non-completers at 16 months showed no significant differences with regards to age, BMI, metabolic variables, and eating behaviors. Furthermore, as presented in Table 1

Discussion

Our study aimed to examine the long-term effects of an HAES intervention in comparison to an SS intervention and a control group. It was found that scores for susceptibility to hunger were significantly lower at 1-year follow-up in both the HAES and SS groups when compared to the control group. In addition, situational susceptibility to disinhibition was significantly lower at 1-year follow-up in the HAES group than in the control group. Overall, these results suggest that, when compared to a

Conclusions

Results from this study showed that women involved in an HAES intervention experienced sustainable improvements in eating behaviors related to disinhibition and hunger, when compared to a control group. In addition, the role of social support appears to be an important factor to consider with regard to eating behavior changes, because no distinctive effects were observed between the HAES and the SS groups. However, significant associations were observed between eating behaviors changes and body

V. Provencher is an assistant professor, Institute of Nutraceuticals and Functional Food, Laval University, Québec, QC, Canada; at the time of the study, she was a doctoral student in nutrition at Laval University, Québec, QC, Canada.

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  • Cited by (0)

    V. Provencher is an assistant professor, Institute of Nutraceuticals and Functional Food, Laval University, Québec, QC, Canada; at the time of the study, she was a doctoral student in nutrition at Laval University, Québec, QC, Canada.

    C. Bégin is a professor, School of Psychology, Laval University, Québec, QC, Canada.

    A. Tremblay is a professor, Division of Kinesiology, Department of Preventive and Social Medicine, Laval University, Québec, QC, Canada.

    L. Corneau is a research assistant, Laval University, Québec, QC, Canada.

    S. Lemieux is a professor, Institute of Nutraceuticals and Functional Foods, Laval University, Québec, QC, Canada.

    S. Dodin is a professor, Department of Obstetrics and Gynecology, Laval University, Québec, QC, Canada.

    L. Mongeau is a scientific advisor, Institut National de Santé Publique du Québec, Montréal, QC, Canada.

    S. Boivin is a clinical psychologist, Centre Maria-Chapdelaine, Dolbeau-Mistassini, QC, Canada; at the time of the study, she was a clinical psychologist, Eating Disorder Treatment Program, Laval University, Québec, QC, Canada.

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