Psychological Impact of a "Health-at-Every-Size" Intervention on Weight-Preoccupied Overweight/Obese Women

Marie-Pierre Gagnon-Girouard, Catherine Bégin, Véronique Provencher, Angelo Tremblay, Lyne Mongeau, Sonia Boivin, Simone Lemieux, Marie-Pierre Gagnon-Girouard, Catherine Bégin, Véronique Provencher, Angelo Tremblay, Lyne Mongeau, Sonia Boivin, Simone Lemieux

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.

Figures

Figure 1
Figure 1
Evolution of body weight from T = 0 to T = 16 for the HAES, SS, and WL group with error bars based on standard errors.
Figure 2
Figure 2
Evolution of psychological variables from T = 0 to T = 16 for the HAES, SS, and WL group with error bars based on standard errors.

References

    1. Lau DC, Douketis JD, Morrison KM, Hramiak IM, Sharma AM, Ur E. 2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children [summary] Canadian Medical Association Journal. 2007;176(8):S1–S13.
    1. Doucet E, Imbeault P, St-Pierre S, et al. Appetite after weight loss by energy restriction and a low-fat diet-exercise follow-up. International Journal of Obesity. 2000;24(7):906–914.
    1. Polivy J. Psychological consequences of food restriction. Journal of the American Dietetic Association. 1996;96(6):589–592.
    1. Chaput J-P, Drapeau V, Hetherington M, Lemieux S, Provencher V, Tremblay A. Psychobiological effects observed in obese men experiencing body weight loss plateau. Depression and Anxiety. 2006;24(7):518–521.
    1. Garner DM, Wooley SC. Confronting the failure of behavioral and dietary treatments for obesity. Clinical Psychology Review. 1991;11(6):729–780.
    1. Polivy J, Peter Herman C. If at first you don’t succeed: false hopes of self-change. American Psychologist. 2002;57(9):677–689.
    1. Foster GD. Non-dieting approaches. In: Fairburn CG, Brownell KD, editors. Eating Disorders and Obesity. 2nd edition. New York, NY, USA: Guilford; 2001. pp. 604–608.
    1. McFarlane T, Polivy J, McCabe RE. Help, not harm: psychological foundation for a nondieting approach toward health. Journal of Social Issues. 1999;55(2):261–276.
    1. Parham ES. Is there a new weight paradigm? Nutrition Today. 1996;31:155–161.
    1. Robison JI. Weight management: shifting the paradigm. Journal of Health Education. 1997;28:28–34.
    1. Carrier KM, Steinhardt MA, Bowman S. Rethinking traditional weight management programs: a 3-year follow-up evaluation of a new approach. The Journal of Psychology. 1994;128(5):517–535.
    1. Jackson EG. Eating order: a 13-week trust model class for dieting casualties. Journal of Nutrition Education and Behavior. 2008;40(1):43–48.
    1. Lewis VJ, Blair AJ, Booth DA. Outcome of group therapy for body-image emotionality and weight-control self-efficacy. Behavioural Psychotherapy. 1992;20(2):155–165.
    1. Mellin L, Croughan-Minihane M, Dickey L. The solution method: 2-year trends in weight, blood pressure, exercise, depression, and functioning of adults trained in development skills. Journal of the American Dietetic Association. 1997;97(10):1133–1138.
    1. Omichinski L, Harrison KR. Reduction of dieting attitudes and practises after participation in a non-diet lifestyle program. Journal of the Canadian Diabetic Association. 1995;56:81–85.
    1. Polivy J, Herman CP. Undieting: a program to help people stop dieting. International Journal of Eating Disorders. 1992;11(3):261–268.
    1. Robinson BE, Bacon JG. The “if only i were thin . . .“ treatment program: decreasing the stigmatizing effects of fatness. Professional Psychology Research and Practice. 1996;27(2):175–183.
    1. Roughan P, Seddon E, Vernon-Roberts J. Long-term effects of a psychologically based group programme for women preoccupied with body weight and eating behaviour. International Journal of Obesity. 1990;14(2):135–147.
    1. Steinhardt MA, Bezner JR, Adams TB. Outcomes of a traditional weight control program and a nondiet alternative: a one-year comparison. The Journal of Psychology. 1999;133(5):495–513.
    1. Allen HN, Craighead LW. Appetite monitoring in the treatment of binge eating disorder. Behavior Therapy. 1999;30(2):253–272.
    1. Bacon L, Keim NL, Van Loan MD, et al. Evaluating a ’non-diet’ wellness intervention for improvement of metabolic fitness, psychological well-being and eating and activity behaviors. International Journal of Obesity. 2002;26(6):854–865.
    1. Bacon L, Stern JS, Van Loan MD, Keim NL. Size acceptance and intuitive eating improve health for obese, female chronic dieters. Journal of the American Dietetic Association. 2005;105(6):929–936.
    1. Ciliska D. Evaluation of two nondieting interventions for obese women. Western Journal of Nursing Research. 1998;20(1):119–135.
    1. Goodrick GK, Poston WSC, II, Kimball KT, Reeves RS, Foreyt JP. Nondieting versus dieting treatment for overweight binge-eating women. Journal of Consulting and Clinical Psychology. 1998;66(2):363–368.
    1. Higgins LC, Gray W. Changing the body image concern and eating behaviour of chronic dieters: the effects of a psychoeducational intervention. Psychology and Health. 1998;13(6):1045–1060.
    1. Miller WC, Wallace JP, Eggert KE, Lindeman AK. Cardiovascular risk reduction in a self-taught, self-administrated weight-loss program called the nondiet diet. Medicine and Exercise for Nutrition and Health. 1993;2:218–223.
    1. Rapoport L, Clark M, Wardle J. Evaluation of a modified cognitive-behavioural programme for weight management. International Journal of Obesity. 2000;24(12):1726–1737.
    1. Sbrocco T, Nedegaard RC, Stone JM, Lewis EL. Behavioral choice treatment promotes continuing weight loss: preliminary results of a cognitive-behavioral decision-based treatment for obesity. Journal of Consulting and Clinical Psychology. 1999;67(2):260–266.
    1. Tanco S, Linden W, Earle T. Well-being and morbid obesity in women: a controlled therapy evaluation. International Journal of Eating Disorders. 1998;23(3):325–339.
    1. Wadden TA, Foster GD, Sarwer DB, et al. Dieting and the development of eating disorders in obese women: results of a randomized controlled trial. American Journal of Clinical Nutrition. 2004;80(3):560–568.
    1. Rothblum ED. Contradictions and confounds in coverage of obesity: psychology journals, textbooks, and the media. Journal of Social Issues. 1999;55(2):355–369.
    1. Teixeira PJ, Going SB, Houtkooper LB, et al. Pretreatment predictors of attrition and successful weight management in women. International Journal of Obesity. 2004;28(9):1124–1133.
    1. Provencher V, Bégin C, Tremblay A, Mongeau L, Boivin S, Lemieux S. Short-term effects of a “health-at-every-size” approach on eating behaviors and appetite ratings. Obesity. 2007;15(4):957–966.
    1. Provencher V, Bégin C, Tremblay A, et al. Health-at-every-size and eating behaviors: 1-year follow-up results of a size acceptance intervention. Journal of the American Dietetic Association. 2009;109(11):1854–18101.
    1. Grodner M. Forever dieting: chronic dieting syndrome. Journal of Nutrition Education. 1992;24:207–210.
    1. Airlie Consensus Conference. Standardization of Anthropometric Measurements. Champaign, Ill, USA: Human Kinetics; 1988.
    1. Mendelson BK, Mendelson MJ, White DR. Body-esteem scale for adolescents and adults. Journal of Personality Assessment. 2001;76(1):90–106.
    1. Beck AT. An inventory for measuring depression. Archives of General Psychiatry. 1961;4:53–63.
    1. Beck AT, Steer RA, Garbin MG. Psychometric properties of the Beck Depression Inventory: twenty-five years of evaluation. Clinical Psychology Review. 1988;8(1):77–100.
    1. Battle J. Culture-Free SEI: Self-Esteem Inventories for Children and Adults. Seattle, Wash, USA: JB Preston; 1981.
    1. Kolotkin RL, Head S, Brookhart A. Construct validity of the impact of weight on quality of life questionnaire. Obesity Research. 1997;5(5):434–441.
    1. Kolotkin RL, Crosby RD. Psychometric evaluation of the impact of weight on quality of life-lite questionnaire (IWQOL-Lite) in a community sample. Quality of Life Research. 2002;11(2):157–171.
    1. Gormally J, Black S, Daston S, Rardin D. The assessment of binge eating severity among obese persons. Addictive Behaviors. 1982;7(1):47–55.
    1. Marcus M, Wing RR. Binge eating and dietary restraint. In: Proceedings of the Annual Meeting of the Society of Behavioral Medicine; March 1983; Baltimore, Ma, USA.
    1. Ware JH. Interpreting incomplete data in studies of diet and weight loss. The New England Journal of Medicine. 2003;348(21):2136–2137.
    1. Keselman HJ, Algina J, Kowalchuk RK. The analysis of repeated measures designs: a review. British Journal of Mathematical and Statistical Psychology. 2001;54(1):1–20.
    1. Kirk R. Experimental Design: Procedures for the Behavioral Sciences. 3rd edition. Pacific Grove, Calif, USA: Brooks/Cole; 1995.

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