This study explored the effects of Health at Every Size®-based intervention on obese women by qualitatively evaluating participants’ perception toward the program and quantitatively evaluating changes related to psychological, behavioral, and body composition assessments. A prospective 1-year quasi-experimental mixed-method trial was conducted. The mixed-method design was characterized by a spiral method, and quantitative and qualitative findings were combined during the interpretation phase. The qualitative data involved three focus groups; and quantitative data comprised physiological, psychological, and behavioral assessments. Initially, 30 participants were recruited; 14 concluded the intervention. From the focus groups, the following interpretative axes were constructed: the intervention as a period of discoveries; shifting parameters: psychological, physical, and behavioral changes; eating changes, and; redefining success. Body weight, body mass index, total body fat mass, and body fat percentage were significantly decreased after the intervention (−3.6, −3.2, −13.0, and −11.1%, respectively; p ≤ 0.05, within-time effect). Participants reported to be more physically active and perceiving better their bodies. Eating-wise, participants reported that the hunger and satiety cues and the consumption of more frequent meals facilitated their eating changes. Finally, participants reported that they could identify feelings with eating choices and refrain from the restrained behavior. These qualitative improvements were accompanied by modest but significant improvements in quantitative assessments. Clinicaltrials.gov registration: NCT02102061.

The present study analyzed obese women’s experiences following a nonprescriptive nutritional intervention, implemented through a 1-year program based on the Health at Every Size® philosophy. We employed an action research method and conducted three focus groups during the intervention. We identified five interpretative axes across the focus groups, as follows: conflicts and perceptions; gaining motivation, perspective, and positioning; becoming autonomous eaters; acquiring tools; and the meetings between the nutritional therapist and participant. Our findings revealed varying levels of readiness among participants in adapting to the intervention and varying valuations of achievements related to eating and health, independent of body-weight changes. Participants reported benefiting from and expressed approval of the intervention. Participants reported positive behavioral and attitudinal changes to their diet and improvements to diet quality, diet structure, and consumption. Finally, participants seemed to show increased autonomy concerning diet and indicated increased confidence, comfort, flexibility, and positivity of attitude regarding eating.

O presente artigo relata, brevemente, a história de um curso comunitário destinado a oferecer intervenções não farmacológicas a mulheres com excesso de peso. Ênfase é dada ao formato atual do curso, que conta com equipe multidisciplinar na área de Saúde apta a oferecer suporte amplo à mulher obesa que encontra dificuldade para se enquadrar o padrão de beleza requerido pela sociedade. Em nosso curso, propomos um programa centrado na saúde e na qualidade de vida do indivíduo obeso, sem foco na perda de peso, de acordo com os princípios da filosofia Health at Every Size. Os resultados qualitativos preliminares indicam que tal abordagem é promissora, oferecendo aos profissionais de saúde uma alternativa à proposta vigente de "perda de peso a qualquer custo". Os avanços no ensino, na pesquisa e na extensão associados ao curso também são discutidos ao longo do artigo.Palavras-chave: Sobrepeso. Exercício. Nutrição. Filosofia. Qualidade de Vida. A B S T R A C TThe present manuscript briefly reports on the history of a community program aimed to provide non-pharmacological interventions to overweight women. Focus is given to the current format of the program, which presents a multidisciplinary health team able to providing full support to the obese woman who faces trouble to find the society's beauty standards. In our program, we propose a health and quality of life-oriented approach, without a focus on weight loss, following the philosophical principles from Health at Every Size. The quantitative and qualitative findings reveal that such approach is promising and may provide an alternative mode of intervention to the traditional one, which is focused on the concept of "weight loss at any cost". The advances on teaching, research and community services will be also addressed throughout the manuscript.

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Introduction Regular physical activity (PA) practice is a way to combat cardiovascular disease, and a PA interventional program, including individualized prescription of walking with limited supervision of execution, may be a strategy to be applied in public parks. Thus, our study tested the effects of a real-world program like this on cardiovascular risk and cardiorespiratory fitness (CF) of the users of a public park. Methods Data came from the Exercise and Heart Project, a real-life park-based PA interventional program. The study phases were 1) a preintervention evaluation; 2) the individualized prescription of PA; 3) the supervision of the first practice sessions; 4) the unsupervised execution of the prescription; and 5) a postintervention evaluation. Results Data from 152 participants (mainly women and aged 40 to 80 years) were analyzed. The intervention significantly increased CF (mean [standard deviation], 99 [19] steps vs 110 [21] steps, P < .001) and reduced body mass index, waist circumference, and systolic blood pressure, decreasing global cardiovascular risk (mean [standard deviation], 0.15 [2.84] vs −0.52 [2.60]; P < .001). The effects of intervention on cardiovascular risk were not different between the participants with low and high initial CF or PA levels. Conclusion The proposed real-life park-based PA interventional program decreased cardiovascular risk of the participants independently of their initial PA or CF levels.