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

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.

Intuitive eating and body appreciation in type 2 diabetes

“…In the last decade, several studies on the appreciation of the body have generated advances in contemporary science of positive body image (Avalos et al, 2005;Bégin et al, 2019;Dimitrov Ulian et al, 2018;Tylka, 2011). When individuals appreciate their own body, they naturally pay more attention to their internal bodily needs and, therefore, respect oneself by eating according to the internal suggestions of hunger and satiety (Avalos and Tylka, 2006).…”

Alimentação intuitiva na Atenção Primária: prática do nutricionista e percepção do usuário

“…Entretanto, intervenções dessa natureza acabam sendo fatores de risco para compulsão alimentar, transtornos alimentares, insatisfação corporal, baixa autoestima, culpabilidade, redução da liberdade pessoal e estigmatização do corpo gordo. 34 Atitudes negativas em relação às pessoas com obesidade são comuns e os profissionais de saúde também estão entre as fontes de preconceito mencionadas pelos pacientes obesos, entre eles, encontram-se médicos, enfermeiros, psicólogos, educadores físicos e nutricionistas. 35 Estudos mostram que os profissionais veem os pacientes obesos como esquisitos, feios, pouco atraentes, inconformados, gulosos, desajeitados, sem determinação e preguiçosos.…”

“…Em um estudo recente que utilizou abordagem não prescritiva com mulheres obesas, os autores concluíram que as participantes tiveram melhoras em suas atitudes e práticas alimentares, na percepção da imagem corporal, na capacidade física e na qualidade de vida relacionada à saúde, mesmo sem haver mudanças no peso corporal. 34 Em nossos resultados, também é possível observar que os relatos da maior parte dos participantes indicam mudanças de pensamento e atitude em relação à comida.…”

Localization of Intuitive Eating Scale-2 and Its Application in Chinese Obese Patients with Primary Hypertension

“…Current body size was evaluated by asking the participant to select a silhouette that best indicates his/her current body size, while ideal body size does the same but with the participant's ideal body size. Chronbach's α ranges from 0.79 to 0.89 [31] . The body size dissatisfaction was calculated by the discrepancy score between current body size and ideal body size.…”