Short-term effects of a non-dieting lifestyle intervention program on weight management, fitness, metabolic risk, and psychological well-being in obese premenopausal females with the metabolic syndrome

Abstract

Lifestyle modification has been widely acknowledged as the primary treatment for the metabolic syndrome (MetS). We examined the short-term effects of a non-dieting lifestyle intervention program, within the theoretical psychological framework of self-determination theory (SDT), on metabolic fitness and psychological well-being among premenopausal, clinically obese women. A secondary analysis of a randomized, controlled, 3 month, intensive, community-based lifestyle intervention study was performed on 31 pre-menopausal obese women with the MetS (56.4% of original study sample). These participants had been randomly allocated to a non-dieting lifestyle intervention group (n = 17) or waiting list control (n = 14). Among participants who completed repeat anthropometric and cardiorespiratory fitness measurements after 3 months intervention, the lifestyle intervention group showed a significant improvement in VO2 (mL.kg(-1).min(-1)) compared with control (test for interaction, p = 0.003). No significant difference was found for body mass. Metabolic improvements were evident for diastolic blood pressure and high-density lipoprotein cholesterol in both groups. The lifestyle intervention group also showed significantly improved general psychological well-being compared with the control group (test for interaction, p = 0.0005). All of the psychological well-being subscales showed significant favourable changes in the intervention group as compared with controls. This short-term, non-dieting lifestyle intervention, consistent with the "Health at Every Size" (HAES) obesity treatment paradigm, significantly improved cardiorespiratory fitness and psychological well-being. Metabolic risk tended to improve after 3 months intervention with no significant difference in the resolution of the MetS between intervention and control participants.

Weight stigma is stressful. A review of evidence for the Cyclic Obesity/Weight-Based Stigma model

“…Conducting successful intervention studies will require careful, nuanced strategies, as the evidence is mixed regarding whether treating weight and obesity stigma can improve psychological and physiological outcomes. Some fat acceptance interventions, notably size acceptance interventions such as those based on the Health at Every Size movement, have shown to improve health even in the absence of weight loss, and are therefore a promising tool (Bacon, 2010;Bacon, Stern, Van Loan, & Keim, 2005;Carroll, Borkoles, & Polman, 2007;Provencher et al, 2009). Similar interventions have also yielded positive weight (Anglin, 2012;Gagnon-Girouard et al, 2010;Lillis, Hayes, Bunting, & Masuda, 2009;Rapoport, Clark, & Wardle, 2000;Tanco, Linden, & Earle, 1998), fitness (Carrier, Steinhardt, & Bowman, 1994) and psychological outcomes (Ciliska, 1998;Gagnon-Girouard et al, 2010;Lillis et al, 2009;Omichinksi & Harrison, 1995;Tanco et al, 1998).…”

Impact of Non-Diet Approaches on Attitudes, Behaviors, and Health Outcomes: A Systematic Review

“…2,3,33,34,36,55,[57][58][59][60][61][62][63][64][65][66][67]69 One intervention included individual counseling 63 and another was delivered through online learning modules. 60 Interventions ranged from 50 minutes to 18 months; most interventions lasted 8-16 weeks.…”

“…50 Many researchers have been implementing non-diet interventions and assessing their effects on anthropometrics, cholesterol, blood pressure, body image, depressions, stress, dietary restraint and disinhibition, dietary quality, and physical activity. 23,33,34,36,[55][56][57][58][59][60][61][62][63][64][65][66][67] The aim of this research was to conduct a systematic review to synthesize the peer-reviewed literature evaluating non-diet interventions to determine their effectiveness. Results are intended to guide the development of more effective intervention efforts and provide directions for future research.…”

Non-dieting group interventions for overweight and obese women: what predicts non-completion and does completion improve outcomes?

“…Such approaches do not involve a preoccupation with food regimens or weight-loss goals; reduce the feelings of guilt and deprivation often associated with dieting (6) ; and help to alleviate the psychological distress caused by long-term dieting failure and perceived lack of self-control (9) . In contrast to the large body of literature evaluating interventions that have a weight loss or dieting focus, there have been relatively few published randomized trials of non-dieting interventions (5,7,(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) . Non-dieting group-based programmes for overweight and obese women have produced greater psychological benefits (5,7,12,15) and improvements in eating behaviours (5,7,15) than dieting (i.e.…”

“…Inclusion of intensive stress management training in a non-dieting group programme for overweight women has been shown to enhance stress management and medical symptom outcomes, but not weight outcomes (20) . To date, among studies of group non-dieting interventions (5,7,10,(16)(17)(18)(19)21) , only one has reported attendance/ completion data (12) . Rapoport et al (12) reported significantly higher binge eating, but no significant BMI, depression or demographic differences in women who attended fewer than seven out of ten sessions compared with those who attended at least seven sessions.…”