Evaluating a 'non-diet' wellness intervention for improvement of metabolic fitness, psychological well-being and eating and activity behaviors.
BACKGROUND
Current public health policy recommends weight loss for obese individuals, and encourages energy-restricted diets. Others advocate an alternative, 'non-diet' approach which emphasizes eating in response to physiological cues (eg hunger and satiety) and enhancing body acceptance.


OBJECTIVE
To evaluate the effects of a 'health-centered' non-diet wellness program, and to compare this program to a traditional 'weight loss-centered' diet program.


METHODS
Six-month, randomized clinical trial.


METHODS
Free-living, general community.


METHODS
Obese, Caucasian, female, chronic dieters, ages 30-45 y (n=78).


METHODS
Six months of weekly group intervention in a non-diet wellness program or a traditional diet program, followed by 6 months of monthly after-care group support.


METHODS
Anthropometry (weight, body mass index); metabolic fitness (blood pressure, blood lipids); energy expenditure; eating behavior (restraint, eating disorder pathology); psychology (self-esteem, depression, body image); attrition and attendance; and participant evaluations of treatment helpfulness. Measures obtained at baseline, 3 months, 6 months and 1 y.


RESULTS
(1 y after program initiation): Cognitive restraint increased in the diet group and decreased in the non-diet group. Both groups demonstrated significant improvement in many metabolic fitness, psychological and eating behavior variables. There was high attrition in the diet group (41%), compared to 8% in the non-diet group. Weight significantly decreased in the diet group (5.9+/-6.3 kg) while there was no significant change in the non-diet group (-0.1+/-4.8 kg).


CONCLUSIONS
Over a 1 y period, a diet approach results in weight loss for those who complete the intervention, while a non-diet approach does not. However, a non-diet approach can produce similar improvements in metabolic fitness, psychology and eating behavior, while at the same time effectively minimizing the attrition common in diet programs.
Bacon
L
L
Department of Nutrition, University of California at Davis, Davis, California, USA. lbacon@ccsf.edu
Keim
N L
NL
Van Loan
M D
MD
Derricote
M
M
Gale
B
B
Kazaks
A
A
Stern
J S
JS
D000328:Adult; D001794:Blood Pressure; D001828:Body Image; D015992:Body Mass Index; D003863:Depression; D004435:Eating; D004734:Energy Metabolism; D015444:Exercise; D005260:Female; D006293:Health Promotion; D006801:Humans; D008055:Lipids / Q000097:blood; D008603:Mental Health; D009765:Obesity / Q000628:therapy*; D010809:Physical Fitness; D012649:Self Concept
D008055:Lipids