title: Impact of non-diet approaches on attitudes, behaviors, and health outcomes: a systematic review.
abstract: OBJECTIVE
  To determine the overall effect of non-diet, weight-neutral interventions on factors such as weight, biochemical measures, food and activity behavior, body image, and mental health.
  
  
  METHODS
  Systematic review of intervention literature.
  
  
  METHODS
  Group classes in community and worksite settings (14 studies), and individual counseling (1) and online education (1) in college settings.
  
  
  METHODS
  Eighteen research articles (representing 16 studies) evaluating non-diet interventions using quasi-experimental and randomized study designs with either a comparison or control group.
  
  
  METHODS
  Anthropometric, physiological, psychological, and dietary intake.
  
  
  METHODS
  Systematic search of 168 articles and review of 18 articles meeting inclusionary criteria.
  
  
  RESULTS
  Non-diet interventions resulted in statistically significant improvements in disordered eating patterns, self-esteem, and depression. None of the interventions resulted in significant weight gain or worsening of blood pressure, blood glucose, or cholesterol, and in 2 studies biochemical measures improved significantly compared with the control or diet group. Primary limitations were inconsistent definitions of non-diet approaches and the use of different assessment instruments for measuring outcomes.
  
  
  CONCLUSIONS
  Because of the long-term ineffectiveness of weight-focused interventions, the psychological improvements seen in weight-neutral, non-diet interventions warrant further investigation.
authors.affiliation: Department of Nutrition and Food Science, California State University, Chico, Chico, CA. Electronic address: declifford@csuchico.edu.
authors.forename: Dawn
authors.initials: D
authors.lastname: Clifford
authors.affiliation: Family, Consumer & Nutrition Sciences, Northern Illinois University, DeKalb, IL.
authors.forename: Amy
authors.initials: A
authors.lastname: Ozier
authors.affiliation: Department of Nutrition and Food Science, California State University, Chico, Chico, CA.
authors.forename: Joanna
authors.initials: J
authors.lastname: Bundros
authors.affiliation: Department of Nutrition and Food Science, California State University, Chico, Chico, CA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Moore
authors.affiliation: Family, Consumer & Nutrition Sciences, Northern Illinois University, DeKalb, IL.
authors.forename: Anna
authors.initials: A
authors.lastname: Kreiser
authors.affiliation: Department of Nutrition and Food Science, California State University, Chico, Chico, CA.
authors.forename: Michelle Neyman
authors.initials: MN
authors.lastname: Morris
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003376:Counseling / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult
keywords: body image; eating disorders; mental health; non-diet; overweight; weight management