title: The Effects of a "Health at Every Size(®)"-Based Approach in Obese Women: A Pilot-Trial of the "Health and Wellness in Obesity" Study.
abstract: 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.
authors.affiliation: Department of Nutrition, Faculty of Public Health, University of São Paulo , São Paulo , Brazil.
authors.forename: Mariana Dimitrov
authors.initials: MD
authors.lastname: Ulian
authors.affiliation: School of Physical Education and Sport, University of São Paulo , São Paulo , Brazil.
authors.forename: Fabiana B
authors.initials: FB
authors.lastname: Benatti
authors.affiliation: Faculty of Applied Sciences, State University of Campinas , Limeira , Brazil.
authors.forename: Patricia Lopes
authors.initials: PL
authors.lastname: de Campos-Ferraz
authors.affiliation: Faculty of Physical Education, State University of Campinas , Campinas , Brazil.
authors.forename: Odilon J
authors.initials: OJ
authors.lastname: Roble
authors.affiliation: Faculty of Philosophy and Letters, National University of Buenos Aires , Buenos Aires , Argentina.
authors.forename: Ramiro Fernandez
authors.initials: RF
authors.lastname: Unsain
authors.affiliation: Institute of Health and Society, Federal University of São Paulo , Santos , Brazil.
authors.forename: Priscila
authors.initials: P
authors.lastname: de Morais Sato
authors.affiliation: Department of Nutrition, Faculty of Public Health, University of São Paulo , São Paulo , Brazil.
authors.forename: Bruna Cristina
authors.initials: BC
authors.lastname: Brito
authors.affiliation: School of Physical Education and Sport, University of São Paulo , São Paulo , Brazil.
authors.forename: Karina Akemi
authors.initials: KA
authors.lastname: Murakawa
authors.affiliation: School of Physical Education and Sport, University of São Paulo , São Paulo , Brazil.
authors.forename: Bruno T
authors.initials: BT
authors.lastname: Modesto
authors.affiliation: Department of Nutrition, Faculty of Public Health, University of São Paulo , São Paulo , Brazil.
authors.forename: Luiz
authors.initials: L
authors.lastname: Aburad
authors.affiliation: School of Physical Education and Sport, University of São Paulo , São Paulo , Brazil.
authors.forename: Rômulo
authors.initials: R
authors.lastname: Bertuzzi
authors.affiliation: School of Physical Education and Sport, University of São Paulo , São Paulo , Brazil.
authors.forename: Antonio H
authors.initials: AH
authors.lastname: Lancha
authors.affiliation: School of Physical Education and Sport, University of São Paulo , São Paulo , Brazil.
authors.forename: Bruno
authors.initials: B
authors.lastname: Gualano
authors.affiliation: Department of Nutrition, Faculty of Public Health, University of São Paulo , São Paulo , Brazil.
authors.forename: Fernanda B
authors.initials: FB
authors.lastname: Scagliusi
keywords: Health at Every Size; mixed method; multidisciplinary intervention; non-dieting intervention; obesity