A weight-neutral versus weight-loss approach for health promotion in women with high BMI: A randomized-controlled trial.
Weight loss is the primary recommendation for health improvement in individuals with high body mass index (BMI) despite limited evidence of long-term success. Alternatives to weight-loss approaches (such as Health At Every Size - a weight-neutral approach) have been met with their own concerns and require further empirical testing. This study compared the effectiveness of a weight-neutral versus a weight-loss program for health promotion. Eighty women, aged 30-45 years, with high body mass index (BMI ≥ 30 kg/m(2)) were randomized to 6 months of facilitator-guided weekly group meetings using structured manuals that emphasized either a weight-loss or weight-neutral approach to health. Health measurements occurred at baseline, post-intervention, and 24-months post-randomization. Measurements included blood pressure, lipid panels, blood glucose, BMI, weight, waist circumference, hip circumference, distress, self-esteem, quality of life, dietary risk, fruit and vegetable intake, intuitive eating, and physical activity. Intention-to-treat analyses were performed using linear mixed-effects models to examine group-by-time interaction effects and between and within-group differences. Group-by-time interactions were found for LDL cholesterol, intuitive eating, BMI, weight, and dietary risk. At post-intervention, the weight-neutral program had larger reductions in LDL cholesterol and greater improvements in intuitive eating; the weight-loss program had larger reductions in BMI, weight, and larger (albeit temporary) decreases in dietary risk. Significant positive changes were observed overall between baseline and 24-month follow-up for waist-to-hip ratio, total cholesterol, physical activity, fruit and vegetable intake, self-esteem, and quality of life. These findings highlight that numerous health benefits, even in the absence of weight loss, are achievable and sustainable in the long term using a weight-neutral approach. The trial positions weight-neutral programs as a viable health promotion alternative to weight-loss programs for women of high weight.
Reading Health System, Sixth Avenue and Spruce Street, West Reading, PA, 19611, USA. Electronic address: jlm448@drexel.edu.
Janell L
JL
Mensinger
School of Psychology, University of Kent, UK.
Rachel M
RM
Calogero
Department of Population Health, Luxembourg Institute of Health, Luxembourg.
Saverio
S
Stranges
Department of Psychology, The Ohio State University, USA.
Tracy L
TL
Tylka
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D001835:Body Weight; D004032:Diet; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D005638:Fruit; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D050177:Overweight / Q000628:therapy*; D011788:Quality of Life; D012959:Socioeconomic Factors; D014675:Vegetables; D055105:Waist Circumference; D049629:Waist-Hip Ratio; D061217:Weight Reduction Programs
D001786:Blood Glucose
Health At Every Size; Health promotion; Intuitive eating; Obesity; Weight loss