|VAN LOAN, MARTA|
Submitted to: International Journal of Obesity
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/10/2002
Publication Date: 1/17/2002
Citation: Bacon, L., Keim, N.L., Van Loan, M.D., Derricote, M., Gale, B., Kazaks, A., Stern, J.S. 2002. EVALUATING A 'NON-DIET' WELLNESS INTERVENTION FOR IMPROVEMENT OF METABOLIC FITNESS, PSYCHOLOGICAL WELL-BEING AND EATING AND ACTIVITY BEHAVIORS. International Journal of Obesity 26:854-865, 2002.
Interpretive Summary: In the United States, to combat the rise in obesity and overweight, public policy endorses the use of weight loss diets to achieve a reduced body weight. However, most individuals who intentionally reduce their body weights are more likely to regain weight within 1-5 years of weight loss. As an alternative to a diet approach for improving wellness in obese individuals, we tested a `non-diet¿ approach to see if health outcomes were comparable to the traditional dieting approach. Only 60% of the women who participated in the traditional dieting program completed the program. Those who completed the dieting program lost weight, improved blood lipids, decreased blood pressure, and had more favorable psychological profiles. On the other hand, more than 90% of the women in the non-diet program completed their program. Despite the fact that they did not lose weight, these non-dieters experienced improvements in blood lipids, blood pressure and psychological profiles, similar to the diet group. These findings are important because they demonstrate that improvements in health can occur when obese individuals participate in a wellness program that supports healthy lifestyle changes like increasing physical activity and choosing healthy foods.
Technical Abstract: Current public health policy recommends weight loss for obese individuals, and encourages energy-restricted diets. Others advocate an alternative, `non-diet¿ approach that emphasizes eating in response to physiological cues and enhancing body acceptance. The objective of this study was 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. A randomized clinical trial was conducted with 78 obese, Caucasian female volunteers who were chronic dieters. The programs consisted of weekly group intervention sessions for 6 months, followed by monthly support group sessions. Outcome measures, taken at baseline, 3, 6 and 12 months, included height, weight, blood pressure, blood lipids, evaluation of eating behavior, self-esteem, depression, body image, and rates of attrition and attendance at intervention sessions. Cognitive restraint increased in the diet group and decreased in the non-diet group. Both groups demonstrated significant improvement in many metabolic, psychological and eating behavior variables. There was high attrition in the diet group (41%), compared to the non-diet group (8%). 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). Over a 1-year 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.