Effects of a new intervention based on the Health at Every Size approach for the management of obesity: The "Health and Wellness in Obesity" study

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Ulian, Mariana Dimitrov ; Pinto, Ana Jessica ; Sato, Priscila de Morais ; Benatti, Fabiana B. ; de Campos-Ferraz, Patricia Lopes ; Coelho, Desire ; Roble, Odilon J. ; Sabatini, Fernanda ; Perez, Isabel ; Aburad, Luiz ; Vessoni, Andre ; Unsain, Ramiro Fernandez ; Rogero, Marcelo Macedo ; Toporcov, Tatiana Natasha ; de Sa-Pinto, Ana Lucia ; Gualano, Bruno ; Scagliusi, Fernanda B.

• Document type: Journal article
• Source: PLoS One; v. 13, n. 7, p. 19-pg., 2018-07-06.

Abstract

Health at Every Size (R) (HAES (R)) is a weight-neutral approach focused on promoting healthy behaviors in people with different body sizes. This study examined multiple physiological, attitudinal, nutritional, and behavioral effects of a newly developed, intensive, interdisciplinary HAES (R)-based intervention in obese women. This was a prospective, seven-month, randomized (2: 1), controlled, mixed-method clinical trial. The intervention group (I-HAES (R); n = 39) took part in an intensified HAES (R)-based intervention comprising a physical activity program, nutrition counseling sessions, and philosophical workshops. The control group (CTRL; n = 19) underwent a traditional HAES (R)-based intervention. Before and after the interventions, participants were assessed for physiological, psychological, and behavioral parameters (quantitative data) and took part in focus groups (qualitative data). Body weight, body mass index, and waist and hip circumferences did not significantly differ within or between groups (P > 0.05). I-HAES (R) showed increased peak oxygen uptake and improved performance in the timed-stand test (P = 0.004 and P = 0.004, between-group comparisons). No significant within-or between-group differences were observed for objectively measured physical activity levels, even though the majority of the I-HAES (R) participants indicated that they were engaged in or had plans to include physical activity in their routines. I-HAES (R) resulted in improvements in eating attitudes and practices. The I-HAES (R) group showed significantly improved all Body Attitude Questionnaire subscale and all Figure Rating Scale scores (P <= 0.05 for all parameters, within-group comparisons), whereas the CTRL group showed slight or no changes. Both groups had significant improvements in health-related quality of life parameters, although the I-HAES (R) group had superior gains in the "physical health," "psychological health," and "overall perception of quality of life and health" (P = 0.05, 0.03, and 0.02, respectively, between-group comparisons) domains. Finally, most of the quantitative improvements were explained by qualitative data. Our results show that this new intensified HAES (R)-based intervention improved participants' eating attitudes and practices, perception of body image, physical capacity, and health-related quality of life despite the lack of changes in body weight and physical activity levels, showing that our novel approach was superior to a traditional HAES (R)-based program. (AU)

• FAPESP's process: 17/17424-9 - Health and Well-Being in Obesity: evaluation of an interdisciplinary intervention based on the "Health at every size" approach for obese women.
• Grantee: Fernanda Baeza Scagliusi
• Support Opportunities: Scholarships abroad - Research
• FAPESP's process: 15/03878-2 - Health and Well-Being in Obesity: evaluation of an interdisciplinary intervention based on the "Health at every size" approach for obese women
• Grantee: Fernanda Baeza Scagliusi
• Support Opportunities: Regular Research Grants
• FAPESP's process: 15/26937-4 - Studies on physical (in)activity in patients with rheumatoid arthritis: characterization, associations with disease and effects of breaking up sedentary time
• Grantee: Ana Jéssica Pinto
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)
• FAPESP's process: 15/12235-8 - The erotic belly: intersections between health, genders, feedings and sexualities in the homosexual bear community in the City of São Paulo, Brazil
• Grantee: Ramiro Andres Fernandez Unsain
• Support Opportunities: Scholarships in Brazil - Doctorate
• FAPESP's process: 17/05651-0 - Ultra processed food consumption and feeding practices of mothers in Cruzeiro do Sul, Acre: a mixed-methods approach
• Grantee: Priscila de Morais Sato
• Support Opportunities: Scholarships in Brazil - Post-Doctoral