Comparing the long-term effects of a Health At Every Size approach versus a traditional dieting intervention on disordered eating among large women

Introduction:  Given the escalation of public health efforts towards the eradication of "obesity", increased attention has been paid to interventions for improving the health of larger persons.  Despite a lack of evidence of long term success, most health promoting methods practiced, utilize weight loss as a treatment goal.  A Health At Every Size approach considers the potential iatrogenic effects of a focus on weight and instead, promotes health through acceptance of all sizes. 

Method: Eighty women enrolled in a RCT comparing the health benefits of two 6-month interventions: Health At Every Size (HAES) versus a traditional dieting intervention (LEARN).  Participants were between 30 and 45 years of age (M=39.6, SD=4.11), 96% identified as Caucasian, 65% attended some college, BMIs ranged from 30 to 45 (M=38; SD= 3.88). The EDE-Q served as the primary outcome measure for disordered eating behaviors.  All measurements were recorded pre-intervention, 6 and 24-months post-intervention.  

Results:  Mixed models analysis indicated a significant time by intervention effect on global disordered eating scores [F(2,118)=6.21;p=.003].  HAES participants saw decreases in symptoms at post-intervention (M=.54; SE = .11) and 24-month follow-up (M=.30; SE =.15). LEARN participants experienced an average increase in symptoms at post-intervention (M = -.14; SE =.12) and no change from baseline to 24-month follow-up (M = .01; SE=.14).

Discussion:In public health, we too must remember the oath taken by our colleagues who practice medicine, ‘Primum non nocere.’  As the present data demonstrated, weight loss interventions for health improvement could have unintended consequences by encouraging pathological eating behaviors.