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PROVENCHER, VÉ RONIQUE, CATHERINE BÉ GIN, ANGELO TREMBLAY, LYNE MONGEAU, SONIA BOIVIN, AND SIMONE LEMIEUX. Short-term effects of a "Health-At-Every-Size" approach on eating behaviors and appetite ratings. Obesity. 2007;15:957-966. Objective: To assess the effects of a "Health-At-EverySize" (HAES) intervention on eating behaviors and appetite ratings in 144 premenopausal overweight women. Research Methods and Procedures: Women were randomly assigned to one of the 3 groups: HAES group, social support (SS) group, and control group (N ϭ 48 in each group). Interventions were conducted over a 4-month period, and measurements were taken before and after this period. Eating behaviors (cognitive dietary restraint, disinhibition, and susceptibility to hunger) were evaluated by the Three-Factor Eating Questionnaire. Appetite ratings (desire to eat, hunger, fullness, and prospective food consumption) were assessed by visual analogue scales before and after a standardized breakfast. Results: More important decreases in susceptibility to hunger and external hunger were observed in the HAES group when compared with the SS group (p ϭ 0.05, for susceptibility to hunger) and the control group (p ϭ 0.02 and p ϭ 0.005, for susceptibility to hunger and external hunger, respectively). In addition, women from the HAES group had more important decreases in postprandial area under the curve for desire to eat (p ϭ 0.02) and hunger (p ϭ 0.04) when compared with the control group. The change in the desire to eat noted in the HAES group was also different from the one observed in SS group (p ϭ 0.02). Women from the HAES group experienced significant weight loss at 4 months (Ϫ1.6 Ϯ 2.5 kg, p Ͻ 0.0001), which did not differ significantly from the SS and control groups (p ϭ 0.09). An increase in flexible restraint was significantly related to a greater weight loss in both HAES and SS groups (r ϭ Ϫ0.39, p Ͻ 0.01; and r ϭ Ϫ0.37, p Ͻ 0.05, respectively). A decrease in habitual susceptibility to disinhibition was also associated with a greater weight loss in HAES and control groups (r ϭ 0.31, p Ͻ 0.05; and r ϭ 0.44, p Ͻ 0.05, respectively). Discussion: These results suggest that a HAES intervention could have significant effects on eating behaviors and appetite ratings in premenopausal overweight women, when compared with an SS intervention or a control group.

This brief report tests the mediating effect of self-esteem in the relationship between body dissatisfaction and symptoms of depression and anxiety. A sample of 409 adolescents (females = 58.4%) aged between 14 and 18 years completed the Rosenberg Self-Esteem Scale, the Contour Drawing Rating Scale, the Multidimensional Anxiety Scale for Children, and the Center for Epidemiologic Studies Depression Scale. Overall, results for the indirect effects analysis were significant for both anxiety and depression, which confirmed the mediating role of self-esteem. Thus, a negative perception of one's body image has the effect of lowering self-esteem, which in turn increases psychological distress.

The aim of the present study was to assess the impact of a “Health-at-every-size” (HAES) intervention on psychological variables and body weight the weight-preoccupied overweight/obese women. Those women were randomized into three groups (1) HAES, (2) social support (SS), (3) waiting-list (WL), and were tested at baseline, post-treatment and six-month and one-year follow-ups. All participants presented significant psychological improvement no matter if they received the HAES intervention or not. However, even if during the intervention, the three groups showed improvements, during the follow up, the HAES group continued to improve while the other groups did not, even sometimes experiencing some deterioration. Furthermore, in the HAES group only, participant's weight maintenance 12 months after the intervention was related to their psychological improvement (quality of life, body dissatisfaction, and binge eating) during the intervention. Thus, even if, in the short-term, our study did not show distinctive effects of the HAES intervention compared to SS and WL on all variables, in the long-term, HAES group seemed to present a different trajectory as psychological variables and body weight are maintained or continue to improve, which was not the case in other groups. These differential long-term effects still need to be documented and further empirically demonstrated.

a Health-At-Every-Size approach (HAES). However, to our knowledge, no study has yet investigated how a HAES intervention could influence dietary intakes and eating patterns in overweight women. Therefore, objectives of this study were to determine changes in dietary intakes and eating patterns in premenopausal overweight women in response to a HAES intervention compared to a social support intervention and a control group, and then to determine whether changes in eating behaviors were associated with changes in dietary intakes and eating patterns in response to the HAES intervention. Methods: Women completed a 3-day food record and the Three-Factor Eating Questionnaire was used to assess eating behaviors. Results: Energy intake (main effect of time; p=0.045) and snack frequency (main effect of time; p=0.0004) decreased similarly over time in the three groups whereas proportion of energy intake from breakfast (main effect of time; p=0.03) increased over time. Within HAES group, decreases in hunger and external hunger were associated with a decrease in total daily energy intake (r=0. 50, p=0.0009 and r=0.50, p=0.0007, respectively). Conclusions: HAES intervention has no specific impact on eating patterns. However, a decrease in hunger, which characterizes women who respond well to HAES, is associated with a decrease in overall energy intake.

Intuitive eating is an adaptive eating style based on the reliance on physiological cues to determine when, what, and how much to eat. The Intuitive Eating Scale-2 (IES-2) is a validated four-subscale tool measuring the degree of adherence to intuitive eating principles. The present series of studies aimed at evaluating the psychometric properties of a French-Canadian adaptation of the IES-2 for the adult population. The factor structure, the reliability (internal consistency and test-retest), the construct validity, and the discriminant validity were evaluated in 334 women and 75 men from the Province of Québec, Canada, across two studies. A confirmatory factor analysis upheld that the four-factor structure of the original IES-2 was adequate for the present sample of French-Canadians. The scale demonstrated adequate internal consistency and test-retest reliability. Construct validity evidence was obtained with the significant associations between intuitive eating and psychological and eating-related variables. Intuitive eating was negatively associated with eating disorder symptomatology and with food- and weight-preoccupation, and positively associated with body-esteem and well-being. The French-Canadian IES-2 was also able to discriminate between genders and body mass index categories. The properties of this new version of the IES-2 are demonstrative of a reliable and valid tool to assess intuitive eating in the French-Canadian adult population of the Province of Québec.