Size Acceptance and Intuitive Eating Improve Health for Obese, Female Chronic Dieters

Bacon, Linda; Stern, Judith S.; Loan, Marta D. Van; Keim, Nancy L.

doi:10.1016/j.jada.2005.03.011

Cited by 378 publications

(470 citation statements)

References 17 publications

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“…Overall improvements in internalized weight 434 stigma between baseline and the 6-month assessment were reported by those in the weight-435 neutral program (p < .001) and those in the conventional weight-management program (p < 436 .001). These positive changes in internalized weight stigma were further sustained at the 24-437 month assessment for the weight-neutral program (p < .001) and the conventional weight These findings are consistent with previous research that has demonstrated the 470 effectiveness of weight-neutral programs for reducing disordered eating and improving adaptive 471 eating among women with high BMI (e.g., Bacon et al, 2005; Carrier, Steinhardt, & Bowman, 472 1994;Mensinger et al, 2016; Provencher et al, 2009;Watkins, Ebbeck, & Levy, 2014). 473…”

supporting

confidence: 84%

“…Although this is not atypical for studies involving weight reduction (e.g., Dalle et al, 2005; 566 Douketis, Macie, Thabane, & Williamson, 2005; Fabricatore et al, 2009), attrition in weight-567 neutral programs has been shown to be better in comparison to conventional weight-management 568 programs (Bacon et al, 2002(Bacon et al, , 2005. Given that the attrition analyses revealed little evidence to 569 suggest characteristics that were predictive of study completion (aside from the significant 570 association with race/ethnicity), we can only speculate about what could have been done 571 differently to encourage better adherence at the 24-month follow-up.…”

Section: Internalized Weight Stigma Moderates Eating Behavior 24mentioning

confidence: 99%

“…drive for thinness, body dissatisfaction, poor interoceptive awareness, and depression (e.g., 84 Bacon et al, 2002;Bacon, Stern, Van Loan, & Keim, 2005; Mensinger, Calogero, Stranges, & 85 Tylka, 2016; for reviews, see Cadena-Schlam & Lopez-Guimera, 2014;Clifford et al, 2015; and 86 Schaefer & Magnuson, 2014). Although this body of research demonstrated effectiveness for 87 weight-neutral programs, what is less clear is whether there are moderators that strengthen or 88 weaken their effectiveness.…”

Section: Internalized Weight Stigma Moderates Eating Behaviormentioning

confidence: 99%

“…Sample size determination was based on data from a previous trial comparing a weight-neutral to 305 a conventional weight-management intervention with 78 obese women and a 50% attrition rate at 306 the 24-month follow-up (Bacon et al, 2005). We determined that with 20 participants per 307 intervention by long-term follow-up, we would have adequate power (.80) to detect differences 308 of a moderate effect size.…”

Section: Internalized Weight Stigma Moderates Eating Behavior 13mentioning

confidence: 99%

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Internalized weight stigma moderates eating behavior outcomes in women with high BMI participating in a healthy living program

2016

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This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT INTERNALIZED WEIGHT STIGMA MODERATES EATING BEHAVIOR 2 ! Abstract 36Weight stigma is a significant socio-structural barrier to reducing health disparities and 37 improving quality of life for higher weight individuals. The aim of this study was to examine the 38 impact of internalized weight stigma on eating behaviors after participating in a randomized 39 controlled trial comparing the health benefits of a weight-neutral program to a conventional 40 weight-management program for 80 community women with high body mass index (BMI > 30, 41 age range: 30-45). Programs involved 6 months of facilitator-guided weekly group meetings 42 using structured manuals. Assessments occurred at baseline, post-intervention (6 months), and 43 24-months post-randomization. Eating behavior outcome measurements included the Eating 44Disorder Examination-Questionnaire and the Intuitive Eating Scale. Intention-to-treat linear 45 mixed models were used to test for higher-order interactions between internalized weight stigma, 46 group, and time. Findings revealed significant 3-way and 2-way interactions between 47 internalized weight stigma, group, and time for disordered and adaptive eating behaviors, 48 respectively. Only weight-neutral program participants with low internalized weight stigma 49 improved global disordered eating scores. Participants from both programs with low internalized 50 weight stigma improved adaptive eating at 6 months, but only weight-neutral program 51 participants maintained changes at follow-up. Participants with high internalized weight stigma 52 demonstrated no changes in disordered and adaptive eating, regardless of program. In order to 53 enhance the overall benefit from weight-neutral approaches, these findings underscore the need 54 to incorporate more innovative and direct methods to reduce internalized weight stigma for 55 women with high BMI. 56Key Words: internalized weight stigma, disordered eating, intuitive eating, obesity, 57 health at every size, conventional weight-management 58 obesity is a pervasive stigmatization of people with a higher weight statusÑa stigmatization that 63 is on the rise among adults and children (Andreyeva, Puhl, & Brownell, 2008; Harriger, 64 Calogero, Witherington, & Smith, 2010;Latner & Stunkard, 2003). Indeed, weight 65 discrimination has been well-documented in educational, workplace, and healthcare settings 66 (e.g., Giel, Thiel, Teufel, Mayer, & Zipfel, 2010;Neumark-Sztainer, Story, & Harr...

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supporting

confidence: 84%

Section: Internalized Weight Stigma Moderates Eating Behavior 24mentioning

confidence: 99%

Section: Internalized Weight Stigma Moderates Eating Behaviormentioning

confidence: 99%

Section: Internalized Weight Stigma Moderates Eating Behavior 13mentioning

confidence: 99%

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Internalized weight stigma moderates eating behavior outcomes in women with high BMI participating in a healthy living program

2016

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“…These latter approaches, however, generally argue that one can be healthy regardless of (over)weight and often address prejudice against overweight or obese people (26)(27)(28)(29) . Intuitive eating, in contrast, usually omits discussion of body weight or whether attaining a 'normal' weight is one of its goals.…”

Section: Development and Validity Of Scales To Measure Intuitive Eatingmentioning

confidence: 99%

Review Article Relationships between intuitive eating and health indicators: literature review

Dyke¹,

Drinkwater

2013

Public Health Nutr.

213

166

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Objective: To review the peer-reviewed literature on relationships between intuitive eating and health indicators and suggest areas of inquiry for future research. We define the fundamental principles of intuitive eating as: (i) eating when hungry; (ii) stopping eating when no longer hungry/full; and (iii) no restrictions on types of food eaten unless for medical reasons. Design: We include articles cited by PubMed, PsycInfo and Science Direct published in peer-reviewed journals or theses that include 'intuitive eating' or related concepts in the title or abstract and that test relationships between intuitive eating and physical or mental health indicators. Results: We found twenty-six articles that met our criteria: seventeen cross-sectional survey studies and nine clinical studies, eight of which were randomised controlled trials. The cross-sectional surveys indicate that intuitive eating is negatively associated with BMI, positively associated with various psychological health indicators, and possibly positively associated with improved dietary intake and/or eating behaviours, but not associated with higher levels of physical activity. From the clinical studies, we conclude that the implementation of intuitive eating results in weight maintenance but perhaps not weight loss, improved psychological health, possibly improved physical health indicators other than BMI (e.g. blood pressure; cholesterol levels) and dietary intake and/or eating behaviours, but probably not higher levels of physical activity. Conclusions: Research on intuitive eating has increased in recent years. Extant research demonstrates substantial and consistent associations between intuitive eating and both lower BMI and better psychological health. Additional research can add to the breadth and depth of these findings. The article concludes with several suggestions for future research.

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Health, not weight loss, focused programmes versus conventional weight loss programmes for cardiovascular risk factors

Khasteganan

Lycett

Turner

et al. 2014

Cochrane Database of Systematic Reviews

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Size Acceptance and Intuitive Eating Improve Health for Obese, Female Chronic Dieters

Cited by 378 publications

References 17 publications

Internalized weight stigma moderates eating behavior outcomes in women with high BMI participating in a healthy living program

Internalized weight stigma moderates eating behavior outcomes in women with high BMI participating in a healthy living program

Review Article Relationships between intuitive eating and health indicators: literature review

Health, not weight loss, focused programmes versus conventional weight loss programmes for cardiovascular risk factors

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