Weight Acceptance Prevents Weight Gain?

This may sound counterintuitive, but it appears that one way to manage your weight and not continue packing on more pounds year after year may be to simply accept your body weight for what it is and, instead of trying to lose weight, to simply focus on healthy behaviours.

As readers of these pages are probably well aware, the long-term results of restrictive weight-loss interventions is indeed rather disappointing. Thus, the advice to simply eat less, although associated with weight loss in the short term, is rarely sustainable and inadvertently leads to weight regain in the vast majority of patients.

Possible reasons why restrictive dieting often fails is because dieting can increase appetite and promote obsessive thoughts about food and eating as well as increase the risk of depression and overeating in response to negative emotions and stress.

In contrast to this restrictive “weight-centred” approach, a more “health-centered” approach, commonly referred to as “Health-At-Every-Size” (HAES), is based on the notion that health is related to behaviours independently of body weight. Thus, rather than considering weight loss the primary goal, the HAES approach focuses on promoting overall health benefits of behavior changes related to dietary habits and physical activity, with an emphasis on size acceptance and nondieting.

But does this approach provide a viable alternative to weight management?

This question was now addressed in a study by Veronique Provencher and colleagues from Laval University, Quebec, published in the Journal of the American Dietetic Association.

In this study, 144 premenopausal overweight/obese women were randomly assigned to either a HAES group, a social support group, or a control group. The HAES intervention consisted of 13 weekly 3 hour sessions and one intensive 1-day session conducted in small groups led by a registered dietitian and a clinical psychologist. The focus was on well-being and a positive healthy lifestyle as well as to impart awareness and knowledge about biological, psychological, and sociocultural aspects of body weight. In the HAES group, the interveners were active leaders, providing specific information and
structured activities to participants.

In contrast, the social support group, which met as often and discussed the same topics as the HAES group, was not specifically directed by the facilitators in terms of content or direction of the discussion. The main function of this group was to mimic the social support and network provided by the HAES group.

The control group consisted of a “waiting list” group, which was not offered any specific intervention at all.

Over the 16 month observation period, situational susceptibility to disinhibition and susceptibility to hunger significantly decreased over time in both the HAES and social support groups, but this difference appeared to be more sustained in the HAES group.

Although, women in the HAES group were not expected to restrict caloric intake, 63.4% of these women had a modestly reduced body weight at 16 months. In contrast, lower body weights were noted in at 16 months in 57.6% of women in the SS group and 43.7% of women in the control group. Significant associations were observed between eating behaviors changes and body weight changes only in the HAES group.

Thus, this study shows that a HAES approach may have long-term beneficial effects in terms of disinhibition and hunger, important behavioural components of healthy ingestive behaviour. Whether or not this approach will translate into better outcomes and long-term prevention of weight gain remains to be seen. It certainly seems to provide a viable alternative to anyone tired of endless weight cycling.

Edmonton, Alberta