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Evaluating a ‘non-diet’ wellness intervention for improvement of metabolic fitness, psychological well-being and eating and activity behaviors

International Journal of Obesity volume 26, pages 854–865 (2002)Cite this article

Abstract

Context: Current public health policy recommends weight loss for obese individuals, and encourages energy-restricted diets. Others advocate an alternative, ‘non-diet’ approach which emphasizes eating in response to physiological cues (eg hunger and satiety) and enhancing body acceptance.

Objective: To evaluate the effects of a ‘health-centered’ non-diet wellness program, and to compare this program to a traditional ‘weight loss-centered’ diet program.

Design: Six-month, randomized clinical trial.

Setting: Free-living, general community.

Participants: Obese, Caucasian, female, chronic dieters, ages 30–45 y (n=78).

Interventions: Six months of weekly group intervention in a non-diet wellness program or a traditional diet program, followed by 6 months of monthly after-care group support.

Outcome Measures: Anthropometry (weight, body mass index); metabolic fitness (blood pressure, blood lipids); energy expenditure; eating behavior (restraint, eating disorder pathology); psychology (self-esteem, depression, body image); attrition and attendance; and participant evaluations of treatment helpfulness. Measures obtained at baseline, 3 months, 6 months and 1 y.

Results (1 y after program initiation): Cognitive restraint increased in the diet group and decreased in the non-diet group. Both groups demonstrated significant improvement in many metabolic fitness, psychological and eating behavior variables. There was high attrition in the diet group (41%), compared to 8% in the non-diet group. Weight significantly decreased in the diet group (5.9±6.3 kg) while there was no significant change in the non-diet group (−0.1±4.8 kg).

Conclusions: Over a 1 y period, a diet approach results in weight loss for those who complete the intervention, while a non-diet approach does not. However, a non-diet approach can produce similar improvements in metabolic fitness, psychology and eating behavior, while at the same time effectively minimizing the attrition common in diet programs.

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Acknowledgements

We thank Sue Hansen and Pauline Morel for their help in data analysis. This study was supported in part by grant no. 1R03DK57738-01A1 from the National Institutes of Health, a cooperative agreement with the Western Human Nutrition Research Center, and a fellowship from the National Science Foundation.

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Affiliations

  1. Department of Nutrition, University of California at Davis, Davis, California, USA

    L Bacon, A Kazaks & JS Stern

  2. Biological Sciences Department, City College of San Francisco—Phelan Campus, San Francisco, California, USA

    L Bacon

  3. USDA-ARS—Western Human Nutrition Research Center, University of California at Davis, Davis, California, USA

    NL Keim, MD Van Loan, M Derricote & B Gale

  4. Division of Endocrinology, Department of Internal Medicine, Clinical Nutrition and Cardiovascular Medicine, University of California at Davis, Davis, California, USA

    JS Stern

Authors
  1. L Bacon
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  2. NL Keim
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  6. A Kazaks
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Correspondence to L Bacon.

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Bacon, L., Keim, N., Van Loan, M. et al. Evaluating a ‘non-diet’ wellness intervention for improvement of metabolic fitness, psychological well-being and eating and activity behaviors. Int J Obes 26, 854–865 (2002). https://doi.org/10.1038/sj.ijo.0802012

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Keywords

  • non-diet intervention
  • eating behavior
  • metabolic fitness
  • weight loss

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