Evaluation of a Health at Every Size vs a Behavioral Weight Loss Approach for Obese Women
Condition: Obesity
MeSH terms: Obesity
Study type: Interventional

Summary: 
      For over four decades the medical literature has observed a relationship between obesity and
      poorer health outcomes. The causal mechanisms of these poorer outcomes however are unclear.
      One assumption that has been supported by correlational data is that increased weight is
      associated with increased cardiovascular disease (CVD) risk factors (i.e., hypertension,
      dyslipidemia, and type 2 diabetes). Consequently, obese people are routinely prescribed
      weight loss programs in order to prevent or control these conditions. Unfortunately, long
      term weight loss has been met with minimal success for the large majority of people.
      Furthermore, the data suggesting that weight loss leads to long term health benefits and
      decreased mortality is limited and contradictory. The purpose of the proposed project is to
      perform a randomized controlled pilot study comparing the effectiveness of two lifestyle
      interventions for preventing CVD risk factors (hypertension, dyslipidemia, and type 2
      diabetes). The interventions are constitutionally similar; however, the treatment condition
      is a wellness-focused intervention that teaches healthy living without consideration of
      weight. The control condition is a traditional curriculum where the prescribed outcome is
      weight loss. The primary goals of both programs are to reduce hypertension and total
      cholesterol, and to enhance glucose control. Secondary outcomes of interest are psychological
      and behavioral in nature (e.g., self-esteem; depressed mood; anxiety; stress; quality of
      life; dietary habits; and physical activity). We will compare the trajectories of the CVD and
      psychological/behavioral risk factors for a total period of 24 months (including the time
      from baseline to the end of the 6-month intervention). Our objectives are to collect data to
      a) determine whether participants in both programs reduce CVD and psychological/behavioral
      risk factors at the completion of the 6-month program, and b) compare the persistency of
      health improvements and rate of relapse at the end of the 18-month follow-up period between
      the traditional weight loss intervention and the wellness-focused intervention.
    


Intervention name(s): Wellness-Centered (HUGS); Weight-Centered (LEARN)
Intervention type(s): Behavioral; Behavioral
Intervention description(s): A health at every size intervention, the HUGS program was conceived and developed in 1987 by Linda Omichinski, Registered Dietitian. HUGS stands for Health focused, Understanding lifestyle, Group supported, and Self-esteem building. It is an integrated approach that promotes healthy eating, active living, and self acceptance regardless of weight. HUGS teaches strategies to recognize and respond to physiological signs of hunger and satiety to determine food intake. The manualized curriculum is accompanied by the books Tailoring Your Tastes and Staying Off of the Diet Roller Coaster which participants will receive in addition to a booklet of handouts. Kelly Bliss, a psychotherapist and fitness professional with 17 years experience in health-centered approaches for weight management, will deliver the intervention in 2 groups of 20 people that meet weekly for 6 months.; The LEARN Program for Weight Management is an evidence-based behavior modification approach to weight loss developed by Dr. Kelly Brownell, Ph.D. Psychologist. LEARN is an acronym that stands for Lifestyle, Exercise, Attitudes, Relationships, and Nutrition. This manualized curriculum shares many principals with the HUGS program in that both emphasize the importance of healthy lifestyle choices and gradual sustainable change. However, the LEARN program makes weight loss an explicit goal and focuses more on food intake levels based on external prescriptions and caloric restriction. Participants in the LEARN program will receive the LEARN Program for Weight Management manual and the LEARN Weight Stabilization and Maintenance Guide along with the LEARN Program CD set. Ann Wellock, a Registered Dietician from The Reading Hospital and Medical Center will deliver the intervention in 2 groups of 20 people that meet weekly for 6 months.
Other intervention name(s): Health At Every Size; Intuitive Eating; behavior based weight loss program
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: 1:1 Parallel assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: obesity; wellness; cardiovascular disease prevention; health at every size; weight loss