Tuesday, July 8, 2008

Is HAES Unhealthy?

In the past, critics have charged that the HAES approach was unhealthy and would harm the health of participants. But a two-year long U.C. Davis study, published in the June 2005 issue of the Journal of the American Dietetic Association (as reported by Medical News Today) found that the Health At Every Size approach actually produced better long-term health benefits than a traditional dieting approach.

Members of the dieting group were told to moderately restrict their food consumption, maintain food diaries and monitor their weight. They were provided with information on the benefits of exercise, on behavioral strategies for successful dieting, and on how to count calories and fat content, read food labels and shop for appropriate foods.

Participants in the non-dieting group were instructed to let go of restrictive eating habits associated with dieting. Instead they were counseled to pay close attention to internal body cues indicating when they were truly hungry or full, and to how the food made them feel. They also received standard nutritional information to help them choose healthful foods, and participated in a support group designed to help them better understand how culture influences the experience of obese people and to become more accepting of their larger bodies. In addition, they were encouraged to identify and deal with barriers, including negative self-image, which might get in the way of enjoying physical activity.

The study spanned two years, with each group meeting for 24 weekly treatment sessions and, after that, for six monthly optional support group meetings. They also attended five testing sessions...At the testing sessions, factors such as blood pressure and cholesterol levels were measured. The participants' levels of physical activity also were evaluated, as were their eating behaviors and attitudes toward weight, body shape and eating.

Study results: Almost all (92 percent) of the non-dieting group stayed in the study throughout the treatment period, while almost half (42 percent) of the dieters dropped out before finishing treatments. This reinforces another message of the research -- that in the long run, people are much more likely to stick with a non-diet than a diet.

When the researchers tallied the results from the participants who completed the study, they found that:

-- The non-dieters maintained their same weight throughout the study. The dieting group lost 5.2 percent of their initial weight by the end of the 24-week treatment period, but regained almost all of it by the end of the two-year study.

-- The non-dieters showed an initial increase in their total cholesterol levels, but this significantly decreased by the end of the study, as did their levels of LDL cholesterol or "bad" cholesterol. The dieters showed no significant change in total or LDL cholesterol levels at any time.

-- Both groups significantly lowered their systolic blood pressure during the first 52 weeks of the study. By the end of the study at 104 weeks, however, the non-dieters had sustained this improvement, while the diet group had not.

-- By the end of the two-year study, the non-dieters had almost quadrupled their moderate physical activity. The dieting group had a significant increase in physical activity right after the treatment period ended but had slipped back to their initial levels by the end of the study.

-- The non-dieters demonstrated significant improvements in self-esteem and depression at the end of the study, while the diet group demonstrated a worsening in self-esteem. The dieters' depression levels initially improved but then returned to baseline.

In summary, while the non-dieters did not lose weight, they succeeded in improving their overall health, as measured by cholesterol levels, blood pressure, physical activity and self-esteem. The dieters, on the other hand, were not able to sustain any of the short-term improvements they experienced and worsened in terms of their self-esteem.

So the Health At Every Size approach can be healthy. While it may seem that dieting to lose weight is healthier, for many people the HAES approach results in better health in the long run.

And that's the most important thing, after all. As Kelly Bliss (author and exercise maven) suggests:

I propose that we END the “War on Obese People” and BEGIN “A Campaign for Healthy Eating and Fitness for ALL People, of ALL Sizes.”


April D said...

THANK YOU for this! People were just bringing up dieting again at work and I just needed the right words, right way to phrase my objection and you've given it to me.

Huzzah for listening to our bodies instead of denying that we might actually know what we need and want.

Anonymous said...

As a chronic yo-yo dieter these results don't surprise me at all but it is nice to see it documented.

Anonymous said...

Linda's research is certainly a very strong starting point for showing that a HAES is 1) not harmful, and 2) has advantages over traditional "dieting" approaches. These are hugely important points to prove empirically if we want HAES to advance and eventually be promoted by healthcare concerns.

Linda is a trailblazer, and I'm excited that she has a book about Health At Every Size coming out soon.

Thank you for reviewing her research and letting people know about it! This is definitely good material to use in the defense of HAES.