Abstract
Introduction
Health at Every Size (HAES) is a weight-neutral approach focused on promoting healthy
behaviors in people with different body sizes and on enhancing pleasure derived from
consuming food to achieve sustainable healthy eating outcomes. However, to the best
of our knowledge, there are no studies in the literature assessing the effects of
the HAES approach on perceptions of eating pleasure.
Objective
We qualitatively investigated the perceptions of obese women about eating pleasure
before and after a new interdisciplinary, nonprescriptive intervention based on the
HAES approach.
Design
The intervention was a randomized controlled clinical trial, designated as Health
and Wellness in Obesity, conducted over 7 months at University of São Paulo (Brazil).
We used a qualitative approach to data construction and analysis of perceptions about
eating pleasure. Participants were randomized to either the intervention (I-HAES)
group or the control (CTRL) group. The I-HAES group featured individual nutritional
counseling, group practice of enjoyable physical activity, and philosophical workshops.
The CTRL group was a traditional HAES intervention group (lecture-based model). Focus
group discussions eliciting perceptions of pleasure around eating were conducted at
baseline and post-study. Focus group transcripts were analyzed by exploratory content
analysis.
Participants
Forty-three women aged 25 to 50 years with body mass index (measured in kilograms
per square meter) between 30 and 39. 9 completed the intervention and the focus groups,
with 32 in the I-HAES group and 11 in the CTRL group.
Results
Lack of guilt about experiencing pleasure while eating and increased reflection on
their own desires increased in participants of both groups after the study. The I-HAES
group also displayed a greater sense of autonomy related to eating, increased pleasure
in commensality, familiarity with the practice of cooking, and decreased automatic
eating.
Conclusion
HAES-based intervention featuring nutritional counseling, appreciation for physical
activity, and philosophical engagement was shown to stimulate pleasure around eating
without leading to indiscriminate eating.
Keywords
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Biography
F. Sabatini is a PhD candidate, School of Public Health, Department of Nutrition, University of São Paulo, São Paulo, Brazil.
Biography
M. D. Ulian is a postdoctoral student, School of Public Health, Department of Nutrition, University of São Paulo, São Paulo, Brazil.
Biography
A. Vessoni is a master's student, School of Public Health, Department of Nutrition, University of São Paulo, São Paulo, Brazil.
Biography
P. de M. Sato is a postdoctoral student, School of Public Health, Department of Nutrition, University of São Paulo, São Paulo, Brazil.
Biography
F. B. Scagliusi is a professor, School of Public Health, Department of Nutrition, University of São Paulo, São Paulo, Brazil.
Biography
I. Perez is a nutritionist, Unified Health System of Brazil, São Paulo, Brazil; at the time of the study, she was a master's student, School of Public Health, Department of Nutrition, University of São Paulo, São Paulo, Brazil.
Biography
A. Jéssica Pinto is a PhD candidate, Applied Physiology & Nutrition Research Group, University of São Paulo, São Paulo, Brazil.
Biography
F. B. Benatti is a professor, Applied Physiology & Nutrition Research Group, University of São Paulo, São Paulo, Brazil.
Biography
D. Coelho is a professor, Applied Physiology & Nutrition Research Group, University of São Paulo, São Paulo, Brazil.
Biography
B. Gualano is a professor, Applied Physiology & Nutrition Research Group, University of São Paulo, São Paulo, Brazil.
Biography
L. Aburad is a nutritionist in private practice, São Paulo, Brazil; at the time of the study, he was a master's student, School of Public Health, Department of Nutrition, University of São Paulo, São Paulo, Brazil.
Biography
P. L. de Campos-Ferraz is a professor, Faculty of Applied Sciences, State University of Campinas, Limeira, Brazil.
Biography
O. J. Roble is a professor, Faculty of Physical Education, State University of Campinas, Campinas, Brazil.
Biography
R. F. Unsain is a professor, Institute of Health and Society, Federal University of São Paulo, São Paulo, Brazil.
Biography
R. C. Schuster is a professor, Center for Global Health, Arizona State University, Tempe.
Article info
Publication history
Published online: March 30, 2019
Accepted:
January 10,
2019
Received:
June 7,
2018
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT Major grant: Research Support Foundation of the State of São Paulo (FAPESP), grant number 2015/03878-2. Individual grants: FAPESP grant number 2017/17424-9 and CNPq grant number 311357/2015-6 to F. B. Scagliusi; FAPESP grants number 2015/26937-4, 2017/05651-0, and 2015/12235-8, respectively, to A. J. Pinto, P. M. Sato, and R. F. Unsain; CNPq, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES) and FAPESP to B. Gualano; and CAPES (Finance Code 001) to M. D. Ulian and F. Sabatini. The study protocol was registered at Clinicaltrials.gov (NCT02102061).
Identification
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© 2019 by the Academy of Nutrition and Dietetics.
