Jaslyn A Dugmore1, Copeland G Winten1, Hannah E Niven1, Judy Bauer1. 1. J.A. Dugmore, C.G. Winten, H.E. Niven, and J. Bauer are with the School of Human Movement and Nutrition Science, The University of Queensland, Brisbane, Australia.
Abstract
CONTEXT: Weight-neutral approaches for health are emerging therapeutic alternatives to traditional weight-loss approaches. The existing literature base comparing these approaches has not yet been systematically evaluated by a meta-analysis. OBJECTIVE: This review aims to determine if weight-neutral approaches are valid alternatives to weight-loss approaches for improving physical, psychological, and behavioral health outcomes. DATA SOURCES: Embase, Scopus, PsycINFO, PubMed, CINAHL, and the University of Queensland Library databases were searched. STUDY SELECTION: Peer-reviewed, experimental, or quasi-experimental studies that included weight-neutral and weight-loss arms and reported physical, psychological, or behavioral outcomes were eligible. A total of 525 studies were identified through initial database searches, with 10 included in the final analysis after exclusion criteria were applied. DATA EXTRACTION: Screening and eligibility assessment of studies followed the PRISMA protocol. The following outcomes were extracted: weight, body mass index, lipid and glucose variables, blood pressure, eating behavior, self-esteem, depression, quality of life, physical activity, and diet quality. DATA ANALYSIS: Studies were graded per the National Health and Medical Research Council (NHMRC) level-of-evidence tool and the Academy of Nutrition and Dietetics quality-evaluation tool. Effect sizes were examined as a meta-analysis of standardized and mean differences using a random-effects inverse-variance model with 95%CIs. Practice recommendations for each outcome were graded per NHMRC body-of-evidence guidelines. CONCLUSIONS: Weight-neutral approaches resulted in greater improvement in bulimia (P = 0.02), but no significant differences were observed for any other outcome. Weight-neutral approaches may be as effective as weight-loss methods for improving physical, psychological, and behavioral outcomes. Limitations include inconsistent definitions of both approaches and variable time frames of follow-up.
CONTEXT: Weight-neutral approaches for health are emerging therapeutic alternatives to traditional weight-loss approaches. The existing literature base comparing these approaches has not yet been systematically evaluated by a meta-analysis. OBJECTIVE: This review aims to determine if weight-neutral approaches are valid alternatives to weight-loss approaches for improving physical, psychological, and behavioral health outcomes. DATA SOURCES: Embase, Scopus, PsycINFO, PubMed, CINAHL, and the University of Queensland Library databases were searched. STUDY SELECTION: Peer-reviewed, experimental, or quasi-experimental studies that included weight-neutral and weight-loss arms and reported physical, psychological, or behavioral outcomes were eligible. A total of 525 studies were identified through initial database searches, with 10 included in the final analysis after exclusion criteria were applied. DATA EXTRACTION: Screening and eligibility assessment of studies followed the PRISMA protocol. The following outcomes were extracted: weight, body mass index, lipid and glucose variables, blood pressure, eating behavior, self-esteem, depression, quality of life, physical activity, and diet quality. DATA ANALYSIS: Studies were graded per the National Health and Medical Research Council (NHMRC) level-of-evidence tool and the Academy of Nutrition and Dietetics quality-evaluation tool. Effect sizes were examined as a meta-analysis of standardized and mean differences using a random-effects inverse-variance model with 95%CIs. Practice recommendations for each outcome were graded per NHMRC body-of-evidence guidelines. CONCLUSIONS: Weight-neutral approaches resulted in greater improvement in bulimia (P = 0.02), but no significant differences were observed for any other outcome. Weight-neutral approaches may be as effective as weight-loss methods for improving physical, psychological, and behavioral outcomes. Limitations include inconsistent definitions of both approaches and variable time frames of follow-up.
Authors: Angelique F Ralph; Leah Brennan; Sue Byrne; Belinda Caldwell; Jo Farmer; Laura M Hart; Gabriella A Heruc; Sarah Maguire; Milan K Piya; Julia Quin; Sarah K Trobe; Andrew Wallis; A J Williams-Tchen; Phillipa Hay Journal: J Eat Disord Date: 2022-08-18