November Question 3:
Do you believe the results achieved with the HAES approach are great enough to make a positive difference in a client's physical health?
posted by ee.spenner @ 12:54 PM
14 comments
ISU Dietetic Internship Journal Club
Objective: To become familiar with current scientific literature on a variety of nutrition topics and to gain experience in gathering, organizing, critically evaluating, presenting and facilitating group discussion of the literature and the implications to practice.
14 Comments:
I don't know that a 1% difference indicates enough difference to use a HAES approach over a traditional weight loss method. However, I also feel that the study needs to be replicated and expounded on in order to determine true significance. Personally, with no scientific data to back up my reasoning, I believe that the HAES approach is more beneficial because it softens the blow of dieting defeat and teaches dieters how to modify behaviors for permenant health benefits, not just in order to reach a number.
Theoretically, I think that the HAES approach is a great idea; however, I think that it ultimately depends on the client. As we've learned, people present with different issues. They require different therapies and most likely respond to different diet regimens. In the grand scheme of things, I think it is extremely important to steer patients away from focusing on a number as it can lead to obsessive thoughts and behaviors pertaining to food, weight and/or weight loss. Even though the patients following the HAES approach maintained a lower weight than the women in the control group; the percentage difference was minimal. In addition, no significant differences were observed between the HAES, SS and control groups regarding age, BMI, eating behaviors, physical activity level, and metabolic variables (with the exception of HDL cholesterol levels).
I think that the HAES approach study is a great basis to continue studying this approach. I am not sure that it would be appropriate at this point for state to a client the success of this approach, however I believe it would be appropriate to tell those who have tried the number thing and have been disappointed that they may have more success with the HAES approach.
Jen and Anna
You both bring up great points. The one study does not statistically prove that this program would be better, however we have all identified how there are very positive aspects of this program. I still believe that it would be interesting to see this study broadened and continued to see if there would eventually be enough statistical significance to back up the effectiveness of the program.
Lifestyle changes take time and are most effective when gradual and not a complete overall. So weight changes at one year may not be that great if they are still working to incorporate what they learned. However, it is a rather small percentage difference between the two groups and even the control. It would interesting to see this 5 years down the road to see if the change would be dramatically different because the lifestyle changes became more permanent. Right now, I don't think these are significantly different to prove HAES is effective, but I think it may be too soon to completely tell.
Anna,
I like your use of "theoretical" because that's basically where we are at with the HAES research. It is still so new that its really more a theory and needs data. It's too bad that this yielded the results you mentioned, but it still needs more research to show that it's not just a theory.
Rachel, you brought up an excellent point about lifestyle changes being a gradual process regarding the fact that this study’s findings were taken at one year. Even though one year may seem like a long time, it really is not, especially for individuals with poor body acceptance who have spent basically all of their life struggling with their weight.
Yes, I do as long as the results are expounded upon and the new behaviors continue to be reinforced for further success. Anyone who has ever lost weight has had a 1-2% loss/change at some point in the process (you have to begin somewhere!). If a 1% difference can be seen as a jumping off point for continuing to achieve positive results then absolutely, the results are indeed enough to make positive difference in health. I think it would be a mistake, however, to acknowledge this slight achievement as all that is needed. It would be better to encourage a client that has reached this point by saying "Let's keep going - now that you've started and this and you have seen good results let's see what else you can accomplish". It would be a shame to look at even slight achievements as negative because they were only slight.
Shelby,
I agree with your comments to Jen and Anna. There is huge potential here - it would be great to see a similar study done with a broader population and a lengthened timeframe. I would welcome further information about the success of this technique so that I could identify it as a legitimate tool for weight loss.
I think that the success of the HAES approach is very individualized. This study only showed a 2% change in weight for the HAES approach, but that is only based on this study. The clients for this study may have not thrived on this approach, but other clients may do excellent using the HAES approach. Overall, I think that this approach could definitely work and make positive changes in a person's physical health, but it ultimately depends on the client and how receptive they are to the HAES approach.
I think that any improvement is better than none. That being said, I think it would be important to continue following up with the people who were in the HAES group to see if they continued to use the principles they learned throughout their lives longterm. If that was the case, then that 2% weight reduction would continue to build upon itself over time to yield much better results than traditional methods. I think even if the numbers don't show on the scale, the information being distributed in the HAES approach would make a positive difference in a client's health overall.
Rachel and Alison,
Rachel, I agree with what you said about lifestyles changes being gradual and producing the greatest lasting results when incorporated over time. I would definately be interested in seeing what was going on with these clients 5 years down the line and even 10 or more years down the line to see what these permanant lifestyles changes have meant to the numbers longterm. And Alison, I completely agree what what you said about any amount of change in the right direction being positive and that it is just important to keep encouraging those small changes to achieve an overall greater result.
If a client is struggling with weight loss and is overly-focused on body weight and restricting calories, than this approach should definitely be attempted. This strategy steers away from having weight loss as the main goal and focuses on overall health benefits of a healthy lifestyle, nondieting, and body size acceptance. When the HAES intervention was compared to a control group, significant lower scores for situational susceptibility to disinhibition and susceptibility to hunger were noted at the 1-year follow-up in the HAES group. Both of these factors are thought to be connected to weight gain, and these results support the idea that this type of intervention could definitely provide some sort of help when it comes to preventing long-term weight gain and establishing healthy eating habits.
This is Steph Hyett
I think that although the results are not as strong as one would hope, a long term study may find that people who adopted the HAES approach may have greater achievements than those focusing only on weight loss. It is more important for clients to have a healthy lifestyle than it is for the pounds to come off. If the clients are focused more on weight loss, it sets them up for disappointment. Telling someone to cut back calories or not eat dessert only makes them want to eat dessert! I say a happy client is more willing to listen to an RD, so start with the acceptance and lifestyle changes.
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