Bacon L, Keim N L, Van Loan M D, Derricote M, Gale B, Kazaks A, Stern J S
Department of Nutrition, University of California at Davis, Davis, California, USA.
Int J Obes Relat Metab Disord. 2002 Jun;26(6):854-65. doi: 10.1038/sj.ijo.0802012.
Current public health policy recommends weight loss for obese individuals, and encourages energy-restricted diets. Others advocate an alternative, 'non-diet' approach which emphasizes eating in response to physiological cues (eg hunger and satiety) and enhancing body acceptance.
To evaluate the effects of a 'health-centered' non-diet wellness program, and to compare this program to a traditional 'weight loss-centered' diet program.
Six-month, randomized clinical trial.
Free-living, general community.
Obese, Caucasian, female, chronic dieters, ages 30-45 y (n=78).
Six months of weekly group intervention in a non-diet wellness program or a traditional diet program, followed by 6 months of monthly after-care group support.
Anthropometry (weight, body mass index); metabolic fitness (blood pressure, blood lipids); energy expenditure; eating behavior (restraint, eating disorder pathology); psychology (self-esteem, depression, body image); attrition and attendance; and participant evaluations of treatment helpfulness. Measures obtained at baseline, 3 months, 6 months and 1 y.
(1 y after program initiation): Cognitive restraint increased in the diet group and decreased in the non-diet group. Both groups demonstrated significant improvement in many metabolic fitness, psychological and eating behavior variables. There was high attrition in the diet group (41%), compared to 8% in the non-diet group. Weight significantly decreased in the diet group (5.9+/-6.3 kg) while there was no significant change in the non-diet group (-0.1+/-4.8 kg).
Over a 1 y period, a diet approach results in weight loss for those who complete the intervention, while a non-diet approach does not. However, a non-diet approach can produce similar improvements in metabolic fitness, psychology and eating behavior, while at the same time effectively minimizing the attrition common in diet programs.
当前公共卫生政策建议肥胖个体减重，并鼓励采用限制能量的饮食方式。其他人则提倡另一种“非节食”方法，该方法强调根据生理信号（如饥饿和饱腹感）进食，并增强对身体的接纳度。
评估以健康为中心的非节食健康计划的效果，并将该计划与传统的以减重为中心的饮食计划进行比较。
为期6个月的随机临床试验。
自由生活的普通社区。
肥胖的白种女性，长期节食者，年龄30 - 45岁（n = 78）。
在非节食健康计划或传统饮食计划中进行为期6个月的每周一次的小组干预，随后进行6个月的每月一次的后续小组支持。
人体测量学指标（体重、体重指数）；代谢健康状况（血压、血脂）；能量消耗；饮食行为（克制、饮食失调病理）；心理指标（自尊、抑郁、身体意象）；损耗率和出勤率；以及参与者对治疗帮助程度的评价。在基线、3个月、6个月和1年时获取测量数据。
（计划开始后1年）：饮食组的认知克制增加，非节食组的认知克制减少。两组在许多代谢健康、心理和饮食行为变量方面均有显著改善。饮食组的损耗率较高（41%），而非节食组为8%。饮食组体重显著下降（5.9±6.3千克），而非节食组无显著变化（-0.1±4.8千克）。
在1年的时间里，节食方法会使完成干预的人减重，而非节食方法则不会。然而，非节食方法可以在代谢健康、心理和饮食行为方面产生类似的改善，同时有效减少饮食计划中常见的损耗率。
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