J Acad Nutr Diet. 2019 Sep;119(9):1470-1482. doi: 10.1016/j.jand.2019.01.006. Epub 2019 Mar 30.
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.
We qualitatively investigated the perceptions of obese women about eating pleasure before and after a new interdisciplinary, nonprescriptive intervention based on the HAES approach.
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.
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.
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.
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.
健康体型（HAES）是一种关注不同体型人群健康行为的体重中立方法，同时增强了从食物中获得愉悦感，以实现可持续的健康饮食结果。然而，据我们所知，目前文献中尚无研究评估 HAES 方法对饮食愉悦感的影响。
我们定性研究了肥胖女性在接受基于 HAES 方法的新的跨学科、非规定性干预之前和之后对饮食愉悦感的看法。
该干预措施是一项在巴西圣保罗大学进行的为期 7 个月的随机对照临床试验，命名为肥胖症的健康与保健，我们采用定性方法构建和分析对饮食愉悦感的看法。参与者被随机分配到干预组（I-HAES）或对照组（CTRL）。I-HAES 组包括个体营养咨询、享受身体活动的小组实践和哲学研讨会。CTRL 组是传统的 HAES 干预组（基于讲座的模式）。在基线和研究后进行焦点小组讨论，以了解有关饮食愉悦感的看法。对焦点小组的转录进行探索性内容分析。
43 名年龄在 25 至 50 岁之间的女性，体重指数（以每平方米公斤为单位测量）在 30 至 39.9 之间，完成了干预和焦点小组，其中 32 名在 I-HAES 组，11 名在 CTRL 组。
研究后，两组参与者在体验饮食愉悦感时的内疚感减少，对自身欲望的反思增加。I-HAES 组在与饮食相关的自主性方面也表现出更大的自主权，共餐的愉悦感增加，对烹饪实践的熟悉度增加，自动进食减少。
以 HAES 为基础的干预措施，包括营养咨询、对身体活动的欣赏和哲学参与，被证明可以激发对饮食的愉悦感，而不会导致不加区分的饮食。
