Abstract
Objective:
Compare the Healthy Weight obesity and eating disorder prevention program, which promotes participant-driven gradual lifestyle changes to bring energy intake and expenditure into balance, to a new intervention, Project Health, which adds activities to create cognitive dissonance about unhealthy eating, a sedentary lifestyle, and excess body fat, and an obesity education video-control condition.
Method:
College students at risk for both outcomes because of weight concerns (N=364, 72% female) were randomized to condition, completing pretest, posttest, and 6, 12 and 24-month follow-up assessments.
Results:
Project Health participants showed significantly smaller increases in measured body mass index (BMI) through 2-year follow-up than both Healthy Weight participants and controls (both d=−0.18), and significantly lower onset of overweight/obesity over 2-year follow-up than Healthy Weight participants and controls (13 vs 21% and 22%). Healthy Weight and Project Health participants showed significantly greater eating disorder symptom reductions than controls through 2-year follow-up. Healthy Weight and Project Health participants showed marginally lower eating disorder onset over follow-up than controls (3 and 3% vs 8% respectively).
Conclusions:
The reduced increases in BMI and future overweight/obesity onset for Project Health relative to both an active matched intervention and a minimal intervention control condition are noteworthy, especially given the short 6-h intervention duration. The reduction in eating disorder symptoms for Healthy Weight and Project Health relative to controls was also encouraging. Results suggest that adding dissonance-induction activities increased weight loss effects. Yet, effects for both were generally small and the eating disorder onset prevention effects were only marginal, potentially because intervention groups included both sexes, which reduced eating disorder incidence and sensitivity.
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Acknowledgements
This study was supported by grant (HD071900) from the National Institutes of Health. We thank project research assistants Juliana Bednarski, Shelley Durant, Julie Pope, and Victoria Perko, as well as the undergraduates who volunteered to participate in this trial. ClinicalTrials.gov Identifier: NCT01680224.
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The first 61 participants assigned to the Healthy Weight condition and the first 62 participants assigned to the educational video condition from the present trial were included in a preliminary evaluation of the Minding Health obesity prevention program, which focuses on cognitive reappraisal techniques. It should also be noted that due to a malfunction in the Bod Pod, we were not able to collect valid body fat data for all participants in the present trial, which was an outcome in the preliminary evaluation of Minding Health.
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Stice, E., Rohde, P., Shaw, H. et al. An experimental therapeutics test of whether adding dissonance-induction activities improves the effectiveness of a selective obesity and eating disorder prevention program. Int J Obes 42, 462–468 (2018). https://doi.org/10.1038/ijo.2017.251
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DOI: https://doi.org/10.1038/ijo.2017.251
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