Williams, Lesley

SummaryDespite the availability of evidence‐based interventions to improve binge eating, Black women have some of the lowest rates of access to care for eating disorders. Innovation is needed to offer accessible and culturally relevant treatment options. To this end, using an open trial design, we investigated the feasibility and acceptability of a group‐based, appetite awareness training (AAT) + lifestyle modification (LM) programme in Black women at risk for BED in a primary care setting. Participants (n = 20) were Black women recruited from a family medicine centre affiliated with a local public university, and who reported at least two binge eating episodes in the last 28 days. Participants completed a 16‐session AAT + LM programme over 4 months. Key outcomes were objective binge eating (assessed by the EDE and the EDE‐Q), body dissatisfaction, and weight change, all assessed at baseline, four (post‐treatment) and 6 months (2‐month follow‐up). Ninety‐five percent of participants completed assessments at post‐treatment and attended nearly 60% of intervention sessions. Among completers (n = 19), body dissatisfaction and objective binge eating decreased from baseline to post‐treatment and this decrease was maintained at the 2‐month follow‐up. In exit interviews, participants reported programme satisfaction. Providing training in appetite awareness combined with lifestyle modification principles may be useful in the treatment of body dissatisfaction and binge eating among Black women.

Purpose of review Weight trends continue to increase in adolescents, but current weight-focused interventions have not demonstrated any lasting impact on overall health. Among adolescents, experiencing weight bias increases risks of harmful weight-related behaviors and decreases engagement in health-promoting behaviors, thus leading to worsened health outcomes. The Health at Every Size (HAES) approach may be an avenue to promote health holistically among adolescents without eliciting harmful weight-related behavior and improving provider-patient rapport. The purpose of this review is to summarize the literature on integrating HAES principles into healthcare and to generate recommendations for healthcare providers. Recent findings Research among adults shows that HAES-informed care can improve some physical health measures and generates improvements in behavioral and psychological outcomes, as well as promotion of social justice and equity. HAES-informed recommendations for adolescent care de-emphasize weight loss and focus on removing barriers to engaging in health-promoting behaviors at the point of assessment, in the diagnosis and management of medical complications, and in treatment. Summary HAES principles can be an invaluable tool for providers who aim to improve overall health whilst avoiding a focus on weight among their clients.