Evaluation of a “Nondieting” Stress Reduction Program for Overweight Women: A Randomized Trial

Abstract

Purpose. Determine if a “nondieting” intervention focused on intensive training in eliciting the relaxation response enhances health outcomes compared with nondieting interventions without such training. Design. Randomized trial with follow-up at 10 weeks, 4 months, and 12 months. Setting. General community. Subjects. Total of 225 overweight and obese women with at least one other cardiovascular risk factor. Interventions. Three 10-week nondieting interventions: a group program (P1) focused on intensive training in techniques for eliciting the relaxation response (n = 60), a group program (P2) focused on healthy eating and physical activity (n = 61), and a self-guided, mail-delivered version of P2 (P3; n = 101). Measures. The Revised Symptom Checklist measured psychological distress, the Medical Symptoms Checklist measured the experience of medical symptoms, and the Health-Promoting Lifestyle Profile measured a range of lifestyle behaviors. Self-efficacy for low-fat eating, intuitive eating, and body mass index were also assessed. Analysis. An intention-to-treat analysis was used. Results. At 12 months, P1 produced statistically greater improvements in stress management behaviors and medical symptom discomfort and was the only program to significantly improve self-efficacy for low-fat eating. In P1, the effect sizes for reductions in depression (0.75) and interpersonal sensitivity (0.85) were large. At 12 months, mean weight was unchanged. Conclusion. Inclusion of intensive relaxation response training in a nondieting program for overweight women enhanced stress management and medical symptoms outcomes but not weight outcomes.